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] | Chapter 5 The Structure of the Head: Why It Is Shaped As It Is, and How Many Configurations It Has

APPENDIX B: Variant shapes of the head (end). Expanded 1555 version

But I think that boy was suffering from a similar affliction to the one I observed at Augsburg in a two-year-old girl whose head had so grown in about seven months that I never saw a man’s head which did not yield to it in size. 34 This was the disorder which the ancients called hydrocephaly from the water that gradually accumulates and is retained in the head. Yet in this girl the water had not accumulated between the skull and the membrane [dura mater] that covers it on the outside or on the skin (where the books of physicians say water is otherwise retained), but in the cavity of the brain itself, and in both left and right ventricles, whose volume had so grown and the brain itself so extended, that they contained almost nine pounds of water or three Augsburg wine measures (believe it or not). 35 In addition, as the cerebrum in the vertex of the head was as thin as a membrane [falx cerebri], and its body nearly of a piece with its own thin membrane, so too the skull was quite membranous [fonticuli cranii] and its bony portion no thicker than the girl’s skull had been before it grew oversize, in much the same way as in newborn infants we see the frontal bone [tuber frontale, os frontale] and the bones of the vertex [tuber parietale] placed where they otherwise border on each other, and in many children appear membranous [fonticulus anterior] for a noticeable interval and area. 36 Meanwhile the cerebellum and the entire base of the cerebrum were normal, as well as the extensions of the nerves [nervi craniales]. In no places whatever did I find water other than in the ventricles of the brain that were swollen in the manner described, and the girl had full use of all her senses until her death. When I examined her a few days before she died, each time her head was moved by those attending her and was elevated a little, no matter how gently, a violent cough with difficult breathing immediately assailed the girl; there was a strange flush over the entire face, a suffusion of blood, and a flood of tears. 37 Her condition in the rest of her body was moderate, though her joints were slack and weak but not limp; there was no great emaciation, serous tumor in her limbs, or signs of epilepsy or tremors. When her liver was examined soon after death, it was slightly pale and somewhat smaller and harder than natural in other cases. The spleen was extremely enlarged and soft, 38 as if it had for a considerable time functioned in place of the liver, so that along with the other physicians present I was less astonished at this than I was that such a mass of water had been so long collected in the ventricles of the brain without greater symptoms. Similarly, at nearly the same time the heart of a very noble and learned man caused us no ordinary astonishment. We found about two pounds of glandular (but blackish) tissue in his left ventricle. 39 The heart was stretched 40 about this mass of flesh like a uterus or that girl’s brain, and the man before his death was in a melancholic state and rather sleepless; his pulse was strangely uneven and irregular, and he clearly showed a contraction of the artery [aorta]. 41 Thus, many months before his death (even though he walked about in other respects like a healthy person) his pulse or artery had been seen to contract more and remain contracted for an interval of three or four pulses or beats as if it were preparing to drive something out. Indeed, in the final weeks of life, after an interval of nine beats only two or three dilations of the artery could be felt afterward. 42 Thereupon, the animal faculty 43 remained sufficient along with the chief functions of the anima until death, which came not so much from damage to the heart as from gangrene of the left leg resulting from an inhibited arterial pulse, 44 as if the weakened pulses of the irregular heart inadequately vented off the innate heat 45 of the leg, particularly because as the result of a wound from a culverin some years previously the artery to his fibula had been damaged. We will pursue countless such cases at greater length in another book, 46 wherein I shall present accounts of dissections I have made that are especially suitable for knowledge of diseases and the practice of the entire medical art. Meanwhile in the present work we have decided to explain only the well knit human body, passing over in silence all things freakish and those which occur only in the unhealthy and diseased. Here we have mentioned unnatural shapes of the head because they have been generally treated by professors of anatomy, 47 and because likenesses of the head that are called unnatural, even by the unusually conscientious (since to be sure the brain requires no special shape, as we now agree) will sometimes be observed, even though such skulls, and particularly those differing from the natural shape in the type of sutures, present themselves to us in cemeteries quite infrequently, as will be stated in the next chapter. Such skulls would perhaps show up now and again if we were to search the cemeteries of the Alpine people who face Styria, 48 as I hear those people’s heads are deformed not only in the shapes of head just mentioned, but in far different ways.



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] | Chapter 5 The Structure of the Head: Why It Is Shaped As It Is, and How Many Configurations It Has