Rutgers New Jersey Medical School, Newark, New Jersey.
Pediatr Neurol. 2017 Oct;75:6-10. doi: 10.1016/j.pediatrneurol.2017.07.004. Epub 2017 Jul 10.
Throughout the Middle Ages, most representations of the brain amounted to highly schematized ventricles housed within abstract squiggles of neural tissue. The works by the pre-eminent Flemish anatomist Andreas Vesalius in his De Humani Corporis Fabrica (1543) added considerably more accuracy and detail; still, his drawings of cerebral hemispheres do not exhibit the gyral-sulcal pattern recognized today. Identifiable cortical landmarks would not be featured in print until Cerebri Anatome (1664) by the English physician Thomas Willis.
A review of primary and secondary sources on the subject.
Medieval doctors understood neurophysiology according to the cell doctrine, whereby the first cell (modern-day lateral ventricles) was responsible for sensation, the second cell (third ventricle) for cognition, and the third cell (fourth ventricle) for memory. Vesalius challenged this ventricle-centric model and resolved to portray physical form only, without the influence of conceptual function. A century later, Willis and his illustrator, Christopher Wren, citing limited clinical evidence, proposed that the corpus striatum, the white matter, and the gray matter replace the three cells, finally allowing the cortex a physiological rather than a structurally supportive role. This relocation of executive function demanded the more meticulous rendering of the brain provided in the Cerebri Anatome.
Thomas Willis produced anatomic drawings of the brain depicting previously ill-defined surface features, as in Fabrica by Vesalius, because of a paradigm shift in neurophysiology, emphasizing the cortex over the ventricles, not because of advances in techniques of dissection or illustration. Perhaps, as the study of the brain continues, another future revelation in neurophysiology will drive another unexpected, enduring change in the study of the structures of the nervous system.
纵观整个中世纪，大多数对大脑的描述都只是高度简化的脑室，位于抽象的神经组织扭结内。杰出的佛兰德解剖学家安德烈亚斯·维萨里乌斯（Andreas Vesalius）在他的《人体构造论》（De Humani Corporis Fabrica，1543 年）中的作品增加了相当多的准确性和细节；尽管如此，他对大脑半球的描绘并没有展示出今天公认的脑回-脑沟模式。直到英国医生托马斯·威利斯（Thomas Willis）的《脑解剖学》（Cerebri Anatome，1664 年）出版，印刷品中才出现可识别的皮质地标。
对主题的主要和次要来源进行回顾。
中世纪的医生根据细胞学说理解神经生理学，即第一个细胞（现代侧脑室）负责感觉，第二个细胞（第三脑室）负责认知，第三个细胞（第四脑室）负责记忆。维萨里乌斯挑战了这种脑室中心模型，并决心只描绘物理形态，不受概念功能的影响。一个世纪后，威利斯和他的插图画家克里斯托弗·雷恩（Christopher Wren）引用有限的临床证据，提出纹状体、白质和灰质取代了三个细胞，最终使皮质具有生理而非结构支持作用。这种执行功能的重新定位要求更细致地描绘大脑，这在《脑解剖学》中得以实现。
托马斯·威利斯（Thomas Willis）绘制了大脑解剖图，描绘了以前定义不明确的表面特征，就像维萨里乌斯的《人体构造论》一样，这是由于神经生理学的范式转变，强调皮质而不是脑室，而不是由于解剖或插图技术的进步。也许，随着对大脑的研究不断深入，神经生理学的另一个未来发现将推动对神经系统结构研究的另一个意外、持久的变化。
