Natale Gianfranco, Bocci Guido, Ribatti Domenico
Department of Translational Research and New Technologies in Medicine and Surgery, Medical School, University of Pisa, Pisa, Italy.
Museum of Human Anatomy 'Filippo Civinini', Department of Translational Research and New Technologies in Medicine and Surgery, Medical School, University of Pisa, Pisa, Italy.
J Anat. 2017 Sep;231(3):417-429. doi: 10.1111/joa.12644. Epub 2017 Jun 14.
The discovery of the lymphatic system has a long and fascinating history. The interest in anatomy and physiology of this system paralleled that of the blood cardiocirculatory system and has been maybe obscured by the latter. Paradoxically, if the closed blood system appeared open in Galen's anatomy and physiology, and took a very long time to be correctly described in terms of pulmonary and general circulation by ibn Al-Nafis/Michael Servetus/Realdo Colombo and William Harvey, respectively, the open lymphatic system was incorrectly described as a closed circuit connected with arteries and veins. In ancient times only macroscopic components of the lymphatic system have been described, although misinterpreted, including lymph nodes and lacteals, the latter being easily identified because of their milk-like content. For about 15 centuries the dogmatic acceptance of Galen's notions did not allow a significant progress in medicine. After Vesalius' revolution in anatomical studies, new knowledge was accumulated, and the 17th century was the golden age for the investigation of the lymphatic system with several discoveries: gut lacteals (Gaspare Aselli), cloacal bursa (Hieronimus Fabricius of Acquapendente), reservoir of the chyle (Jean Pecquet), extra-intestinal lymphatic vessels (Thomas Bartholin and Olaus Rudbeck dispute), hepatic lymph circulation (Francis Glisson). In the Enlightenment century Frederik Ruysch described the function of lymphatic valves, and Paolo Mascagni provided a magnificent iconography of the lymphatic network in humans. In recent times, Leonetto Comparini realized three-dimensional reconstructions of the liver lymphatic vessels, and Kari Alitalo discovered the lymphatic growth factor/receptor system. Far from a complete understanding of its anatomy and function, the lymphatic system still needs to be profoundly examined.
淋巴系统的发现有着漫长而引人入胜的历史。人们对该系统解剖学和生理学的兴趣与对血液循环系统的兴趣相当,且可能被后者所掩盖。矛盾的是,如果说封闭的血液系统在盖伦的解剖学和生理学中看似开放,并且分别经过伊本·纳菲斯/迈克尔·塞尔维特/雷亚尔多·哥伦布和威廉·哈维很长时间才被正确描述为肺循环和体循环,那么开放的淋巴系统却被错误地描述为与动脉和静脉相连的封闭回路。在古代,尽管存在误解,但人们已经描述了淋巴系统的宏观组成部分,包括淋巴结和乳糜管,后者因其类似乳汁的内容物而易于识别。大约15个世纪以来,对盖伦观念的教条式接受阻碍了医学的重大进步。在维萨里解剖学研究的革命之后,新的知识不断积累,17世纪是淋巴系统研究的黄金时代,有多项发现:肠乳糜管(加斯帕雷·阿塞利)、泄殖腔囊(阿夸彭登特的希罗尼穆斯·法布里修斯)、乳糜池(让·佩凯)、肠外淋巴管(托马斯·巴托林和奥劳斯·鲁德贝克之争)、肝淋巴循环(弗朗西斯·格利森)。在启蒙运动时期,弗雷德里克·鲁伊斯描述了淋巴瓣膜的功能,保罗·马斯卡尼提供了人类淋巴网络的精美图谱。近代,莱奥内托·孔帕里尼实现了肝淋巴管的三维重建,卡里·阿利塔洛发现了淋巴生长因子/受体系统。尽管对淋巴系统的解剖学和功能尚未完全了解,但仍需要对其进行深入研究。