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Book One -- The things that sustain and support the entire body, and what braces and attaches them all. [the bones and the ligaments that interconnect them] |
[Figures of Chapter 27]
The two first figures at the beginning of the twenty-fifth
chapter show the sequence of finger bones, as do the three tables illustrating
the entire assembly of bones which are placed at the end of this Book. The
illustration inserted here, broken down as it were into three figures (so that
each presents two bones) presents to view the joints
2
of the fingers.
The first of these represents two bones, one of which I have marked
A
; it is the metacarpal bone
[os metacarpale II] that supports
the index finger
[digitus secundus]. The other is
marked
B
, and it is the first bone
[phalanx proximalis] of the index
finger drawn from the outside
[prospectus dorsalis], as is the
metacarpal bone. In this figure, a picture of the first joint
[articulatio metacarpophalangealis]
of the fingers is set forth.
C
marks the round head
[caput metacarpale] of the
metacarpal bone,
D
the depression
[basis phalangis] of the first bone
of the index finger that receives the head marked C. The second figure also
shows the first bone of the index finger, marked
E
, and the second
[phalanx media], marked
F
, in such a way that the drawing would illustrate the appearance
of the second joint
[art. interphalangealis] of the four
fingers.
G
and
H
mark the two capitula
[tuberositas phalangis distalis] of
the first bone of the index finger.
I
and
K
mark the depressions
[facies] of the second bone which
the two heads
[condyles] of the first bone enter,
while
L
marks the depression that lies between the heads of the first
bone, and into which the tubercle
[dorsum] of the second bone, marked
M
, rising between the two depressions, labeled I and K, enters.
The third figure represents the second bone of the index finger, marked
N
, and the third
[phalanx distalis], marked
O
, so as to show the appearance of the third joint of each digit,
which because it closely resembles the second joint of the four fingers we have
not filled with other letters. It is also possible to look up pictures of these
joints in the first two figures of the twenty-fifth chapter.
3
The fingers are rightly made up of three bones each
It was stated in the previous chapter that all the digits of the hand
(in figs. 1 and 2, ch. 25, the bones of the thumb are marked A, B, C, those of
the index finger D, E, F; the system applies also to the others) consist of
three bones each
4
— they are called internodes, joints, and acies
5
, or also fa/laggoj,
6
skutali/dej,
7
and ko/nduloi.
8
These bones are hard and dense, but not entirely without marrow (as we have
sometimes warned contrary to Galen’s view).
9
For besides the fact that they are somewhat spongy above and below
like epiphyses, each has a rather large cavity provided to hold marrow as in
the metacarpal bones. I believe it is no secret that we require the bones of
the fingers for strength of action in grasping things, and we need many of them
because of the various motions which the hands perform and the diversity of
things which are grasped by them.
10
Next, it is very easily inferred
that it was altogether practical for the fingers that there are neither more
bones nor fewer than three, because if there were more than that number, not
only
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The just size of the bones
11
Since it is worthwhile that a bone that comes before be larger than the
one that comes after it, or the bearer than the one borne, Nature also rightly
fashioned the first bone of each digit larger than the second, and the second
in turn greater
12
than the third, reducing the lower bones not
only in length but also in thickness and width, in this way chiefly
constricting the fingers from a wider base gradually to a point and arranging a
shape of the fingers which we consider most becoming in women.
13
The fitting shape of bones and entire fingers
But with amazing design she did not bestow the same shape on the finger
bones as on the fingers when covered with nails and skin. She shaped the digits
as a whole a little less than completely round because she knew such a shape to
be less prone to injuries than any other, as naturally a shape without
projections is least likely to be fractured or crushed by collisions with
outside objects. Consider it done for some useful purpose that the fingers are
precisely rounded on the outside
[prospectus dorsalis] while inside
[prospectus palmaris] and on the
sides they are more compressed. In their inner region the fingers soften,
knead, rub, and grasp: all of which they would do less well if the fingers were
convex in that area.
14
I pass
over the rather firm fatty tissue that is filled with sinews and stretched over
the inner surface of the fingers for the functions I have just mentioned and to
protect the tendons;
15
I shall discuss this at
greater length in a separate chapter of the second Book. Furthermore, since we
try to do none of these tasks or perform any other with the outside of the
fingers, it was reasonable that they be made perfectly convex for durability
only. But since the fingers are less exposed to damage on the sides, and needed
to be drawn up against each other, held in, and to leave no empty space between
themselves, it was not at all useful for them to be made convex on the sides.
The thumb, little finger, and index finger give sufficient support to the
purposes I have just mentioned if the thumb has either side
16
convex but especially the inside
[ulnaris or pars medialis], while
the little finger is convex only on the outside
[ulnaris] and the index contrariwise
has the inner side
[radialis] convex, for on these
sides they are not protected by another. In this way we see no small cleverness
of Nature in the shape of the complete finger. I shall now endeavor to explain
to what extent the bones diverge from this shape. (Keep an eye here on the
figures in which the bones of the fingers are illustrated.) No finger bone can
be found which is not thicker and denser at the upper and lower ends
17
than along its length; this is also commonly seen in virtually all the long
bones, which constantly thicken and grow toward the articulation.
18
For if they were
equally thick everywhere, they would considerably impair a creature with their
weight and bulk, and the joints themselves, unless they were fitted with
correspondingly larger bases, would be quite weak. It is in this respect first
that the shape of the bones varies from that of the finger as a whole. If the
finger imitated the shape of the bones along their sides, as can be seen in
persons who are thin and emaciated, the space between the sides of the fingers
would be empty, which would make it impossible for the fingers to hold a
liquid, at no small inconvenience. This area of the bones is filled with the
rather firm fatty tissue which we mentioned in passing a little earlier.
19
In
addition, each bone of the finger is smooth and convex on its outer surface
[prospectus dorsalis], protruding
nowhere conspicuously beyond a straight line, even in the area of the joints,
as even on the sides
[radialis / ulnaris] the bones do
not project very much around the joints. The exception is the first bone of the
thumb
[os metacarpale I], which on its
outer surface is wide, more flat, and depressed, and does not seem convex like
the others. The third bones of the fingers
[ossa phalanges distales] are convex
on the outside
[prospectus dorsalis], but they run
downward from the joint where they are articulated to the second bone
[phalanx media] and do not bulge
outward in the same way the other bones, but give way a little for the
fingernail. They jut out less, proportionally to the space the fingernails
occupy, no doubt so that the entire finger will not protrude outward farther at
the third bone
20
than in the others. The inner side
[prospectus palmaris] of each bone
is much different from the outer surface
[prospectus dorsalis] of the
fingers, depressed or rather concave no less than the outer is convex;
21
but here too you should make an exception
of the first bone of the thumb, which on its inner surface resembles the bones
of the metacarpus.
22
For although it
protrudes more above and below in the area of the joints into the internal area
of the hand, and appears interiorly concave in the middle of its course but
curved on the outside, still it is not wide, depressed, and level like the
other bones of the fingers, but rather convex and more sharp inside
[palmar] than outside
[dorsal]. Nature devised this by no
means randomly or by chance; for along the inner
[palmar] part of the second and
third bone of the thumb, as along the three bones of the four fingers, slender
tendons
23
(see the hands in the 5th table of muscles as well as the
6th and 7th) needed to be extended, which unless the inner surface of the bones
were wide, depressed, and more or less concave, would not have been able to
remain in place, any more than we ever observe smoothly rounded bodies lie upon
each other.
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The system of articulation of the finger bones
31
But it would now be timely to consider the providence of Nature in the
joints of the fingers, and not to acquiesce casually in Galen’s account where
he pronounces in a simple way
32
that the head
[caput phalangis] of the upper bone
enters into the depression
[basis phalangis] of the bone that
follows, and that the outer
[dorsal] rims of the depressions are
extended or swell out more prominently than the inside
[palmar] ones,
33
and when he attributes the
same type of articulation to all the finger joints. This is to say nothing for
the time being about the tendons (p, r in the 3rd table of muscles, z, z in the
6th, f, g in the 7th, C, P in the 10th, etc.) of the muscles which draw the
fingers to the side
34
and are
thought by Galen to be just as common to the second and third finger joints as
they are to the first.
35
But we will now show with ease that
neither the third joint of the thumb nor the second or the third joints of the
other fingers are moved to the side by primary motion.
Attachment of the first thumb bone to the carpus
The first bone of the thumb
[os metacarpale I] is joined to the
fifth bone of the wrist
[os trapezium] by a rare and
peculiar type of joint (G, a, b, c, d in fig. 6, Ch. 25)
[art. carpometacarpalis pollicis]
that can be flexed and extended as well as moved to the sides; it is prepared
in such a way that it provides separately more for motion that is performed to
the sides than for flexion and extension.
36
The fifth carpal bone forms a broad depression
that projects transversely in a rather wide extension and is carved out more
visibly on the inner and outer surface than on the sides. The first bone of the
thumb is carved out transversely, or between its inner and outer side, at its
upper end
[basis metacarpalis], and as it
protrudes inside and out it elegantly fits the depression
[facies articularis metacarpalis] of
the fifth carpal bone, and articulates with it as if by mutual entry. But this
is not so pronounced that it has but a single motion, like the mutual entry of
other joints. Rather, since the inner surface
[facies ulnaris] of the first bone
of the thumb juts out more than the outer
[facies radialis], and enters more
deeply into the depression of the fifth carpal bone which is more deeply
grooved at that point, the first thumb bone can be flexed more than
extended.
The type of joint of the second thumb bone with the first, and its
motions
The second bone of the thumb
[phalanx proximalis] (see here C in
fig. 1, which is inserted into D) is articulated with the first by that type of
joint
37
which the
Greeks call e)na/rqrwsij.
38
The
lower part of the first thumb bone ends in something like a round capitulum
[caput metacarpale] that enters the
round cavity
[basis phalangis] of the second
bone. But because this head protrudes transversely, i.e., from the inner side
of the thumb more to the outside, and is more or less transversely elongated
and is depressed on the sides scarcely more than in the center, and because the
depression of the second bone is precisely fitted to this head, the second bone
of the thumb is flexed and extended more than it is bent to the sides. It could
be moved as well to the side if the capitulum of the first bone were perfectly
round, and if it were as compressed on the sides as it is on its anterior
surface. Because of the type of joint (since the capitulum is quite depressed
in its inner surface), the second bone should be capable of extreme flexion
into a very sharp angle; to prevent this, two ossicles
[ossa sesamoidea] (T in fig. 1, ch.
25) which are compared by the Greeks to a sesame seed stand in the way here.
The head of the first bone is the reason why the second bone of the thumb can
scarcely be extended beyond a straight line,
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The system of articulation of the third bone of the thumb with the
second
The second bone of the thumb
[phalanx proximalis] is joined with
the third
[phalanx distalis] (insert G and H
in fig. 2 into I and K, and M into L) differently than the first with the
carpus, or the the second with the first. The lower end of the second bone is
divided into two more or less round capitula separated by an elongated
depression which like the capitula themselves is coated with cartilage
[cart. articularis]. The upper
[proximal] end
[basis phalangis] of the third bone
has two depressions separated by an elongated projection. These depressions
receive the two capitula
[caput phalangis] of the second
bone, while the projection of the third bone enters the depression carved
between the capitula of the second bone. In this manner the second bone enters
into the third and in turn receives the third bone. Both bones are so cleverly
attached
[articulatio interphalangealis] by
mutual entry that the third bone can only be flexed and extended but not even
in the least degree moved laterally.
39
The reason
why the third bone is flexed to an angle but is not extended beyond a straight
line and can only be straightened from a flexed position, lies in the capitula
and depressions of the joint. For the capitula, which exactly match the
depressions, are moved to the inside more than the outside, and are pressed
down. So obscurely are they extended to the outside and positioned there that
they scarcely present the appearance of a head, and so prevent the third bone
from being bent backward: as we learn is advantageous for this bone when we
consider its use in flexion. At the same time we infer in what ways this joint
would be weakened if it could be as easily extended and moved to the sides as
it is now flexed by the great providence of Nature.
The form of the first, second, and third joints of the four
fingers
It is by this very type of joint that the second and third joints
40
of the remaining fingers are attached (the figures at the
front of this chapter show these in order). The first of them
41
agrees for the most part with the second joint of the
thumb, as we previously stated. But it moves much more to the side, though not
as markedly as it is flexed. For the heads of the metacarpal bones are much
extended to the inside and are pushed down, while on the sides they do not
broaden out very much, but instead are actually depressed a little there, so
that flexion is easier than extension or movement to the side. By contrast, the
index and little finger claim the separate distinction in the first joint that
they move laterally more than the middle and ring fingers, a movement which
takes place chiefly from compression in the sides of the head of the metacarpal
bone. But it is not because the heads of the metacarpals are less depressed on
the inside that the first joint of the four fingers does not bend in an angle
as sharp as the second and third joints. Rather, certain tiny ossicles
[ossa sesamoidea] (V, V in fig. 1,
ch 25) which look like sesame seeds perform this function because they
reinforce the joint as well as preventing it from bending more loosely than it
should. The first joint of the fingers flexes and extends more than the others,
because the heads of the metacarpus
42
are more depressed on the
outside than the heads of the finger bones; in some people they permit the
joints to be extended further, the more they are depressed on the outside. We
see that certain people can bend not only the first joint of their fingers
remarkably far backward, but all the others as well — particularly the
third.
The flexible and elegant fingers of Giovanni Centurio
A fine specimen of this is provided by a young man of the highest
prospects and keenest judgment, distinguished for his noble lineage, generous
character, and singular erudition in belles lettres and a variety of
disciplines: Giovanni Centurio of Genoa,
43
who bends his fingers (which are unusually well-rounded and long,
perfectly suited for every art, and most elegant) so amazingly backward that he
can hold water in them as easily as we do in our palm. But he displays a
remarkable looseness combined with unusual strength not just in the joints of
his fingers but also in all the joints of his body, particularly in the joints
of his ribs to the thoracic vertebrae.
44
Such, in general, is the articulation of
the fingers. It readily confirms that the bones of the fingers deservedly turn
out thicker next to the joints than in their remaining length.
The small processes of the third finger bone
The third bone
[phalanx distalis] protrudes also on
its lower end where it is attached to no other bone, and it has a rough head
equipped with two small rather hook-shaped projections; this is mainly so the
tendon which flexes it (tendons of muscles C and h in the 6th table of muscles,
and c, b in the 7th)
45
may be attached to the entire inner surface and
powerfully inserted at its end into the tip of the bone. This tendon is easily
the largest of all those that move the other bones of the fingers, and makes
the most robust insertion.
The digits are justly made five in number
46
It is not at all difficult to discover why five digits were fashioned if
we consider for what functions the fingers are useful. If they were fewer, they
would undertake a great many actions less perfectly, while there is no reason
we would require more. If fewer had been formed many actions would be lost, as
we will readily appreciate if we describe each in a separate account.
The dignity of the fingers
47
If the thumb (which it was convenient to have opposed to the other four
and was for this reason called a)nti/xeir
48
by the Greeks as if to say promanum, “in front of the
hand”) were missing, all the others would be deprived of their power, since
without its aid they can do nothing — as our very judges show, who no less
often than they amputate thieves’ ears take off the thumbs
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Why the fingers are unequal
52
Why the fingers are made unequal and the middle one excels the others in
length may be gathered from the fact that it is better for the ends of the
fingers to attain equality whenever we grasp a mass that is greater in
circumference, and when we are trying to hold a liquid or some small object in
them. For firmly grasping or holding onto larger objects, or for forcibly
propelling or throwing them away, an equal grasp on all sides is most suitable.
The five fingers are seen to come together on the circumference of a single
circle whenever we surround a perfectly spherical body with them. Moreover, to
close the hands completely when our desire is exactly to enclose a small or
liquid substance, the inequality of the fingers performs a manifest function,
and for this the location of the thumb is in no small way conducive.
The thumb is handsomely situated
For while the thumb is opposed to the other digits in function, it was
also necessary for it to be opposed to them in location. But if it were placed
quite out of opposition and took for itself the middle of the carpus, it would
impede the hand in a great number of uses, particularly interfering with those
which we perform with the palm of either hand separately, or with both palms at
the same time. It was therefore necessary for it to be placed at the side and
to be very much separated from the other fingers and linked to them. And while
the transverse region of the hand extends equally to the index finger and the
little finger, it was better that the thumb be placed next to the index finger,
and (as has been stated above) to be loosely articulated to the lower row of
carpal bones.
53
For it
was fitting that the hands be turned toward each other by the index fingers but
turned away at the little fingers. Indeed, in extreme flexions of the fingers
the little finger leaves no place empty while the index finger leaves an area
of some magnitude which can be closed or blocked by the thumb in the manner of
a lid.
Appendix: the 1555 version of Chapter XXVII
(See note 13 above) For Nature herself had no less a rationale for the
number and magnitude of the finger bones than for all of them together, which
we see are rightly constructed in sets of five because of the tasks we perform
with them, with four placed together in a row and a single large one more or
less opposed to them to act as a kind of deputy hand, promanus (whence it is
called a)nti/xeir by the Greeks
54
and by us pollex because of its
strength). Similarly we see the fingers differ from each other in size and
strength, and they differ in their functions. We perceive why they are unequal
in length whenever we grasp a round object or when we put the fingers together
and hold water or something of that sort, or hold them together and straight
and forcefully thrust them at something.
The shape of the fingers taken together
We will the better judge the function of the hands with a single
dissection the more it is realized that the bones of the fingers do not have at
all the same shape as the complete fingers when still covered with skin and
nails and possessed of the somewhat hard adipose tissue filled with nerves
[nn. digitales palmares proprii] in
the sides of the fingers and the larger number still in the internal areas
beneath the skin.
55
Complete fingers
are shaped a little less than completely round because such a shape, protruding
in various ways but with no eminences, is less vulnerable to injuries. They are
not as perfectly and exactly rounded on the inner side
[palmaris] as on the outer
[dorsalis] because some provision
for resisting injury was necessary only on the outside, while on the inside the
fingers knead, rub, and grasp; all of which they would do less well if they
were smooth here. Moreover, since the fingers are less exposed to injuries in
their sides, and being drawn together need for various reasons to be tightened
and leave no empty space between them, it was in no way useful that they be
smoothly rounded on the sides. Whence even the thumb has both sides smooth, and
the inside more so, while the little finger has only its outside smooth but the
index finger has its inside smooth, because these are the surfaces on which
those fingers do not touch others, and they more or less resemble the outer
surface of the fingers as far as repelling injuries is concerned.
In what way the finger bones differ from intact fingers above and
below, and of what kind their substance consists
No bone of the fingers presents itself which is not thicker above and
below
[proximally and distally] than along
its length, a common feature that is observed in almost all long bones, always
thickening and growing toward the articulation. For if they were everywhere of
the same thickness as they are at the joints, they would quite encumber a
person with their weight and mass; and the joints themselves, if not
proportionally fitted to wider bases, and not increased more than the bones
elsewhere // p. 150 // along their length, would be quite weak. For this
reason, although the bones of the fingers are hard and dense, they are not
entirely lacking in marrow (look for these in bones that have been broken in
various ways), as Galen believes.
56
For besides the fact that some of the epiphyses at either
end are somewhat spongy, each also has a rather large cavity provided to hold
marrow, as also in the metacarpal bones.
Design of the joints by which the finger bones are attached to each
other and to adjacent bones
I shall now attempt to explain by what shape of joints the finger bones
are articulated, and describe in each case what appearance they present
throughout their length. The surface (G in figs. 3, 6, ch. 25) of the fifth
carpal bone
[os trapezium] (5 in the figs. of
ch. 25), which is coated with smooth, slippery cartilage
[cartilago articularis] for the
first joint of the thumb
[art. carpometacarpalis pollicis],
projects transversely in a wide, elongated tuberosity (a to b in fig. 6, ch.
25), and is hollowed before (c in the same fig.) and behind (d in the same
fig.) — but much more in front.
Attachment of the first bone of the thumb to the carpus
The first bone
[os metacarpale 1] (A in figs. 1, 2,
ch. 25) of the thumb is incised with a long, wide depression running
transversely as seen from above or toward the outside if seen from the palm,
57
and it is convex anteriorly
[distally] and posteriorly
[proximally] (but more anteriorly),
corresponding by mutual entry with the surface of the fifth carpal bone
[os trapezium] just mentioned. The
depression is not, however, so pronounced that this joint is moved in only one
way; the same is true as a rule of the other joints that are brought together
in this way. Though it is particularly capable of the lateral motion by which
we move the thumb toward the index finger and back away again, and the joint
appears to have been constructed especially for that motion, nevertheless it
flexes and extends to some degree, and its flexion exceeds its extension by as
much as the joint itself can be projected into the anterior side of the hand,
or the palm, farther than into the posterior or outer side.
58
How the first bone of the thumb is articulated to the second
The first bone
[os metacarpale 1] of the thumb is
articulated
[art. metacarpophalangealis] after a
fashion to the second
[phalanx proximalis] (this joint
sometimes resembles C and D in the first fig.); its lower
[distal] part ends in a single head,
entering a single, simple depression of the second bone. But this head is not
altogether round, nor is it equally pressed into a circle on every side. On its
posterior surface and still more on its sides, it swells out nearly as much as
the tip of its middle region, and only where it is brought out to the middle is
it depressed, covered and fitted with cartilage for the second bone of the
thumb. Over that head we flex the thumb more than we extend it or move it
laterally.
59
How the second is articulated to the third
The third joint
[art. interphalangealis] (this one
exactly resembles the second fig.) of the thumb differs considerably from both
the first and the second in the type of construction: the lower
[distal] part of the second bone
[phalanx proximalis] is divided into
two oblong capitula running from the outside inwards, separately projected and
rounded. They are separated by an elongated depression no less coated with
cartilage than the capitula themselves, extending more into the inside than to
the outside. The upper
[proximal] surface
[basis phalangis] of the third bone
[phalanx distalis] has two
depressions (I, K in fig. 2) separated by an elongated prominence (M in fig.
2); these receive the two capitula
[caput phalangis] of the second
bone, while the prominence of the third bone enters the depression of the
second between its two capitula. In this way the second bone enters into the
third and in turn receives the third, and both bones are so joined by mutual
entry, and so cleverly, that the third bone can only be extended and flexed but
in no way moved laterally, even in the smallest way. But because the capitula
of the second bone extend with their depression to the inside as we just
stated, the third bone flexes into an angle but extends from its flexion only
to an erect position, not beyond a straight line in well articulated men.
60
How the second and third joints of the four fingers are
articulated
The second (G and H into I and K and M into L in fig. 2) and third (as
in fig. 3) joints
[articulationes interphalangeales]
of the remaining fingers are constructed with an altogether similar type of
articulation, and experience only acute flexion and erect extension without any
motion to the sides.
How the first of these is articulated
The first joint
[art. metacarpophalangis] (A with B
in fig. 1) of the four fingers is made with a single head
[caput phalangis] (C in fig. 1) and
a single depression (D in fig. 1). The metacarpal bones end in a single head
that is much longer from the outside to the inside than from one side to the
other, being transversely wide and substantial. This head extends much farther
to the inside of the hand than to the outside, and is coated over a longer
interval there with cartilage. But the depression // p. 151 // carved in the
upper
[proximal] end of the first bone of
the four fingers is quite round, and the first bone is flexed, extended, and
moved to either side above that head. But it is not, because of the shape of
the head, which we said was oblong, rotated. The extension of this joint and
its lateral motions are not as pronounced as its flexion; it does not make as
sharp angles because the heads of the metacarpals are so slightly depressed on
the outside and to the sides. But the farther this head is covered with
cartilage to the outside than the heads of the second and third joints, the
farther the first joints can be extended beyond a straight line than the second
and third. In the same way, the index finger
[digitus secundus] can be inclined
to the inside
[medially] and the little finger to
the outside
[laterally] more than the other
fingers because the heads of their first joint are extended on those sides and
widened as if into a circle to such a degree that the unique purposefulness of
Nature occurs everywhere, making such careful provision for the strength of the
parts that she did not want the first joints to rotate, since the pronating and
supinating motions of the hand and the radius abundantly provide for the
rotation of the fingers.
Nature’s purposes in the joints of the fingers
As those motions, together with the rotation of the humerus on the
scapula, make an equal flexion and extension of the fingers unnecessary for us,
so because we are able to move the first joints of the fingers laterally there
is no need for the second and third joints to be built so loosely that they are
capable of the same motion. And so it is that the more diligently I ponder
these things that present one artifice of Nature hard upon another, the more I
wonder why Galen categorized all the finger joints as having a more or less
mutual entry in his book On the Use of the Parts,
61
and
in his book On the Bones
62
he attributes the same type of joint to all the bones when he says
that the head of the upper bone enters the depression of the one that follows,
no differently than if he had thought that all joints are brought together in
the same articulation. Then in his books On Anatomical Procedures he so
composed his account of the muscles in all respect contrary to the views of the
ancients that he assigns tendons that move the fingers laterally
[abduction] no less to the second
and third finger bones than to the first.
63
However this may be, even in their system of
articulation the bones of the fingers vary considerable from the appearance of
intact fingers.
The extremity and tip of the third finger bone
In addition, the third bone also protrudes in its lower surface
[tuberositas phalangis distalis]
(the tips in figs. 1,2, ch. 25) where it is not attached to any bone, and has a
rough capitulum with two vinculum-like connections so that a tendon (q of
muscle h and g of muscle C)
64
is attached to the entire inner surface of this
bone
[phalanx distalis] which flexes it
and is at last very strongly inserted at its end as if into the tip of the
bone, which is somewhat cartilaginous at its extremity. For the sake of this
tendon (compare the first fig. of ch. 25 with the second, and the bones with
each other), the third bone
[phalanx distalis] is rough and
irregular on its entire lower surface, where it protrudes slightly.
The inner surface of the bones along their longitude
Along its longitude, the inner surface of the first bone of the thumb
resembles the inner surface of the metacarpals, which projects a little more
sharply than a rounded shape. But the first bones of the four fingers, and the
second bones as well as the second bone of the thumb, are depressed and more
concave with a flat surface than convex in the entire region visible between
their joints; this is for the tendons
65
that are extended upon them, which
because they are smooth and round could not have rested upon a body that is
also smooth and round. Indeed, not only are such tendons extended along those
bones, but ligaments also are brought from the bones, on which tendons run as
if on rings
66
by which they are held against the depressed
surface of the bones and are not allowed to rise up from them. There is
situated on the second bone
[phalanx proximalis] of the thumb a
tendon
[m. flexor pollicis longus, tendo] (q of muscle h in the 6th
table of muscles) that flexes its third bone
[phalanx distalis]; and in the first
bones of the four fingers two tendons present themselves, of which one
[m. flexor digitorum superficialis,
tendo] (o of muscle Q in the 5th
table of muscles and d of muscle e in the 6th) flexes the second bone of the
finger and the other
[m. flexor digitorum profundus,
tendo] (g of muscle C in the 6th
table of muscles) flexes the third; it is also brought down from the second
bone, though no such tendon is attached to the first bone of the thumb, which
like the metacarpal bones is wide on its outer side and more depressed than
convex. But the outer surfaces of the remaining finger bones are quite convex
and smooth, and on these surfaces widely expanded tendons
[m. extensor digitorum, tendines] (of muscles Z, Q, f in the
9th table of muscles) like membranes are inserted; no round tendons are carried
on these surfaces. Now the third // p. 152 // finger bones, though they are
smoothly rounded on the outside, from the articulation by which they are joined
to the second bones to their extremity are not as convex as the rest. But as
they make way for the nails they are less protuberant proportionally to how
much space the nails occupy, lest the entire finger rise higher over the third
bone than over the others.
The sides
The sides of the first bone of the thumb, like those of the third bones,
are more or less smoothly rounded. The sides of the first bones that are in the
four fingers and of the second bones of the five fingers resemble the side of
the half that would be cut through the middle from a rounded body; for such
bones would need to be flat on the inside and convex on the outside. The sides
of the bones of the thumb, index finger, and little finger are in no way
exceptional at this point (like the whole fingers at other points). Thus Galen
may be seen wrongly to declare that the form of the intact fingers and that of
their bones is identical.
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Book One -- The things that sustain and support the entire body, and what braces and attaches them all. [the bones and the ligaments that interconnect them] |
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