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 39 By What Method the Bones and Cartilages of the Human Body May Be Prepared for Inspection

How the cleaned bones should be joined

As for the assembly and erection of cooked bones, these must be joined together soon after cleaning (lest they harden too much). Immediately after cooking, the bones are easily perforated with nothing but awls with which shoes are pierced for sewing, 31 and are tied together with brass wires. Each person will accomplish this with his own skill according to the diligence of his hand and his attention to what we have described so far in this entire book. First, after some awls have been obtained and brass wire of heavier and lighter gauge, let the wire be placed in the fire to make it more pliant and resistant to breakage no matter how variously twisted. 32 To these will be added two holders or forceps: one with which the wire will be twisted, the other with which the twisted wire will be cut off. 33 Begin the articulation of bones from the feet; first join the talus to the calcaneus, then the cuboid bone to the calcaneus, the navicular bone to the talus, and the three inner bones of the tarsus [ossa cuneiformia] to the navicular. To these then attach the metatarsal bones and to them in order the bones of the toes along with the sesamoid bones. Perforate these carefully with a thinner awl the harder and more solid they are and the more easily divided and split by the action of the awl. When you have articulated both feet, the protuberance of the tibia [tuberculum intercondylare] which separates the recesses that take the heads of the femur must be perforated with a long but narrow knife. 34 This opening should be big enough to receive a hard rod which will be pushed into the femur like a spike and thus join the tibia to the femur, as we see beams attached without glue. An extra hole must be made in the lower end of the femur aligned with the one that I wished made in the tibia so the same rod may be inserted in the femur and the tibia and by this means the joint may remain unbent at the knee. But besides this rod, the femur must be joined to the tibia on each side with a heavy wire, so as not to leave out the cartilages [meniscus lateralis, m. medialis] that enlarge the depressions in the tibia. When these bones are joined and fastened together with them, the cartilages will be kept in the knee joint. The fibula will then be attached to the tibia above and below, and the patella secured to both femur and tibia. When this has been accomplished on both legs, the iliac bones must be bound to the sides of the sacrum with a heavy wire, and then the pubic bones must be joined with their cartilage between them. Now there will be at hand a round plank upon which the bones will be erected. The diameter of this plank should be sufficient for the feet to be properly secured to it in whatever position you decide to erect the bones. A hole is made in the center of the plank so that when you put away the bones in an upright case the bottom of the case will have an axis which, when put into the hole, will allow the circular base to turn. Besides this hole, another is made near the plank’s circumference into which a piece of wood can be fitted that is made like a weapon, spear, or scythe (however seems best) to support the hand of the skeleton. 35 When the round base

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has been set up in this way, attach the feet to it, and with the aid of an assistant make sure the remaining leg bones rest on top of the feet. Then place the heads of the femora into the acetabula of the hipbones so you can accurately measure with a string or a rod the distance from the circle to the lower part of the foramen [canalis sacralis] incised in the sacrum for the dorsal medulla. This distance will tell you how long the iron rod must be made which will be fitted to the round base and put into the foramen of the sacrum and the vertebrae that carries the dorsal medulla, and will handsomely support all the bones. The iron rod must be prepared so it can be firmly nailed into the middle of the circle; from the round base to the lowest part of the foramen [hiatus sacralis] just named it may be rounded or square. From there upward it should be wider than it is thick, so that later it can be bent to the curve of the spine and the vertebrae fitted to it 36 so as to be immovable and never turn upon it. For this, the iron should first be made thin where the sacrum must be supported to keep it from slipping downward. Unless this bone is secured and supported, the remaining vertebrae will gradually subside along with it, and over time the legs of the skeleton will be awkwardly bent. 37 This is why the the distance from the circle to the bottom of the foramen of the sacrum 38 must be carefully measured. The length of the remaining rod is not so important since it can easily be cut off after the bones are assembled if it is too long. Even if you have decided to put the skeleton in a case, it will be very useful that a rod be made more or less two palms longer than the whole skeleton so that the part of it extending beyond the top of the head can be put in the hole at the top end of the case and turned therein. When the rod has been fitted perpendicularly in the round base, take a sharp knife and slowly carve out the foramen of the sacrum made for the dorsal medulla so the rod can easily be pushed into it. Since this foramen is naturally too tight and quite oblique, it does not admit the rod unless it is enlarged as we have just stated to enable you to push the rod through from its point to the part of it which we said should be made no longer round or square. If this part seems unsuited for supporting the sacrum, it will be worth the trouble to roughen this part of the rod with a file and wrap a nodule on it with brass wire which will readily support the sacrum. Once the sacrum is supported in this way, 39 bind the heads of the femur into the acetabula of the hipbones with a heavy wire, carefully considering how much you turn the femora outward or inward, lest you attach the legs with an unsightly twist, or the patellae face the inside of the legs rather than the front. This will surely happen unless you join the heads to the sockets correctly. 40 But however you do it, the wire must not be twisted too much in this connection before you fasten the feet to the circlar base and to the tibiae in the position that looks most elegant to you. You will determine this best from the shape of the staff on which the hands will be steadied. A scythe calls for one position, a spear another, another still a pike, or a Neptune’s trident, or some other instrument. All the vertebrae must be fitted in order; observe the place and order of each, which is not hard to ascertain: the shape of the vertebrae and the manner of articulation will readily show this. As soon as you have put them all in order on the table, join the five lumbar vertebrae at two connections made in the side [proc. articularis superior et inferior] of the bodies; these should include the cartilaginous ligament [discus intervertebralis] which we have said comes between the vertebral bodies. These ligaments should be taken up in order from the paper on which they were laid, always leaving behind the one that lies between the vertebrae which you are not connecting. Of such a kind, for now, is the ligament or cartilage between the sacrum and the lowest lumbar vertebra and the one that comes between the highest lumbar and the lowest thoracic vertebrae. After the lumbar vertebrae have been joined, the six lower thoracic vertebrae and then the six upper will be connected to the lower cervical vertebra. The remaining cervical vertebrae do not need to be connected to each other, but the cartilage 41 between them must be only glued to the body of the lower vertebra. Though the cervical vertebrae are not even attached but only placed around the rod, they keep their place; they have no need to be immovable like the thoracic vertebrae that support the ribs. When you attach the vertebrae in the manner suggested, before the rod is put through them, place the attached lumbar vertebrae on the rod and carefully bend it to their position and curvature; 42 then connect the lowest vertebra to the sacrum in the same way you previously joined together the lumbar vertebrae. Then add the lower thoracic vertebrae to them, always bending the rod as accurately as possible as necessity requires, 43 and attaching the lowest thoracic vertebra to the highest lumbar. The upper thoracic vertebrae will be added in the same way and the lowest of these attached to the highest of those just now placed on the rod. Insert a rather wide, long stick, stained black, placing it along the back part of the rod as low as possible between the rod and the vertebrae to hold the vertebrae more firmly against the rod and to prevent them from being turned in any way, lest afterward the whole thorax be able to turn this way or that in an unsightly way. To attach the skull to the rod, it is necessary for the vertex to be perforated with a hole exactly matching the width and thickness of the rod, so that when you have put the rod through it 44 the skull will not turn every which way for any reason. According to whether you wish to have the face look straight forward

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or sidewise, this foramen should be carved with a knife either transversely or obliquely. Similarly, the skull should again be perforated so that the cut which you made in the skull with the saw may be closed with straps and when desired the skull can be removed from the iron rod and dismantled again. 45 It is extremely useful to look into the inner cavity of the skull where the brain is contained. To make this possible, both parts of the skull should be perforated with three matching holes, using a red-hot iron or the point of a knife. 46 One hole is best made in the occiput, and one in each of the temples. Join the lower maxilla to the upper 47 with a brass wire, making the connection with its heads into the depressions of the upper maxilla. 48 But since this connection is not strong enough to bring the teeth together precisely, the lower maxilla hangs down, and it is elegant to have it open and close. In addition to the connection mentioned, the acute processes of the lower maxilla should also be perforated and a string tied to them which is threaded under the jugal bone and rests on the vertex. It can be pulled now toward the forehead and now toward the occiput, and in this way the teeth can be snapped shut. But however that may be, the greatest care should be taken with the iron rod that it not be ineptly bent backward and forward and support the body in an unbecoming way. 49 To prevent this, it is quite important to know the course of the backbone. Now is the time to attach the ribs to the vertebrae and their cartilages. To do this exactly and with care, first separate all the right ribs from the left, basing your conjecture on the depression [sulcus costae] in which the vein, nerve, and artery are extended out along the ribs, as well as on the upper surface of the ribs, which is wider and thicker than the lower. Then put the ribs in order on a table in more or less this way ((( ))), taking care that the right ribs match the left. It will be easy to put each in its place if what we said above about distinguishing the ribs is not forgotten. From this row of ribs attach the first rib of each side to its cartilage on the pectoral bone; then give your partner the pectoral bone and its cartilages to hold in place, and tie the first ribs to the transverse processes of the first thoracic vertebra. Connect the second ribs to their vertebra and after that to their cartilages, and so all of them in order, seeing to it that you allow those ribs to stay apart over their entire length which prior to dissection had been separated from each other by cartilages. 50 Now tie the humeri to the scapuli with a heavy wire, and after that the clavicles to the acromia with a thin wire, the scapulae to the ribs, and the clavicles to the pectoral bone. But when you attach the humeri to the scapulae, it must be considered in what position you want the hands placed. For at this point it makes a considerable difference how the head of the humerus is attached to the depression [cavitas glenoidalis] of the scapula. The cartilage [labrum glenoidale] by means of which the depression of the scapula is sometimes augmented must not be overlooked in this attachment; so also the cartilages [discus articularis] peculiar to the joints of the jaw and the clavicle are not neglected and are attached to their joints. The bones of the lower arm must not be attached to the humerus before the entire hand has been connected. The radius must be tied to the ulna above and below. 51 If the carpal bones are separated and free of their ligaments, they must be connected to each other; otherwise they are sufficiently held together by their own ligaments. To their lower end, attach the first bone of the thumb [os metacarpale I] and the four metacarpal bones, and then to these the bones of the fingers [phalanges] together with the sesamoid ossicles. Finally, join the carpus to the radius, then the ulna to the humerus. When this has been accomplished for both arms, tie the hands to the staff which I said must be firmly attached to the circular base like a sickle or otherwise set up. With the bones now erected, a necklace may be made from the hyoid bone, the ossicles of the organ of hearing, the cartilages of the rough artery [trachea], the ears and the eyelids, and from a nail and the cartilages of the heart, all of these being attached to a little chain or the dried sinew of a leg or arm. 52

From this it is clear with how little trouble the bones of the human body, extremely desirable for a physician, can be prepared: a task in which nothing will seem to a person who has not attempted it more difficult than the actual connecting. But it turned out well enough when I first tried it, taking my example from people I had occasionally seen putting together broken dishes and stone crocks, will have fair results. Its effectiveness in medicine for softening had taught me the technique of cooking. When I returned from Paris to Louvain because of the commotion of war and I walked out with Gemma Phrysius, 53 equally celebrated as a physician and a Mathematician with very few peers, to look at bones at the place where (to the great convenience of students) everyone who had been subjected to the ultimate punishment was exhibited to the rustics on a public road, I came upon a cadaver dried out in the same way as the bandit had been that Galen says he had seen. 54 In the same way the birds had freed that corpse of flesh, so I imagine they had cleaned this one as well, because the man had been only scorched with straw the year before and toasted, as it were, then tied to a pole. Such a fine feast had he presented to the birds that his bones were everywhere bare and held together by the ligaments alone, with only the origins and insertions of muscles preserved. This never happens in the cadavers of those who have been hanged, since on account of the thickness of the skin the birds tear nothing apart but the eyes (though the common folk think otherwise). The skin being undamaged in such cases, the bones are affected with decomposition within and are quite useless for study. Looking as I did at a dried-up body that was nowhere damp or dirty, I did not pass up this unanticipated opportunity, for which I had often looked. With Gemma’s help I climbed the pole

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and pulled a femur away from the hipbone, and as I pulled, the scapulae followed, along with the arms and hands; but the fingers of one hand, both patellae, and one of the feet were missing. When after a series of secretly repeated visits I had brought home the arms and legs (leaving behind only the head and trunk), in order to get the thorax which was secured up high by a chain, I let myself be locked out of the city at night; so ardent was I with longing and zeal for obtaining bones that I did not shudder to pull away what I was looking for at midnight in that multitude of bodies, climbing up the pole with no small labor and industry, with no witnesses present. Taking far off the bones I had removed, I hid them in a secret place, and piece by piece I brought them home the following day through another gate of the city. When I began to cut away the ligaments, I made no progress on account of their extraordinary hardness and was compelled to soften them in scalding water. And to fulfill my hope, I finally boiled all the bones in secret, and having cleaned them in this way I built the skeleton which is preserved in Louvain at the home of my very best friend Gisbertus Carbo, a prominent physician trained in many disciplines and my comrade in studies since boyhood. With such speed did I prepare this skeleton, acquiring elsewhere a hand, a foot, and two patellae with no less labor and industry, that I persuaded everyone I had brought it from Paris. By this means I evaded all suspicion that the bones had been stolen. The burgomaster of the city was afterward so well-disposed to the studies of medical students that he was glad to grant them any corpse; he himself had no ordinary knowledge of anatomy, and he was an eager spectator whenever I gave an anatomy there. When, therefore, sucess so quickly attended our first efforts, what now must we think lies ahead, after we have described the method of assembly to others as well? In addition to the plates now to be added, are skeletons on display in several universities, thanks (if you will) to me? Not only should the bones of humans, but also of apes and dogs, on account of Galen, and for Aristotle’s sake the bones of birds, fish, and reptiles, joined together or at least in pieces — all should be available to the student of medicine and natural philosophy. Unless perhaps we think this part of philosophy has nothing to do with us and persuade ourselves that it is enough if without Anatomy we can impose on mortals with our syrups, and fill our cash-boxes.

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 39 By What Method the Bones and Cartilages of the Human Body May Be Prepared for Inspection