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The neuroanatomy of Leonardo da Vinci
Surg Neurol 1992;38:241-3
241
Book Reviews
The Neuroanatomy of Leonardo da Vinci By E d w i n M. T o d d . 189 pages. P a r k R i d g e , Ill: A m e r i c a n A s s o c i a t i o n o f N e u r o l o g i c a l S u r g e o n s , 1991. We can learn from the recent biography by Serge Bramly [2] about Leonardo da Vinci, the artist, scientist, philosopher, genius--arguably one of the most fascinating figures in recorded history. Since the beautifully written, gentle biographical sketch by Georgio Vasari, in its second edition in 1563 [4], the multifaceted personality of this extraordinary man has been the subject of many books and essays. I recall, growing up in Central Europe before the War, the impact Merezhkovsky's wonderful romantic account of Leonardo da Vinci's life made on us [10]. Merezhkovsky placed Leonardo in the middle of his trilogy The Christ and the Antichrist, between Julian the Apostate and Peter the Great, meditating on the delicate balance the genius of Leonardo achieved. His various contributions to painting, sculpture, architecture, engineering, anatomical observations, and natural descriptions were the subject of comprehensive individual books [8], and there are wonderful contributions to Leonardo the painter [1], the engineer [3], the inventor [13], the musician [15], the philosopher [5,14], the all-around nature man [7], and the drawer [12]. Many works exist describing the various facsimilies and manuscripts of Leonardo, together with his numerous drawings and observations. The most exhaustive work is by Charles D. O'Malley and J.B. de C.M. Saunders [11], where drawings dedicated to the nervous system occupy 26 pages of a total of 216, a remarkable achievement. As Giorgio de Santillana said: An artist first and last, Leonardo believed that understanding can be reached only by of the eye which 'knows how to see,' of the hand which knows how to follow the intellect, for basically it is the work of the hand which defines for him the compass of man's thought. It is heartwarming that the American Association of Neurological Surgeons was able to publish this particular book, which is dedicated only to the drawings on the nervous system, based on scholarly studies by Dr. Todd. As most of the other works are rather dry descriptions, the elegant style of Dr. Todd as he makes his comments going through the drawings in chronological order is very refreshing, but at the same time, it is a real addition to the scholarly literature on Leonardo da Vinci. Due to the extraordinary impact of the media on public knowledge (one of the few benefits of intelligent television), and to the fact that people are traveling a lot, individuals interested in the life of this unusual genius can enjoy the atmosphere of the last few years of his life in Amboise, espe© 1992 by Elsevier Science Publishing Co., Inc.
cially at the adjacent small Clos-Luc~, where Leonardo moved at the invitation of the King of France, Francois I, in 1517. You can wander through a wonderful museum where reconstructions of all the gadgets related to the imagination and extraordinary curiosity of Leonardo can be seen. Even one of the original codexes of Leonardo is now here in America, as the Leonardo Codex originally in the bibliotheca of Lord Leicester in Holkham Hall was purchased by Dr. Hammer, himself a medical man, and now can be seen at the Los Angeles County Museum of Art. Going back to Dr. Todd's extraordinary dedication to this particular topic, it is sufficient to say that he enlightens the large works dedicated to the anatomical drawings of Leonardo, namely the already mentioned book of O'Malley and Saunders [11], the contributions of Keele and Pedretti [6], who both provided a genuinely warm and appreciative introduction to this work, and Edward MacCurdy's important publication of the notebooks of Leonardo da Vinci [9]. Dr. Todd's individual contributions to Leonardo's genius and his farsighted observations of the nervous system represent an encouraging trend to see neurosurgeons in a different light. Many of the pioneering neurosurgeons had a basic curiosity about how the braia works, how the history of ideas and observations are important in shaping our own philosophy, and how scholarship in humanities and arts molds our own performance. One has only to think of Dr. Cushing and his dedication to the history of medicine and to literary pursuits (his Pulitzer Prize winning Osier biography); of Norman Dott, whose archaeological acumen was extraordinary and who was at the same time a dedicated musician, a cellist, and a great connoisseur of paintings; of Gosta Norlen, whose musical talent almost surpassed his neurosurgical skill; or of Larry Pool, whose critical knowledge about visual art and his passion in appreciating and collecting paintings rivaled his professional skill. To return to Dr. Todd's book, the introductions and forewords of Kenneth Keele and Carlo Pedretti are a great tribute to Dr. Todd's scholarly and artistic mind. After a short reflection on Leonardo and the nervous system in general, Dr. Todd spends some time explaining why drawing is such an important tool in preserving knowledge and why, true to his original philosophy, Leonardo believed that visual information is better than description with words. An interesting chapter gives an account of anatomical illustrations before Leonardo da Vinci, contrasting the rather naive presentations of the past with the extraordinary sophistication of Leonardo's concept. The illustrations in the next chapter cover the skull; there is an analysis of the famous drawing of the Vitruvian Man, now in the possession of the Gallerie dell'Accademia in Venice, regarding the proportions of the human body within a circle, and within a square. 0090-3019/92/$5.00
242
Surg Neurol
Book Reviews
1992;38:241-3
In the chapter on the senses, of course vision occupies most of the observations. Hearing, smell, taste, and touch following in decreasing order. It is interesting to note that in spite of his extraordinary accuracy in certain areas, theories from previous ages were weighing strongly on Leonardo when he presented his drawings on the brain and the cranial nerves. The authoritative weight of Galen, Avicenna, and the theologically heavy burden of Albertus Magnus definitely influenced the presentation by Leonardo. Dr. Todd points out correctly that Leonardo's studies of the nervous system were.continuously dominated by attempts to precisely locate a percipient soul in the center of the brain. In a beautiful illustration of one of the finest representations of the brain, the cerebral ventricles, and cranial nerves, found in an anatomical sheet now in Weimar, a combination of the philosophical burden and the power of observation resulted in an astonishingly interesting concept. Some of the cranial nerves are correctly observed, but for example, the seventh cranial nerve, the facial nerve, was never "discovered" by Leonardo. Dr. Todd's interesting analysis reads like a detective story, again very well integrated with the original observations and quotations from the studies of Keele and Pedretti. Personally, I very much liked Dr. Todd's discussion on Leonardo's approach to the spine and spinal cord, with interesting juxtaposed illustrations from Donatello, Signorelli, and even Masaccio. The eighth chapter is dedicated to the peripheral nerves and the plexuses. It points out the extraordinary difficulties Leonardo must have had in observing cadavers that were decomposed. Without fixation, it is no wonder that details of the plexus, i.e., how the nerve roots formed the spinal nerves, were not better demonstrated in his drawing. Dr. Todd points out that Leonardo indeed was unaware of species differences and quite often resorted to animal dissection to substitute one part for another, making not the most accurate representations. This, however, does not take away the extraordinary lucidity and details of the peripheral nerves, as they are represented in the well-documented illustrations. The summary points out that "Leonardo as an anatomist became a legend in his own time. It was a legend that grew as the unsubstantiated generalities became more exuberant after his death, sustained and implemented by his growing reputation as a painter, but his neuroanatomical endeavors ostensibly lay hidden in unyielding private hands." A very well balanced account is given of the value of the anatomical observations, of the technique, and some of the speculations in regard to function. However, it is quite clear that Leonardo added nothing to our knowledge of the functional capacities of the brain. "His notions of brain function were vague and confused, based upon a garbled interpretation of traditional philosophical doctrina." Conversely, "discovery and original illustration are intimately interwoven in the excellent drawings that reveal the course and interrelationships of the cranial nerves." An addendum analyzes the handwriting of Leonardo, including a very interesting comment on a drawing he made of a man who was hanged for his revolutionary activities and which shows how he started to use this special handwriting at the age of 25 years. The challenge to decipher Leonardo's writing is not unlike the decoding of the hieroglyphics; proper
recognition is given to scholars like Richter, Harvey, and others. A very comprehensive bibliography concludes the book. In summary, I think it is a landmark that the American Association of Neurological Surgeons published this delightfully written, elegantly presented book, as it may encourage other neurosurgeons approaching retirement to exploit some of their investments in their youth into areas not directly related to professional excellence. It may stimulate us to sit down and enjoy the atmosphere of a scholarly research, which, as it is quite clear from the love and warmth of Dr. Todd's observations, may lead us nearer to a comprehensive understanding of our human existence and help us to become better specialists through the disciplines of a universal approach to art and history. GEORGE B. UDVARHELYI, M.D., F.A.C.S. Baltimore, Maryland
References 1. B~rence F. Tout 1' oeuvre paint par Leonard de Vinci. Paris: 1950. 2. Bramly S; Reynolds S, trans. Leonardo: discovering the life of Leonardo da Vinci. Edward Burlingame Books, 1991. 3. Cianchi M. Les machines de Leonard de Vinci, Florence: 1984. 4. ConawayJ, Bondanella V. Georgio Vasari: the lives of the artists; a new translation. Cambridge, UK: Oxford University Press, 1991. 5. de Hevesy A. Pdlerinage avec Leonardo da Vinci. Paris: 1939 6. Keele KD, Pedretti C. Leonardo da Vinci, corpus of the anatomical studies in the collection of her majesty the Queen at Windsor castle. New York: Johnson Reprint Harcourt Brace Jovanovitch, 1979. 7. Kemp M. Leonardo da Vinci: the marvelous works of nature and man. Cambridge, Mass: 1981 8. Leonardo da Vinci. New York: Raynal, 1956. 9. MacCurdy, E. The notebooks of Leonardo da Vinci. New York: George Brasiker, 1954. 10. Merezhkovsky D. The Forerunner: the romance of Leonardo da Vinci. London: 1926. 11. O'Malley CD, Saunders JB. Leonardo da Vinci on the human body: the anatomical, physiological, and embryological drawings of Leonardo da Vinci. New York: Greenwich House, 1962. 12. Popham AE. The drawings of Leonardo da Vinci. London: 1946. 13. Reti L. Leonard de Vinci, i'humaniste, rartiste, l'inventeur. Paris: 1974. 14. Stites RS. The sublimations of Leonardo da Vinci. Washington, DC: 1970. 15. Winternitz E. Leonardo da Vinci as a musician. New Haven: 1982.
Intracerebral Hematomas. Edited by Howard H. Kaufman. 227 pages. N e w York: Raven Press, 1992. I S B N #0-88167-843-0. This book has been long in preparation by the editor, Dr. Kaufman, who began to take an interest in this subject when he was at the National Hospital for Nervous Disease at Queen's Square with Wiley McKissock in 1967-1968.
241
Book Reviews
The Neuroanatomy of Leonardo da Vinci By E d w i n M. T o d d . 189 pages. P a r k R i d g e , Ill: A m e r i c a n A s s o c i a t i o n o f N e u r o l o g i c a l S u r g e o n s , 1991. We can learn from the recent biography by Serge Bramly [2] about Leonardo da Vinci, the artist, scientist, philosopher, genius--arguably one of the most fascinating figures in recorded history. Since the beautifully written, gentle biographical sketch by Georgio Vasari, in its second edition in 1563 [4], the multifaceted personality of this extraordinary man has been the subject of many books and essays. I recall, growing up in Central Europe before the War, the impact Merezhkovsky's wonderful romantic account of Leonardo da Vinci's life made on us [10]. Merezhkovsky placed Leonardo in the middle of his trilogy The Christ and the Antichrist, between Julian the Apostate and Peter the Great, meditating on the delicate balance the genius of Leonardo achieved. His various contributions to painting, sculpture, architecture, engineering, anatomical observations, and natural descriptions were the subject of comprehensive individual books [8], and there are wonderful contributions to Leonardo the painter [1], the engineer [3], the inventor [13], the musician [15], the philosopher [5,14], the all-around nature man [7], and the drawer [12]. Many works exist describing the various facsimilies and manuscripts of Leonardo, together with his numerous drawings and observations. The most exhaustive work is by Charles D. O'Malley and J.B. de C.M. Saunders [11], where drawings dedicated to the nervous system occupy 26 pages of a total of 216, a remarkable achievement. As Giorgio de Santillana said: An artist first and last, Leonardo believed that understanding can be reached only by of the eye which 'knows how to see,' of the hand which knows how to follow the intellect, for basically it is the work of the hand which defines for him the compass of man's thought. It is heartwarming that the American Association of Neurological Surgeons was able to publish this particular book, which is dedicated only to the drawings on the nervous system, based on scholarly studies by Dr. Todd. As most of the other works are rather dry descriptions, the elegant style of Dr. Todd as he makes his comments going through the drawings in chronological order is very refreshing, but at the same time, it is a real addition to the scholarly literature on Leonardo da Vinci. Due to the extraordinary impact of the media on public knowledge (one of the few benefits of intelligent television), and to the fact that people are traveling a lot, individuals interested in the life of this unusual genius can enjoy the atmosphere of the last few years of his life in Amboise, espe© 1992 by Elsevier Science Publishing Co., Inc.
cially at the adjacent small Clos-Luc~, where Leonardo moved at the invitation of the King of France, Francois I, in 1517. You can wander through a wonderful museum where reconstructions of all the gadgets related to the imagination and extraordinary curiosity of Leonardo can be seen. Even one of the original codexes of Leonardo is now here in America, as the Leonardo Codex originally in the bibliotheca of Lord Leicester in Holkham Hall was purchased by Dr. Hammer, himself a medical man, and now can be seen at the Los Angeles County Museum of Art. Going back to Dr. Todd's extraordinary dedication to this particular topic, it is sufficient to say that he enlightens the large works dedicated to the anatomical drawings of Leonardo, namely the already mentioned book of O'Malley and Saunders [11], the contributions of Keele and Pedretti [6], who both provided a genuinely warm and appreciative introduction to this work, and Edward MacCurdy's important publication of the notebooks of Leonardo da Vinci [9]. Dr. Todd's individual contributions to Leonardo's genius and his farsighted observations of the nervous system represent an encouraging trend to see neurosurgeons in a different light. Many of the pioneering neurosurgeons had a basic curiosity about how the braia works, how the history of ideas and observations are important in shaping our own philosophy, and how scholarship in humanities and arts molds our own performance. One has only to think of Dr. Cushing and his dedication to the history of medicine and to literary pursuits (his Pulitzer Prize winning Osier biography); of Norman Dott, whose archaeological acumen was extraordinary and who was at the same time a dedicated musician, a cellist, and a great connoisseur of paintings; of Gosta Norlen, whose musical talent almost surpassed his neurosurgical skill; or of Larry Pool, whose critical knowledge about visual art and his passion in appreciating and collecting paintings rivaled his professional skill. To return to Dr. Todd's book, the introductions and forewords of Kenneth Keele and Carlo Pedretti are a great tribute to Dr. Todd's scholarly and artistic mind. After a short reflection on Leonardo and the nervous system in general, Dr. Todd spends some time explaining why drawing is such an important tool in preserving knowledge and why, true to his original philosophy, Leonardo believed that visual information is better than description with words. An interesting chapter gives an account of anatomical illustrations before Leonardo da Vinci, contrasting the rather naive presentations of the past with the extraordinary sophistication of Leonardo's concept. The illustrations in the next chapter cover the skull; there is an analysis of the famous drawing of the Vitruvian Man, now in the possession of the Gallerie dell'Accademia in Venice, regarding the proportions of the human body within a circle, and within a square. 0090-3019/92/$5.00
242
Surg Neurol
Book Reviews
1992;38:241-3
In the chapter on the senses, of course vision occupies most of the observations. Hearing, smell, taste, and touch following in decreasing order. It is interesting to note that in spite of his extraordinary accuracy in certain areas, theories from previous ages were weighing strongly on Leonardo when he presented his drawings on the brain and the cranial nerves. The authoritative weight of Galen, Avicenna, and the theologically heavy burden of Albertus Magnus definitely influenced the presentation by Leonardo. Dr. Todd points out correctly that Leonardo's studies of the nervous system were.continuously dominated by attempts to precisely locate a percipient soul in the center of the brain. In a beautiful illustration of one of the finest representations of the brain, the cerebral ventricles, and cranial nerves, found in an anatomical sheet now in Weimar, a combination of the philosophical burden and the power of observation resulted in an astonishingly interesting concept. Some of the cranial nerves are correctly observed, but for example, the seventh cranial nerve, the facial nerve, was never "discovered" by Leonardo. Dr. Todd's interesting analysis reads like a detective story, again very well integrated with the original observations and quotations from the studies of Keele and Pedretti. Personally, I very much liked Dr. Todd's discussion on Leonardo's approach to the spine and spinal cord, with interesting juxtaposed illustrations from Donatello, Signorelli, and even Masaccio. The eighth chapter is dedicated to the peripheral nerves and the plexuses. It points out the extraordinary difficulties Leonardo must have had in observing cadavers that were decomposed. Without fixation, it is no wonder that details of the plexus, i.e., how the nerve roots formed the spinal nerves, were not better demonstrated in his drawing. Dr. Todd points out that Leonardo indeed was unaware of species differences and quite often resorted to animal dissection to substitute one part for another, making not the most accurate representations. This, however, does not take away the extraordinary lucidity and details of the peripheral nerves, as they are represented in the well-documented illustrations. The summary points out that "Leonardo as an anatomist became a legend in his own time. It was a legend that grew as the unsubstantiated generalities became more exuberant after his death, sustained and implemented by his growing reputation as a painter, but his neuroanatomical endeavors ostensibly lay hidden in unyielding private hands." A very well balanced account is given of the value of the anatomical observations, of the technique, and some of the speculations in regard to function. However, it is quite clear that Leonardo added nothing to our knowledge of the functional capacities of the brain. "His notions of brain function were vague and confused, based upon a garbled interpretation of traditional philosophical doctrina." Conversely, "discovery and original illustration are intimately interwoven in the excellent drawings that reveal the course and interrelationships of the cranial nerves." An addendum analyzes the handwriting of Leonardo, including a very interesting comment on a drawing he made of a man who was hanged for his revolutionary activities and which shows how he started to use this special handwriting at the age of 25 years. The challenge to decipher Leonardo's writing is not unlike the decoding of the hieroglyphics; proper
recognition is given to scholars like Richter, Harvey, and others. A very comprehensive bibliography concludes the book. In summary, I think it is a landmark that the American Association of Neurological Surgeons published this delightfully written, elegantly presented book, as it may encourage other neurosurgeons approaching retirement to exploit some of their investments in their youth into areas not directly related to professional excellence. It may stimulate us to sit down and enjoy the atmosphere of a scholarly research, which, as it is quite clear from the love and warmth of Dr. Todd's observations, may lead us nearer to a comprehensive understanding of our human existence and help us to become better specialists through the disciplines of a universal approach to art and history. GEORGE B. UDVARHELYI, M.D., F.A.C.S. Baltimore, Maryland
References 1. B~rence F. Tout 1' oeuvre paint par Leonard de Vinci. Paris: 1950. 2. Bramly S; Reynolds S, trans. Leonardo: discovering the life of Leonardo da Vinci. Edward Burlingame Books, 1991. 3. Cianchi M. Les machines de Leonard de Vinci, Florence: 1984. 4. ConawayJ, Bondanella V. Georgio Vasari: the lives of the artists; a new translation. Cambridge, UK: Oxford University Press, 1991. 5. de Hevesy A. Pdlerinage avec Leonardo da Vinci. Paris: 1939 6. Keele KD, Pedretti C. Leonardo da Vinci, corpus of the anatomical studies in the collection of her majesty the Queen at Windsor castle. New York: Johnson Reprint Harcourt Brace Jovanovitch, 1979. 7. Kemp M. Leonardo da Vinci: the marvelous works of nature and man. Cambridge, Mass: 1981 8. Leonardo da Vinci. New York: Raynal, 1956. 9. MacCurdy, E. The notebooks of Leonardo da Vinci. New York: George Brasiker, 1954. 10. Merezhkovsky D. The Forerunner: the romance of Leonardo da Vinci. London: 1926. 11. O'Malley CD, Saunders JB. Leonardo da Vinci on the human body: the anatomical, physiological, and embryological drawings of Leonardo da Vinci. New York: Greenwich House, 1962. 12. Popham AE. The drawings of Leonardo da Vinci. London: 1946. 13. Reti L. Leonard de Vinci, i'humaniste, rartiste, l'inventeur. Paris: 1974. 14. Stites RS. The sublimations of Leonardo da Vinci. Washington, DC: 1970. 15. Winternitz E. Leonardo da Vinci as a musician. New Haven: 1982.
Intracerebral Hematomas. Edited by Howard H. Kaufman. 227 pages. N e w York: Raven Press, 1992. I S B N #0-88167-843-0. This book has been long in preparation by the editor, Dr. Kaufman, who began to take an interest in this subject when he was at the National Hospital for Nervous Disease at Queen's Square with Wiley McKissock in 1967-1968.