Elsevier

The Lancet

Volume 393, Issue 10179, 6–12 April 2019, Pages 1465-1472
The Lancet

Review
Leonardo da Vinci's studies of the brain

https://doi.org/10.1016/S0140-6736(19)30302-2Get rights and content

Summary

Leonardo da Vinci (1452–1519) contributed to the study of the nervous system. His earliest surviving anatomical drawings (circa 1485–93) included studies of the skull, brain, and cerebral ventricles. These works reflected his efforts to understand medieval psychology, including the localisation of sensory and motor functions to the brain. He was also the first to pith a frog, concluding that piercing the spinal medulla causes immediate death. After a 10-year interval in the early 1500s Leonardo resumed his anatomical studies and developed a method to inject hot wax into the ventricular system, creating a cast that showed the shape and extent of the ventricles. During this period he also progressed in his understanding of the anatomy of the cranial nerves. Besides being the first to identify the olfactory nerve as a cranial nerve, his dissections showed him that contrary to previous theories, the nerves do not converge on the lateral or third ventricles. Leonardo also performed detailed studies of the peripheral nervous system. Although his discoveries had little influence on the development of the field of anatomy, they represent an astonishingly sharp break from the field that had seen little if any progress in the previous 13 centuries. His work reflects the emergence of the modern scientific era and forms a key part of his integrative approach to art and science.

Introduction

Leonardo's first exposure to anatomy came during his training as an artist in the studio of Andrea del Verrocchio. He would write in his Treatise on Painting (assembled in the 16th century and first printed in 1651) why the painter should learn anatomy: “It is a necessary thing for the painter, in order to be good at arranging parts of the body in attitudes and gestures which can be represented in the nude, to know the anatomy of the sinews, bones, muscles, and tendons.”17 Other artists, such as Lorenzo Ghiberti, Andrea Mantegna, Albrecht Dürer, and Michelangelo, also studied anatomy in the service of their art. And so Leonardo began as an observer of surfaces. By the time he concluded his studies in 1513, Leonardo arguably made more progress than anyone else from the time of the greatest anatomist of antiquity, Galen of Pergamum (circa 130–200 CE) to the author of the De humani corporis fabrica, Andreas Vesalius (1514–64). It is remarkable to consider that Leonardo was not formally trained as an anatomist or physician, and in addition to making dozens of original discoveries he essentially introduced modern methods of anatomical illustration. In addition to approaching anatomy with an artist's perspective, Leonardo also applied his interest in engineering and what he called the elements of machines in an effort to understand the mechanism of the body. Leonardo adopted an ancient framework in which the microcosm (human beings) is analogous to the macrocosm (the universe). This idea, which extends back at least as far as the Timaeus of Plato, led Leonardo to consider the structure and function of the body in direct relation to the planet (eg, comparing bones to mountains and blood to the oceans).

Section snippets

Early studies of the brain and its ventricles

The bulk of Leonardo's surviving anatomical drawings are preserved at Windsor Castle.9 Of these drawings, the earliest are a set of seven sheets dated circa 1485–87, when he was at Milan in his mid-30s and working on painting The Virgin of the Rocks. On one sheet, parts of which were copied by Albrecht Dürer in his Dresden Sketchbook, Leonardo described pithing a frog (figure 1). He wrote: “The frog retains life for some hours when deprived of its head and heart and all its bowels. And if you

Theories of brain function before Leonardo

We can trace theories of sensation and perception to the Greeks. To Aristotle, sensation occurs in a place of convergence of the senses, the sensorium communis or common sense (called senso comune by Leonardo). He believed this sensorium communis was localised to the heart; he reasoned that we feel emotions such as love and loss (“heart-ache”) in our hearts, when we bleed we can lose consciousness, and the heart appears to be the source of heat that drives all of life.

The prevalent view among

Leonardo's understanding of brain function

In a crucial passage entitled “How the five senses are servants of the soul” Leonardo outlined his anatomical and philosophical framework.32 In reading this passage, note that anatomists including Leonardo were confused about the distinction between nerves and tendons, a confusion that lasted until the 17th century: “The soul seems to reside in the judgment, and the judgment would seem to be seated in that part where all the senses meet; and this is called the Common Sense and is not

Exquisite drawings of the skull

Leonardo drew an exquisite set of drawings of the skull, their delicacy enhanced by the masterful use of metalpoint. The main purpose was to locate the geometric center of the brain, which he thought was the location of the senso comune. While the drawings are exceptional from an artistic point of view, they also reflect a collision between Leonardo's impulses of naturalistic observation and his efforts to interpret the confused body of knowledge he inherited about brain structure and function.

Imaging the ventricles

In an effort to determine the shape of the cerebral ventricles Leonardo performed a remarkable experiment circa 1506–08. Working in a slaughterhouse, he injected hot wax directly into the brain of an ox, and after the wax cooled and hardened he dissected away the brain tissue to produce a cast of the lateral, third, and fourth ventricles (figure 5A).38 At the top left we see a lateral view, and Leonardo describes his procedure: “Make two vents in the horns of the great ventricles and inject

Perspective and summary of accomplishments

Leonardo emphasised visualised knowledge. His contributions to neuroscience included many topics beyond studying the ventricles (panel). His studies of the brain, nerves, and ventricles are significant for several reasons. They show his contributions as an anatomist, making observations from experience in a way that had not even been attempted since the time of Galen 1300 years earlier. As an experimentalist, his wax injections represent a significant advance in understanding of the structure

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