Book 4: Vital Parts in the Chest

Book 4: Treating of the Vital Parts Contained in the Chest

I. What the Thorax, or the Chest is, into what parts it may be divided and the nature of these parts
II. Of the Containing, and Contained Parts of the Chest
III. Of the Breasts or Dugs
IV. Of the Clavicles, or Collar Bones and Ribs
V. The Anatomical Administration of the Sternum
VI. Of the Pleura, or Coat Investing the Ribs
VII. Of the Mediastinum
VIII. Of the Diaphram or Midriff
IX. Of the Lungs
X. Of the Pericardium or Purse of the heart
XI. Of the heart
Of the Ventricles of the heart
Of the Orifices and Valves of the heart
XII. Of the Distribution of the Vena Arteriosa and the Arteria Venosa
XIII. The Distribution of the Ascendant Hollow Vein
XIV. The Distribution of the Nerves, or Sinews of the sixth Conjugation
XV. The Division of the Arteries
XVI. Of the Thymus
XVII. Of the Aspera Arteria, the rough artery or weasand
XVIII. Of the Gullet

The Preface

Having finished the first book of our anatomy, in explanation of the natural parts contained in the lower belly, now order requires, that we treat of the breast; that so the parts in some sort already explained (I mean the veins and arteries) may be dispatched after the same order and manner, without interposition of any other matter.

And besides also that we may the more exactly and cheerfully show the rest of the parts which remain, as the head and limbs, knowing already the origin of the those vessels which are dispersed through them. To this purpose, we will define what the chest is, and then we will divide it into its parts. Thirdly, in these we will consider which parts contain, and which are contained, that so we may more happily finish our intended discourse.

I. What the Thorax, or the Chest is, into what parts it may be divided and the nature of these parts

The thorax, or chest, is the middle belly, terminated, or bounded, above with the collar bones, below with the midriff, before with the sternum or breast, behind, with the twelve vertebrae of the back on both sides, with the true and bastard ribs, and with the intercostal and intercartilaginous muscles. Nature has given it this structure and composition, lest that being a defense for the vital parts, against external injuries, it should hinder respirations, which is no less needed for the preservation of the native heat, diffused by the vital spirits, and shut up in the heart, as in the fountain thereof against internal injuries than the other aforementioned parts against external. For if the chest should have been all bony, verily it had been the stronger, but it would have hindered our respiration or breathing, which is performed by the dilating, and contracting thereof. Wherefore lest one of these should hinder the other, nature has framed it, partly bony and gristly, and partly fleshy. Some render another reason hereof, which is, that nature has framed the chest, that it might here also observe the order used by it in the fabric of things, which is, that it might conjoin the parts much disagreeing in their composure, as the lower belly, altogether fleshy, and the head all bony, by a medium partaker both of the bony and fleshy substance; which course we see it has observed in the connection of the fire and water, by the interposition of the air; of the earth and air, by the water placed between them.

The chest is divided into three parts, the upper, lower, and middle: the collar bones contain the upper, the midriff the lower, and the sternum the middle. The sternum in Galen’s opinion is composed of seven bones, I believe by reason of the great stature of the people that lived then. Now in our times you shall oft find it compact of three, or four, or five bones, although we will not deny but that we have often observed it, (especially in young bodies) to consist of seven or eight bones.

Wherefore those who have fewer bones in number in their sternum, have them larger, that they might be sufficient to receive the ribs. This is the common opinion of the sternum. Yet Fallopius has described it far otherwise, wherefore let those who desire to know more hereof, look in his observations.

At the lower part of the sternum, there is a gristle, commonly called Furcula, and Malum granatum, or the pomegranate, because it resembles that fruit; others call it Cartilago sentiformis, that is, the breast-blade.

It is placed there to be as it were a bulwark or defense to the mouth of the stomach, endued with most exquisite sense; and also that it should do the like to that part of the midriff, which the liver bears up in that place, situated above the orifice of the ventricle by the ligament coming between, descending from the lower part of the same gristle into the upper part of the liver.

The common people think that this gristle sometimes falls down. But it so adheres, and is united to the bones of the sternum, that the falling thereof may seem to be without any danger, although often it may be so moistened with watery and serous humidities, with which the orifice of the stomach abounds, that as it were soaked and drunk with these, it may be so relaxed, that it may seem to be out of its place; in which case it may be pressed and forced by the hand, into the former place and seat, as also by applying outwardly, and taking inwardly astringent and drying medicines to exhaust the superfluous humidity.

This gristle at its beginning is narrow, but more broad and obtuse at its end, somewhat resembling the round or blunt point of a sword, whereupon it is also called caritilago ensiformis or the swordlike gristle. In some if has a double, in others a single point.

In old people it degenerates into a bone. Now because we make mention of this gristle, we will show both what a gristle is, and how many differences thereof there be, that henceforward as often as we shall have occasion to speak of a gristle, you may understand what it is.

A gristle is a similar part of our bodies, next to a bone most terrestrial, cold, dry, hard, weighty, and without sense, differing from a bone in dryness only, the which is more in a bone. Wherefore a gristle being lost cannot be regenerated, like as a bone without the interposition of a callus.

The difference of these are almost the same with bones, that is from their consistency, substance, greatness, number, site, figure, connection, action, and use. Omitting the other for brevity sake, I will only handle those differences which arise from site, use, and connection. Therefore gristles, either adhere to the bones, or of, and by themselves make some part, as the gristles of the eyelids called Tarsi, of the epiglottis and throttle. And others which adhere to bones, either adhere by the interposition of no medium, as those which come between the bones of the sternum, the collar bones, the share and haunch bones and others; or by the ligament coming between, as those which are at the ends of the bastard ribs to the sternum by the means of a ligament, that by those ligaments being softer than gristle, the motions of the chest, may be more quickly and safely performed. The gristles which depend on bones, do not only yield strength to the bones, but to themselves, and the parts contained in them, against such things as may break and bruise them. The gristles of the sternum, and at the ends of the bastard ribs are of this sort.

By this we may gather that the gristles have a double use, one to polish and levigate the parts to which that slippery smoothness was necessary for performance of their duty; and for this use serve the gristles which are at the joints, to make their motions the more nimble. The other use is to defend those parts upon which they are placed, from external injuries, by breaking violent assaults, by somewhat yielding to their impression, no otherwise than soft things opposed against cannon shot. We will prosecute the other differences of gristles in their place, as occasion shall be offered and required.

II. Of the Containing, and Contained Parts of the Chest

The containing parts of the chest are both the skins, the fleshy pannicle, the fat, the breasts, the common coat of the muscles, the muscles of that place, the aforementioned bones, the coat investing the rib and the diaphragm or midriff. The parts contained are the mediastinum, the pericardium or purse of the heart, the heart, the lungs and their vessels. Of the containing parts, some are common to all the body, or the most part thereof, as both the skins, the fleshy pannicle and fat. Of which being we have spoken in our first book, there is no need now further to insist upon; others are proper to the chest, as its muscles, of which we will speak in their place, the breasts, the aforementioned bones, the membrane investing the ribs, and the diaphragm or midriff.

We will treat of all these in order, after we have first shown you the way, how you may separate the skin from the rest of the chest. Putting your knife down even to the perfect division of the skin, you must draw a straight line from the upper part of the lower belly, even to the chin; then draw another straight line, over thwart at the collar bones even to the shoulder-blades; and in the places beneath the collar-bones: (if you desire to shun prolixity) you may at once separate both the skin, the fleshy pannicle, the fat, and common coat of the muscles; because these parts were shown and spoken of in the dissection of the lower belly.

Yet you must reserve the breasts in dissecting of the bodies of women; wherefore from the upper parts of the breasts, as artificially as you can, separate only the skin from the parts lying under it, that so you may show the pannicle which there becomes fleshy and musculous, and is so spread over the neck, and parts of the face, even to the roots of the hairs.

III. Of the Breasts or Dugs

The breasts, as we said, when we spoke of the nature of glandules, are of a glandulous substance, white, rare, or spongious, in maids, and women that do not give suck, they are more solid and not so large.

Wherefore the size of the dugs is different, although of a sufficient magnitude in all. Their figure is round; somewhat long, and in some sort pyramidal. Their composure is of the skin, the fleshy pannicle, glandules, fat, nerves, veins, and arteries, descending to them from the axillaris under the sternum between the fourth and fifth, and sometimes the sixth of the true ribs.

And there they are divided into infinite rivelets by the interposition of the glandules and fat, by which fit matter may be brought, to be changed into milk by the faculty of the dugs.

We will speak no more of the nature of glandules, or kernels, as having treated of them before; only we will add this, that some of the glandules have nerves, as those of the breasts, which they receive from the parts lying under them, that is, from the intercostal, by which it comes to pass that they have more exquisite sense. Others wants a nerve, as those which serve only for division of the vessels, and which have no action, but only use.

They be two in number, on each side one, seated at the sides of the sternum upon the fourth fifth and sixth true ribs.

Wherefore they have connection with the mentioned parts with their body, but by their vessels with all other parts, but especially with the womb by the reliques of the mammillary veins and arteries, which descend down at the sides of the breastblade; in which place these veins insinuating themselves through the substance of the muscles, are a little above the navel conjoined with the epigastrics, whose origin is in some sort opposite to the hypogastrics, which send forth branches to the womb. By the meeting of these it is more likely that this commerce should arise, than from other and those almost capillary branches, which are sometimes seen to descend to the womb from the epigastric.

They are of a cold and moist temper, wherefore they say, that the blood by being converted into milk becomes raw, phlegmatic, and white by the force of the proper flesh of the dugs. Their action is to prepare nourishment for the new born babe, to warm the heart from whence they have received heat, and to adorn the breast.

By this you may know that some glandules have action, others use, and some both. At the top of the dugs there are certain hillocks, or eminencies called teats or nipples, by sucking of which the child is nourished through certain small and crooked passages, which though they appear manifest to the sight, whilst you press out the milk by pressing the dug, yet when the milk is pressed out they do not appear, nor so much as admit the point of a needle, by reason of the crooked ways, made by nature in those passages, for this use, that the milk being perfectly made should not flow out of its own accord against the nurse’s will. For so the seed is retained and kept for a certain time in the prostates.

IV. Of the Clavicles, or Collar Bones and Ribs

If we should handle these parts after the common order, we should now treat of the muscles of the chest which move the arm, and serve for respiration, and which first offer themselves to our fight.

But for that they cannot be fitly shown, unless we hurt the muscles of the shoulder blade and neck, therefore I think it better, to defer the explanation of these muscles until such time as I have shown the rest of the contained and containing parts, not only of the chest, but also of the head, that having finished these we may come to a full demonstration of all the rest of the muscles, beginning with those of the head, which we first meet with, and so prosecuting the rest even to the muscles of the feet, as they shall seem to offer themselves more fitly to dissection, that so, as much as lies in us, we may shun confusion.

Wherefore returned to our proposed task, after the aforesaid muscles come the collar bones, the sternum and ribs.

But that these parts may be the more easily understood, we must first know what a bone is, and whence the differences thereof are drawn.

Therefore a bone is a part of our body most terrestrial, cold, dry, hard, wanting all manifest sense, if the teeth by excepted.

I said manifest sense, that you may understand that the parts have a double sense of touching, the one manifest, such as resides in the flesh, skin, membranes, nerves, teeth, and certain other parts; the other obscure, yet which may suffice to discern the helping and hurting tactile qualities, such sense the bowels and bones have; for very small fibers of the nerves are disseminated to these parts by mediation of their coat, or membrane, I say so small, that they can scarce be discerned by the eyes, unless (as Galen says) by plucking such coats away from the parts.

But is it no marvel if nature would have these parts in like manner to have such small veins, contrary to the lungs and most part of the muscles, only to yield so much nourishment to the part, as should be needful; for seeing the substance of the bones is cold, hard, dense, and solid and it wastes the less.

Wherefore they need not so much blood for their nourishment, as the hot and soft parts, and besides the lesser bones have neither veins, nor arteries, but draw fit nourishment, only by the force of the attractive faculty implanted in them.

The differences of bones are taken from many things, as from their apophyses, epiphyses, gristles, necks, heads, solidity, cavity, eminencies, marrow, consistency, size, number, figure, site. We will prosecute all these as they shall offer themselves in the demonstration of the bones; to which doctrine we will give a beginning at the clavicles or collar bones.

The clavicles are two very hard and solid bones, without any great or notable cavity, situated on each side between the side and upper part of the sternum and top of the shoulder-blade, for the strength and stability of these parts, whence they take the name of clavicula clavicles (from the Greek, which signifies a key or any other bar or fastening of a door). They carry the shape of a surgeon’s lavatory.

But you must note that the clavicles seems to be fastened to the sternum by the mediation of a gristly bone. Moreover the space and cavity contained within the collar bones is called by the Latins jugulum, by the French the upper furcula, because the jugular veins pass that way; it sticks to the upper process of the shoulder by a gristle which Galen calls the small gristle bone, although it be nothing else but a production of the Os juguli.

For the sternum, which we said is framed of diverse bones, as sometimes 3, sometimes 4, 5, 6, 7, and sometimes 8, you must note they are very spongy and full of pores, and of a far softer consistency than the collar bones, wherefore more subject to corruption; besides they are mutually joined by interposition of muscles. Their use is to be as a shield to defend the vital parts.

The ribs are 24 in number, on each side 12, seven of these are called true or perfect ribs, because they make a circle, at the one end joined to the sternum, on the other to the vertebrae, the other are called bastard or short ribs because they fall short in their way and come not to the sternum; but they are fastened on the fore-side to the sternum by gristles and ligaments, but on the back part to the transverse vertebrae of the backbone, and to the sides of the said vertebrae. But the short ribs are only knit to the vertebrae, wherefore that part of the vertebrae is called the root of the ribs.

The exterior or fore-part of the bastard or short ribs is gristly, that they should not be broken, and that they might be the easier lifted up in the distensions of the stomach filled with meat. They are of a consistency sufficiently hard, yet more towards their root, than at the sternum, where they come nearer together, and are more hardly broken, they are smooth both within and without, but in the midst they have some sign of being double, or hollow to receive the veins and arteries, which nourish their bony substance, they are fashioned like a bow; their use is the same with the sternum, and besides to carry and strengthen the muscles serving for respiration.

V. The Anatomical Administration of the Sternum

The coat investing the ribs, which the common Anatomists call Pleura, is the last of the containing parts of the chest, which because it lies hid in the inner part thereof, it cannot be shown unless by pulling asunder of the sternum; wherefore we must now show the manner of opening the sternum, that hereby we may not violate the origin or insertion of any of the muscles. Wherefore first you must understand that he which will show in their proper place the origin and insertion of the pectoral muscles, of the mastoids, of the two muscles of the bone hyoid, of the muscles subclavii and intercartilaginei, ought first of all to separate all the pectoral muscles from the sternum and the gristles from the true ribs; then to cut the ligaments, next the bones themselves, even from the sixth true rib to the clavicles.

And then showing the Mediastinum stretched under the sternum all the length thereof, he must separate the sternum with his knife and bend it up to the clavicles, and there cut it, reserving together with it the four muscles, that is, the two mastoids and the two moving the bone hyoid, because they either wholly or for the most part arise from the sternum.

Lastly the clavicles being somewhat thrust upwards, the gristles must on each side be turned outwards towards the arm; that so the containing parts of the chest may not only lie open to view and be easily showed, but also the muscles may be contained in their place, until they come to be showed in their order.

And because the collar bones must be lifted up very high, that the recurrent nerves may be more easily seen and the distribution of the veins and arteries, the two small subclavian muscles one on each side must be shown by the way, who have their origin from the inner and fore part of the clavicles, and an oblique descent to the sternum towards the gristle of the first rib.

For the clavicles cannot be thus separated, but that these muscles must be violated and spoiled. Also you may divide the sternum in the midst, that you may show the inward pectoral muscles whole, having separated the muscles which arise from the upper part. All which things being performed as they ought, we must come to the coat investing the ribs and then to the mediastinum as arising from it.

VI. Of the Pleura, or Coat Investing the Ribs

The Tunica subcostalis, or coat investing the ribs being the last of the containing parts of the chest, is a large and a broad membrane answerable in proportion of use and action to the peritoneum of the lower belly. For as the peritoneum generally and particularly covers all the natural parts, binding and holding them in their places, so this coat invests all the vital parts in general because it is stretched over all the inside of the chest, but in particular, whilst it gives each a coat from itself.

It has its origin from the periosteum, (or as others will have it from the pericranium) investing the vertebrae of the chest at the roots of the ribs. Wherefore it sticks very fast to the ribs, scarce to be separated, as also to all the parts bounding the chest, and contained in it.

Vesalius reprehends Galen, because he said, that this was double on both sides; yet Columbus defends Galen, and verily it is seen to be double in the inner part of the chest, under the ribs and the muscles of the ribs, that in that space there may be way for the veins, arteries and nerves.

Some have made it two-fold, and divided it into the internal and external; as those which have made two sorts of pleurisies, the true and bastard; placing the external above the ribs and intercostal muscles; but the internal under the ribs, muscles, diaphragm and sternum.

But we to shun ambiguity, intend only to prosecute those things which are manifest to the eyes; wherefore we say that the ribs are lined on the inside with a double coat; one which immediately and firmly sticks to them on every side called the periosteum, which is common to them and other bones.

The other which lies upon that periosteum and on the inside invests all the ribs, whence it is called the subcostalis tunica. The substance, temper and composure are the same, as in other membranes. The magnitude in length, as also the figure is the same with the compass of the inner part of the chest; the thickness of it is very little. This coat is commonly called the Pleura from the name of the part which it covers or lines and in like manner which happens betwixt the periosteum and this pleura, is called either a true or bastard pleurisy.

VII. Of the mediastinum

Now we must speak of the parts contained in the chest, seeing we have already handled the containing, beginning with the mediastinum as being a part which in dissection first presents itself to our sight. The mediastinum is of the same substance, thickness, composure, number, temper as the Pleura. For the substance of the mediastinum is membranous, and though it be stretched all the length of the chest, yet it is of a small thickness, receiving veins, nerves and arteries from all the parts to which it is knit, like as the Pleura does; but especially from the mamillary vessels descending under the sternum.

It is in number one, but it is made of two membranes produced from the subcostal, for this ascending on each side by the hollowness of the chest to the sternum, and then at right angles it is reflected to the bodies of the vertebrae, whence the pleura has its origin.

In that reflection there is so much distance between each membrane, as may be sufficient to receive 2 fingers. For otherwise, seeing that they cannot penetrate through the heart, it was fit each side of the pleura should turn to the Pericardium, that so they might arrive at the appointed place without offense. Nether yet is that space void and empty, but woven with many small nervous fibers; Columbus adds, that, that place is often filled with a certain humor besides nature, which you may draw our, or evacuate by opening the sternum.

Yet I would gladly learn of Columbus, by what signs we may know that such an humor is contained there. For the figure, the mediastinum with the Pleura on each side represents the figure of a Leather bottle, whose flat side is the mediastinum, whose other side the Pleura; the bottom that part of the pleura which is next the midriff, the mouth the upper part of the Pleura at the first ribs. We showed the site and connection of the mediastinum, when we declared its origin.

The use thereof is to separate the vital parts, as it were into 2 cells, the right and left, that if peradventure it happen that the one be hurt, the creature may live by the benefit of the other.

And it has another use which is to prop and hold up the Pericardium, that it fall not upon the heart with its weight, but tossed with the motions of the heart and chest, it may move to this or that side.

VIII. Of the Diaphragm or Midriff

Although the midriff may seem to be accounted rather a part containing than contained, yet for commodities sake we have deferred the demonstration thereof till now. Therefore it is a muscle round and long, terminating the lower part of the chest.

It is of the same substance, composition and temper, as the muscles of the Epigastrium, it is made of two coats the lower whereof is from the Peritoneum, and the upper from the Pleura. Which getting to them flesh but not there, but in their circumference, by the benefit of the blood brought thither by the veins and arteries distributed through it, turn into a muscle, whose middle is nervous and membranous, but the extremities by which it is inserted, one while fleshy as in that part next to the bastard ribs; another while tendinous, as where it touches the first & second vertebrae of the loins, for it ends in them by 2 tendons manifest enough. It is one in number, interposed with an oblique site between the natural and vital parts.

It has connection with the lower part of the sternum and short ribs, and the two first vertebrae of the loins, but by its coats and vessels with the parts from whence it received them.

The extent thereof is equal to the compass of the lower part of the chest. The length of it is from the breast blade even to the first and second vertebra of the loins. The thickness is diverse, for it is far thicker in its fleshy extremity, than in its nervous origin.

The action thereof is to help the expulsion of the Excrements by the mutual assistance of the Epigastric muscles, but the chief use is for respiration, of which it is one of the prime instruments. This partition the Ancients called Phrenes, because the inflammation thereof caused like symptoms as the inflammation of the brain, by reason of the large nerves on each side one which come to it directly & primarily from the third, fourth and fifth vertebra of the neck. This muscle differs from other muscles, specially in figure. It is perforated in three places, to give way or passage to the ascendent Hollow-vein, to the Artery Aorta, and the Gullet.

IX. Of the Lungs

The lungs are of a soft substance and flesh, rare and like a sponge, of a various color pale red, their quantity is sufficiently large; for most commonly they are divided into 4 lobes disjoined with a manifest and visible division, on each side two, whereby they may be the more easily opened and contracted, and the air may the better enter.

Besides also in large bodies, who have a very great chest, there is found a fifth lobe, arising from the second lobe of the right side, as a cushion, or bolster to bear up the hollow vein ascending from the midriff to the heart.

In little men who have a shorter chest, because the heart is so near as to touch the diaphragm, this lobe is not seen, yet it is always found in dogs.

The lungs represent the figure or shape of an ox’s foot, or hoof, for like it they are thicker in their base, but slenderer in their circumference, as you may see in blowing them up, by the weasand, with your mouth or a pair of bellows. They are compounded of a coat coming from the pleura, which on each side receives sufficient number of nerves from the sixth conjugation; and also of the Vena artery coming from the right ventricle of the heart, and the Arteria vein from the left, as shall be showed in the Anatomy of the heart; besides the Aspera arteria or weasand coming from the throat, and lastly its own flesh, which is nothing else than the concretion of choleric blood poured out like foam about the divisions of the aforesaid vessels, as we have said of other parts.

The body of the lungs is one in number, unless you will divide it into two, by reason of the variety of its site, because the lobes of the lungs stretched forth into the right & left side do almost involve all the heart, that so they may defend it against the hardness of the bones which are about it; they are tied to the heart, chiefly at its basis, but to the roots of the ribs and their vertebrae by the coat it has from thence; but by the vessels to these parts from whence they proceed. But oft times presently from the first and natural conformation they are bound to the circumference of the ribs by certain thin membranous productions which descend from thence to the lungs, otherwise they are tied to the ribs by the pleura.

The nourishment of the Lungs is unlike to the nourishment of other parts of the body; for you cannot find a part equally rare, light and full of air, which may be nourished with blood equally thin and vaporous. In temper they incline more to heat than to cold, whether you have regard to their composure of choleric blood, or their use, which is to prepare and alter the air that it hurt not the heart by its coldness. The lungs is the instrument of voice and breathing by the weasand or windpipe. For the lobes are the instruments of voice, and the ligaments, of respiration. But the larynx or throttle is the chief instrument of the voice, for the weasand first prepares the voice for the throttle, in which it being in some measure formed is perfected in the palate of the mouth, as in the upper part of a lute, or such like instrument, by the help of the Gargareon or uvula as a certain quill to play withall.

But as long as one holds his breath, he cannot speak; for then the muscles of the larynx, ribs, the diaphragm and the epigastric muscles are pressed down, whence proceeds a suppression of the vocal matter, which must be sent forth, in making or uttering a voice.

Nature would have the lungs light for many reasons, the first is that seeing they are of themselves immoveable, they might be more obsequious and ready to follow the motion of the chest, for when it is straitened, the lungs are straightened and subside with it; and when it is dilated, they also are dilated, and swell so big that they almost fill up all the upper capacity thereof.

Another cause is that by this their rarity they might more easily admit the entering air, at such times as they have much, or sudden necessity, as in running a race.

And lastly, that in Pleurisies and other purnient abscesses of the chest the pus or matter poured forth into the capacity of the chest may be sucked in by the rare substance of the lungs, and by that means the sooner sent forth and expectorated.

The use of respiration is to cool and temper the raging heat of the heart. For it is cooled in drawing in the breath by the cool air, and in sending out thereof by avoiding the hot fuliginous vapor. Therefore the chest performs two contrary motions, for whilst it is dilated it draws in the encompassing air, and when it is depressed it expels the fuliginous vapor of the heart; which any one may easily perceive by the example of a pair of a smith’s bellows.

X. Of the Pericardium or Purse of the heart

The pericardium is as it were the house of the heart, which arises at the basis thereof (either the ligaments of the vertebrae situated there or else the vessels of the heart yielding it matter) is of a nervous, thick and dense substance without any fibers. It retains the figure of the heart, and leaves an empty space for the heart to perform its proper motions. Wherefore the size of the Pericardium exceeds that of the heart.

It consists of a double coat, one proper of which we have spoken, another common coming from the pleura; and also of veins, arteries and nerves; the vessels partly coming from the mamillary, partly from the diaphragm, chiefly there where it touches it; the nerves come on each side from the sixth conjugation.

It is only one, placed about the heart and annexed to it at the Basis thereof by its membranes, to the origin of the lungs, and the vertebrae lying under them, and by the vessels to the parts from whence it received them. It is of a cold and dry temper as every membrane is.

The use thereof is to cover the heart, and preserve it in its native humidity, by a certain natural moisture contained in it, unless you had rather say that the moisture we see contained in the Pericardium, is generated in it after death by the condensation and concretion of the spirits. Although this seems not very likely; because it grows and is heaped up in so great quantity in living bodies, that it hinders the motion of the heart, and causes such palpitation or violent beating thereof; that it often suffocates a man.

For this palpitation happens also to hearty and stout men, whose harts are hot, but blood thin and waterish by reason of some infirmity of the stomach or liver; and this humor may be generated of vapors which on every side exhale into the pericardium from the blood boiling in the ventricles of the heart, where kept in by the density thereof, they turn into yellowish moisture, as we see it happens in an Alembic.

Nature would have the pericardium of a dense and hard consistency, that by the force thereof the heart might be kept in better state; for if the Pericardium had been bony, it would have made the heart like iron by the continual attrition; on the contrary, if it had been soft and fungous, it would have made it spongy and soft like the lungs.

XI. Of the heart

The heart is the chief mansion of the soul, the organ of the vital faculty, the beginning of life, the fountain of the vital spirits, & so consequently the continual nourisher of the vital heat, the first living and last dying, which because it must have a natural motion of it self, was made of a dense solid and more compact substance than any other part of the body.

The flesh thereof is woven with three sorts of fibers, for it has the right in the inner part descending from the basis into the point, that they might dilate it, and so draw the blood from the hollow vein into the receptacles thereof, and the breath or air from the lungs by the Arteria venosa; it has the transverse without, which pass through the right at right angles, to contract the heart, and so drive the vital spirits into the great Artery Aorta, and the choleric blood to the lungs by the vena arteriosa, for their nourishment; It has the oblique in the midst to contain the air and blood drawn thither by the aforementioned vessels until they be sufficiently claborate by the heart.

All these fibers do their parts by contracting themselves towards their origin, as the right from the point of the heart towards the basis, whereby it comes to passe that by this contraction of the fibers the heart dilated becomes shorter, but broader, no otherwise than it is made more long and narrow by the contraction of the transverse, but by the drawing of the oblique it is lessened in that part which looks towards the vertebra’s, which chiefly appears in the point thereof.

It is of an indifferent size, but yet in some bigger, in some less according to the diverse temper of cold or hot men, as we noted in the liver.

The figure thereof is Pyramidal, that is, it is broader in the basis, and narrower at his round point.

It is composed of the most dense flesh of all the body, by the affusion of blood at the divisions and foldings of the vessels, and there concrete; as it happens also to the other Entrails. For the blood being there a little more dried, than that which is concrete for the making of the liver, turns into a fleshy substance more dense than the common flesh, even as in hollow ulcers, when they come to a cicatrize.

It has the Coronal veins and arteries, which it receives either on the right side from the hollow vein, or on the left from the basis at the entrance of the Artery Aorta. You cannot by your Eye discern that the heart has any other Nerves than those which come to it with the Pleura.

Yet I have plainly enough observed others in certain beasts, which have great hearts, as swine; they appeared seated under the fat which covers the vessels, and basis of the heart, lest the humid substance of these parts should be dissolved and dissipated by the burning heat of the heart. Whereby you may perceive that the heat of the heart is different from the Elementary heat, as that which suffers fat to grow about this entrail, where otherwise it does not concrete unless by cold or a remiss heat, which thing is chiefly worth admiration.

The heart is one alone, situated most commonly upon the fourth vertebra of the chest, which is in the midst of the chest. Yet some think that it inclines somewhat to the left side because we there feel the motion or beating thereof; but that happens by reason of its left ventricle, which being it is filled with many spirits, and the beginning of the arteries, it beats far more vehemently, than the right. It required that seat by the decree of nature, because that region is the most safe and armed, and besides it is here on every side covered as it were with the hands of the lungs.

It has connection with the fore mentioned vertebrae, but by the parts composing it, with those parts from whence it has them; with the lungs by the Vena arteriosa, and the Arteria venosa, and lastly with all the parts of the body by the arteries which it sends to them all.

It is of a hot and moist temper, as every fleshy part is. The action thereof is, first to prepare the blood in its right ventricle, for the fit nourishment of the lungs, for from hence it is that Galen says; this right ventricle was made for the necessity of the lungs. Secondly to generate the vital spirits in its left ventricle for the use of the whole body. But this spirit is nothing else than a certain middle substance between air and blood fit to preserve and carry the native heat, wherefore it is named the vital, as being the author and preserver of life. In the inner parts of the heart there present themselves to our consideration the ventricles and the parts contained in the ventricles and between them; such are the Valvulae or valves, the vessels and their mouths, their distribution into the lungs, the wall or partition, and the two productions or ears of the heart; which because they are doubtful, whether they may be reckoned amongst the external or internal parts of the heart, I will here handle in the first place.

Therefore these Auriculae or ears are of a soft and nervous substance, compact of three sorts of fibers, that so by their softness they might the more easily follow the motions of the heart, and so break the violence of the matters entering the heart with great force when it is dilated. For otherwise by their violent and abundant entrance they might hurt the heart, and as it were overwhelm and suffocate it; but they have that capacity which we see given by nature, that so they might as it were keep in store the blood and air, and then little by little draw it forth for the use or necessity of the heart. But if any inquire, if such matters may be drawn into the heart by the only force of the Diastole ad fugam vacui, for avoiding of emptiness; I will answer that that drawing in, or attraction is caused by the heat of the heart; which continually draws these matters to it no otherwise than a fire draws the adjacent air, and the flame of a candle the tallow which is about the weak for nourishments sake. Whilst the heart is dilated it draws the air, whilst it is drawn together or contracted, it expels it. This motion of the heart is absolutely natural, as the motion of the lungs is animal. Some add a third cause of the attraction of the heart; to wit the similitude of the whole substance. But in my judgment, this rather takes place in that attraction which is of blood by the venae coronales for the proper nourishment of the heart, than in that which is performed for attraction of matters for the benefit of the whole body.

These ears differ in quantity, for the right is far more capacious than the left because it was made to receive a greater abundance of matter. They are two in number, on each side one, situated at the base of the heart; The greater at the entrance of the hollow vein into the heart, the less at the entrance of the venous and of the great Artery with which parts they both have connection. We have formerly declared what use they have; that is, to break the violence of the matters, and besides to bee stays or props to the Arteria venosa and great Artery, which could not think so rapid and violent a motion as that of the heart by reason of their tenderness of substance.

Of the ventricles of the heart.

The ventricles are in number two, on each side one, distinguished with a fleshy partition strong enough, having many holes in the superficies, yet nowhere piercing through.

The right of these ventricles is the bigger and encompassed with the softer and rarer flesh; the left is the lesser but is engirt with a threefold more dense and compact flesh; for the right ventricle was made for a place to receive the blood brought by the hollow vein, and for distributing of it, partly by the vena arteriosa into the lungs for their nourishment, partly into the left ventricle, by sweating through the wall or partition, to yield matter for the generation of the vital spirits.Therefore because it was needful there should be so great a quantity of this blood, it was likewise fit that there should be a place proportionable to receive that matter. And because the blood which was to bee received in the right ventricle was more thick, it was not so needful, that the flesh to contain it should be so compact; but on the contrary the arterial blood and vital spirit have need of a more dense receptacle, for fear of wasting and lest they should vanish into air; and also less roome that so the heat being united might become the stronger, and more powerfully set upon the elaboration of the blood and spirits.

Therefore the right ventricle of the heart is made for the preparation of the blood appointed for the nourishment of the lungs, and the generation of the vital spirits, as the lungs are made for the mitification, or qualifying of the air. Which works were necessary, if the Physical Axiome be true; That like is nourished by like, as the rare and spongious lungs with more subtle blood; the substance of the heart grosse and dense, with the venous blood as it flows from the liver, that is grosse.

And it has its cororall veins from the Hollow vein, that it might thence draw as much as should be sufficient.

But the left ventricle is for the perfecting of the vital spirit, and the preservation of the native heat.

Of the Orifices and Valves of the heart.

There be four orifices of the heart, two in the right, & as many in the left ventricle; the greater of the two former gives passage to the vein, or the blood carried by the hollow vein to the heart; the lesser opens a passage to the vena arteriosa or the choleric blood carried in it for the nourishment of the lungs.

The larger of the two other makes a way for the distribution of the Artery Aorta and the vital spirit through all the body; but the lesser gives egress and regress, to the Arteria venosa, or to the air and fuliginous vapors. And because it was convenient that the matters should be admitted into their proper ventricles by these orifices, by the Diastole, to wit, into the right ventricle by the greater orifice, and into the left by the lesser, and because on the contrary it was fit that the matters should be expelled by the systole from their ventricles by the aforementioned orifices.

Therefore nature to all these orifices has put cleaven valves, that is to say, six in the right ventricle, that there might be three to each orifice; five in the left, that the greater orifice might have three, and the lesser two, for the reason we will presently give.

These valves differ many ways; first in action; for some of them carry in matter to the heart, others hinder that which is gone out that it come not back again; Secondly they differ in site, for those which bring in have membranes without, looking in; those which carry out have them within looking out. Thirdly in figures, for those which carry in, have a pyramidal figure, but those which hinder the coming back again are made in the shape of the Roman letter C. Fourthly in substance, for the former for the most part are fleshy, or woven with fleshy fibers into certain fleshy knots ending towards the point of the heart. The latter are wholly membranous.

Fifthly they differ in number, for there be only five which bring in, three in the right ventricle at the greater orifice, and two in the left at the lesser orifice; those which prohibit the coming back are six in each ventricle, three at each orifice. Lastly they differ in motion; for the fleshy ones are opened in the Diastole for the bringing in of blood and spirit, and contrary wise are shut in the systole, that they may contain all or the greater part of that they brought in. The membranous on the contrary are opened in the systole to give passage forth to the blood and spirits over all the body, but shut in the Diastole, that that which is excluded might not flow back into the heart. But you shall observe that nature has placed only two valves at the Orifice of the Arteria Venosa, because it was needful that this Orifice should bee always open, either wholly, or certainly a third part thereof; that the air might continually be drawn into the heart by this orifice in inspiration, and sent forth by expiration in the contraction of the heart. Whereby we may gather this, that there is but one third part of that air we draw into the heart in breathing, sent forth again in the form of vapor in expiration, because nature would have but one third part of the orifice to lie open for its passage out. Therefore the expiration or breathing out, and the systole of the heart and arteries, is shorter than the inspiration, so that we may truly say, that the inspiration, or drawing the breath in, is equally so long as the expiration is together with the rest, which is in the middest between the two motions

XII. Of the Distribution of the Vena Arteriosa and the Arteria Venosa

Having hitherto showed the origin of each of the vessels of the heart, we must now speak of their distribution. The Vena arteriosa, or the arterial vein, and the arteria venosa or the venous arterie each proceeding out of his proper ventricle, that is, the right and left, are divided into two large branches; one of which goes to the right and the other to the left hand, the one lying cross ways over the other, the vein always riding over the artery, as you may understand better by the sight of your eyes, than by reading of books. These branches at their entrance of the lungs are divided into two other large branches, and each of them go to his peculiar lobe of the lungs; and these again run almost into infinite other branches, dispersed in three places over the lungs.

These vessels have acquired their names by reason of that transmutation of consistency, whereby the composure of a vein degenerates into an artery, and that of an artery into a vein, for the commodity of life. For this is a miracle of prudent nature to change the coats of the vessels of the lungs; producing a vein which in its body should imitate an artery, and an artery which should represent a vein: For if the vena arteriosae should have retained its proper consistency, the arterial blood which is carried by it from the heart to nourish the lungs, might by reason of its subtility penetrate through, and flow away by reason of the rarity of the veinous texture: and so nature should never have attained her conceived end, that is, to nourish the lungs, by reason of the continual motion of their contraction and dilatation.

For nourishment cannot be assimulated to the part, unless it be put and cleave to it. Wherefore it was fit, that nature should make the body of this vein solid; that it might be immovable, unshaken and stubborn (in respect of a vein which by its softness would have been too obsequious and yielding to the agitation of the lungs) that so it might have nourishment, which might be diffused into all parts thereof, and which might neither be drawn by its Diastole, nor driven back into the heart by its systole. But the artery has the consistency of a vein, that by that veinous softness according to the necessity of nature it might be the more readily contracted and dilated, to bring the air in and carry the vapors forth of the heart. Here we meet with a difficulty, which is, by what way the blood is carried out of the right into the left ventricle of the heart.

Galen thinks that there be certain holes in the partition made for that purpose, and verily there are such, but they are not perforated. Wherefore Columbus has found out a new way, which is, that the blood is carried to the lungs by the vena arteriosa, and there attenuated; and carried from thence together with the air by the Arteria venosa to the left ventricle of the heart; this he writes truly very probably. Botallus in his treatise De Catarrho has found out a third way, to wit a vein, which he calls Arteriarum nutrix, that is, The nurse of the arteries, which creeps a little above the Coronall to the right ear of the heart, and then goes into the left ear thereof. But yet I am very much afraid, that this vein observed by Botallus, is that vessell observed by Fallopius, whereby the Vena arterialis is joined to the Aorta, & by which all the vital blood is carried for the forming and nourishment of the lungs whilst the infant is yet in the womb. Of which also Galen makes mention, but it had lain hid from his time to this day, but that Fallopius raised up the memory of it again.

XIII. The Distribution of the Ascendant Hollow Vein

The Hollow vein rising out of the gibbous part of the liver, and resembling the body of a tree (according to Galen), is divided into two notable branches, but not of a like size. For the greater, by the hind part of the liver upon the back bone and by the way, receives certain other branches from the substance of the liver which entered not into the great trunk with the rest. You may often see this descendent branch even to the back bone upon which it lies in this its descent, covered with the substance of the liver, so that it may seem that branch proceeds not from that common trunk together with the ascendant, although indeed it always does. But the lesser branch ascends to the upper parts, and is distributed after this manner following. For first arising into the midriff it bestows two small veins upon it, on each side one, which from that part are called Phrenicae. But from thence when it arrives at the right ear of the heart, it makes the Coronales, the coronal or Crown veins, which encompass the base of the heart in manner of a Crown. Thirdly entering somewhat more deeply into its right ear, in its greater part it produces the vena arteriosa. Fourthly lifted up above the heart, on the right side it produces the vein Azygos or sine pari (that is, without a fellow) which descending to the fourth rib, (reckoning from above downwards) nourishes the intercostal muscles and also the membranes of the 8 lower ribs, on both sides, sending a branch into each of the muscles at the lower part of the rib, which may be sufficient for their nourishment. Besides also oftentimes, especially in little men, this vein Azygos nourishes all the spaces between all the ribs by the like branches, which it sends in the same manner to the four upper ribs. Moreover also this Azygos sometimes, though but seldom, is found double, that is, on each side one. Here you must chiefly observe, that this vein after it has nourished the spaces between the lower ribs, in its remainder descends under the Diaphragm and is joined on the left side to the Emulgent vein; by which it is manifest how an abscess, may be critically evacuated by the urine, in a pleurisy. But this same Azygos is more depressed on the right side, and meets with the Venae lumbares, but especially with one of them, which goes down to the thigh, whereby Fallopius gathers that it is very convenient in the beginnings of pleurisy to open the vena poplitis, the vein of the Ham. Fifthly above the Azygos (when it is wanting there) it sends forth the branch called Intercostalis to the other spaces between the upper ribs; although this is sometimes seen to come from the Axillares, which Sylvius calls the subclaviae. Sixthly it brings forth the Mammariae so called, because in their greater part they run to the breasts between the fourth and fifth ribs, for the uses formerly mentioned; men and women have on each side one of these coming from the Subclavia. They are sometimes found to proceed by a certain common orifice from the hollow vein, before it be divided into the Subclavian branches, but it is rather in beasts than in men; these veins descending by the sides of the sternum yield nourishment to the 2 inner muscles of the chest, to the 7 intercostal muscles of the true ribs, to the sternum itself and to its ligaments and gristles, as also to the mediastinum and the upper part of the right muscles, and the adjacent parts. Seventhly, it produces the Cervicalis which on both sides through the holes of the productions of the Vertebrae of the neck, ascends to the head, sending many small branches into the spinal marrow through the holes by which the nerves pass, and also into the membranes, ligaments, gristles, bones, and neighboring muscles. Eighthly, the Musculosa or musculous, which also arising out of the Subclavis is divided into two other branches; the one whereof goes upon the breast to the paps, nourishing the foremost muscles; wherefore in a bastard pleurisy cupping glasses may be fitly applied in this place.

The other branch descends to the upper muscles of the chest, but specially to that which is called Latissimus. The tenth is the Axillaris. The eleventh the Humeralis, of which wee will treat in their place. The twelfth and last is the Jugularis properly so called, which is twofold, the internal and external. The internal being the lesser does presently on both sides from this very beginning ascend by the sides of the Aspera Arteria or weasand even to the mouth and skull, yielding nourishment to the parts by which it passes, as to the next membranes and nerves. But when it comes to the base of the Cranium it is divided into two branches, the greater whereof going back along the base of the Cranium to the hind part thereof, sending a branch to the long muscle situated upon the esophagus, it enters the Cranium with the small Carotids through the hole of the nerves of the sixth conjugation, where they become one common vessell. The lesser sending a slip to the organ of hearing by the hole called Cacum (or the blind) also enters the Cranium and is spent in the thicker meninx near to the hole of the third and fourth conjugation of nerves. The external Jugular vein being greater and fairer, most commonly simple, yet sometimes double, either presently at his beginning, or a little after, ascends superficially on both sides of the neck, between the broad muscle or fleshy pannicle, being there easy to be discerned, and other muscles situated at the sides of the neck, into which as also into the skin it sends certain branches for nourishment.

The Figure of the hollow vein whole and freed from the rest of the body.

A, The trunk of the hollow vein. The lower AA, At this place of the liver, is seated the left part of the vein, and distributes branches to the left side.

B, shows how the trunk of the hollow vein in the chest (to give way to the heart) is curved or bowed to the right hand.

Between A. and B. that part of the hollow vein which is between the gibbous side of the liver and the midriff.

the left midriff vein called Phrenica sinistra, from which surcles do run in a man unto the purse of the heart, for the midriff and it do grow together.

D, The orifice of the hollow vein which grows unto the heart.

E, the crown-vein called coronaria, which like a crown compasses the basis of the heart, and sprinkles his surcles on the outside thereof as far as to the cone or point.

F F, The trunk of the vein, Azygos or non parill, descending along the right side of the rack-bones unto the loins.

GG, the lower intercostal veins, to the branches of the vein Azygos, which go unto the distances between the ribs, & afford surcles unto the muscles which lie upon the ribs & the rack-bones, & the membranes of the chest.

H, the division of the hollow vein into two subclavian trunks near the jugular under the breast-bone.

ll, the subclavian branch tending on either side unto the arm; called by some Axillaris.

K, the upper intercostal vein which commonly sends three slips unto the distances of the upper ribs, unto which the first intercostal vein sent no branches.

LL, the descending mammary vein: this descends under the breast-bone unto the right muscles of the Abdomen, & affords surcles to the distances of the gristles of the true ribs, to the mediastinum, the muscles that lie upon the breast and the skin of the Abdomen.

M, the conjunction of the mammary with the epigastric vein ascending about the navel under the right muscles.

N, the vein of the neck called Cervicalis, ascending toward the skull, which allows surcles to those muscles that lie upon the neck.

O, the vein called Muscula, which is propagated with many surcles into the muscles that occupy the lower parts of the neck and the upper parts of the chest.

P, Thoracica superior, the upper chest vein which goes to the muscles lying upon the chest, to the skin of that place and to the dugs.

Q, the double Scapularis distributed into the hollow part of the shoulder-blade and the neighbor muscles: so also betwixt P and R, sometimes small veins do reach unto the glandules that are in the arm-holes.

R, Thoracica inferior running downward along the sides of the chest, and especially distributed into the muscle of the arm called Latissimus.

S, the inner Jugular vein which enters into the Skull after it has bestowed some surcles upon the rough artery.

T, the external Jugular vein.

the division of this vein under the root of the ear.
a branch of the external Jugular which goes into the inside of the mouth, and is diversely divided into the parts therein contained.
the exterior branch distributed near the Faces into the muscles of the chops and the whole skin of the head.
a portion of the branch, y, reaching unto the face.

a, ae. the vein of the fore-head.

a portion of it creeping through the temples
a propagation that goes unto the skin of the Nowle or Occiput.

a a. the vein called Cephalica, or the external vein of the arm which others call Humeraria.

Muscula superior, a propagation of the Cephalica vein which goes unto the backward muscles of the neck. Betwixt b. and d. on the backside issues a branch from the Cephalica which passes unto the outside of the blade, and a portion thereof runs betwixt the flesh and the skin.
d, a vein from the Cephalica which attains unto the top of the shoulder, and is consumed into the muscle that elevates or lifts up the arm and into his skin.

e, e. a small vein from the Cephalica dispersed through the skin and the muscles of the arm.

the division of the Cephalica into three parts.
the first branch runs deep unto the muscles which arise out of the external Protuberation of the arm.
the second branch which goes to make the median vein.
i. the third branch running obliquely above the wand and the outside of the arm.
from this branch certain circles are divided into the skin, the chief whereof is marked with k.
the third branch at the wrist which is joined at l, with the branch of the Basilica marked with x. m. the Basilica which on the right hand is called Hepatica, on the left hand Lienaris.
o. a branch of the Basilica going to the heads of the muscles of the cubit at n, and to the muscles themselves at o.

p, a notable branch of the Basilica running obliquely, and bestowing surcles upon the muscles that issue from the external protuberation. This branch descends together with the fourth nerve. q, division of the Basilica into two branches, and that is noted with q, is ever accompanied with an artery.

s, a branch of this vein bestowed upon the skin of the arm.

t, a branch of the Basilica which together with the branch of the Cephalica marked with h, makes the mediana or middle vein marked with a.

u, a branch of the Basilica going to the inner head of the arm.

xx, a branch issuing out of the former that creeps along unto the wrist and toward the little finger conjoining itself with a branch of the Cephalica.

y, A vein running out unto the skin at the outside of the cubit.

Upper Z. A propagation issuing out of a branch of the Basilica marked with t.

Lower z. A branch of the Basilica x, going to the inside of the arm.

The Median or common vein,

β, The partition of the Median vein above the wrist: This division should have been made above γ. γ. The external branch of the partition which goes to the outside of the head.

δ, From which issues a small branch to the inside. The internal branch under 〈◊〉, which toward the middle and the ring finger is especially disposed.

{que}, The vein of the thumb dispersed into the mountenet or hillock, which is conjoined with the branch noted with δ ζ, the trunk of the hollow vein from which issue branches unto the parts seated under the liver. 〈◊〉, The fatty vein called Adiposa sinistra, which goes unto the fat of the kidneys.

θ μ, The two Emulgents which lead wheyey blood unto the kidneys.

λ μ, the two spermatic veins leading the matter of the seed unto the testicles.

V, the beginning of the bodden vessell called vas varicosum.

ξ, the veins of the loins called Lumbares which are sent in the knots or knees to the rackbones, to the marrow of the back, to the muscles that lies upon the loins, and to the Peritonaum.

ο, the bifurcation of the hollow vein into the Iliac branches, which bifurcation is not unlike λ.

ω, Muscula superior, a transverse branch going to the muscles of the Abdomen, and to the Peritonaenm. ρ σ, the division of the left Iliac vein, into an inner branch at ρ, and an utter at τ.

τ, Muscula media the utter propagation of the branch ρ, distributed through the muscles of the coxa and the skin of the buttocks.

ν, An inner propagation of the same branch ρ which goes unto the holes of the holy bone.

φ, the vein called Sacra, which goes to the upper holes of the holy bone.

χ ψ, the vein Hypogastrica distributed to the bladder, to the muscles of the fundament, and the neck of the womb.

ω, A vein arising from the utter branch marked with σ which is joined with some branches of the internal vein, near the holes or perforations of the share bone.

ʒ ι, A vein which when it has passed the share bone distributes one branch into the cup of the coxendix and to the muscles of that place.

χ, Another small branch which runs under the skin at the inside of the thigh.

χ, The congress or meeting of the foresaid vein, with a branch marked with char. 2. and distributed into the leg.

I, The Epigastric vein, a propagation of the utter branch σ perforating the Peritonaeum, whereto as also to the muscles of the Abdomen, and the skin it offers branches, the chief branch of this vein is joined with the descending mammary above the navel at M.

Δ, Pudenda an inner propagation of the branch σ, running overthwart unto the privities.

Θ, Saphaena or the ankle vein or the inner branch of the crural trunk, which creeps through the inside of the leg under the skin unto the tops of the toes.

Λ, the first interior propagation of the Saphaena offered to the groin.

Ξ, The utter propagation thereof divided to the foreside or outside of the thigh.

Π, The second propagation of the Saphaena going to the first muscle of the leg.

〈◊〉, The third propagation of the Saphaena going to the skin of the whirle-bone, and unto the ham.

φ, The fourth propagation of the Saphaena dispersing his muscles forward and backward.

Ψ, Branches from this unto the foreside of the inner ankle, to the upper part of the foot, and to all the toes.

Ω, Ischias minor called also muscula interior, the utter branch of the crural trunk divided into the muscles of the coxendix, and to the skin of that place.

1, 2, And this also may be called muscula. 1, the exterior and lesser which passes into some muscles of the leg.

〈◊〉, the interior greater and deeper unto the muscles of the thigh.

3, 4. The vein called Poplitea, made of two crural veins divided under the knee.

5, From this a surcle is reached upward unto the skin of the thigh.

But the greater part runs by the bent of the knee under the skin as far as the heel.

7, Also to the skin of the outward ankle.

8, The vein called Suralis or calf vein, because it runs unto the muscles that make the calf of the leg.

9, The division of the Surall vein into an exterior trunk 9, and an interior 14.

10, 11, The division of the exterior trunk under the knee into an external branch, which along the brace attains unto the muscles of the foot

11, and in internal. 12, 13, 12, 13, Which descending along the outside of the leg to the upper part of the foot is cloven into divers branches, and in the back of the foot mixes itself with Poplitea, or the ham vein

20.14, The interior branch of the Surall vein which runs into the backside of the leg.

15, A branch hereof descending to the inside of the heel and the great toe, and is divided into diverse surcles.

17, Ischias major issuing out of the internal trunk at 14, and running through the muscles of the calf.

18, A propagation hereof derived unto the upper part of the foot, & affording two surcles to every toe.

19, the remainder of the inner trunk 14, behind the inner ankle, approaches to the bottom of the foot and is consumed into all the toes.

20, the mixture of the vein Poplitea with the surall or calf-branch at 13.

But when it arrives to the basis of the lower part of the head, it is divided into more branches, one whereof is carried to the muscles of the bone Hyoid, the Larinx, the tongue and the lower part of the tongue (in which place it is commonly opened in squinancies, and other inflammations of the mouth) and to the coat of the nose. Another is carried to the Dura mater, passing on both sides through a hole situated under the bone mastoids, and besides, ascending to the bone of the back part of the skull, it comes obliquely to the upper part of the suture lambdoids, where these branches meeting together, pass into the reduplication of the Dura mater, dividing the forepart of the brain, that so joined and united, they may make the torcular; the third ascendent is distributed upon the back part and basis of the lower jaw, to the lips, the sides of the nose, and the muscles thereof: and in like manner to the greater corner of the eyes, to the forehead and other parts of the face, and at length by meeting together of many branches, it makes in the forehead the vein which is called vena recta or vena frontis, that is, the forehead vein. The fourth, ascending by the glandules behind the ears, after it has sent forth many branches to them, is divided into two others, one whereof passing before, and the other behind the ear, are at length spent in the skin of the head. The fifth and last wandering over all the lower part of the head, going to the back part thereof, makes the vena pupis, which extended the length of the head by the sagittal suture, at the length goes so far, that it meets with the vena frontis, which meeting is the cause, that a vein opened in the forehead, is good in griefs of the hinder parts of the head, and so on the contrary. But we must observe that in the Cranium of some, the vena pupis by one or more manifest passages sends some portion thereof to the inner part of the head, so that the vena pupis being opened may make revulsion of the matter which causes the internal pains of the head.

XIV. The Distribution of the Nerves, or Sinews of the sixth Conjugation

Because the Distribution of the arteries cannot be well shown, unless we violate those nerves which are carried over the chest, therefore before we show the distribution of the arteries, we will as briefly as we can, prosecute the distribution of these nerves.

Now the sixth conjugation brings forth three pair of nerves; for passing out of the skull, as it comes down to the chest, it by the way sends forth some branches to certain muscles of the neck, and to the three ascendant muscles of the Larynx on each side of the sternum and upon the clavicles. Then the remainder descending into the chest, is divided on each side into these three pair. The first pair makes the Ramus costalis. The second, the Ramus recurrens. The third pair, the Ramus stomachicus. The Ramus costalis, or costall branch is so called, because descending by the roots of the ribs, even to the holy bone, and joyning themselves to these which proceed from each of the Vertebrae of the spine, they are carried to all the natural parts.

The Recurrens, or recurrent is also called, because as it were starting up from the chest, it runs upwards again, but these two Recurrent nerves do not run back from the same place; but the right from below the artery, called by some the axillary, by others Subclavian, and the left from beneath the great artery, descending to the natural parts. But each of them on each side ascending along by the weasand, even to the Larynx, and then they insinuate themselves by the wings of the Cartilago scutiformis, and Thyroids into the proper muscles, which open and shut the Larynx.

By how much the nerves are nearer the origin, to wit, the brain, or spinal marrow, they are by so much the softer. On the contrary, by how much they are further absent from their origin, they are so much the harder and stronger, which is the reason, that Nature would have these recurrent nerves to run back again upwards, that so they might be the stronger to perform the motions of the muscles of the Larinx. But the Stomachicus or stomach-branch is so called, because it descends to the stomach or ventricle. For this branch descending on both sides by the sides of the gullet, sends many branches from it into the inner substance of the lungs, into the coat thereof, into the Pericardium and heart; and then coming into the upper orifice of the stomach, it is spent in many branches, which folded after divers manners and ways, chiefly makes that mouth or stomach, which is the seat of the animal appetite (as they term it) and hunger, and the judger of things convenient or hurtful for the stomach. But from thence they are diversely disseminated over all the body of the ventricle.

Moreover, the same branch sends forth some small branches to the liver and bladder of the gall, giving each part by the way, so much sense as should be sufficiently necessary for it. Here you must note, the stomach branch descends on each side one, knit to the gullet, and by the way they divide themselves into two branches, each of which goes to the opposite side, that it may there join itself to the nerve of that side. To which purpose the right is carried above the gullet, the left below it, so that these two stomach become four, and again these four presently become two.

XV. The Division of the Arteries

The artery arising forth of the left ventricle of the heart, is presently (the two coronal arteries being first spread over the substance of the heart) divided into two unequal branches. The greater whereof descends to the lower parts, being distributed, as we formerly mentioned in the third book, 22nd Chapter. The lesser ascending to the upper parts, is again divided into two other unequal branches, the lesser of which ascending towards the left side, sends forth no artery from it, until it arrive at the first rib of the chest, where it produces the subclavian artery, which is distributed after the manner following.

First, it produces the intercostal, and by it imparts life to the three intercostal muscles of the four upper ribs, and to the neighboring places.

Secondly, it brings forth the Mammillary branch, which is distributed as the Mammillary vein is.

Thirdly, the Cervicalis, which ascends along the neck by the transverse productions to the Dura mater, being distributed as the vena cervicalis is.

Fourthly, passing out of the chest, from the back part of the chest, it sends forth the musculosa, whereby it gives life to the hind muscles of the neck, even to the back part of the head.

Fiftly, having wholly left the chest, it sends forth the two Humerariae, or shoulder arteries, the one whereof goes to the muscles of the hollow part of the shoulder blade, the other to the joint of the arm and the muscles situate there, and the gibbous part of the shoulder blade.

Sixthly and lastly, it produces the Thoracica, which also is two fold, for the one goes to the fore muscles of the chest, the other to the Latissimus, as we said of the vein, the remnant of it makes the Axillaris of that side.

The other greater branch likewise ascending by the right side, even to the first rib of the chest, makes also the subclavian of that side, which besides those divisions it makes on this side, like those of the left side, has also another which makes the right and left Carotides or sleepy arteries, which ascending undivided with a nerve of the sixth conjugation and the internal jugular vein, by the sides of the Aspera Arteria or windpipe, when they come to the Pharinx, they are divided on each side into two branches, the one internal, the other external. The internal and greater is sent to the Pharinx, Larinx and tongue; then entering into the head by the long hole, and the back part of the upper jaw, it sends many branches to the nose, eyes, the inside of the temporal muscles and to the Crassa meninx, or Dura mater: the remainder of this branch going by the side holes of the same, that it might there make the Plexus admirabilis as we see. And then it is spent upon the basis of the brain abundantly diffused over the tenuis meninx or Pia mater, and the membrane or Plexus Choroides. The external or lesser branch of the sleepy arteries goes to the cheekes, the temples, and behind the ears; lastly, it sends a branch into the long muscle of the neck, with which the internal Jugular vein insinuates itself into the Dura mater, entering by the hole of the nerves of the sixth conjugation.

The Figure of the Arteries.

The orifice of the great Artery, or the beginning thereof, where it issues out of the heart.
Coronaria, so called, because like a crown it compasses the basis of the heart.
The division of the great artery into two trunks V i.
the left subclavian climbing obliquely upward unto the ribs.
the upper intercostal artery, or a branch which bestows four propagations unto the distances of the lower rib.
the neck artery which through the transverse processes of the rackbones of the neck, attains to the skull, bestowing surcles unto the marrow and his neighbor muscles.
the left Mammary artery running under the breast-bone, and to the navel.

It distributes surcles to the mediastinum, the muscles of the brest, and of the Abdomen.

Muscula, or a branch attaining to the backward muscles of the neck.
the Scapular arteries which go unto the hollowness of the blade, and of the muscles that lie thereon.
Humeraria which climbs over the top of the shoulder.
Thoracica superior, sprinkled unto the forward muscles of the chest.
Thoracica inferior, which passing along the sides of the chest, attains to the broad muscles of the arm.
the axillary artery running out into the arm and affording branches unto the muscles thereof. O. A branch reaching to the outside of the cubit lying deepe.
Branches to the joint of the cubit with the arm.
the upper branch of the artery running along the Radius and offering surcles to the thumb, the fore-finger and the middle finger.

k A surcle creeping unto the outside of the hand and led betwixt the first bone of the thumb and that of the after-wrist, supports the fore-finger where wee use to feel the pulse.

the lower branch of the artery running along the ulna and communicating surcles to the little finger, the ring finger, and the middle finger. A little branch unto the muscles about the little finger.
the distribution of the upper and lower branches into the hand and the fingers
the trunk of the great artery ascending to the jugulum, and the division thereof in that place into X, Y, Z. X, the left Carotis or sleepy artery.

Y, Subclavian dextra is divided into branches, as the right is divided.

Carotis dextra, called also Apoplectica and Lithargica.

a, The division of the left Carotis in the chops.

b, the exterior branch of that division going into the face, the temples, and behind the ears.

c, the inner branch going to the throttle, the chops and the tongue.

d, the division hereof at the basis of the skull, into two branches which enter the sinus of the Dura mater.

e, A propagation of the branch b, unto the muscles of the face.

f, the distribution of the branch b, under the root of the ear.

the fore-branch hereof creeping up the temples.
the back branch running on the backside of the ear under the skin.

i, the trunk of the great artery, descending unto the spondels of the back.

kkk, the lower intercostal arteries which go unto the distances of the eight lower ribs, from which are offered surcles to the marrow, and to the muscles that grow to the back and to the chest.

l, the artery of the midriff called Phronica or Diaphragmatica. ζ, Mesenterica Superior, but you must note that above ζ, the trunk of the Coeliac artery is taken away, left the multitude of letters in so small a Table should breed obscurity.

r, the right and left emulgents running from the Aorta or great artery unto the kidneys, the spermatic arteries on either side going to the testicles.

λ, the lower Mesentericall artery on the left below μ, running especially into the Colic gut on that side.

μμ, the arteries called Lumbares which run overthwart and like knees, affording surcles to the muscles that grow to the loins, and to the Peritonaeum.

μ, the lower; Muscula superior running into the sides of the Abdomen and the muscles.

v v, the bifurcation of the great artery into two Iliac trunks, and at the sides, but some-what inward are branches which make those that are called Sacrae.

T, the division of the left Iliac trunk into an inner branch at ξ and an utter at φ. ξ, the inner Iliac branch., Muscula inferior, the utter propagation of the inner branch going unto the muscles which cover the branch bone and the Coxendix, Hypogastrica, the inner propagation of the inner branch going to the bladder, the yard and the neck of the womb., the umbilical artery, the remainder of the branch ξ, assuming an addition from the utter branch near φ, and so falling through the hole of the share bone into the leg. τ, Epigastrica, it ascendeth upward unto the right muscle of the Abdomen, and about the navel is joined with the mammary artery. ν, Pudenda, it creeps overthwart the share bone. the Crural trunk without the Peritoneum. χ, Muscula cruralis exterior, going into the fore muscles of the thigh., Muscula cruralis interior, going unto the muscles of the inside of the thigh.

ω, The conjunction of this artery with the branches., Poplitaea, going to the muscles on the backside of the thigh.

ΔΔ, which communicates small branches to the joint of the knee, and the muscles that make the calf of the leg., the division of the Crural artery under the ham into three branches.

Λ, Tibiaea exterior, it accompanies the brace-bone, and is consumed into the muscles. the chief part of the crural artery.

Σ, the upper & backr Tibiaea.

Πφ, the lower and backr Tibiaea running unto the upper side of the foote at φ.

ψ, A propagation of the crural artery going to the inner and upper side of the foot, and sprinkling a branch unto the ankle.

Ω, A propagation unto the lower part of the foot which affords surcles to each toe.

But we must note that there be more veins in a man’s body, than arteries, and besides that the veins are far thicker. For there is no need for preserving the native heat in the parts themselves, either of so many, or so large instruments of that kind. Therefore you may often find veins without arteries, but never arteries without veins.

But we understand that an artery is a companion to a vein, not only when it touches it, or adheres to it by common membranes, as usually it happens; but also when it is appointed together with the vein for the use of the same part.

XVI. Of the Thymus

The Thymus is a glandule of a soft, rare, and spongeous substance, of large size, situate in the furthest and highest part of the chest, amongst the divisions of the subclavian or jugular veins and arteries, as yet contained in the chest, for this use; that it might serve these vessels for a defense against the bony hardness of the chest, and besides, that as it were by this prop or stay, the distributions of these vessels might become the stronger; for so we see that nature has provided for others, especially such as are the more noble and worthy. This glandule appears very large in beasts and young men, but in such as have attained to full growth it is much less, and scarce to be seen.

XVII. Of the Aspera Arteria, the rough artery or weasand

The Aspera Arteria, or weasand, seeing it is the instrument of voice and respiration, is of a gristly, ligamentous, and wholly various substance. For if it had been one rough and continued body with the larynx or throttle, it could be neither dilated, nor compressed; opened, nor shut, neither could it order the voice according to our desire.

It is composed of veins from the internal jugular, of arteries arising from the carotids, and of nerves proceeding from the Recurrent branch, of a double membrane, of which the external comes from the peritoneum; the internal, which is the stronger and woven with right fibers, from the inner coat of the mouth, the which is common with the inner coat of the esophagus or gullet. And also it consists of round gristles, yet not drawn into a perfect circle, composed in manner of a channel, and mutually joined together in order, by the ligaments that proceed from their sides and ends.

These same ligaments perfect the remnant of the circle of this Aspera Arteriae, on that part next the gullet; which is thought to be done to this end; that that softness of a ligament, might then give place, when we swallow harder and greater gobbets of meat. Of the two sorts of ligaments which are annexed to the gristles of the weasand, some tie and fasten together the rings, or circles, which give means both to it, and these circles to be drawn out in length; others bring these gristles into a perfect circle, which also yield them means of dilatation. These ligaments cover the inner superficies, but the gristles are placed without, to resist the incursion of external injuries. But we must note, that by this communion of the inner coats of the weasand and gullet, we reap this benefit in the commodiousness of the action, that one of these parts being depressed, the other is lifted up, like a rope running in a wheel or pully. For thus whilst the gullet is depressed to swallow any thing, the weasand is lifted up; and on the contrary when the stomach rises up in vomiting, the weasand is depressed. It is only one, and that seated between the larynx (from which it takes its beginning) and the lunges in which it ends; first dividing itself into two large branches, the right and the left, and besides each of these entering into the substance of the lungs, is again divided into two others; to each of the lobes one; and to conclude, these be subdivided into infinite others, through the substance of the lobes.

All these branches are gristly even to the ends. They are situated between the ends of the Arteria venosa, and the Vena arteriosa, that the entrance of the air into the heart by the arteria venosa might be speedier, as also the passage out of the vapor, by the vena arteriosa. Thus it has connection with these in the ends, or utmost parts thereof, but by the other parts compassing it, with the members from whence it takes them. The temperament thereof is cold and dry. The action is to carry the air to, and vapors from the lungs; that by dilating, but this by pressing the gristles together.

The Figure of the Aspera Arteria or weasand.

The orifice of the great artery cut from the heart, aa. the coronal arteries of the heart.
C. D. the division of the great artery into two trunks, the descending C. the ascending D.
the left axillary, or subclavian artery.
the right axillary or subclavian artery.
the right Carotids or sleepy artery.
the left Carotid.
the trunk of the rough artery or weasand.
L. The division of the rough artery into two branches, of which the right goes into the right, and the left into the left side of the lungs; which branches are again subdivided into many other.
The head of the Rough Artery called the larynx or throttle.
N. certain glandules or kernels at the root of it.
The right and left nerves of the sixth and seventh conjugation.
A Revolution of small branches of the right nerve, to the right Axillary Artery.

Q Q. The right Recurrent Nerve.

A revolution of small branches of the left nerve unto the descending trunk of the great Artery.

S S. The left Recurrent Nerve.

XVIII. Of the Gullet

The esophagus, or gullet, which is the passage of the meat and drink, is of a middle substance between the flesh and sinews, because it consists of one nervous membrane and another fleshy. The nervous is placed the innermost, and is continued to the inner coat of the mouth even to the lips (whereby it comes to pass) that the lips tremble in diseases which are ready to be judged by a critical vomiting and to the inner part of the aspera arteria; it consists of right fibers for the attraction of the meat, which we see is sometimes so quick and forcible in hungry people, that they have scarce time to chew it, before they find it, to be plucked down, as it were with a hand. The fleshy coat placed without is woven with transverse fibers, to hasten the going of the meat into the stomach, and for expulsion in vomiting and breaking of wind. These two coats are continued with the two coats of the stomach, and have the like site. Besides, the gullet has these parts composing it, as a vein from the gate and hollow ascendent vein, a nerve from the sixt conjugation, an artery from that which creeps along the bottom of the stomach with the vena Gastrica, or else from the arteries ascending the hollow part thereof; but also besides all these vessels it may have a third coat from the membrane investing the ribs, or pleura. The magnitude of the gullet is large enough, yet some be bigger, some less according to the variety of bodies. The figure of it is round, that so it might be more large to swallow meat, and less subject to offense. It is placed between the backbone and the weasand from the roots of the tongue even to the stomach. But as it descends along the backbone, when it comes to the fourth vertebra of the chest, it turns to the right side, to give way to the great artery aorta and the descendent artery, then it turns to the left side to the stomach, or mouth of the ventricle. Nature has fastened it to the diaphragm with strong membranous ties, lest that, if it had lain upon the artery it should have hindered the passage of the vital spirit to the lower parts. It is only one and that tied to the aforementioned parts, both by its vessels and membranes. It is of temper rather cold than hot, as all those parts, which are more nervous than fleshy, are. The action thereof is to draw and carry down the meat, and to cast forth such things by vomit as trouble the stomach. Here you must note, that whilst we swallow down, the gullet is drawn downwards, and the weasand upwards, which is the cause that we cannot sup and blow, swallow and breath together at the same instant; which we must think to happen by God’s singular providence, to whose name be glory for everlasting, Amen.

The End of the Fourth Book.