Because apothecaries lack anatomical knowledge, they are unable to apply plasters, ointments, cataplasms, fomentations, or poultices to the appropriate areas, such as the sutures of the skull, the heart, liver, stomach, spleen, kidneys, womb, or bladder. Consider a scenario in which the liver is afflicted by excessive heat, while the stomach is experiencing cold—a condition that is not uncommon because the overheated liver can generate vapors that rise to the head, resulting in cold humors descending into the stomach. If a physician prescribes hot treatments for the stomach, the apothecary may inadvertently apply these remedies to both the stomach and the adjacent liver. The application of the hot poultice to the stomach would only serve to exacerbate the liver’s preexisting heat, failing to alleviate the patient’s condition. Would this ignorance not thwart the patient’s hopes, the physician’s intentions, and the medicine’s efficacy?
The testicles serve a purpose beyond the necessity of the individual body; they are vital for the preservation of the species. Galen compares the testicles to the heart, arguing that the former are more noble because living well and happily is superior to merely existing. The testicles allow for a vibrant and pleasurable life, while the heart’s role is limited to sustaining life alone, as evidenced by the condition of eunuchs and those who have been castrated. This perspective positions the testicles among the principal parts of the body. Just as city builders strive to ensure their establishment remains populated and flourishing long after its construction, nature designs its reproductive organs to facilitate the continuation of life. Despite the many cities that have risen and fallen throughout history, none endure without the decay of their original fame and the names of their founders. However, nature’s work regarding reproduction has persisted for millennia and will likely continue, as it has devised a means for each individual to leave behind a successor before departing this life.
This is why all creatures possess reproductive organs which are equipped with inherent pleasures to encourage mutual attraction and mating. The mind, which governs these organs, possesses a remarkable drive for propagation, a desire that even incites animals to perpetuate their species. Recognizing the inherent fragility and mortality of its creations, nature has sought to mitigate the inevitability of death by ensuring a continuous succession of individuals.
By reason the partition of mans body can hardly be understood, if the distinction of the proper faculties of the soul be not understood, for whose cause the body enjoys that form (which we see) and division into divers instruments; Therefore I thought good in few words to touch that distinction of the faculties of the soul, for the better understanding of the partition of the body which we intend. Wherefore the soul, the perfection of the body, and beginning of all its functions, is commonly distinguished and that in the first and general division, into three faculties, which are the animal, vital, and natural. But the animal is divided into the principal, sensitive, and motive; Again, the principal is distinguished into the imaginative, reasonable, and memorative. And the sensitive into seeing, hearing, smelling, tasting, and touching. But the motive into progressive and apprehensive. And the vital is divided into the dilative, and contractive faculty of the heart and arteries, which we know or understand by the pulsific faculty. But the natural is parted into the nutritive, octave, and generative faculties, which are the attractive, retentive, concocted, assimulative, and expulsive.
After the self same manner, the organ or instrument of the soul, to wit, man’s body, at the first division is distinguished into three parts, which from their office they call animal, vital, and natural. These again, according to the subdivision of the subalternal faculties, are divided particularly into other parts; so that anyone may now the organ of each faculty, by the property of the function. For while other anatomists divide man’s body into four universal and chief parts, they distinguish from the three first those which they call the extremities, neither do they teach to what rank of the three prime parts each extremity should be reduced. From whence many difficulties happen in reading the writings of anatomists; for shunning whereof, we will prosecute, as we have said, that distinction of man’s body, which we have touched before.
Therefore, as previously mentioned, the human body is divided into three parts. The category of animal parts encompasses not only those associated with the head—bounded by the crown, collarbones, and the first vertebra of the thorax—but also includes the extremities, as these serve as the organs and instruments of the motive faculty. Hippocrates seems to support this notion when he claims that individuals with larger and thicker heads tend to have larger bones, nerves, and limbs. He further states that those with significant head size and long necks—particularly evident when they bend forward—exhibit larger proportions in all their parts, especially the animal ones.
Hippocrates does not imply that the head is the source or cause of the size and greatness of the bones and other body parts. Rather, he seeks to demonstrate nature’s inherent equality and meticulous governance in the construction of the human body. If nature skillfully crafts the head, it follows that she would not neglect the other parts that might be less visible.
I felt it necessary to elaborate on this point to prevent any potential misinterpretation of Hippocrates’ authority. One should not conclude that all animal components—bones, membranes, ligaments, cartilage, and other structures, including veins and arteries—are derived from the head as their origin. Observers of our classification of the body’s parts will grasp that our intent is quite different.
By “vital parts,” we refer specifically to the heart, arteries, lungs, windpipe, and other associated structures. In contrast, “natural parts” encompasses all components found within the peritoneum or abdominal cavity, as well as the structures surrounding the second layer of the testicles. Any additional parts that fall under the category of “containing” should be classified as animal parts; however, these can be further divided into principal, sensitive, and motive categories, which we will detail below.
For first the principal is divided into the imaginative, which is the first and upper part of the brain, with its two ventricles and other annexed particles; into the reasoning, which is a part of the brain, lying under the former, and as it were the top thereof with its third ventricle. Into the memorative, which is the cerebellum or afterbrain, with a ventricle hollowed in its substance. Secondly, the sensitive is parted into the visive, which is in the eyes; the auditive, in the ears, the smelling, in the nose, the tasting in the tongue and palate, the tactive, or touching which is in the body, but most exquisite in the skin which invests the palms of the hands. Thirdly, the motive is divided into the progressive, which intimates the legs, and the comprehensive, which intimates the hands.
Lastly, into simply motive, which are three parts, called bellies, for the greatest part terminating and containing, for the vital, the instrument of the faculty of the heart, and dilatation of the arteries, are the direct or straight fibers, but of the constrictive the transverse; but the three kinds of fibers together, of the pulsific; or if you please you may divide them into parts serving for respiration, as are the lungs, and weasand, and
parts serving for vital motion, as are the heart and arteries, furnished with these fibers, which we formerly mentioned. The division of the natural parts remains, which is into the nourishing, auctive and generative, which again are distributed into attractive, universal, and particular; retentive, concoctive, distributive, assimulative, and expulsive.
The attractive, as the gullet and upper orifice of the ventricule;
the retentive, as the pylorus or lower passage of the stomach;
the concoctive, as the body of the ventricle, or its inner coat;
the distributive, as the three small guts;
the expulsive, as the three great guts; we may say the same of the liver, for that draws by the mesaraic and gate veins,
retains by the narrow orifices of the veins dispersed through the substance thereof;
it concocts by its proper flesh;
distributes by the hollow vein,
expels by the spleen, bladder of the gall and kidneys.
The parts within the testicles can also be categorized according to their functions. They draw substances through preparatory vessels, retain them within varicose and convoluted passages, and concoct semen utilizing their own intrinsic properties and capabilities. The distribution of this semen occurs through the ejaculatory ducts, at the glands known as the prostate, as well as in the horns of the uterus, where they serve a role similar to that of prostates. Finally, the expulsion of the semen is achieved through the prostates, horns, and adjacent structures.
The individual functions—such as attraction, retention, concoction, distribution, and assimilation—are influenced by the specific temperament and, as it is often termed, the hidden properties of each analogous and fundamental part. Therefore, while these particular actions may seem distinct from the universal functions, they do not fundamentally differ; the general actions are facilitated by three types of fibers, whereas the specific actions stem from the unique, latent properties of the flesh, which arise from their individual temperatures—this we might refer to as a specific property.
In the design of the human body, nature primarily focuses on three essential objectives.
And this is my opinion, of the true distinction of man’s body, furnished with so many parts, for the performance of so many faculties; which you, if you please, may approve of and follow. If not, you may follow the common and vulgar, which is, into three bellies, or capacities, the upper, middle and lower, (that is, the head, breast and lower belly) and the limbs or joints. In which by the head we do not understand all the animal parts, but only those which are from the crown of the head to the first vertebra of the neck, or to the first of the back, if according to the opinion of Galen, where he makes mention of Enarthrosis and Arthrodia, we reckon the neck amongst the parts of the head. By the breast, whatsoever is contained from the collar bones to the ends of the true and bastard, or short ribs, and the midriff. By the lower belly, the rest of the trunk of the body, from the ends of the ribs to the share-bones; by the limbs, we understand the arms and legs. We will follow this division in this our anatomical discourse, because we cannot follow the former in dissecting the parts of man’s body, by reason the animal parts are mutually mixed with the vital and natural, and first of the lower belly.
Nature would not have this lower belly bony, because the ventricle might be more easily dilated by meat and drink, children might grow the better, and the body be more flexible. It is convenient we begin our anatomical administration from this, because it is more subject to putrefaction than the rest, both by reason of its cold and moist temperature, as also by reason of the feculent excrements therein contained. Yet before we go any further, if the anatomical administration must be performed in public, the body bring first handsomely placed, and all the instruments necessary for dissection made ready, the belly must be divided into its parts, of which some contain, and others are contained.
They are called containing, which make all that capacity which is terminated by the peritoneum or Rim of the belly. The upper part whereof is bounded by Galen within the compass of the direct muscles, and by a general name is called epigastrium, or the upper part of the lower belly. That again is divided into three parts, that is, into that which is above the navel, and which carries the name of the whole, into that which is about the navel, and is called the umbilical or middle part; and lastly, into that which is below the navel, called the hypogastrium, or the lower part of the lower belly.
In every of which three parts there be two lateral, or side parts to be considered, as in the epigastrium, the right and left hypochondria, which are bounded above and below, as in the compass of the midriff, and the short ribs. In the umbilical the two lumbars (some call them latera sides) which on both sides from the lowest parts of the breast, are drawn to the flanks, or hanch-bones, in the hypogastrium the two ilia, or flanks, bounded with the hanch and share-bones. Neither am I ignorant, the ilia or flanks, which the Greeks call Λαƴȯɛꜱ signify all the empty parts, from the ends of the ribs, even to the hanch-bones, whereupon they also call them Kɛ𝙫େωƴɛsͻ as if you should say, empty spaces, because they are not encompassed with any bone. Yet I thought good that this doctrine of dividing the belly should be more distinct, to call the parts which are on each side the navel lumbares, and those on the lower part of the lower belly ilia, flanks. But we must observe that the ancients have been so diligent in deciphering the containing parts, that as exactly as might be, they designed the bowels contained in the belly, which being diverse lie in sundry places; for the greater portion of the liver lies under the right hypochondrium; under the left almost all the ventricle and spleen. Under the epigastrium the lower orifice of the ventricle, and the smaller portion of the liver; in the lumbars, or sides, in the right and upper part the right kidney, in the lower part towards the flank, the blind gut; in the middle part thereof the colic and empty guts. In the upper part of the left side lies the left kidney, in the middle part, the rest of the empty and colic guts. Under the region of the navel, lies the girdle or upper part of the caul, the colic gut thrusting itself also through that way. Under the ilia or flanks, the right and left, lie the greater part of the gut ileon, the horns of the womb in women big with child, and the spermatic vessels in men and women. Under the Hypogastrium in the lower part lies the right, or straight gut, the bladder, womb, and the rest of the caul.
If we know, and well understand these things, we shall more easily discern the parts affect by the place of the pain, and cure it by fit application of remedies, without the hurting of any part. The distinction of such places, and the parts in those places, as seeming most profitable, I have thought good to illustrate by the placing these two following figures, in which thou have deciphered, not only the aforesaid parts, containing and contained but also of the whole body, and many other things which may seem to conduce to the knowledge of the mentioned parts. The figures are these.
The containing parts of the Epigastrium are the Epidermis or thin outward skin, the true skin, the fleshy or fatty pannicle, the eight muscles of the Epigastrium with their common coat, the Rim of the belly, the five vertebras of the loins, all the holy-bone, the hanch-bone, share-bone, the white line, and midriff. Of these parts some are common to the whole body, as the three first; the other proper to the parts contained in the epigastrium taken in general. Which that you may see in their order, first you must cut round about the navel, to the upper superficies of the muscles, that so we may keep it, til such time, association shall offer itself, to show the umbilical vessels lying in that place, which are one vein, two arteries, and the urachus (if it be there). Which being done, you must draw a straight line from the chest over the breast-blade, even to the share-bone, which may divide the common containing parts, even to the white line.
Then presently it will be convenient to draw two other lines across, or overthwart, of the like depth on each hand, from the circumference of the navel, even to the sides, that so on each part we may draw the skin more commodiously from the parts lying under it; the sight of which otherwise it would hinder. These things being done, the skin must be divided from the parts lying under it from the designed circumference left about the navel. We must teach how the skin is two-fold, the true and false, and render a reason of the name, which we will every where do, as far as the thing will suffer, and it shall lie in our power, and in doing or examining these things, it will be convenient diligently to inquire into the nine things mentioned in the preface. We will begin with the skin, because that part is first obvious to our senses.
The skin being the first part, and spread all over the body, is twofold, that is, the true, and bastard skin. The true is called by the Greeks Derma, which may almost everywhere be pulled from the parts lying under it, which it invests, except in the face, ears, the palms of the hands, soles of the feet, fingers, and privities, where it sticks so close that it cannot be separated.
The bastard (which first of all we will declare, because it first presents itself to our sight) is by the Greeks called epidermis, because it covers the true skin, they term it commonly the cuticle. The substance of it is excrementitious and as it were a certain dry flowering, or production of the true skin. That it draws not its substance from the seed is apparent by this, that as it is easily lost, so it is easily repaired, which happens not in parts truly spermatical. This utmost thin skin, or cuticle, may two manner of ways be made apparent by itself, and separated from the other, as by burning with fire, or ardent heat of the sun (in some delicate bodies, and such as are not accustomed to be conversant in sunshine). The quantity in thickness is very small, but the extent is most large, because it covers all the skin; the figure of it is round, and long, like those parts which it invests. The composure of it is obscure, yet because this cuticle is the excrement of the true skin, we say it has its matter from the excrementitious superfluidity of the nerves, veins, arteries, and substance of the true skin.
It is in number one, like as the true skin which it outwardly covers, that it might be a medium between the object, and fixed faculty of touching, diffused over all the true skin which everywhere lies under it. For the temperature, by the common consent of physicians, it is in the midst of all excess; for that seeing it is the medium between the object and faculty, if it should be hotter, colder, moister, or drier, it would deceive the faculty by exhibiting all objects, not as they are of themselves, but as it should be; no otherwise than as to such as look through red or green spectacles, all things appear red or green. Wherefore for this reason it was convenient the cuticle should be void of all sense. It has no action in the body; but it has use, for it preserves and beautifies the true skin; for it seems to be given by the singular indulgence of nature, to be a muniment and ornament, to the true skin. This providence of nature, the industry of some artisans (or rather curtisans) does imitate, who for to seem more beautiful, do smooth and polish it. By this you may understand, that not all the parts of the body have action, yet have they their use, because, according to Aristotle’s opinion, nature has made nothing in vain. Also you must note that this thin skin, or cuticle being lost, may everywhere be generated, unless in the place which is covered with a scar. For here the true skin being deficient, both the matter and former faculty of the cuticle is wanting.
The true skin called by the Greeks Derma, is of a spermatic substance, wherefore being once lost, it cannot be restored as formerly it was. For in place thereof comes a scar, which is nothing else but flesh dried beyond measure. It is of sufficient thickness, as appears by the separating from the flesh.
But for the extent thereof it encompasses the whole body, if you except the eyes,
ears, nose, privities, fundament, mouth, the ends of the fingers where the nails grow, that is, all the parts by which any excrements are evacuated. The figure of it is like the cuticle round and long, with its productions, with which it covers the extremities of the parts.
It is composed of nerves, veins, arteries, and of a proper flesh and substance of its kind, which we have said to be spermatical, which arises from the process of the secundine, which lead the spermatic vessels even to the navel, in which place each of them into the parts appointed by nature, send forth such vessels as are spread abroad and diffused from the generation of the skin. Which also the similitude of them both, that is, the skin and membrane Chorion do argue. For as the Chorion is double, without sense, encompassing the whole infant, lightly fastened to the first coat which is called Amnios; to the skin is double, and of itself insensible (for otherwise the nerves were added in vain from the parts lying under it) ingirting the whole body, lightly cleaving to the fleshy Pannicle. But if any object that the cuticle is no part of the true skin, seeing it is wholly different from it, and easily to be separated from it, and wholly void of sense: I will answer, these arguments do not prevail. For that the true skin is more crass, thick, sensible, vivid, and fleshy, is not of itself, being rather by the assistance and admixture of the parts, which derived from the three principal it receives into its proper substance; which happens not in the cuticle. Neither if it should happen would it be better for it, but verily exceeding ill for us, because so our life should life fit and open to receive a thousand external injuries, which encompass us on every side, as the violent and contrary access of the four first qualities.
There is only one skin, as that which should cover but one body, the which it every where does, except in those places I formerly mentioned. It has connection with the parts lying under it by the nerves, veins, and arteries, with those subjacent parts put forth into the skin investing them, that there may be a certain communion of all the parts of the body amongst themselves.
It is cold and dry in its proper temper in respect of its proper flesh and substance, for it is a spermatical part. Yet if any consider the sinews, veins, arteries, and fleshy threads which are mixed in its body, it will seem temperate, and placed as it were in the midst of contrary qualities, as which has grown up from the like portion of hot, cold, moist and dry bodies. The use of the skin is to keep safe and sound the continuity of the whole body, and all the parts thereof, from the violent assault of all external dangers, for which cause it is everywhere endued with sense, in some parts more exact, in others more dull, according to the dignity and necessity of the parts which it engirts, that they might all be admonished of their safety and preservation. Lastly, it is penetrated with many pores, as breathing places, as we may see by the flowing out of sweat, that so the arteries in their diastole might draw the encompassing air into the body, for the tempering and nourishing of the fixed inbred heat, and in the systole expel the fuliginous excrement, which in winter suppressed by the cold air encompassing us, makes the skin black and rough. We have an argument and example of breathing through these, by drawing the air in by transpiration, in women troubled with the mother, who without respiration live only for some pretty space by transpiration.
After the true skin, follows the membrane, which anatomists call the fleshy Pannicle, whose nature that we may more easily prosecute and declare, we must first show what a membrane is, and how many ways the word is taken. Then wherefore it has the name of the fleshy pannicle. A membrane therefore is a simple part, broad and thin, yet strong and dense, white and nervous, and the which may easily, without any great danger be extended and contracted. Sometimes it is called a coat, which is, when it covers and defends some part. This is called the fleshy pannicle because in some parts it degenerates into flesh, and becomes musculous, as in a man from the collar bones, to the hair of the head, in which part it is therefore called the broad muscle, where as in other places it is a simple membrane, here and there entangled with the fat lying under it, from whence it may seem to take or borrow the name of the fatty pannicle. But in beasts (whence it took that name, because in those a fleshy substance makes a great part of this pannicle) it appears manifestly fleshy and musculous over all the body, as you may see in horses, and oxen; that by the means being movable, they may drive and shake off their flies, and other troublesome things, by their shaking and contracting their backs. These things considered, we say the fleshy pannicle in its proper body, is of a nervous or membranous substance, as that which has its origin from the coat amnios, (which is next to the infant) dilated near to the navel and stretch forth for the generation of this pannicle; in which thing I think good to note, that as the membranes chorion and amnios mutually interwoven with small nervous fibers, encompass and invest the child, as long as it is contained in the womb; so the skin and fleshy pannicle knit together by such like bands, engirt the whole body.
Therefore the fleshy pannicle is equal in magnitude and like in figure to the true skin, but that it lies under it, and is contained in it, in some places mixed with the fat, in others increased by the flesh interwoven with it, and in othersome is only a simple membrane.
The composition of it is such, as the sight of it presents to our eye, that is, of veins, arteries, nerves, and the proper flesh, somewhiles mixed and interlaced with fat, and sometimes the musculous flesh. It is but one, by reason of the use we shall presently show. It is situated between the skin and fat, or common coat of the muscles, annexed to these and the other parts lying under it, by the veins, nerves, and arteries ascending from these inward parts, and implanting themselves into the substance thereof, and then into the true skin.
The temperature thereof is diverse, according to the variety of the parts interwoven with it. The use of it is, to lead, direct, and strengthen in their passage, the vessels which are disseminated into the true skin, and the whole superficies of the body. But in beasts is has another commodity, that is, it gives a shaking or trembling motion to their skin and back, for that cause we formerly touched.
The fat coming near the condition of an excrement, rather than of a part (as we said, when we treated of the similar parts) is of an oily substance, bred of the airy and vaporous portion of the blood, which sweating through the pores of the coats, or mouths of the vessels, becomes concrete about the membranes, and nerves, and cold bodies, and turns into fat by the coldness of the place. Whereby we may know that cold, or a more remiss heat, is the efficient cause of fat, which is manifest by contemplation not only of creatures of diverse kinds, but also by those of the same species and sex, if so be that the one be colder than the other.
By which we may understand that the fat is the more or less in quantity according to the different temper of the whole body, and of its particular parts; for its composition, it consists of that portion of the blood which we formerly mentioned, intermixed with certain membranes, nervous fibers, veins and arteries. The greatest part of it lies between the fleshy pannicle and the common coat of the muscles. Otherwise is diffused over all the body, in some places more, in some less, yet it is always about the nervous bodies, to which it delights to cleave. Most Anatomists inquire whether the fat lie above or beneath the fleshy pannicle. But methinks this question is both impertinent and idle; being we often see the fat to be on both sides. It is of a middle temper between heat and cold, being it arises of the more airy portion of the blood; although it may seem cold in respect of the efficient cause, that is, of cold by which it concreats. For the rest, moisture is predominant in the fat. The use thereof is, to moisten the parts which may become dry by long fasting, vehement exercise or immoderate heat, and besides to give heat, or keep the parts warm. Although it does this last rather by accident than of its own nature, as heated by exercise, or by some such other chance, it heats the adjacent parts, or may therefore be thought to heat them, because it hinders the dissipation of the native and internal heat; like as cold heats in winter, whereby the bellies are at that time the hotter. I know some learned physicians of our time stiffly maintained, that the fat was hot, neither did they acknowledge any other efficient cause thereof, than temperate heat and not cold. But I think it best to leave the more subtle agitation of these questions to natural philosophers. But we must note, that at the joints which are more usually moved, there is another sort of fat, far more solid and hard, than that which we formerly mentioned, often found mixed with a viscid and tough humor like the whites of eggs, that so it might be sufficient for a longer time to moisten these parts, subject to be hurt by dryness, and make them slippery and so fitter for motion, in imitation whereof they usually grease hard bodies, which must be in frequent motion, as coach wheels and axeltrees. And there is another kind of fat, which is called sevum, seam, in one thing differing from the ordinary fat, that is much drier, the moister and softer portion of the fat being dissipated by the raging heat of the place. For it is found principally about the midriff, where there are many windings of arteries and veins, and it is also about the kidneys, loins, and basis of the heart. The fat is wasted by long fasting; is dried and hardened by vehement exercise and immoderate heat. Hence it is that it is much more compact in the palms of the hands, and soles of the feet, about the eyes and heart, so that it resembles the flesh in density and hardness; because by the continual motion and strong heat of these parts, the thinner portion being dissipated and diffused, the more gross and terrestrial remain.
Next under the fat appears a certain coat, spread over all the muscles, and called the common coat of the muscles, it is of a nervous substance, as all other membranes are. The quantity and breadth thereof is bounded by the quantity of the muscles which it involves, and fits itself to, as that which encompasses the muscles of the epigastrium, is of equal largeness with the same muscles. The figure of it is round. It is composed of veins, nerves, arteries and its peculiar flesh consisting of three sorts of fibers; the beginning of it is from the periosteum, in that part where the bones give ligaments to the muscles, or according to the opinions of others, of the nervous and ligamentous fibers of the muscles, which rising up and diffused over the fleshy superficies thereof, are united for the generation of this coat. But this membrane arising from the periosteum (as every membrane which is below the head takes its original from the periosteum either primarily, by the interposition of no medium, or secondarily) is stretched over the muscles by their tendons. But if any object, that this membrane plucked from the belly of the muscle, may seem to end in a ligament. I will answer, that it is the condition of every nervous part, so to bind or fasten itself to another part of his own kind as to a stay, so that it can scarce be plucked from thence. We see the proof hereof, in the peritoneum or rim in the epigastrium or lower part of the lower belly. That which covers the muscles of the epigastrium is but one, unless you had rather part it in two, the right and the left distinguished by the interposition of the linea alba, or white line. It is situated between the fat and muscles, for it is fastened above and below to these parts with fibers, which in smallness and fitness exceed the spider’s web. But by its vessels, it participates with the three principal parts, and is of a cold and dry temper. The use of it is, to contain the muscles in their natural union, and to keep them as much as in it lies, from putrefaction, which may happen to them from pus or matter, which is often cast forth of the similar parts into the empty spaces and distances of the muscles. Wherefore going about to separate the fat of the epigastrium (where you must begin the dissection of man’s body) you must have a care, that you hurt it not with your knife, but that, before you touch the muscles, see you artificially take it away, that you may the more easily separate the muscles lying under it, distinguished by a manifest space at the white line, which is made by the meeting together of the proper coats of all those muscles.
A muscle is the instrument of voluntary motion, and simple voluntary motion is performed six manner of ways: upwards, downwards, forwards, backwards, to the right and to the left. But the compound one way, which is circularly, the which is performed by the continual succession of the motion of the muscles engirting the part. Such a motion falconers use when they stretch forth their hand and lure their hawk. We have some parts, which have motion without a muscle, but that motion is not voluntary; such parts be the heart, stomach, guts, both the bladders (that is, that of the gall and that of the urine) and diverse others which have the motions of attraction, expulsion and retention, by the means of the three sorts of fibers; for they draw by the right, expel by the transverse, and retain by the oblique. The differences of muscles which are many and diverse, are taken from their substance, origin, insertion into the part which they move, form or figure, holes or openings, magnitude, color, site, kind of fibers, their conjugation or connection, heads, bellies, tendons, opposition in action and office. Some in substance are nervous, venous, arterious, because they have manifest nerves, veins, and arteries, as the midriff, the intercostal and epigastric muscles and many more, and that for their difference from other muscles, into which neither nerve nor vein, or arteries are manifestly inserted, although secretly they admit them all for sense and motion, life and nourishment, such are the muscles of the wrist, the wormy muscles of the hands and feet, for if there be any nerves observed in them, they are very small. Some had rather make the difference of muscles thus, that some of them are fleshy, some nervous, others membranous. From their origin, some arise from the bones, as these which move the hands, arms and legs; others from gristles, as the muscles of the throat; others from membranes which invest the tendons, as the wormy muscles of the hands and feet; others from ligaments as the extenders of the fingers, others from other muscles, as the two lower muscles of the yard which proceed from the sphincter muscle of the fundament. Others have no original, as the membrane which we call the fleshy pannicle assumes flesh in certain places, and degenerates into a muscle; such are the cremaster or hanging muscles of the testicles, the large muscles of the face, and if you please the midriff, as that which is composed of two coats, the one encompassing the ribs and the peritoneum, has flesh in the midst between the two membranes. And moreover some muscles have their original from only one bone, as these which bend and extend the cubite, others arise of many bones as the oblique descending, the dorsal and many muscles of the neck, with arise together from many spondyls and sides of spondyls. There are others according to the opinion of some men, both from the bones and gristles of the pubis at the right or direct muscles of the epigastrium, yet by their favor I think otherwise. Because by the anatomical and received axiome, a muscle is there thought to take his beginnings from whence he receives a nerve, but these muscles take a nerve from the intercostal muscles, wherefore their original ought to be referred to the sides of the breast blades, as shall be shown in due place. From their insertion arise these differences, some are inserted into a bone, as those which move the head, arms and legs. Others into a gristle, as those of the throttle, eyelids, nose, and the oblique ascendant muscles of the epigastrium, some into a bone and gristle both, as the right muscles of the epigastrium and the midriff; some into the skin, as the muscles of the lips, others into the coats as the muscles of the eyes, others into ligaments, as the muscles of the yard. But these differences following may be drawn both from their insertion and original. For some muscles arising from many parts, are inserted into some one part, as diverse of these which move the arm, and the shoulder, which arising from many spondyles are inserted into the bone of the shoulder and the shoulder blade. Others arise from one part, and insert themselves into more, as those which arise from the bottom of the shoulder blades, are extended and inserted into some eight or nine of the upper ribs, to help respiration, and the benders and extenders of the fingers and toes. Others arising from many bones are inserted into as many, as some of those which serve for respiration, to wit those which we call the hinder saw-muscles and the semispinatus, which sends a tendon into all the ribs. Others have their origin from many bones, and end in gristles of the seven ribs, as those two which lie under the sternum. Moreover also these differences of muscles may be drawn from the origin and insertion, that some proceed from bones and are inserted into the next bone, to help and strengthen the motion thereof, as the three muscles of the hip; others arise from an upper bone and are not inserted into the next, but into some other, as the long muscles. Some are named from the part they move, as the temporal muscle because they move the temples; others from their office, as the grinding muscles, because they move the skin as a mill, to grind asunder the meal. From their form or figure, because some are like mice, other like lizards which have their legs cut off, for that they imitate in their belly, body or tendon, the belly or tail of such creatures, and from whence the names of Musculus and Lacertus are derived. Such are those which bend the wrist, and which are fastened to the bone of the leg, and which extend the foot; others are triangular, as that which lifts up the arm, called epomis or deltoids, and that which draws the arm to the breast, called the pectoral muscle. Others quadrangular as the rhomboids, or lozenge muscle of the shoulder blade and the two hindesum-muscles serving for respiration, and two of the wrists which turn down the hand; others consist of more than four angles, as the oblique descending, and that muscle which joins itself to it from the shoulder blade; others are round and broad, as the midriff, others circular as the sphincter muscle of the fundament and bladder; others are of a pyramidal figure, as the seventh muscle of the eye, which compasses the optic nerve in beasts but not in men. Others have a semicircular form, as that which shuts up the eye seated at the lesser corner thereof. Others resemble a monk’s cowl, or hood, as the trapezius of the shoulder blade. Besides others at their first origin are narrow, but broad at their insertion, as the saw-muscle of the shoulder and the transverse of the epigastrium, others are quite contrary, as the three muscles of the hip; others keep an equal breadth or bigness in all places, as the intercostal muscles and these of the wrist; others are long and slender, as the long muscle of the thigh; others are long and broad , as the oblique descending muscles of the epigastrium; others are directly contrary, as the intercostals, which are very narrow. From their perforations, for some are perforated, as the midriff which has three holes, as also the oblique and transverse of the epigastrium, that so they may give passage forth to the preparing spermatic vessels, and to the ejaculatory vessels, the coat erythroids associating and strengthening them; others are not perforated. From their magnitude for some are most large, as the two muscles of the hip, others very small, as the eight small muscles of the neck, and the proper muscles of the throttle, and the wormy muscles. Others are of an indifferent magnitude. From their color, for some are white and red, as the temporal muscles, which have tendons coming from the midst of their belly; others are livid, as the three greater muscles of the calf of the leg, which color they have by the admixtion of the white, or tendinous nervy coat with the red flesh, for this coat by its thickness darkening the color of the flesh, so that it cannot show its redness and fresh color, makes it seem of that livid color. From their situation, for some are superficiary, as those which appear under the skin and fat; others deep in and hid, as the smooth and four twin muscles; some are stretched out and as it were spread over in a straight and plain passage, as the muscles of the thigh which move the leg, except the ham muscles; others oblique, as those of the epigastrium; othersome transverse, as the transverse of the epigastrium, where you must observe, that although all the fibers of the muscles are direct, yet we call them oblique, and transverse by comparing them to the right muscles, as which by the concourse of the fibers make a straight or acute angle.
From the sorts of fibers; for some have one kind of fiber; yet the greatest part enjoy two sorts running up and down, that they either are crossed like the letter X, as happens in the pectoral and grinding muscles; or else do not concur, as in the trapezij. Others have three sorts of fibers, as the broad muscle of the face.
From their coherence and connection, or their texture of nervous fibers, for some have fibers somewhat more distant and remote immediately at their origin, than in other places, as you may see in the muscles of the buttocks; others in their midst and belly, which by reason thereof in such muscles is more big or tumid, their head and tail being slender, as happens in most of the muscles of the arm and leg, in which the dense mass of flesh interwoven with fibers, disjoins the fibers in so great a distance; in others the fibers are more distant in the tail, as in the greater saw-muscle arising from the bottom of the shoulder blade; in others they are equally distant through the whole muscle, as in the muscles of the wrist and between the ribs.
From their head; for in some it is fleshy interwoven with few fibers, as in the muscles of the buttocks; in others it is wholly nervous, as in the most-broad-muscle common to the arm and shoulder blade, and in the three muscles of the thigh proceeding from the tuberosity of the hucle bone; in some it is nervous and fleshy as in the internal and external muscle of the arm. Besides some have one head, others two, as the bender of the elbow and the external of the leg, others three as the threeheaded muscle of the thigh. But we must note that the word nerve or sinew is here taken in a large signification, for a ligament, nerve and tendon, as Galen says (Lib. de Ofsibus) and moreover we must observe, that the head of a muscle, is one while above, another while below, otherwhiles in the midst as in the midriff, as you may know by the insertion of the nerve, because it enters the muscle by its head.
From their belly also, there be some differences of muscles taken; for some have their belly immediately at their beginning, as the muscles of the buttocks, others at their insertion, as the midriff. Others just at their head, as those which put forth the calf of the leg, in others it is somewhat further off, as in those which draw back the arm, and which bend the leg, in others the belly extends even from the head to the tail, as in the intercostal muscles and these of the wrist; in others it is produced even to their insertion, as in those of the palms of the hands and soles of the feet; some have a double belly, distinguished by a nervous substance; as those which open the mouth, and those which arise from the root of the lower process of the shoulder blade.
Moreover the differences of muscles are drawn also from the tendons, for some have none, at least which are manifest, as the muscles of the lips and the sphincter muscles, the intercostal and those of the wrist; others have them in part, and want them in part, as the midriff; for the midriff wants a tendon at the ends of the shorter ribs, but has two at the first vertebra of the loins in which it is terminated; others have a tendon indeed. But some of these move with the bone, some not, as the muscles of the eyes, and besides, some of these have broad and membranous tendons, as the muscles of the eyes and epigastrium, except the right muscles; in others they are thick and round, as in the benders of the fingers; in others they are less round, but more broad than thick, such as the tendon arising from the twin muscles and soleus of the leg: others have short tendons, as the muscles which turn down the hand; othersome long, as those of the palms of the hands and soles of the feet; besides others produce tendons, from the end of their belly which tendons are manifest, others from the midst, as the temporal muscles.
Besides also others diffuse many tendons from their belly, as in the hands the benders of the fingers, and the extenders of the feet. Othersome put forth but one, which sometimes is divided into many, as those which bend the third articulation of the foot; otherwhile many muscles by their meeting together make one tendon, as the three muscles of the calf of the leg, and those which bend the cubit and leg. All tendons have their origin, when the nerves and ligaments dispersed through the fleshy substance of a muscle, are little by little drawn and meet together, until at last carried to the joint they are there fastened for the fit bending and extension thereof. From the contrariety of their actions, for some parts have contrary muscles, benders and extenders; other part have none, for the cods and fundament have only lifters up. From their function, for some are made for direct motions, as those which extend the fingers and toes; others for oblique, as the supinators of the hand and the pronators, others perform both, as the pectoral muscle, which moves the arm obliquely upward and downward, as the upper and lower fibers are contracted; and also out right, if all the fibers be contracted together, which also happens to the deltoids and trapezius. I have thought it good to handle particularly these differences of muscles, because that by understanding them the prognostic will be more certain; and also the application of remedies to each part; and if any occasion be either to make incision, or suture, we may be more certain, whether the part affected be more or less nervous.
Having declared the nature and differences of a muscle, we must note that some of the parts thereof are compound, or universal, others simple or particular. The compound are the head, belly and tail. The simple are ligaments, a nerve, flesh, a vein, artery, and coat. For the compound parts, by the head we understand the beginning and origin of a muscle, which is one while ligamentous and nervous, otherwise also fleshy. By the belly, that portion which is absolutely fleshy; but by the tail, we understand a tendon consisting partly of a nerve, partly of a ligament promiscuously coming forth from the belly of the muscle. For as much as belongs to the simple, which are six in number, three are called proper and three common. The proper are a ligament from a bone, a nerve proceeding from the brain, or spinal marrow, and flesh compact by the concretion of blood. The common are, a vein from the liver or trunk arising from thence, an artery proceeding from the heart, a coat produced by the nervous and ligamentous fibers spreading over the superficies of the muscle. But for the simple use of all such parts, the nerve is as it were the principal part of a muscle, which gives it sense and motion, the ligament gives strength, the flesh contains the nervous and ligamentous fibers of the muscle and strengthens it filling up all the void spaces, and also it preserves the native humidity of these parts and cherishes the heat implanted in them, and to conclude, defends it from all external injuries; for like a fan it opposes itself against the heat of the sun, and is as a garment against the cold; and as a cushion in all falls and bruises, and as a buckler or defense against wounding weapons. The vein nourishes the muscle, the artery gives it life, the coat preserves the harmony of all the parts thereof, lest they should be any way disjoined or corrupted by purulent abscesses breaking into the empty or void spaces of the muscles, as we see it happens in a gangrene, where the corruption has invaded this membrane by the breaking out of the more acrid matter or filth.
Having gone thus far, it remains, that we more particularly inquire into each part of a muscle, that (if it be possible) nothing may be wanting to this discourse. Wherefore a ligament properly so called, is a simple part of mans body, next of a bone and gristle, the most terrestrial, dry, hard, cold, white, taking its original immediately, or by the interposition of some medium from the bones, or gristles (from whence also the muscles have their beginning) whereby it comes to pass that a ligament is void of sense, unless it receive a nerve from some other place; (for so the ligaments which compose and strengthen the tongue and yard, are partakers of sense) and it inserts itself into the bone and gristle that so it may bind them together, and strengthen and beautify the whole joint or connection; (for these three be the principal uses of a ligament) then diffusing itself into the membranes and muscles to strengthen those parts. A nerve to speak properly, is also a simple part of our body, bred and nourished by a gross and phlegmatic humor, such as the brain, the original of all the nerves, and also the spinal marrow endued with the faculty of feeling and oftentimes also of moving. For there be diverse parts of the body which have nerves, yet are destitute of all voluntary motion, having the sense only of feeling, as the membranes, veins, arteries, guts and all the entrails. A nerve is covered with a double cover from the two membranes of the brain, and besides also with a third proceeding from the ligaments which fasten the hinder part or the head to the vertebrae, or else from the pericranium. We understand no other things by the fibers of a nerve, or of a ligament, than long and slender threads, white, solid, cold, strong more or less according to the quantity of the substance, which is partly nervous and sensible, partly ligamentous and insensible. You must imagine the same of the fleshy fibers in their kind; but of these threads some are straight for attraction, others oblique for retention of that which is convenient for the creature, and lastly some transverse for the expulsion of which is unprofitable. But when these transverse threads are extended in length, they are lessened in breadth, but when they are directly contracted, they are shortened in length. But when they are extended all together as it were with an unanimous consent, the whole member is wrinkled as contracted into itself, as on the contrary it is extended when they are relaxed. Some of these are bestowed upon the animal parts, to perform voluntary motions; others upon the vital to perform the agitation of the heart and arteries; others upon the natural for attraction, retention and expulsion. Yet we must observe, that the attraction of no similar part is performed by the help of the aforesaid fibers or threads, but rather by the heat implanted in them, or by the shunning of emptiness, or the familiarity of the substance. The flesh also is a simple and soft part composed of the purer portion of the blood insinuating itself into the spaces between the fibers, so to invest them for the uses formerly mentioned. This is as it were a certain wall and bulwark against the injuries of heat and cold, against all falls and bruises, as it were a certain soft pillow or cushion yielding to any violent impression. There be three sorts of flesh; one more ruddy, as the musculous flesh of perfect creatures and such as have blood; for the flesh of all tender and young things having blood, as calves, and also of all sorts of fish, is whitish, by reason of the too much humidity of the blood. The second kind is more pallid, even in perfect creatures having blood, such as the flesh of the heart, stomach, weasand, guts, bladder, womb. The third is belonging to the entrails, or the proper substance of each entrail, as that which remains of the liver (the veins, arteries and coat being taken away) of the bladder of the gall, brain, kidneys, milt. Some add a fourth sort of flesh which is spongy, and that they say is proper to the tongue alone.
A vein is a vessel, pipe or channel of the blood, or bloody matter; it has a spermatic substance, consists of one coat composed of three sorts of fibers.
An artery is also the receptacle of blood but that spirituous and yellowish, consisting in like manner of a spermatic substance; but it has two coats, with three sorts of fibers, the utmost whereof is most thin, consisting of right fibers and some oblique. But the inner is five times more thick and dense than the utmost, interwoven with transverse fibers; and it does not only contain blood and spirit, but also a serous humor, which we may believe because there be two emulgent arteries, as well as veins.
But the inner coat of an artery is therefore more thick, because it may contain blood which is more hot, subtle and spirituous; for the spirit, seeing it is naturally more thin and light in perpetual motion, would quickly fly away, unless it were held in a stronger hold. There is other reason for a vein, as that which contains blood gross, ponderous and slow of motion. Wherefore if it had acquired a dense and gross coat, it could scarce be distributed to the neighboring parts; God the maker of the universe, foreseeing this, made the coats of the vessels contrary to the consistence of the bodies contained in them. The anastomosis of the veins and arteries, that is to say, the application of the mouths of the one to the other, is very remarkable, by benefit of which they mutually communicate and draw the matters contained in them, and so also transfuse them by insensible passages, although that anastomosis is apparent in the vein and artery that meet together at the joint and bending of the arm, which I have sometimes shown in the physick schools, at such times as I there dissected anatomies.
But the action or function of a muscle is either to move, or confirm the part according to our will, into which it is implanted; which it does when it draws itself towards its original, that is to say, its head. But we define the head by the insertion of the nerve, which we understand by the manner of the working of the muscle.
Now seeing that we have taught what a muscle is, and what the differences of them are, and what simple and compound parts it has, and what the use, action and manner of action in each part is; it remains that we come to the particular explication of each muscle, beginning with those of the lower belly, as those are what we first meet with in dissection.
There are 8 in number: 4 oblique, 2 on each side, two right or direct, one on the right, another on the left side, and in like manner 2 transverse. All these are alike in force, magnitude and action, so mutually composed, that the oblique descendent of one side, is conjoined with the other oblique descendent on the other side, and so of the rest.
We may add to this number the 2 little supplying or assisting muscles, which are of a pyramidal form and arise from the share-bone, above the insertion of the right muscles. Of the oblique muscles of each side the one ascends, the other descends, whereupon it comes to pass, that they are called the oblique descendant and ascendant muscles. Those oblique which we first meet with, are the descendent, whose substance is partly sanguine, partly spermatic, for they are fleshy, nervous, ligamentous, venous, arterious, and membranous. Yet the fleshy portion is predominant in them, out of which respect Hippocrates is wont to express the muscles by the name of fleshes; their greatness is indifferent between the large and the small muscles; their figure 3 square. They are composed of the forementioned parts, they are two in number; their site is oblique taking their beginning, from the touching of the great saw muscle and from the sixth and seventh true ribs, or rather from the spaces between the six lower ribs, and rather on the fore part of the muscles than of the ribs themselves, from whence shunning the vertebras of the loins, the fleshy parts of them are terminated in the external and upper eminency of the haunch-bone, and the membranous end in the lower eminency of the share-bone and the white-line. Yet Columbus dissenting from this common description of the oblique muscles, thinks that they are only terminated in the white line and not in the share-bone. For (says he) wherefore should they be inserted into the share-bone which is not moved? But because it would be an infinite labor and trouble to set down at large the several opinions of all authors of anatomy, I have thought it sufficient for me to touch them lightly by the way. Their connection is with the oblique ascendant lying under them, and with the direct, or right. Their temperament is twofold, the one hot and moist by reason of the belly and the fleshy portion of them; the other cold and dry in respect of their ligamentous and tendinous portion. Their action is to draw the parts into which they are inserted towards their original, or else to unite them firmly. Yet each of these privately and properly draws the hip in an oblique manner towards the cartilago scutiformis or breast-blade. Then follows the oblique ascendant, who have the same substance, quantity, figure, composure, number and temper the descendent has. They are situated between the descendent and transverse with whom they have connection, especially by the vessels which are brought from the parts beneath. All the fleshy parts arise from the rackbones of the haunch to the ends of the bastard ribs, which they seem to admit above and below, being fleshy even to the fourth, and then becoming membranous they take their way to the white line, with a double aponeurosis, which passes through the right muscles above and below, as we may plainly see from the navel downwards. In their fleshy part they draw their original from the spine of the haunch bones a little lower than the descendent end in their fleshy part. But for the membranous parts, they arise before from the share bone, but behind from the spondyles of the holy bone, and vertebrae of the loins obliquely ascending upwards to the white line, into which they are terminated by an aponeurosis or membranous tendon (which seems to penetrate the right muscle upwards and downwards, especially under the navel) but by their fleshy part at the ends of all the bastard ribs, which they seem to receive above and below. And because these muscles are terminated in the white line, they have also another use, yet such as is common to all the muscles of the epigastrium, that is, to press down the guts. Their action is (if they perform it together) to draw down the chest, and dilate the breast, but if their actions be separate, they draw the chest to the hip with an oblique motion. After these follow the right muscles, so called because they descend according to the length of the body, and because they have right or straight fibers.
We will say nothing (to shun prolixity, which in all other places we will avoid) of their substance and other conditions, which they have common with the forementioned muscles. They are situated in the eminentest or extuberating region of the belly, bounding the epigastrium taken in general, (or the superficiary belly) they are divided by the manifest intercourse of the white line, even to the navel, in which place they seem to be united even to the place of their insertion. They draw their original not from the share bone, as some would have it, but according to the insertion of their nerves, from the sides of the cartilago scutiformis and the ends of the sixth seventh and eighth ribs, but they end in the share bone where they make a common tendon sufficiently strong and short. Sylvius, Vesalius and Columbus think they arise from the share bone, because they cannot be inserted into that bone, because it is immovable. You may perceive in these muscles certain nervous and transverse intersections, often times three in number for the strength of these muscles (of which Galen makes no mention, although they may be seen in apes). And also in the inner side of these muscles you may see four veins and as many arteries, of which some creep upwards, others run downwards. The upper called the mamillary descend from the axillary by the side and lower parts of the sternum, the slenderer portions thereof being distributed by the way, to the mediastinum, and about the fourth and fifth rib to the dugs, from whence they take their name.
That which remains breaking out by the sides of the breast-blade inserts itself into those muscles creeping along, even almost to the navel, in which place they are manifestly united (that is the veins with the veins, and arteries with the arteries) with the epigastric, which ascend from the upper part of the iliaca on each side under the said muscles until they meet with these 4 mamillary vessels. That you may find this concourse of the veins and arteries about the navel, you must follow both the upper and the lower somewhat deep into the flesh, pressing the blood on both sides from above downwards, and from below upwards until you shall find the exosculation of these vessels, which will appear by this, that the blood will flow from this into that and from that into this, otherwise you can scarce perceive it, by reason of the smallness of such vessels which want blood. But that by the benefit of such concourse of the vessels, the matters may be communicated and transported both from the womb to the dugs, and again from the dugs to the womb, appears in nurses, who want their courses, when the milk comes into their dugs, and on the contrary lose their milk when their courses flow plentifully. Otherwise to what purpose should there be such concourse between the vessels of the paps and womb, for there are veins and arteries diffused to the sides of the womb from the root of the epigastrics, for indeed the epigastrics which in their ascent meet with the mamillary, go not to the womb, though they be next to them, and arise from the same trunk with the hypogastric vein of the womb. The action of these muscles is, to move or draw near together the parts of the hypogastrium to the precordia or hypochondriac. Their use, in Columbus’s opinion, is to draw the breast downwards so to dilate it. At the ends of these nature produced two other small muscles from the upper part of the share bone, of a triangular figure for the safety of the thick and common tendon of the right muscles, whereupon they are called succenturiati, or assisters.
Some (moved with I know not what reason) would have these two small muscles to help the erection of the yard. Columbus thinks they should not be separated from the right, and that they only are the fleshy beginnings of the right. But on the contrary, Fallopius manifestly proves them different and separate from the right and shows their use. The transverse remain to be spoken of, so called by reason of their fibers which make right angles with the fibers of the right muscles.
They have a quadrangular figure situated upon the greatest part of the peritoneum, so which they stick so close that they scarce can be separated. They take their origin from the production of the loins, the eminency of the haunch-bone, the transverse productions of the vertebrae of the loins and the ends of the bastard ribs; contrary to the opinion of many, whom the insertion of the nerve convinces, but they end in the white line, as all the rest do.
Their action is to press the guts, especially for the expulsion of excrements. But all the 8 recited muscles, besides their proper use, have another common, that is, they stand for a defense or bulwark for all the parts lying under them, and serve for the expulsion both of the excrements, infant, and vapors, and also for the strengthening of the voice, as experience shows in those who sound trumpets and cornets.
Therefore these muscles do equally on every side press the belly; but the midriff, the intercostal muscles assisting it, do drive from above downwards, from which conspiring contention follows the excretion of the excrements by the fundament; but unless the midriff should assist, these muscles would press the excrements no more downwards than upwards to the mouth.
Although to this excretion of the excrements, it is not sufficient that the epigastric, midriff, and intercostal muscles press the belly, but the muscles of the throttle must be also shut. For the mouth being open the excrements never go well forth; because the vapors that pass out of the mouth, which being restrained and driven to the midriff, by stretching it powerfully thrusts down the excrement. Wherefore apothecaries when they give glisters, bid the patient to open his mouth, that the glister may easily go up, which otherwise would scarcely go up, the mouth being shut, because so we should have no place empty in us, into which the glister might be admitted.
The white line is nothing else than the bound and extremities of the muscles of the epigastrium distinguishing the belly in the middle into two parts, the right and left. It is called white, both of its own color, and also for that no fleshy part lies under it, or is placed above it. It is broader above the navel, but narrower below, because the right muscles do there grow into one, now we must treat of the coat or membrane, peritoneum or rim of the belly; it is so called, because it is stretched over all the lower belly, and particularly over all the parts contained in the ventricle, to which also it freely lends a common coat. It has a spermatic substance as all other membranes have, the quantity of it in thickness is very small, (for it is almost as thin as a spiders web) yet differing in diverse places in men and women; for men have it more thick and strong above the navel, that so it may contain the extension of the stomach, often stretched beyond measure with meat and drink. On the contrary women have it so think and strong below their navel that it seems double, that so they may more easily endure the distention of their womb caused by the child contained in it. But above the navel men and women have the peritoneum of an equal strength, for the self same reason. The longitude and latitude of it is known by the circumscription of the belly.
The figure is round and somewhat long, it puts forth some productions, like finger stalls, both for the leading and strengthening the spermatic vessels and the cremaster muscles of the testicles, and besides it the ejaculatory vessels, as also to impart a coat to the testicles and all the natural parts.
It is composed of slender, membranous, and nervous fibers, certain small branches of veins and arteries concurring with them, which it receives for life and nourishment from the adherent parts.
This membrane is one in number, and besides everywhere one and equal, although Galen would have it perforated in that place where the spermatic vessels descend to the testicles; but in truth we must not think that a hole, but rather a production as we said before.
The latter anatomists have observed, the coat peritoneum is doubled below the navel, and that by the spaces of these reduplications the umbilical arteries ascend to the navel.
It is situated near the natural parts and compasses them about, and joined by the coat, which it gives them, as also on the sides, it is joined to the vertebrae of the loins, from whose ligaments, (or rather periosteum) it takes the origin: on the lower part it cleaves to the share bone, and on the upper to the midriff whose lower part it wholly invests; on the fore or outer part it sticks so close to the transverse muscles, that it cannot be plucked from them but by force, by reason of the complication and adhesion of the fibers thereof with the fibers of the proper membrane of these muscles, which membrane in Galen’s opinion proceeds from this peritoneum, that so it is no marvel that we may more easily break than separate these two coats. It is of temperature cold and dry, as all other membranes are.
It has many uses, the first is to invest and cover all the parts of the lower belly, especially the caul, least it should be squeezed by great compressors and violent attempts into the empty spaces of the muscles, as it sometimes happens in the wounds of the epigastrium, unless the lips of the ulcer are very well united, for then appears a tumor about the wound by the guts and caul thrusting without the peritoneum into those spaces of the muscles, from whence proceeds cruel pain.
Another use is to further the casting forth of the excrements by pressing the ventricle and guts on the foreside, as the midriff does above, as one should do it by both their hands joined together.
The third use is it inhibits the repletion of the parts with flatulency after the expulsion of the excrements, by straightening and pressing them down.
The fourth and last is that it contains all the parts in their seat and binds them to the backbone, principally that they should not fly out of their places by violent motions, as leaping and falling from on high.
Lastly, we must know, that the rim is of that nature that it will easily dilate itself, as we see in dropsy, in women with child, and in tumors against nature.
After the containing parts, follow the contained, the first of which is the epiploon (or caul) so called, because it as it were swims upon all the guts. The substance of it is fatty and spermatic, the quantity of it for thickness is diverse in diverse men according to their temperament. The latitude of it is described by the quantity of the guts. It is in figure like a purse, because it is double. It is composed of veins, arteries, fat and a membrane, which sliding down from the gibbous part of the ventricle, and the flat part of the gut duodenum and spleen over the guts, is turned back from the lower belly to the top of the colon. It is one as we said covering the guts. It has its chief connection with the first vertebrae of the loins, from which place in beasts it seems to take a coat, as in men from the hollow part of the spleen and gibbous of the ventricle and depressed part of the duodenum, from whence doubled it is terminated in the fore and higher part of the colic gut. Which moved Galen to write that the upper part of the membrane of the caul was annexed to the ventricle, but the lower, to the laxer part of the colic gut. From the vessels of which parts it borrows his, as also the nerves, if it have any. The temper of it in lean bodies is cold and dry, because their caul is without fat; but in fat bodies it is cold and moist by reason of the fat. The use of it is two-fold: the first is to heat and moisten the guts, and help with concoction, although it do it by accident, as that which through the density of the fat hinders the cold air from piercing in, and also forbids the dissipation of the internal heat. Another use is, that in want of nourishment in times of great famine, for sometimes it cherishes, and as it were by its dew preserves the innate heat both of the ventricle and the neighboring parts, as it is written by Galen. Moreover we must observe, that in a rupture or relaxation of the peritoneum the caul falls down into the scrotum, from whence comes that rupture we call, epiplocele. But in women that are somewhat more fat it thrusts itself between the bladder and the neck of the womb, and by its compression hinders, that the seed comes not with full force into the womb, and so frustrates the conception. Besides, when by a wound or some other chance, any part of it is defective, then that part of the belly which answers to it will afterwards remain cold and raw.
The second figure: of the lower belly.
AABB. The inner face of the peritoneum cut into four parts, and so turned backward
From D to the upper B: The umbilical vein
The breast-blade
KKKK. The caul covering the guts
QQQ2. Certain branches of the vessels distributed to the upper membrane of the omentum and compassed with fat.
Now we must speak of the stomach, the receptacle of the food necessary for the whole body, the seat of appetite, by reason of the nerves dispersed into its upper orifice, and so into its whole substance. The substance thereof is rather spermatic than sanguine, because that for one fleshy membrane, it has two nervous. The quantity or magnitude of the ventricle is diverse according to the various magnitude of bodies, and gluttony of men. The figure of it is round and somewhat long, like a bagpipe. The stomach is composed of two proper coats, and one common from the peritoneum, together with veins, sinews, and arteries; the innermost of its proper coats is membranous woven with right fibers, for the attraction of meats, it is extended and propagated even to the mouth thereof, whereby it comes to pass that the affections of one part may easily be communicated to the other by sympathy, or consent. This coat has its origin from the membranes of the brain which accompany the nerves descending from the third and fourth conjugation to the mouth thereof. And in like sort from other productions descending by the passages of the head, from whence also another reason may be drawn from that, which they commonly bring from the nerves of the sixth conjugation; why in wounds of the head, the stomach does so soon suffer by consent with the brain. The exterior, or outer is more fleshy and thick, woven with oblique fibers, to retain and expel. It draws its origin from the pericranium, which as soon as it comes to the gullet, takes unto it certain fleshy fibers. There be nerves sent into the stomach from the sixth conjugation of the brain, as it shall be shown in its proper place. Veins and arteries are spread into it from the gastrica, the gastrepiploids, the coronaria and splenic, from the second, third and fourth distribution of the vena porta, or gate-vein, and the third of the descendent artery to the natural parts, as soon as it passes forth of the midriff.
It is one in number. The greater part of it is situated on the left side between the spleen, the hollowness of the liver, and the guts, that assisted by the heat of such neighboring parts, it may more cheerfully perform the concoction of the meat. Neither am I ignorant that Galen wrote that a great part of the stomach lies on the left side. But inspection itself, and reason makes me derogate from Galen’s authority, for because there is more empty space on the left side, by reason the spleen is less than the liver, it was fit it should lie more on the left side. The more proper connection of it is with the gullet and guts, by its two orifices; with the brain by its nerves, with the liver and spleen by its veins; with the heart by its arteries; and with all the natural parts by its common membrane.
The temper of the ventricle in men of good habit, is temperate, because it is almost composed of the equal commixture of sanguine and spermatic parts; or according to Galen’s opinion, it is cold of itself, and by the parts composing it; and hot by the vicinity of the bowels. But in some it is hotter, in others colder, according to the diverse temper and complexion of diverse bodies. That stomach is to be thought well tempered, that powerfully draws down the meat and drink, and embraces and retains them so drawn, until by concoction and elixation, they shall be turned into a juice like cream (which the Greeks call Chylos) and lastly, which does strongly send from it, and repel the excrements of this first concoction.
The stomach is known to be hotter by this, that it better concocts and digests course and hard meats, as beef, hard eggs, and the like, than soft meats easy of digestion, which it corrupts and turns into belchings. For so a young chicken, is sooner burnt than well roasted at a great fire. The stomach which is colder, desires much meat, but is slow in concocting them, especially if they are cold and hard of digestion, which for that case quickly turn sour. The action of a well conditioned stomach, is twofold, one common, another proper. The common is to attenuate mix and digest the meats taken in at the mouth, for the nutrition of itself and the whole body, after the liver performed its duty, which before it’s done, the ventricle only enjoys the sweet pleasure of the chyle and comforts itself against the heat and impurity of the adjacent parts, wherefore it’s called the work-horse of concoction. Its first action is to attract, retain, and assimilate to itself that which is convenient; but to expel whatsoever shall be contrary, either in quantity, or quality, or in the whole substance.
It has two orifices, one above, which they commonly call the stomach and heart, the other lower, which is called the pylorus, or lower mouth of the stomach. The upper bends to the left side near the back bone; it is far larger and more capacious than the lower, that so it may more commodiously receive meats half chewed, hard and gross, which gluttons cast down with great greediness; it has an exquisite sense of feeling, because it is the seat of the appetite, by reason of the nerves encompassing this orifice, with their mutual embracing, whereby it happens that the ventricle in that part is endued with a quick sense, that perceiving the want and emptiness of meat, it may stir up the creature to seek food. For albeit nature bestowed four faculties on other parts, yet they are not sensible of their wants, but are only nourished by the continual sucking of the veins, as plants by juice drawn from the earth.
This orifice is seated at the fifth vertebra of the chest, upon which they say it almost rests. Yet I had rather say that it lies upon the twelfth vertebra of the chest, and the first of the loins, for in this place the gullet perforates the midriff, and makes this upper orifice. The lower orifice bends rather to the right side of the body, under the cavity of the liver. It is far straighter than the upper, lest anything should pass away before it is well attenuated and concocted; and it does that by the help or assistance of, as it were a certain ring, like the sphincter muscle of the anus which some have thought a glandule made by the transposition of the inner and fleshy membrane of the ventricle into that which is the outer of the guts. I know Columbus laughs at this glandulous ring, but anyone that looks more attentively shall perceive that the pylorus is glandulous. The stomach in its lower and inner side has many folds and wrinkles which serve to hold and contain the meats until they are perfectly concocted. In the ventricle we observe parts gibbous and hollow. The hollow is next to the liver and midriff. The gibbous is towards the guts. Now we must note that the ventricle when it is much resolved or loosed, may slide down even to the navel near the bladder, the which we have observed in some bodies dissected after their death.
Third and Fourth figures:
The first figure shows the foreside of the stomach and gullet:
The guts, the instruments of distribution and expulsion, are of the same substance and composure with the stomach, but that the site of the coats of the stomach is contrary to those of the guts. For that which is the innermost coat of the stomach is the outermost of the guts, and so on the contrary. The figure of the guts is round, hollow and capacious, some more, some less, according to the diverse sizes.
But for the quantity of the guts, some are small, some great, more or less, according to the variety of bodies. But they are six in number, for there are three small:
Three great:
All which have had their names for the following reasons:
The first, because it is extended the length of 12 fingers, like another stomach, without any turning or winding; of which greatness it is found in great bodied men, such as were more frequently to be met withall in Galen’s time than in our time, in which this gut is found no longer than seven, eight or nine fingers at the most. The cause of this length is, that there may be a free passage to the gate vein, coming out of the liver, as also to the artery and nerve which run into it. For seeing that this gut may sometimes rise to the top of the liver, it would possess the space under the bladder of the gall (with which it is often tinctured) if it had any revolutions that way, which is the passage for such like vessels. Others give another reason of this figure, which is, that there should be nothing to hinder the easy and fit distribution of the perfectly concocted chyle to the liver.
The second is called Jejunum, or the empty gut, not because it is absolutely so, but because it contains little in comparison of the other. There is a triple cause of this emptiness, the first the multitude of the meseraic veins and arteries which are about it, whereupon there is a greater and quicker distribution of the chyle. The second is the vicinity or neighborhood of the liver strongly drawing the chyle contained in it; the third is the flowing down of the choleric humor from the bladder of the gall into it, whichever and anon by its acrimony cleanses away the filth, and by continual flowing facilitates it to expulsion. The third is called ilion because it lies between the ilia or flanks, it differs nothing from the rest in substance and magnitude, but in this one thing, that there is more matter contained in it than in the rest, by reason of the paucity of the vessels terminated in it, that it is no marvel that there can be no exact demonstration made of them. The fourth is called cacum, or the blind, because it has but one passage to send out and receive in the matter. This gut has a long and straight production, which according to the opinion of some (though altogether erroneous) often falls down into the scrotum in the rupture, or relaxation of the rim of the belly; for that production in the lower belly strongly sticks to the peritoneum or rim, which hinders such falling down. But Galen seems by such a blind gut to have meant this long and narrow production, and certainly so thinks the common sort of anatomists, but here Vesalius justly reprehended Galen. Wherefore Sylvius that he might free Galen of this fault, would have us by the blind gut to understand the beginning of the colic gut. The fifth is called colon (or colic gut) because it is greater and more capacious than the rest. The sixth and last, the right gut, by reason of the rightness or straightness of the passage. This in beasts especially, has a certain fatness in it to make the passage slippery, and lest the gut should be exulcerated in the passage, by the sharpness of hard and acrid excrements.
The site of these guts is thus, the duodenum upon the backbone bends to the right hand; the jejunum possesses a great part of the upper umbilical region, diffuses itself into both sides with windings, like to these of the gut ileum, even to the flanks. The gut ilium is situated at the lower part of the umbilical region, going with many turnings and windings, even to the hollowness of the holy-bone above the bladder and side parts of the hypogastrium which they call the flanks.
The blind bends to the right hand, a little below the kidney, above the first and fourth vertebra of the loins. The colon or colic gut is crooked and bent in the form of a scythian bow, filling all the space from the blind gut, below the right kidney, even to the hollowness of the liver, and then it goes by the gibbous part of the stomach above the small guts, even to the hollowness of the spleen, from whence sliding under the left kidney, with some turnings, it is terminated upon the vertebrae of the loins.
By all which turnings and windings of the colic gut, it is easy to distinguish the pain of the stone of the kidneys, which remains fixed in one certain place, from the colic wandering through these crooked passages we mentioned. The right gut tends with an oblique site towards the left hand, upon the holy bone even to the very anus. They have all one and a common connection: for they are all mutually joined together by their coats, because there is but one way from the gullet even to the anus, but they are joined to the principal parts by their nerves, veins, and arteries.
But a more proper connection is that, where the duodenum on the upper part of it, is joined with the pylorus, but on the lower part, to the jejunum, and the parts lying under it, by the coat of the peritoneum. The jejunum, or empty gut, is joined to the duodenum and ileum. The ileum with the empty and blind guts. The blind with the ilium and colon, and with the right side of the backbone where it is tied more straightly. The colon with the blind and right guts, and in his middle part, with the kidneys and the gibbous part of the stomach; whereby it comes to pass, that being distended with wind in the colic, it overturns and presses the stomach, and so causes vomiting.
Lastly, the right gut is annexed with the colic gut and anus. At the end whereof there is a muscle fastened, of figure round and circular called the sphincter arising from the lower vertebras of the holy bone and rump, by the benefit of which as of a door or gate, the excrements are restrained at our will, lest man born for all honest actions, without all shame, in every time and place, should be forced every where to ease his belly. For such as have lost the benefit of this muscle by the palsy, have their excrements go from them against their wills. There is a body situated at the end of the right gut, of a middle substance between the skin and flesh, as it were arising from the mixture of them both, like the extremities of the lips, of the same use with the sphincter, but that it is not altogether so powerful. But there are also certain veins situated about it called the haemorrhoidal, of which we will speak in their place.
Besides, there are two other muscles that descend to the end of this gut, being broad and membranous on each side, one arising from the side and inner parts of the share and hip bones, which inserted above the sphincter pull up the anus falling down, wherefor they are called levatores ant, or the lifters up of the anus. Wherefore when as either they are too weak, or resolved, or the anus oppressed with the weight of the stomach, salt, coleric, and sharp humors the gut is scarce restored into its place, that there is need of the help of the fingers for that purpose.
The guts follow the temper of the stomach. Their action is the distribution of the chyle by the mesenteric veins (which of duty belongs to the three small guts) and the receiving the excrements of the chyle, and retention of them, til a fit time of expulsion, which belongs to the third quarter. Besides, these small guts finish up the work of concoction, begun in the stomach, although they be not altogether made for that use. But nature is often accustomed to abuse the parts of the body for some better use.
After the guts follows the mesentery, being partly of a fatty and partly of a spermatic substance. The greatness of it is apparent enough, although in some it be bigger, and in some lesser according to the greatness of the body. It is of a round figure and not very thick. It is composed of a double coat arising from the beginning and root of the peritoneum. In the midst thereof it admits nerves from the costal of the fixed conjugation, veins from the vena porta or gate vein; arteries from the descendant artery, over and besides a great quantity of fat and many glandulous bodies, to prop up the division of the vessels spread over it, as also to moisten their substance. It is in number one, situated in the middle of the guts, from whence it took its name. Yet some divide it into two part, to wit, into the meseraeum, that is, the portion interwoven with the small guts, and into the mesocolon, which is joined with the great. It has connection by its vessels with the principal parts, by its whole substance with the guts, and in some sort with the kidneys, from whose region it seems to take its coats.
It is of a cold and moist temper, if you have respect to his fatty substance, but if to the rest of the parts, cold and dry.
The action and use of it is, to bind and hold together the guts, each in his place, least they should rashly be folded together; and by the meseraic veins (which they term the hands of the liver) carry the chyle to the liver.
In which you must note, that all the meseraic veins come from the liver, as we understand by the dissection of bodies, although some have affirmed, that there are some veins serving for the nourishment of the guts, no ways appertaining to the liver, but which end in certain glandulous bodies, dispersed through the mesentery, of whose use we will treat hereafter.
A glandule is a simple part of the body, sometimes of a spongy and soft substance, sometimes of a dense and hard. Of the soft glandules are the tonsils, or almonds, like in substance to blanched almonds. The thymus, pancreas, testicles, prostate. But the dense and hard are the parotids and other like. The glandules differ amongst themselves in quantity and figure, for some are greater than others, and some are round and others plain, as the thymus and pancreas.
Others are compounded of veins, nerves, arteries, and their proper flesh, as the almonds of the ears, the milky glandules in the breasts and the testicles. Others want nerves, at least which may be seen, as the parotids, the axillary, or those under the armholes and others. The number of glandules is uncertain, by reason of the infinite multitude and variety of sporting nature. You shall find them always in these places, where the great divisions of vessels are made; as in the middle ventricle of the brain, in the upper part of the chest, in the mesentery and other like places.
Although others are seated in such places, as nature thinks needful to generate and cast forth of them a profitable humor to this creature; as the almonds at the roots of the tongue, the kernels in the dugs, the spermatic vessels in the scrotum and at the sides of the womb; or where nature has decreed to make emunctories for the principal parts, as behind the ears, under the armholes, and in the groins. The connection of glandules is not only with the vessels of the parts concurring to their composition, but also with those, whose division they keep and preserve. They are of a cold temper, wherefore physicians say the blood recrudescere, (i) to become raw again in the dugs, when it takes upon it in the form of milk. But of these some have action, as the almonds, which pour our spattle useful for the whole mouth, the dugs milk, the testicles seed, others, use only as those which are made to preserve, underprop and fill up the divisions of the vessels. Besides this we have spoken of glandules in general, we must know that the pancreas is a glandulous and fleshy body, as that which has everywhere the shape and resemblance of flesh. It is situated at the flat end of the liver, under the duodenum with which it has great connection, and under the gate-vein, to serve as a bulwark, both to it and the divisions thereof, whilst it fills up the empty spaces, between the vessels themselves, and so hinders, that they be not plucked asunder, nor hurt by any violent motion, as a fall or the like.
Having progressed thus far, the next step in our dissection requires us to address the distribution of the portal vein. However, to fully comprehend this topic, one must first understand the fundamental nature of the liver from which the portal vein arises. Therefore, we will defer this discussion to a more appropriate point and turn our attention to the liver itself.
According to Galen’s perspective in “De Form. Fetus,” the liver is the first organ in the body to achieve full conformation. It serves as both the site and source of blood production as well as the origin of the veins. The liver’s substance resembles the viscous residue of coagulated blood, and its size varies not only among different species but also among individuals of the same species. For instance, among humans, some may be gluttonous and fearful while others exhibit boldness and temperance; those with a larger liver have a greater capacity to receive and process an increased volume of chyme.
Nonetheless, the liver is significant in all humans as it must supply a substantial quantity of blood to replenish the many spirits and essential moisture that are continuously depleted by both action and contemplation.
There may be two primary reasons why individuals who are fearful tend to possess larger livers. The first reason lies in the weakness of the vital faculty—associated with the courage and anger found in the heart—in such individuals. This deficiency necessitates compensation through the strength of the natural faculty. Nature, it seems, has a way of balancing deficits in one area by enhancing another.
The second reason is that individuals characterized by coldness often experience an increased appetite. According to Galen in “De Arte Parva,” coldness can amplify appetite, leading to a greater intake of chyle. This abundance in chyle allows for nourishing the liver, causing it to grow larger.
In some animals, such as dogs and pigs, the liver is divided into five or more lobes. In contrast, humans typically possess only one to three lobes, which are not as distinctly separated. These lobes serve to support the upper and hollow area of the stomach, facilitating the process of digestion. Thus, the liver is nearly satisfied with just one lobe, although it often features a minor division that allows the umbilical vein to penetrate its roots and substance freely. Additionally, there is sometimes a small lobe beneath the umbilical vein, functioning almost like a cushion.
The liver has a gibbous shape, rising smoothly towards the diaphragm, while its side facing the stomach is concave and somewhat irregular, roughened by the presence of lobes, the origin of the hollow vein, and the location of the gallbladder.
The liver is composed of veins, nerves, arteries, and a fibrous outer layer encompassing the parenchyma, which is the dense, solid component often referred to as the gross and concrete blood. Veins and arteries reach the liver from the navel, while the nerves connect directly to these vessels, spreading across the surface of the stomach, as noted by Hippocrates. However, these nerves do not penetrate deeply into the liver’s structure, as the organ apparently does not require such precise sensory functions. Instead, the nerves are primarily distributed over the outer layer, as this organ is meant to distribute nutrients throughout the body and does not harbor any corrosive or harmful fluids that would necessitate deeper sensation. Nonetheless, the outer layer does send numerous nerve fibers into the liver itself, a fact that becomes evident when the coating is removed from a boiled liver. This characterization likely holds true for other internal organs as well.
The liver is encased in a coat formed from the peritoneum, which narrows as it extends from the umbilical vein, dividing to create the portal and hepatic veins, as noted by Galen in his work *De Format: Fetus*. The liver is a single organ, predominantly located on the right side of the body, with a smaller portion extending to the left, in contrast to the position of the stomach. Its primary connections are with the stomach and intestines via the veins and membranes of the peritoneum; with the heart through the hepatic portal vein and hepatic artery; with the brain via nerves; and through the same vessels with all other body parts.
The liver has a hot and moist disposition; individuals with a hotter liver tend to have larger veins and warmer blood, while those with a cooler liver exhibit smaller veins and a pale color. The liver’s main function is to convert chyle into blood, a process known as the second concoction. Although chyle entering the mesenteric veins takes on some characteristics of blood, it does not attain the complete form and quality of blood until it undergoes thorough processing in the liver.
The liver is anchored by three robust ligaments: two located laterally in the midsection of the false ribs to support its sides, and a third, stronger ligament that descends from the breastbone to uphold its structure. This prevention of pressure on the lower opening of the stomach serves to avoid any downward displacement of the sternum and collarbone.
In addition to these three ligaments, previously mentioned were its common attachments, including veins, arteries, nerves, and the peritoneal coat, linking it to the loins and other organs. It is important to note, as Sylvius has pointed out in his anatomical studies and Hollerius in his practical observations on pleuritis, that the liver is also associated with other ligaments that connect to the false ribs.
Now, let us turn our attention to the gallbladder, which is composed of nervous tissue and resembles the size of a small pear. It has a round shape with a wider base, while its sides and opening are narrower and more elongated. The gallbladder consists of a double-layered coat: an inner, proper coat made of three types of fibers, and an outer layer derived from the peritoneum. It receives a vein from the portal vein, an artery that branches off into the liver, and a nerve from the sixth cranial nerve.
The gallbladder is singularly located on the right side, nestled beneath the larger lobe of the liver. It is connected to the liver by direct contact and through the ducts and channels that facilitate its functions, as well as with the duodenum and, at times, the stomach through an additional passage. Ultimately, it interacts with all body parts via its veins, arteries, nerves, and common coat. The gallbladder possesses a cold temperament, characteristic of nervous structures.
Its primary function is to separate the choleric humor and excrementitious substances from the liver, aided by the specialized fibers that purify the blood. The oblique fibers help retain the bile until it reaches a troublesome quantity or quality, at which point the transverse fibers propel it into the duodenum to stimulate bowel movement. Although Fallopius disputes the existence of so many fibers assisting in the action of the gallbladder, Vesalius offers a compelling counterargument.
The gallbladder features various channels; its narrow neck leads to the initial section of the bile duct, which then splits into two pathways. One of these pathways does not divide further and directs bile into the duodenum, although it may alternatively send a branch to the base of the stomach, as noted by Galen. Individuals with this particular arrangement may suffer from miserable, choleric vomiting, especially on empty stomachs, accompanied by severe stomach and head pain, as Galen describes. The other channel emerges from the liver, dividing into two or three pathways that again infiltrate the liver’s substance, branching out extensively alongside the branches of the portal vein. Thus, only the most refined and pure blood is allowed to ascend into the vena cava. Dissection clearly demonstrates these anatomical details.
The sixth figure: of the bladder of the gall.
g. The cystic twins from the gate vein.
However, in order to adequately explain the distribution of the portal vein, it is necessary to first remove the spleen from its anatomical position. Thus, before we proceed further, I believe it is important to discuss the spleen.
The spleen is composed of a soft, rare, and spongy substance, allowing it to effectively absorb the remnants of blood from the liver. Its flesh has a darker hue than that of the liver, reflecting the color of the impure blood from which it is formed. While the spleen varies in size, it is generally of moderate dimensions, with some individuals exhibiting a larger spleen than others, depending on their unique temperaments and constitutions.
The spleen has an almost triangular shape, with a protruding section that adheres to the ribs and diaphragm, while the area adjacent to the stomach is more hollow. It consists of several components, including a membrane derived from the peritoneum, its own fleshy tissue formed from the residual blood products, and the natural humors associated with melancholy. The spleen receives blood supply from the fourth branch of the portal vein, and its arterial supply comes from the first branch of the descending artery shortly after it passes through the diaphragm.
It also receives a nerve supply from the left costal nerve, derived from the sixth cranial nerve, which traverses the inner surface near the upper ribs. This nerve can be observed branching out through the splenic coat and penetrating its fleshy tissue, much like we see in the heart and lungs.
The spleen is singular in number and located on the left side of the abdomen, nestled between the stomach and the lower ribs, or more accurately, the diaphragm that descends to their roots. Often, it is closely associated with the diaphragm on its gibbous side, connected by a peritoneal coating, while on the hollow side it is linked to the stomach through certain veins that extend into the stomach and by the greater omentum. The spleen maintains connections, either directly or indirectly, with virtually all other parts of the body through its vascular system.
It is of a cold and dry temper; the action and use of it is to separate the melancholic humor, which being succulent and drossy, may be attenuated by the force of many arteries dispersed through its substance. For by their continual motion, and native heat, which they carry in full force with them from the heart, that gross blood puts off its grossness, which the spleen sends away by passages fit for that purpose, retaining the subtler portion for its nourishment. The passages by which it purges itself from the grossness of the melancholy blood, are a vein ascending from it into the stomach to stir up the appetite by its sourness, and strengthen the substance thereof by its astriction; and also another vein, which sometimes from the spleen branch, sometimes from the gate vein, plainly under its orifice, descends to the fundament, there to make the hemorrhoidal veins.
The gate-vein, as also, all the other veins, is of a spermatic substance, of a manifest largeness, of a round and hollow figure, like to a pipe or quill. It is composed of its proper coat, and one common from the peritoneum. It is only one, and that situate in the simous or hollow part of the liver, from whence it breaks forth (or rather out of the umbilical vein) into the midst of all the guts, with which it has connection, as also with the stomach, spleen, sphincter of the fundament and peritoneum, by the coat which it receives from thence. It is of a cold and dry temper. The action of it is, to suck the chyle out of the ventricle and guts, and so to take and carry it to the liver, until it may carry back the same turned into blood for the nutriment of the stomach, spleen and guts. This gate vein coming out of the simous part of the liver, is divided into six branches, that is four simple and two compound, again divided into many other branches. The first of the simple ascends from the fore part of the trunk to the bladder of the gall by the passage of the choler (and are marked with g.g.) with a like artery for life and nourishment, and this distribution is known by the name of the cystica gemella or cystic twins. The second is called the gastrica or stomach vein arising in like manner from the fore part of the trunk, is carried to the pylorus and the simous or back part of the stomach next to it.
The third is called gastroepiploic, the stomach and caul vein, which coming from the right side of the gate vein goes to the gibbous part of the stomach next to the pylorus and the right side of the caul.
The fourth going forth from behind and on the right hand of the gate vein, ascends above the root of the mesenteric branch, even to the beginning of the gut jejunum, along the gut duodenum, from whence it is called intestinalis, or the gut-vein. And these are the four simple branches. Now we will speak of the compound.
The first is the splenic, which is divided after the following manner. For in its first beginning and upper part, it sends forth the coronalis, or crown vein of the stomach, which by the back part of the stomach ascends into the upper and hollow part thereof; to which place, as soon as it arrives, it is divided again into two branches, the one whereof climbs up even to its higher orifice, the other descends down to the lower, sending forth by the way other branches to the fore and back parts of the stomach. These engirt and on every side encompass the body of the ventricle, for which cause they are named the crown veins.
I have sometimes observed this coming forth of the trunk, a little above the orifice of the splenic branch. But this same splenic branch on its lower part, produces the branch of the hemorrhoidal veins, which descending to the fundament above the left side of the loins, diffuses a good portion thereof into the least part of the colic gut, and the right gut, at the end whereof it is often seen to be divided into five hemorrhoidal veins, sometimes more, sometimes less.
Sylvius writes that the hemorrhoidal branch descends from the mesenteric, and truly we have sometimes observed it to have been so. Yet it is more futable to reason, that it should descend from the splenic, not only for that we have seen with our eyes that it is so, but also because it is appointed by nature for the evacuation of the excrementitious melancholic humor. But this same splenic branch out of the middle almost of its upper part produces the third branch going to the gibbous part of the stomach, and the caul; they term it the greater, middle and left gastroepiploic. But on the lower part towards the spleen it produces the simple epiploic, or caul-vein, which it diffuses through the left side of the caul. Moreover from its upper part, which touches the liver, it sends forth a short branch called vas breve, or venosum, to the upper orifice of the ventricle for the stirring up the appetite.
We have oftentimes and almost always observed, that this veiny vessel, which Galen calls vas breve, comes from the very body of the spleen, and is terminated in the midst of the stomach on the left side, but never pierces both the coats thereof. Wherefore it is somewhat difficult to find, how the melancholy juice can that way be poured, or sent into the capacity of the stomach. Now the splenic branch, when it has produced out of it those five forementioned branches, is wasted and dispersed into the substance and body of the spleen.
Then follows another compound branch of the vena porta, called the mesenteric, which is divided into three parts; the first and least whereof goes to the blind gut, and to the right and middle part of the colic gut, divided into an infinite multitude of other branches. The second and middle is wasted in the ilium; as the third and greater in the jejunum or empty gut. It is called mesenteric because it is diffused over all the mesentery, as the splenic is in the spleen. And thus much we have to say of the division of the gate vein, the which if at any time thou shalt find to be otherwise, than I have set down, you must not wonder at it, for you shall scarce find it the same in two bodies, by reason of the infinite variety of particular bodies, which (as the philosophers say) have each their own, or peculiar gifts. Our judgment is the same of other divisions of the vessels. Yet we have set down that which we have most frequently observed.
Those things being thus finished and considered, the guts should be pulled away, but seeing that if we should do so, we should disturb and loose the division of the artery descending to the natural parts; therefore I have thought it better to handle the division thereof, before the guts be plucked away. Therefore we must suppose, according to Galen’s opinion, that as all the veins come from the liver, so all arteries proceed from the heart. This presently at the beginning is divided into two branches, the greater thereof descends downwards to the natural parts upon the spine of the back, taking its beginning at the fifth vertebra thereof, from whence it goes into the following arteries. The first called the intercostal, runs amongst the intercostal muscles, and the distances of the ribs, and spinal marrow, through the perforations of the nerves on the right and left hand from the fifth true, even to the last of the bastard ribs.
This in going this progress makes 7 little branchings, distributed after the forementioned manner, and going forth of the trunk of the descendant over against each of the intercostal muscles.
The second being parted into two goes on each side to the midriff, whence it may be called, or expressed by the name of the Diaphragmatica or Phrenica (i) the midriff artery. The third being of a large proportion, arising from the upper part of the artery presently after it has passed the midriff, is divided into two notable branches, whereof on goes to the stomach, spleen, caul, to the hollow part of the liver and the gall; the other is sent forth to the mesentery and guts after the same manner, as we said of the mesenteric veins, wherefore it is called the celiaca, or stomach artery. But we must note, all their mouths penetrate even to the innermost coat of the guts, that by that means they may the better and more easily attract the chyle contained in them.
The fourth is carried to the kidneys, where it is named the reinall or emulgent, because it sucks fit matter from the whole mass of blood.
The fifth is sent to the testicles with the preparing spermatic veins, whence also it is named the spermatic artery, which arises on the right side, from the very trunk of the descendent artery; that it may associate the spermatic vein of the same side, they run one above another, beneath the hollow vein, wherefore we must have a great care whilst we labor to lay it open, that we do not hurt and break it.
The seventh figure: of the lower belly.
A.A. the midriff turned back with the ribs and the peritoneum
a.b. The emulgent veins with the arteries under them
the connection of the bladder with the peritoneum.
The sixth going from the front and upper part of this descendant artery, descends with the hemorrhoidal veins to the fundament, presently from his beginning, sending forth certain branches alongst the colic gut, which by anastomosis are united with other branches of the celiac arteries; for whosoever shall look more attentively, he shall often observe that veins are so united amongst themselves, and also arteries, and sometimes also the veins with the arteries. For an anastomosis is a communion and communicating of the vessels amongst themselves, by the application of their mouths, that so by mutual supplies they may ease each other’s defects. But they call this the lower mesenteric artery.
The seventh proceeding from the trunk with so many branches as there be vertebra in the loins, goes to the loins and the parts belonging to them, that is, the spinal marrow of that part, and other parts encompassing these vertebrae, whereupon it is styled the lumbaris or loin artery.
The eighth makes the iliac arteries, until such time as it departs from the peritoneum where the crural arteries take their origin. This iliac artery sends many divarications towards the holy bone, which because they run the same course as the iliac veins, for brevity’s sake, we will let pass further mention of them, til we come to treat of the iliac veins.
It remains, that before the bowels be taken away, we show the nerves sent to the entrails and natural parts, that as wife and provident men we may seem to have omitted nothing. First we must know that these nerves are of the sixth conjugation, which descend as well to the stomach all along the gullet and the sides thereof, as those at the roots of the ribs on both sides within. But when they are passed through the midriff, those which are distributed amongst the natural parts follow the turnings of the veins and arteries, but especially of the arteries. Wherefore if you have a mind to follow this distribution of the nerves, you must chiefly look for it in those places, in which the artery is distributed amongst the guts above the loins.
These nerves are but small, because the parts serving for nutrition, needed none but little nerves, for the performance of the third duty of the nerves, which is in the discerning and knowing of what is troublesome to them. For unless they had this sense, there is nothing would hinder, but these bowels necessary for life, being possessed with some hurtful thing, the creature should presently fall down dead; but we have this benefit by this sense, that as soon as anything troubles and vellicates the bowels, we being admonished thereof may look for help in time.
And besides if they were destitute of this sense, they might be gnawed, ulcerated and putrified by the raging acrimony of the excrements falling into and staying in them, but now (by means thereof) as soon as they find themselves pricked, or plucked, presently by the expulsive faculty they endeavor to expel that which is troublesome, and so free themselves of present and future dangers.
When removing the intestines, you should start with the right colon. First, tie the gut securely in two separate locations, approximately four fingers’ breadth from the end, and then cut between the two ligatures with a sharp knife. Once this is accomplished, you should expose the intestinal coats and fibers, as well as the common layer derived from the peritoneum.
Next, carefully ligate the trunk of the portal vein as close to its origin as possible, ensuring that all its branches are similarly tied to prevent any risk of blood effusion. You should also perform the same procedure with the celiac artery near the left kidney, and with the inferior mesenteric artery that supplies the right colon along with the hemorrhoidal veins.
After securing these vessels, you can gently pull the intestines free up to the duodenum. The duodenum should also be tied off in two locations, below the entry point of the common bile duct. It is important to take note of the oblique angle at which the bile duct inserts into the duodenum, as this anatomical feature prevents bile from flowing back into the gallbladder due to the compression exerted by the intestine from below. Once these steps are completed, the entire arrangement of intestines can be removed from the body.
Because the rest of the natural parts do almost all depend upon the descendent hollow vein, therefore before we go any further, we will show its origin and distribution. We said before that all veins proceeded from the liver, but yet in diverse places. For the gate vein goes out of the hollow part, and the hollow vein out of the gibbous part of the liver, which going forth like the body of a tree, is divided into two great branches, the lesser of which goes to the vital and animal parts, and the extremities of these parts, as we shall show in their place. The greater descending from the back part of the liver above the vertebrae of the loins to the parts beneath, goes in the manner following. The first division thereof is to the membranes of the kidneys, which come from the peritoneum. Wherefore there it produces the vena adiposa, or fatty veins, so called because they bring forth a great quantity of fat in those places; of these fatty veins, there is a diverse origin, for the right do often times arise from the right emulgent because it is higher; but the less comes from the very trunk of the hollow vein, because the emulgent on that side is lower, and you shall scarce see it happen otherwise.
The second being the kidney or emulgent veins, go to the kidneys, which at their entrance, or a little before, is divided into two branches, like as the artery is, the one higher, the other lower, and these again into many other through the substance of the kidneys, as you may learn better by ocular inspection, than by book. They are thick and broad that the serous humor may without impediment have freer passage. Their origin is different, for the right emulgent, often times comes forth of the hollow vein somewhat higher than the left; that seeing their office and duty is to purge the mass of blood from the choleric and serous humor, that if any part thereof slide by the one, it may not so scape, but fall as it were into the other. Which certainly would not have happened if they had been placed the one just opposite the other. For the serous or wheyish humor would have stayed as equally balanced or poised, by reason of the contrariety of the action and traction, or drawing thereof. But we must remember that in dissecting of bodies, I have often times found in such as have been troubled with the stone, seven emulgent veins and so many arteries; four from the left side coming from diverse places, of which the last came from the iliac; three from the right hand likewise in diverse places.
The third division is called the spermatic or seed vein, it goes to the testicles; the origin thereof is thus, that the right arises on the front part of the trunk of the hollow vein, but the left most commonly from the emulgent. Besides you shall sometimes find that these have companions with them, to the right emulgent; but to the left another from the hollow vein, in some but on one side, in others on both. But also I have sometimes observed the left emulgent to proceed from the spermatic or seed vein.
The fourth because it goes to the loins, is called lumbaris; which in his origin and insertion is wholly like the artery of the loins. But there are four lumbars or loin veins on each side, that is, one in each of the four spaces of the five vertebrae of the loins.
The sixth division makes the iliac, until passing through the peritoneum, they take the name of crural veins; these are first divided into the musculous, so called, because they go to the oblique ascendant and transverse muscles and to the peritoneum. Sometimes they have their origin from the end of the trunk. And then the same iliac are divided into the sacra, or holy, which go to the spinal marrow of the holy bone, through those holy holes, by which the nerves generated of this marrow, have their passage.
Thirdly the iliaca are divided into the hypogastrica so called, because they are distributed to all the parts of the hypogastrium, or lower part of the lower belly, as to the right gut, the muscles thereof, the musculous skin, (in which place they often make the external hemorrhoidal, ordained for the purging of such blood as offends in quantity, as those other [that is, the inward hemorrhoidal] which descend to the right gut from the gate vein by the splenic branch, serves for cleansing of that which offends in quality) to the bladder and the neck thereof even to the end of the yard, to the womb, and even to the neck of the womb and utmost parts of the privities; from whence it is likely the courses break forth in women with child and virgins. But this same vein also sends a portion of it without the epigastrium by that perforation which is common to the share and haunch bones, which strengthened by meeting of the other internal crural veins descends even to the ham, but in the meantime by the way it is communicated to the muscles of the thigh called obturators and other parts within. Fourthly, the iliaca produce the epigastrica which on both sides from below ascend according to the length of the right muscles, spreading also by the way some branches to the oblique and transverse muscles and also to the peritoneum. Fifthly, these iliaca produce the pudenda or veins of the privities because they go in women in their privities, and into men to the cods, where they enter that fleshy coat filled with veins, and go to the skin of the yard, they take there beginning under the hypogastrica.
Now follow the kidneys, which that they may be more easily seen, (after that you have diligently obscured their situation) you shall dispoil of there fat, if they have any about them, as also of the membrane they have from the peritoneum. First you shall show all their conditions, beginning at their substance.
The substance of the kidneys is fleshy, dense and solid, least they should be hurt by the sharpness of the urine, their magnitude is large enough, as you may see. Their figure is somewhat long and round almost resembling a semicircle, and they are lightly flatted above and below. They are partly hollow and partly gibbous; the hollow lies next to the hollow vein, and on this side they receive the emulgent veins and arteries, and send forth the ureters, there gibbous part lies towards the loins. They are composed of a coat coming from the peritoneum, their own peculiar flesh, with the effusion of blood about the proper vessels (as happens also in other entrails) generates a small nerve, which springing from the costal of the sixth conjugation is diffused to each kidney on his side into the coat of the kidney itself, although others think it always accompanies the vein and artery.
But Fallopius, that most diligent author of anatomy has observed, that this nerve is not only often times divaricated into the coat of the kidneys, but also pierces into their substance. They are two in number that if the one of them should by chance be hurt, the other might supply those necessities of nature, for which the kidneys are made. They lie upon the loins at the sides of the great vessels, on which they depend by their proper veins and arteries, and they stick to them, as it were by a certain second coat, lest that they might be shaken by any violent motions. Wherefore we may say that the kidneys have two coats, one proper adhering to their substance, the other as it were coming from the peritoneum on that part they stick to it. The right kidney is almost always the higher, for those reasons I gave, speaking of the origin of the emulgent vessels. Columbus seems to think the contrary, but such like controversies may be quickly decided by the eye. They have connection with the principal vessels by the veins, nerves and arteries, by the coats with the loins and the other parts of the lower belly, but especially with the bladder by the ureters. They are of a hot and moist temper, as all fleshy parts are. Their action is to cleanse the mass of the blood from the greater part of the serous and choleric humor. I said the greater part, because it is needful that some portion thereof should go with the alimentary blood to the solid parts, to serve instead of a vehicle lest otherwise it should be too thick.
Besides you must note that in each kidney there is a cavity bounded by a certain membrane, encompassed by the division of the emulgent veins and arteries, through which the urine is strained partly by the expulsive faculty of the kidneys, partly by the attractive of the ureters, which run through the substance of the kidneys on the hollow side, no otherwise than the porus cholagogus through the body of the liver.
The ninth and tenth figures: of the vessels of the seed and urine.
The first figure shows the front side, the second the back side.
[image]
aaa.1. The front part of the right kidney
bbb.2. The back part of the left kidney
c.1. The outside
dd.1.2. The inner side
ee.1.2. The two cavities whereinto the emulgent vessels are inserted
ff.1.2. The trunk of the hollow vein
gg.1.2. The trunk of the great artery
hi.1.2. The emulgent vein and artery
kk.1.2. The right fatty vein
l.1. The left fatty vein
.1. The celiac artery
mn.1.2. The ureters
opq.1.2. The right spermatic vein which arises near p. The left near q
⟆.1.2. Small branches distributed from the spermatic veins to the peritoneum
t.1.2. The spiry varicose body, called varicosum vas pyramidale
u.1.2. The parasta, or epididymis
x.1. The testicle covered with its coat
y.1.2. The place where the leading vessel called vas deferens arises
a.1.2. The descent of the same leading vessel
ß.1.2. The revolution of the same leading vessel
y.1.2. The passage of the same vessel reflected like a recurrent nerve
δ.2. The meeting of the same leading vessels
έ.1.2. The bladder of urine, the first figure shows it open, the second shows the back parts
𐅠𐅠.1. The small bladder of the seed opened
ηη.2. The glandules called glandula prostata
θ.2. The sphincter muscle of the bladder
ll.1.2. The two bodies which make the substance of the yard
χχ.1. The vessels which go into the yard and neck of the bladder.
λ.1. The passage which is common to the urine and seed, cut open
𐅣.2. The implantation of the ureters into the bladder.
Now we should have spoken of the ureters, because as we said before, they are passages derived from the kidneys to carry the urine to the bladder. But because they cannot be distinguished and shown unless by the corrupting and vitiating the site of the spermatic vessels, therefore I have thought it better to pass to the explication of all the spermatic parts.
And first of all you must gently separate them, (that so the declaration of them may be more easy and manifest) and that from the coat which comes from the peritoneum, and the fat which invests them even to the share-bone, having diligently considered their site before you separate them. Then you shall teach that the substance of these vessels, is like to that of the veins and arteries. Their quantity is small in thickness, but of an indifferent length, by reason of the distance of their origin from the testicles. They are no longer in men than in women, because these have their testicles hanging without their belly, but women have them lying hid within their belly. Their figure and composure is wholly like the figure and composition of the veins and arteries, except in this one thing, that from that place where they go forth of great capacity of the peritoneum, they are turned into many intricate windings, like crooked swollen veins, even to the testicles. That the spermatic matter in that one tract, which yet is no other than blood, may be prepared to concoction, or rather be turned into seed in these vessels, by the irradiation of the faculty of the testicles. These vessels are six in number, four preparing, and two ejaculatory, of which we will speak hereafter. Therefore on each side there be two preparing vessels, that is, a vein and an artery, arising as we told you when we spoke of the distribution of the hollow vein. They are inserted into the testicles through that coat which some call epididymis, others darton. Their site is oblique above the loins and flanks, whilst they run down between the ends of the share and haunch bone, they are knit to the parts lying under them, both by certain fibers which they send from them, as also by the membrane they have from the peritoneum. They have like temperature as the veins and arteries have. Their action is to carry blood to the testicles, for generating seed.
The testicles are composed of a glandular, soft, white, and loose substance, allowing them to more effectively absorb spermatic material. They are of equal size and shape, resembling a small, slightly flattened pullet’s egg. Their structure consists of veins, arteries, membranes, and their own specific tissue. The veins and arteries originate from the spermatic vessels, while the nerves arise from the sixth spinal nerve, emanating from the roots of the ribs and the sacral area.
Each testicle is encased in four layers of tissue: two common layers and two specific layers. The common layers include the scrotum, which is the skin surrounding the testicles and derived from the true skin, and the fleshy layer, which consists of a muscular sheath densely packed with numerous blood vessels, hence its name as the fleshy pannicle.
The proper coats are first the erythrosis arising from the process of the peritoneum, going into the scrotum together with the spermatic vessels which it involves and covers; this appears red both by reason of the vessels as also of the cremaster muscles of the testicles; then the epididymis or dartos which takes its origin of the membrane of the spermatic preparing vessels. The flesh of the testicles is as it were a certain effusion of matter about the vessels, as we said of other entrails. But you must observe that the erythrois encompasses the whole stone, except its head, in which place it sticks to the epididymis which is continued through the whole substance of the testicle. This epididymis or dartos was therefore put about the stones, because the testicles themselves, are loose, spongeous, cavernous and soft, so that they cannot safely be joined to the spermatic vessels which are hard and strong. Wherefore Nature that it might join extremes by a fit medium, or mean, formed this coat epididymis. This is scarce apparent in women by reason of its smallness. The two aforementioned common coats, adhere or stick together by their vessels not only amongst themselves, but also with the erythrois. You must besides observe the cremaster muscles are of the said substance with other muscles, small and thin, of an oblique and broad figure, arising from the membrane of the peritoneum, which (as we said before) assumes flesh from the flanks. Their composition is like that of other muscles. They are two, one on each side on. They are situated from the ends of the flanks, even to the stones. They have connection with the process of the peritoneum and testicles. Their temper is like that of other muscles. Their action is to hang and draw up the testicles towards the belly, whence they are called, hanging muscles. The testicles are most commonly two in number, on each side one, sometimes there be three, sometimes one alone, as it happens also in the kidneys; for some have but one kidney. They lie hid in the scrotum at the very roots of the share bone, connected to the principal parts of their vessels, with the neck of the bladder and yard; but by their coats they adhere to the parts from whence they have them. They are of a cold and moist temper, because they are glandulous; although they may be hot by accident by reason of the multitude of the vessels flowing thither. Those whose testicles are more hot are prompt to venery, and have their privities and the adjacent parts very hairy, and besides their testicles are more large and compact. Those on the contrary that have them cold are slow to venery, neither do they beget many children, and those they get are rather female than male, their privities have little hair upon them, and their testicles are small, soft and flat.
The action of the testicles is to generate seed, to corroborate all the parts of the body, and by a certain manly irradiation to breed or increase a true masculine courage. This you may know by eunuchs or such as are gelt, who are of a womanish nature, and are oftentimes more tender and weak than women. As Hippocrates teaches by the example of the Scythians, lib. De Aere, locis et aquis.
The varicose parastata are nervous and white bodies, like as the nerves, round and close woven amongst themselves, they are stretched even from the top to the bottom of the testicles, from whence presently by their departure produce the vasa ejaculatoria, or trading vessels.
But unless we do very well distinguish their names, we shall scarce shun confusion. For that which I call parastata, that is, as it were the head of the testicle, being as it were like another stone, is called epididymis by Galen lib. I. de femine. But I by the example and authority of many anatomists, understand by the epididymis the proper coat of the testicles, of which thing I thought good by the way to admonish you of. Their action is by their crooked passages to hinder the seed from departing out of the preparing into the leading vessels, before it shall be most perfectly labored and concocted in these vessels by the power and force of the testicles. For in the first windings, the blood looks pure, but in the last it is not so red, but somewhat whitish. For Nature commonly does thus delay the matter in its passage either by straightness, or obliquity, which it desires to make more perfect and elaborate by any new concoction, this we may learn by the foldings of the Rete mirable, the windings of the guts, the wrinkles in the bottom of the stomach, the straightness of the pylorus, the capillary veins dispersed through the body of the liver; certainly nature has intended some such thing in the making of the spermatic vessels. Their quantity is visible, and figure round tending somewhat to sharpness. They are composed of veins, nerves and arteries (which they enjoy from the vessels of the testicles, from the epididymis, or the coat, from the peritoneum and their proper substance. Their temper is cold and dry. They be two in number, one to each testicle. But these varicose bodies are called parastata, assisters, because they superficially assist, and are knit to the testicles according to their length, or long-ways. Out of the parastata proceed the vasa ejaculatoria, or leading vessels, being of the same substance as their progenitors, that is, solid, white and as it were nervous. Their quantity is indifferent, their figure round, and hollow, that the seed may have a free passage through them, yet they seem not to be perforated by any manifest passage, unless by chance in such as have had a long gonorrhea. They have like temper as the parastata, between which and the prostates they are seated, immediately knit with them both; as both in the coat and the other vessels with the parts from whence they take them.
But we must note, that such like vessels coming out of the parastats ascend from the bottom of the stones even to the top, in which place meeting with the preparing vessels, they rise into the belly by the same passages, and bind themselves together by nervous fibers, even to the inner capacity of the belly; from whence turning back, they forsake the preparing, that so they may run to the bottom of the share-bone, into the midst of two glandulous bodies which they call prostates situated at the neck of the bladder, that there meeting together they may grow into one passage.
For thus of three passages, that is, of the 2 leading vessels and 1 passage of the bladder, there is one common one in men for the casting forth of seed and urine. A caruncle rising like a crest at the beginning of the neck of the bladder argues this uniting of the passages, which receiving this same passage which is sufficiently large, is oft times taken by such as are ignorant in anatomy for an unnatural caruncle, then especially when it is swollen through any occasion. These leading vessels are two in number, on each side one. Their action is to convey the seed made by the testicles to the prostates and so to the neck of the bladder, so to be cast forth at the common passage. But if any ask whether that common passage made by the two leading vessels between the two glandulous bodies be obvious to sense or no? We answer it is not manifest, though reason compel us to confess that that way is perforated by reason of the spermatic, gross and viscous matter carried that way. But peradventure the reason why that passage cannot be seen is, because in a dead carcass all small passages are closed and hid, the heat and spirits being gone, and the great appear much less, by reason all the perforations fade, and fall into themselves. Yet certainly these passage must needs be very straight, even in a living man, seeing that in a dead they will not admit the point of a needle. Wherefore we need not fear, least in searching, whilst we thrust the catheter into the bladder, it penetrate into the common passage of the leading vessels which runs within the caruncle, unless peradventure by some chance, as a gonnorrhea, or some great phlegmon, it be much dilated besides nature. For I have sometimes seen such passages so open, that they would receive the head of a spathern; which thing should admonish us, that in searching we take great care, that we do not rashly hurt this caruncle, for being somewhat rashly handled with a catheter it casts forth blood, especially if it be inflamed. But also the concourse of the spirits flowing with great violence together with the seed, much helps forward such ejaculation thereof performed through these straight passages by the power of the imaginative faculty in the act of generation.
After the leading vessels follow the prostata, being glandulous bodies of the same substance and temper that other glandules are. Their quantity is large enough, their figure round, and somewhat long, sending forth on each side a soft production of an indifferent length. They are composed of veins, nerves, arteries, a coat (which they have from the neighboring parts) and lastly their proper flesh, which they have from their first conformation. They are two in number, situated at the root of the neck of the bladder, somewhat straightly bound, or tied to the same, to the leading vessels, and the parts annexed to them. But always observe, that every part which enjoys nourishment, life and sense, either first or last has connection with the principal parts of the body, by the intercourse of the vessels which they receive from thence.
The use of the prostates is, to receive in their proper body and seed labored in the testicles, and to contain it there, until it be troublesome either in quantity or quality or both. Besides they contain a certain oily or viscous humor in their glandulous body, that continually distilling into the passage of the urine, it may preserve it from the acrimony and sharpness thereof. But we have observed also on each side other glandules, which Rondeletius calls Appendices glandulosa, glandulous dependances to arise from these prostates, in which also their seed is reserved.
The tenth figure, wherein those things shown in the former figure are more exactly set forth:
[image]
bb cc. The convex or gibbous part of the liver marked with bb. The hollow or concavous part with cc
d e. The right and left ligaments of the liver
oo pp. The fat tunicles or coats torn from both the kidneys
α. The origin of the spermatic arteries
β. Certain branches from the spermatic arteries which run unto the peritoneum
ƴ. The passage of the spermatic vessels through the productions of the peritoneum, which must be observed by such as use to cut for the rupture
δ. The spirie bodden bodies entrance into the testicle, it is called Corpus varicos um pyramidale
ε. The parastata
ζ. The stone or testicle covered with his innermost coat
η. The descent of the leading vessel called vas deferens
Vy. The bladder.
The right gut
Ꝣ. The glandules called prostata into which the leading-vessels are inserted.
ꜱꝉu Two bodies of the yard, s and t and u his vessels
ᵠᵪ. The coat of the testicle
Ꞣ The muscle of the testicle and his vessels
Now it seems fit to speak of the ureters, bladder, and parts belonging to the bladder. Therefore the ureters are of a spermatic, white, dense and solid substance, of an indifferent size in length and thickness. Their figure is round and hollow. They are composed of two coats, one proper consisting of right and transverse fibers, which comes from the emulgent veins and arteries; the other common from the peritoneum, besides they have veins, nerves and arteries from the neighboring parts.
They are two in number on each side one; they are situated between the kidneys (out of whose hollow part they proceed) and the bladder. But the manner how the ureters insert or enter themselves into the bladder, and the porus cholagogus into the duodenum, exceeds admiration, for the ureters are not directly but obliquely implanted near the orifice of the bladder and penetrate into the inner space thereof; for within they do as it were divide the membrane or membranous coat of the body of the bladder, and insinuate themselves into that, as though it were double. But this is opened at the entrance of the urine, but shut at other times, the cover as it were falling upon it, so that the humor which is fallen into the capacity of the bladder cannot be forced or driven back, no not so much as the air blown into it can come this way out, as we see in swine’s bladders blown up and filled with air.
For we see it is the air contained in these which fills them thus, neither can it be pressed forth but with extraordinary force.
For as this skin or coat turned in by the force of the humor gives way, so it being pressed out of the body contained within, thrusts its whole body into the passage as a stopple; like to this is the insertion of the porus cholagogus into the guts.
The ureters have connection with the above mentioned parts, with the muscles of the loins, upon which they run from the kidneys to the bladder.
Wherefore nothing hinders, but that the stone sliding through the ureters into the bladder, may stupefy the thigh as much as it did when it was in the kidney. They are of a cold and dry temper.
Their use is, to serve as passages, or channels for carrying the urine into the bladder.
The bladder is of the same substance that the ureters, that is nervous, that so it may be the more easily dilated.
It is of a large proportion, in some bigger in some less, according to the difference of age, and habit of body. It is of a round figure and as it were pyramidal.
It is composed of two coats, one proper which is very thick and strong composed of the three sorts of fibers, that is, in the inner side of the direct; without of the transverse, and in the midst of the oblique.
The other common coat coming from the peritoneum has veins and arteries on each side one, from the hypogastric vessels above the holy-bone, also it has nerves on each side from the sixth conjugation mixed with the nerves of the holy-bone.
For these nerves descend from the brain even to the end of the holy-bone.
It is but one and that situated in men in the lower belly upon the right gut and below the share bone, but in women between the womb and that bone, to which it cleaves with its membranous ligaments, as it does to the yard by its neck, and to the right gut by its common coat and proper vessels. It is of a cold and dry temper.
The use and action thereof is by the fibers continually to draw the urine, and contain it as long as need requires, and then to expel it by the neck, partly by compression either of itself, or rather of the muscles of the epigastrium and midriff, because this motion, seeing it is voluntary cannot be performed unless by a muscle which the bladder wants; partly also by the dilatation and relaxation of the sphincter muscle composed of transverse fibers, like the sphincter of the fundament, after the same manner to shut up the orifice of the bladder, that the urine flow not out against our will. But the bladder as it fills is dilated, but as it is emptied, it is contracted like a purse. You may easily observe this muscle in a sow’s bladder, it is stretched from the orifice of the bladder and beginning of the urinary passage even to the privities even in women; but in men it is terminated in the perineum, as soon as it has left the right gut.
Besides, this muscle is thus far stretched forth, that the urine by its compression should be wholly pressed out of the bladder, which by too long stay would be its acrimony do some harm. This is the common opinion of anatomists concerning the sphincter of the bladder, which nevertheless Fallopius allows not of. For (says he) if this muscle should be situated beneath the glandulous bodies, the seed in copulation could never be cast forth without some small quantity of urine. Wherefore he thinks that this muscle is situated above the prostates, and that it is nothing else but the beginning of the neck of the bladder, which becomes more fleshy whilst it is woven with transverse fibers.
The eleventh figure: of the bladder and yard.
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AB,1,2,3,4,5,7,9. The two bodies which make the yard
CC 2,3. The place where these two bodies arise
D 1,2,4,5,7,9. The nut of the yard called glans penis
EE 4,5. The fungous and red substance of the bodies of the yard
F 4,5. The mutual connection of the bodies of the yard, and the nervous outward substance of the same, compassing round about the former fungous substance
G 1,2,3,4,5,7,9. The passage of the urine, or common pipe running under the yard all along his length
H.I.1.2. The first pair of muscles of the yard, which in the first figure do yet grow into it, but in the second they hang from their origin.
K.L.1.2. The second pair of muscles of the yard, in the first figure growing, in the second hanging from their insertion
M.1.2. The sphincter of the right gut
N.3,7,8,9. The round sphincter muscle of the bladder
OO,A. membrane which is over the holes of the share bone.
P2. a round ligament from the meeting of the share bones unto the head of the thigh
Q.3,7,8. The body of the bladder
RR,3,7. The prostate, into which seed when it is perfectly labored, is led
SS,3,8. Portions of the ureters
TT3, portions of the vessels which lead down the seed
VV,7,8. The umbilical arteries
X.7,8. The ligament of the bladder called urachus
Y,7,8. The navel or umbilicus
Z,7,8. The umbilical vein
aa7. The vein and artery of the yard.
b5. The artery distributed through the body of the yard
For the neck of the bladder it differs nothing in substance, composure, number, and temper from the bladder, but only in quantity, which is neither so large, nor round in figure, but somewhat long together with the yard representing the shape of the letter S. It is placed in men at the end of the right gut and perineum, rising upwards even to the roots of the yard, and with it bending itself downwards; in women it is short, broad, and straight, ending at the orifice of the neck of the womb between the nervous bodies of the nymphae.
In men it has connection with the bladder, the ejaculatory vessels, the right gut and yard; but in women only with the neck of the womb and privities. The use of it is in men to cast forth seed and urine, in women only urine. But we must note that the share bones must be divided and pulled asunder, in that part where they are joined, that so you may the more exactly observe the situation of these parts. Besides you must note that by the perineum we understand nothing else, in men and women, than that space which is from the fundament to the privities in which the seam is called taurus.
Next, we will explore the anatomy of the male and female reproductive organs, beginning with the male anatomy. The penis is comprised of a ligamentous tissue due to its bony origins. It varies in size across individuals, exhibiting an average magnitude, although some may be larger or smaller than this average. Its shape is generally cylindrical, but it tends to be slightly flattened on both the upper and lower surfaces.
It consists of a double layer: the skin and the underlying tissue, along with nerves, veins, arteries, two ligaments, the urethra, and four muscles. Its outer layer derives from both the true skin and the fleshy subcutaneous tissue. The veins and arteries originate from the lower abdomen, running along the inferior part of the sacrum into the penis, while the seminal vessels travel along the upper region.
The ligaments of the penis originate on both sides from the lateral and lower commissure of the pubic bones. Consequently, at its base, the penis is supported by a double ligament, which shortly merges into a single spongy structure. The urethra, located at the lower part of the penis, extends from the neck of the bladder between these two ligaments.
Regarding the four muscles, the two lateral ones, which make up a significant portion of the penis, arise from the inner prominence of the hip bone. They expand from their point of origin before tapering down again. The other two muscles, located below, originate from the muscles of the perineum and accompany the urinary passage along the length of the perineum until they enter the penis. These latter muscles are closely aligned, giving them the appearance of a single triangular structure.
The primary function of these four muscles during the act of reproduction is to open and expand the shared passage for urine and semen, allowing for the forceful expulsion of semen into the reproductive tract. Additionally, they maintain the rigidity of the penis, preventing it from bending to either side.
The penis is a singular structure situated at the lower portion of the pubic bones, which enhances its stiffness during erection. It is connected to the pubic bone and neighboring structures through its constituent tissues. Characterized by a cold and dry temperament, its primary role is to deliver semen into the womb, thereby ensuring the continuity of humanity.
The head of the penis begins where the tendons terminate. This structure, due to its shape, is referred to as the glans, or balanus, which means “the nut.” The skin covering this head is known as the prepuce, or foreskin. The tissue of this gland is of an intermediate nature, situated between glandular flesh and true skin. It is important to note that the ligaments of the penis are spongy, in contrast to those of other regions, and are filled with thick, dark blood. These features, stimulated by the pleasure of lust and ignited by sexual desire, contribute to the swelling and erection of the penis.
Now we will discuss the female reproductive organs. However, since they are closely related to the cervix and the structure of the womb, we will start by examining the womb itself. Before doing so, it is essential to clarify the differences between the spermatic vessels and testicles in men and women. It is important to note that the spermatic vessels in women are not fundamentally different from those in men regarding substance, shape, composition, quantity, arrangement, temperament, origin, and function; the only distinctions lie in their size and distribution, as women tend to have larger and shorter vessels.
It is appropriate for the spermatic vessels in women to be larger, as they must not only convey the material necessary for the generation of offspring and the nourishment of the testicles but also provide sufficient support for the womb and the developing child. They are shorter, however, because they terminate at the testicles and womb within the abdominal cavity of women. It is important to note that the preparatory spermatic vessels, just before reaching the testicles, divide into two unequal branches. The smaller, curved branch, similar to that in men, enters the head of the testicle, through which it sends a fine branch into the layers of the testicle for sustenance and vitality, extending not only to the outer layers but also to the primary vessels. In contrast, the larger branch descends on each side, situated above the womb, and runs between the individual layer and the common layer, branching out from the peritoneum into various offshoots. This distinction in the anatomy of the spermatic vessels helps to explain why women produce less seminal fluid than men.
Women’s testicles differ from men’s primarily in quantity; they are smaller and possess a more hollow and flattened shape due to their insufficient heat, which prevents them from reaching their full size. Their structure is simpler, lacking the scrotum and fleshy coat found in men, and according to some opinions, the erythroids. Instead, they are covered by a layer derived from the peritoneum, which encompasses the proper coat, known as the epididymis or dartos. Sylvius asserts that women’s testicles lack the erythroids; however, it is certain that, in addition to their unique dartos coat, they possess another layer from the peritoneum referred to as the erythroids, or, as Fallopius calls it, the elythroids, synonymous with the vaginalis or sheath. It seems this error may have arisen from a misinterpretation of Galen’s writings, where he states that women’s testicles do not have the epididymis. It should be understood that this refers not to the coat itself but to the varicose parastats, as I previously mentioned. In terms of quantity, women’s testicles are the same as men’s, but they differ in positioning. In men, the testicles hang externally near the pubic bone above the peritoneum, while in women, they are situated concealed within the abdomen, near the lower sides of the womb, though they do not make contact with the womb itself.
The testicles are connected to the womb by a layer derived from the peritoneum and by the leading vessels that descend to the horns of the womb. They also connect to the rest of the body through vessels and nerves that originate from the sacrum and the costal nerves. Compared to men’s testicles, those of women are characterized by a colder temperament.
The ejaculatory or leading vessels in women differ from those in men. They begin large and possess a veiny texture that makes them difficult to distinguish from the peritoneal coat. Shortly thereafter, they transition into a narrower, more delicate form, appearing almost broken or torn, although this is not the case. As they approach the horns of the womb, they widen again. While their overall structure is similar to that of men’s vessels, they are generally more slender and shorter.
Their shape is round, but they feature more intricate convolutions than those found in males. I believe these convolutions may compensate for the deficiency in the varicose parastats. These vessels are located between the testicles and the womb, originating from the head of the testicle and then being enveloped in a layer from the peritoneum as they connect to the womb at its horns.
The twelfth figure: of the womb.
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a vessel leading the seeds unto the womb
The second figure
The third figure.
Aa. the spermatic vessels
kk.ii. The other branch ending in the neck, by which women with child avoid their seed
The fourth figure
IIII. a portion of the membranes which tie the womb
The womb is an organ unique to women, provided by nature as a counterpart to the scrotum in men, while the neck of the womb and its associated structures serve as a substitute for the male genitalia. A closer examination of the reproductive anatomy in both genders reveals that the components are not significantly different in number; rather, they differ in their location and function.
What is externally visible in men is internally concealed in women, a design attributed to the thoughtful arrangements of nature and the lesser degree of heat in women, which does not permit for the emergence of these structures as it does in men. The womb possesses a nervous and membranous composition, allowing it to expand and contract easily as circumstances necessitate.
The size of the womb varies significantly depending on factors such as age, sexual activity, menstrual flow, and the timing of conception. In individuals who are young and have not engaged in sexual activity or who are menstruating, the womb is relatively small; consequently, its volume cannot be accurately defined.
The shape of the womb closely resembles that of the bladder, particularly when viewed without the appendages that Herophilus referred to as “horns,” due to their resemblance to the horns of young cattle. The womb is composed of both simple and complex structures. The simple structures include the veins, arteries, nerves, and membranes. Specifically, there are four major vessels: two from the spermatic vessels and two that ascend from the hypogastric region.
Initially, these vessels split into two branches on each side before ascending to the womb. From these branches, some vessels lead to the lower part of the womb, while others extend to the neck of the womb, facilitating the expulsion of excess menstrual blood in cases of conception.
Nerves also approach the womb from both sides, originating from the sixth cervical nerve and descending along the length of the spine, as well as from the sacrum. These nerves then unite and ascend, dispersing throughout the womb in a manner akin to the distribution of veins and arteries.
The outermost layer of the womb arises from the peritoneum, specifically at the point where it contacts the sacrum. In contrast, the inner layer of the womb originates from its initial formation, consisting of three types of fibers: the longitudinal fibers on the inner side, which facilitate the attraction of both male and female gametes; the transverse fibers on the outer side, which assist in expelling contents when necessary; and the oblique fibers in the center, which promote proper retention of said contents.
The womb does not exhibit any significant divisions, apart from a subtle line or seam that distinguishes the right side from the left, similar to that seen in the scrotum, though less pronounced. Furthermore, contrary to the beliefs of the ancients, we should not assume the presence of additional compartments within the womb. Nature dictates that a woman can bear no more than two offspring in a single delivery, a fact supported by the limited number of mammary glands she possesses. If a woman were to give birth to more than two, it would be an anomaly, as nature has made no provisions for the nourishment of additional offspring.
Nature has strategically positioned the womb at the lower abdomen, deeming it the most suitable area for receiving and nurturing new life. It resides between the bladder and the right intestine, securely connected more tightly by its neck than by its body. Furthermore, it is supported by two robust ligaments attached to the sides and upper regions of the pubic bone, allowing it to seemingly suspend in place. Additional support is provided by a thick layer of the peritoneum, which binds it not only to the pelvic bone but also to the bones of the hips and loins.
By reason of this straight connection, a woman with child feeling that painful drawing back, and as it were, convulsions of those ligaments, knows herself with child. It is of a cold and moist temper, rather by accident, than of itself. The action thereof is to contain both the seeds, and to cherish, preserve, and nourish it, so contained, until the time appointed by nature; and also besides, to receive, and evacuate the menstrual blood. The compound parts of the womb are, the proper body and neck thereof. That body is extended in women big with child, even to the navel, in some higher, in some lower.
In the inner side the cotyledons comes into our consideration, which are nothing else than the orifices and mouths of the veins, ending in that place. They scarce appear in women, unless presently after child-bearing, or their menstrual purgation; but they are apparent in sheep, goats, and kine, at all times like wheat corns, unless when they are with young, for then they are of the size of hazelnuts; but then also they swell up in women, and are like a rude piece of flesh of a finger and a half thick, which begirt all the natural parts of the infant shut up in the womb; out of which respect this shapeless flesh, according to the opinion of some, is reckoned amongst the number of coats investing the infant, and called chorion, because, as in beasts, the chorion is interwoven with veins and arteries, whence the umbilical vessels proceed; so in women this fleshy lump is woven with veins, and arteries, whence such vessels have their origin. Which thing, how true and agreeable to reason it is, let other men judge.
There is one thing whereof I would admonish thee, that as the growth of the cotyledons in beasts, are not called by the name of chorion, but are only said to be the dependents thereof, so in women such swollen cotyledons merit not the name of chorion, but rather of the dependances thereof.
This body ends in a certain straightness which is met withall, in following it towards the privities, in women who have born no children, or have remained barren some certain time; for in such as are lately delivered, you can see nothing but a cavity and no straightness at all. This straightness we call the proper orifice of the womb, which is most exactly shut after the conception, especially until the membrane, or coats encompassing the child be finished, and strong enough to contain the seed, that it flow not forth, nor be corrupted by entrance of the air; for it is opened to send forth the seed, and in some the courses and serous humors, which are heaped up in the womb in the time of their being with child.
From this orifice the neck of the womb taking its origin, is extended even to the privities. It is of a musculous substance, composed of soft flesh, because it might be extended and contracted, wrinkled, and stretched forth, and unfolded, and rested, and shaken at the coming forth of the child, and after be restored to its former soundness and integrity. In process of age it grows harder, both by use of venery, and also by reason of age, by which the whole body in all parts thereof becomes dry and hard. But in growing, and young women, it is more tractable and flexible for the necessity of nature.
The magnitude is sufficiently large in all dimensions, though diverse, by reason of the infinite variety of bodies. The figure is long, round, and hollow. The composition is the same with the womb, but it receives not so many vessels as the womb; for it has none but those which are sent from the hypogastric veins, by the branches ascending to the womb. This neck on the inside is wrinkled with many crests, like the upper part of a dog’s mouth, so in copulation to cause greater pleasure by that inequality, and also to shorten the act.
It is only one, and that situated between the neck of the bladder and the right gut, to which it closely sticks, as to the womb by the proper orifice thereof, and to the privities by its own orifice; but by the vessels to all the parts from whence they are sent.
It is of a cold and dry temper, and the way to admit the seed into the womb, to exclude the infant out of the womb, as also the menstrual evacuation. But it is worth observation, that in all this passage there is no such membrane found, as that they called hymen, which they feigned to be broken at the first coition. Yet notwithstanding Columbus, Fallopius, Wierus and many other learned men of our time think otherwise, and say, that in virgins a little above the passage of the urine, may be found and seen such a nervous membrane, placed overthwart as it were in the middle way of this neck, and perforated for the passage of the courses. But you may find this false by experience; it is likely the ancients fell into this error through this occasion, because that in some a good quantity of blood breaks forth of these places at the first copulation.
But it is more probable, that this happens by the violent attrition of certain vessels lying in the inward superficies of the neck of the womb, not being able to endure without breaking so great extension as that nervous neck undergoes at the first coition. For a maid which is marriageable, and has her genital parts proportionable in quantity and bigness to a man’s, shall find no such effusion of blood, as we shall show more at large in our Book of Generation.
This neck ends at the privities, where its proper orifice is, which privy parts we must treat of, as being the productions and appendices of this neck. This Pudendum, or privity, is of a middle substance, between the flesh and a nerve; the magnitude is sufficiently large, the figure round, hollow, long. It is composed of veins, arteries, nerves, descending to the neck of the womb, and a double coat proceeding from the true skin and fleshy pannicle; both those coats are there firmly united by the flesh coming between them; whereupon it is said, that this part consists of a musculous coat. It is one in number, situated above the perineum. It has connection with the fundament, the neck of the womb and bladder by both their peculiar orifices.
It has a middle temper, between hot and cold, moist and dry. It has the same use as a man’s preputium or foreskin, that is, that together with the numpha it may hinder the entrance of the air, by which the womb may be in danger to take cold. The lips of the privities called by the Greeks <in non-Latin alphabet>, by the Latins Ala, contain all that region which is invested with hairs; and because we have fallen into mention of these nympha, you must know that they are as it were productions of the musculous skin, which descend on both sides, from the upper part of the share-bone downwards, even to the orifice of the neck of the bladder, oft times growing to so great a bigness, that they will stand out like a man’s yard. Wherefore in some they must be cut off in their young years, yet with a great deal of caution, lest if they be cut too rashly, so great an effusion of blood may follow, that it may cause, either death to the woman, or barrenness of the womb by reason of the refrigeration by the too great effusion of blood. The latter anatomists, as Columbus and Fallopius besides these parts, have made mention of another particle, which stands forth in the upper parts of the privities, and also of the urinary passage, which joins together those wings we formerly mentioned. Columbus calls it tentigo, Fallopius clitoris, whence proceeds that infamous word cleitorizein, which signifies impudently to handle that part). But because it is an obscene part, let those which desire to know more of it, read the authors which I cited.
The Thirteenth figure, showing the parts of women different from those in men.
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ABCD. the peritoneum reflected or turned backward, above and below
The figures belonging to the dugs and breasts
β. The veins of the dugs derived from those which through the arm-hole are led into the hand
γ. The body of the dug or breast
δδ. The kernels and fat between them
εε. The vessels of the dugs descending from the lower part of the neck called iugulum, under the breastbone
The membranes or coats containing the infant in the womb of the mother, are of a spermatic and nervous substance, having their matter from the seed of the mother. But they are nervous that so they may be the more easily extended, as it shall be necessary for the child. They are of good length and breadth, especially near the time of deliverance, they are round in figure like the womb.
Their composition is of veins, arteries, and their proper substance. The veins and arteries are distributed to them (whether obscurely, or manifestly, more or fewer) from the womb by the cotyledons, which have the same office, as long as the child is contained in the womb, as the nipples or paps of the nurses after it is born. For thus the womb brings the cotyledons, or veins, degenerating into them, through the coats like certain paps to the infant shut up in them.
Galen identifies three distinct membranes: the chorion, also known as the secundine or afterbirth; the allantois; and the amnios. In my studies, I observe these three layers in animals, but not in human females. Some propose counting the cotyledons, which can swell and develop into a fleshy mass, as additional membranes, a view held by numerous anatomical experts. However, I do not support this interpretation as accurate. Despite exhaustive efforts, I have never identified the allantois in pregnant women or in newborns at six, seven, eight, or even at full term in the ninth month. My investigations have been thorough, conducted without the involvement of midwives, who might otherwise compromise the integrity of the membranes.
In approaching this task, I carefully dissected the deceased mother’s body across the region of the womb. Removing any impediments that might obstruct our work with as much skill as possible, we successfully extracted the infant’s receptacle, which had adhered to the inner surface of the womb via the cotyledons. Additionally, we separated the first membrane, known as the chorion, from the underlying membrane called the amnios, doing so without any rending or tearing. This method ensured that no moisture was released, thus preventing any claim that the protective layers encompassing that fluid were damaged. Subsequently, we examined the site closely, with numerous witnesses present, to ascertain whether there was any visible distinction between the two membranes, the allantois and the amnios, which serve to separate the contained fluids and fulfill various other functions as discussed in existing literature.
When we could not detect any such substance, we turned our attention to the amniotic sac, which was filled with fluid on its upper side. After carefully opening it, two assistants held the aperture to prevent any moisture from spilling into the surrounding chorion or womb. We then used sponges to gently extract the fluid, little by little, while ensuring that the infant still inside was ready to be delivered. This process allowed us to clear the amniotic membrane of moisture, enabling us to examine whether any other fluids were present in the additional membranes. Having executed this task with exceptional care and precision, we observed no other fluid or separation of the membranes beyond what was already noted.
From that time onward, I have confidently maintained the belief that the fetus in the womb is enclosed solely by two layers: the chorion and amnion. However, seeking further assurance regarding the allantois, I decided to investigate more closely. After passing through the two outer layers, I approached the fetus and inserted a quill into its bladder, blowing into it as forcefully as I could. My aim was to determine whether my breath would inflate the layer in question, as some have suggested in their writings.
Despite my efforts, I was unable to force any air from the bladder through the navel into the disputed layer. Instead, I observed the air escaping from the bladder through the genital area. Therefore, I am firmly convinced that there is no allantois.
Furthermore, I was unable to locate or observe the passage known as the urachus in the navel, which is alleged to be the origin of the allantoic layer. However, if we accept the premise that the allantois does not exist, what disadvantages would stem from this conclusion?
Particularly considering that the sweat and urine of an infant can be effortlessly and conveniently gathered and held in the same membrane, given the slight difference between them. Should anyone argue that the acidity and contact of urine might harm the infant, I would counter that the urine of such a young child lacks significant harshness. Moreover, any acidity present is mitigated by the mixing of the mild vapors from sweat.
Besides, if you consider, or have regard to the use of such a humor (which is to hold up the child, lest by its weight it breaks the ties, by which it is bound to the womb) we shall find no humor more fit for this purpose than this serous, as which by its thickness is much more fit to bear up a weight, than the thin and to liquid sweat. For so we see the seat or saltwater carries greater weights without danger of drowning, than fresh rivers do. Wherefore I conclude that there is no need, that the urine should be kept and contained in one coat, and the sweat in another. The ancients who have written otherwise have written from observations made in beasts. Wherefore we make but only two coats the chorion and amnios, the one of which seeing it contains the other, they both so encompass the child, that they vest it on every side.
Fallopius in some sort seems to be of this opinion; for he only makes two coats; the chorion and amnios, but he thinks the infant makes the water into a certain part of the chorion, as you may perceive by reading of his observations. Both these coats are tied between themselves by the intercourse of most slender nervous fibers, and small vessels penetrating from the outer chorion to the inner amnios. Wherefore unless you warily handle these coats you may easily tear the amnios in separating it. They are of the same temper with other membranes. Their use is different, for the chorion is made both for the preservation of the vessels, which it receives from the womb for the generating of the umbilical veins and arteries, as also, to keep whole and safe the parts which it invests.
But the amnios is to receive and contain the excrementitious and serous humors, which the child shut up in the womb is accustomed to evacuate. But this coat is very thin and soft, but strong and smooth, lest by its touch it might hurt the infant, whereupon it is called the lamb-skin coat.
The navel is found just beyond these membranes; it appears as a white structure resembling a twisted cord or the girdle worn by Franciscan friars, though it lacks the prominent knots and instead features slight swellings that mimic the appearance of knots, gently raised on one side. This structure originates from a fleshy mass referred to as swelling cotyledons and extends into the central region of the infant’s lower abdomen, and indeed into the core of the entire body, which is why it is described as its root.
For even as a tree by the root, sucks nourishment from the earth, so the infant in the womb draws its nourishment by the navel. The greatness of it in breadth and thickness, equal the bigness of the little finger. But it is a foot and a half long, so that children are brought forth with it, encompassing their middle, neck, arms, or legs. The figure of it is round. It is composed of two arteries, one vein, and two coats. It has these vessels from that great multitude of capillary veins and arteries, which are seen dispersed over the chorion. Wherefore the vein entering in at the navel, penetrates from thence into the hollow part of the liver, where divided into two, according to Galen’s opinion, it makes the gate and hollow veins. But the arteries, carried by themselves the length of the navel, cast themselves into the iliaca, which they make, as also all other, that from thence the vital spirit may be carried by them over all the infant. It has two coats from the chorion.
But seeing they are mutually woven and conjoined without any medium, and are of a sufficient strength and thickness over all the navel, they may seem to make the infants external skin and fleshy pannicle. I know very many reckon two umbilical veins, as also arteries, and the urachus by, or through which the urine flows into the coat allantoids. But because this is not to be found in women, but only in beasts, I willingly omit it, because I do not intend to mention any parts, but such as belong to human bodies. Yet if there be any, which can teach me, that these parts, which I think proper to brute beasts, are to be found in women, I will willingly confess, and that to his credit, from whom I have reaped much benefit.
The other things that may be required concerning the navel as of its number, site, connection, temper, and use, may easily appear by that we have spoken before. For we have apparently set down the use, when we said the navel was made for that purpose, that the infant may be nourished by it, as the tree by the root, by reason of the continuation of the vessels thereof, with the preparing spermatic vessels, made by God for that purpose, to whom be honor and glory forever and ever. Amen.
End of Book Three.