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 9 On the Twelve Bones of the Upper Maxilla, Including the Bones of the Nose

Not everything thus far stated in this chapter fits the opinions of Galen; some items are enumerated at the end of the chapter.

If you closely examine each of the things I have described in this chapter, and afterwards read carefully Galen’s description of the upper maxilla, many particulars will occur in which I depart from his opinions. Though I shall not (trusting in your diligence) mention all of them here, I will add a few items from which you may sample my diligence or neglect (depending on whether you perceive them as consonant or dissonant with the truth). 45 When Galen is about to describe the peculiar sutures of the maxilla in his book De ossibus, 46 he begins his list of them from the lowest and outermost part of the cheek [os zygomaticum, facies lateralis] (in fig. 1, a in the human skull, k in the canine), which I stated is rough and uneven; that is because the masseter muscle runs the strongest and most sinewy portion of its beginning from here. Galen therefore describes a suture here [sutura zygomaticomaxillaris], the one separating the first maxillary bone from the fourth, calling the part of the suture visible in the hollow [fossa temporalis] of the temple (f in the hollow of the temple in fig. 4, ch. 6) the first suture. The portion of this suture [sutura zygomaticomaxillaris] occurring in the anterior part of the maxilla, which extends from the rough area of the cheekbone upward to the middle of the lower perimeter of the eye socket (fig. 1: from a to b in man, from k to l in the dog), he calls the second suture. This, he says, afterward divides into three, and he declares that the first part of this second suture [sutura lacrimomaxillaris et sutura frontomaxillaris] (in the dog, from l to m in fig. 1) proceeds along the large or inner angle [canthus] of the eye socket [aditus orbitalis, margo medialis] on the outside to the point between the eyebrows and the suture common to the frontal bone and the maxilla [sutura frontomaxillaris]. Humans lack this part of the suture, but it is quite obvious in dogs and in apes with tails. It does not, in fact, run quite to the point [glabella] between the brows, but only to the point where it has been said the fourth maxillary bone [maxilla] is separated from the second [os lacrimale]. If you follow Galen, you will have to look for this part in a dog’s skull. Furthermore, he says that the second part of the second suture runs through the hollow of the eye socket below the large angle to the suture [sutura frontomaxillaris] between the head and the maxilla (imagine that a continuous suture is run in figure 1 from b through c and d to T, as can be seen in a dog), and that it includes this same angle. This part would be the suture [sutura ethmoidolacrimalis] which we have explained separates the second [os lacrimale] and third [os ethmoidale] bones of the maxilla on their lower side from the fourth. But in man, this suture is by no means joined to Galen’s second suture; much less does it reach the first part of the second suture, since this is seen only in dogs and apes but not in humans. In addition, the foramen [fissura orbitalis inferior] (D in figure 1) which according to Galen lies beneath this second part is, I believe, the long, quite open one in the eye socket, appearing between the fourth bone of the maxilla and the cuneiform [os sphenoidale, ala major, facies orbitalis]. The portion of suture (from b along D through Q to S in fig. 1) separating the first bone from the fourth [sutura zygomaticomaxillaris] which is seen in the eye socket, together with the suture [sutura sphenozygomatica] that divides the cuneiform bone from the first bone of the maxilla and is also seen in the eye socket, is what Galen calls the third part of the second suture. For it is Galen’s opinion that under the two sutures mentioned (the two first parts of the second suture) “its third part [fissura orbitalis inferior] ascends the lower perimeter [paries inferior] in the eye socket [orbita] and goes to the bottom on the inside, and there it is joined to the suture common to the head [os frontalis] and the maxilla.” 47 Galen later adds that three bones 48 of the upper maxilla are surrounded by these sutures, by which they are joined to the head [pars orbitalis ossis frontalis]. The first would be what I established as the first bone [os zygomaticum] of the maxilla (G in figure 1); the second [os lacrimale], those which I was counting the second and third: those two would be numbered as a single bone in Galen’s opinion. The third [corpus maxillae, facies orbitalis] (L in the eye socket of figure 1; this bone of Galen would be surrounded after a fashion by b, C, c, d, H, D) would be part of our fourth bone, namely whatever is situated in the eye socket where the foramen [fissura orbitalis inferior] (L in the eye socket, figure 1) begins which extends from the eye socket into the anterior region [foramen infraorbitale] of the maxilla. Consider carefully here whether up to this point Galen has explained the bones of the maxilla in man more truthfully than I, and how much he has omitted so far in apes and dogs; then, whether my understanding of Galen is based on my knowledge of the subject, or on a translation, 49 and what sort of Delian swimmer 50 Galen’s treatise on the bones of the maxilla requires, particularly when certain persons indifferent or even hostile to the common good so suppress the Greek copy [of Galen’s De ossibus] that I was unable for any reason to obtain permission from them to use it for a time. Except for Balamius and Cardinal Rodolphus, 51 they even admitted that they had it, but only on condition that it not be shared with me. Yet I shall devote every effort not to seem to have suffered the lack of that book or of certain others of Galen on anatomy, all of which they hide and render useless, or in any case they prefer that the better editions be eaten by worms (since they cannot use the books themselves). 52 Galen’s establishment of special bones [os incisivum] in which the incisor teeth are fitted can be accounted for by his excessive regard for his apes, which he imagined were more like humans than they are. In dogs, apes, pigs, and other animals whose canine teeth are strong and prominent, two quite conspicuous sutures (n in the canine skull) [suturae maxillo-incisivae], or rather harmoniae, are seen, as I have said before, which man lacks. For from the suture [sutura nasomaxillaris] separating the fifth maxillary bone [os nasale], which is one of the nasal bones, from the fourth,


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another suture [sutura maxilloincisura] runs obliquely downward between the canine and the incisor next to it; this suture joins the one [sutura incisiva] at the end of the palate next to the incisor teeth, which runs transversely in those animals. Even without intervening cartilage, this suture is so conspicuous that dogs show what I count as the fourth bone [maxilla] of the maxilla divided in two. But it must not be thought that this suture running between the tooth sockets in dogs or apes comes from between the brows [margo supraorbitalis] downward in a continuous course (even though Galen does say so), but as we have just pointed out it [sutura nasoincisiva] begins about halfway down the suture which constitutes the outer side of the nasal bones. When you examine this in a dog or an ape, consider carefully how impossible it is that this suture should extend between the teeth of a human, who possesses an extremely short jaw as well as small canine teeth. Ponder also what Galen meant in De usu partium when he wrote in passing that there are twelve bones of the upper maxilla; likewise the author of Introductio seu medicus 53 counts just twelve bones of the maxilla, doubtless from the opinion of the Ancients; or when Galen, describing these bones more fully, 54 numbers only nine, not including in that number the cuneiform bone, and attributes no bone specifically to the incisor teeth.



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 9 On the Twelve Bones of the Upper Maxilla, Including the Bones of the Nose