1720RuyschF

 

The author draws attention to the well-developed blood supply of the acetabular fossa, as well as the ligamentum capitis femoris (LCF). In the work, it is referred to as the «ligamentum nerveo-cartilagineum», which literally means the tough cartilaginous ligament and implies its strength. With the difficulty of accessing the acetabular fossa, and therefore the LCF, Frederik Ruysch associates the inefficiency of treating hip joint pain. The writer presumably implies osteoarthritis. In our opinion, its development is initiated by the pathology of the LCF (2012АрхиповСВ). The discussed work includes a black and white drawing of the LCF of a child, made by the illustrator Jan Wandelaar. In color, the same preparation, but from a different angle, was depicted by the artist Jan l'Admiral in a separate publication (1738LadmiralJ).

Ruysch F. Adversarium anatomico-medico-chirurgicorum decas secunda. In quâ varia notatu digna recensentur. Cum figuris aeneis. Amsterdami: apud Janssonio-Waesbergios, MDCCXX [1720].
Quote pp. 1-3
I. De Membrana & vafis Sanguiferis in Acetabulo Coxa. Omnia offa fuâ ambiri membranâ fcripferant Anatomici, folos Dentes Periostio dicebant carere. Illi vero qui accuratâ indagine mirabilia in Conchâ Auris Officula deinde detexerant , & hæc, Dentium inftar, omni proprio veftimento nuda tam feverê docent, ut infanire viderer Principi in Anatomicis viro, quando olim & hæc ipfà arctê investiri verâ membranâ, verô Perioftio, fcripferam, addideramque fimul vafa Sanguifera excipi, ordinatim diftribui, perque membranam hanc in meatus horum Officulorum introire, humores eô deferre, imô verô & inde iterum recipere vascular, quæ perfunctos munere fuo humores ex ipfis horum officulorum meditulliis reducunt. Neque minus incredibilia proferre cenfebar, quando fcribebam publicè inventum mihi Corticem Cerebri folo fabrefactum vasculorum Sanguiferorum contextu. Quid itaque cenfebunt, qui me legunt fcribentem, cavitatem Acetabuli in offibus innominatis ex parte obducta effe membranulâ tenuiffimâ, quæ ita contexitur mirabili vasculorum fanguiferorum apparatu, ut arte meâ repleta hæc totam membranulam nitenti undique pingant rubedine: eminus enim luftrata oculo membrana hæc abfolute rubra apparet. Neque eft, ut quis putet membranofas partes ex tenerrimis contextas vafis ilicó in locis illis perire debere utpote, quæ fuftinent molem fuperioris corporis, atque attritu perpetuo in fe invicem actæ facile deftruerent tenella hæcce vascular, unde inflammations, dolores, fuppurationes, atque alia mala perpetuo fequerentur. Ut enim hæc caveret incommode Creator, cavitatem hanc ita conftruxit, ut impoffibile fit, capiti Offis Femoris membranam hanc, vel vascular ejus, attingere. Locus namque in quo tuta reconditur, eft extra hemifphoricam fuperficiem cavam Acetabuli, unde globofum offis Femoris caput, mobile intra descriptam cavitatem: eique fere congruens, nullâ parte fuæ fuperficiei unquam poffit tangere membranulam, ejusque vascular, ut manifeftum erit unicuique qui infpicit Figuram. Nemo miretur latuiffe tamdiu atque effugiffe omnem perfpicacium Anatomicorum induftriam hujus membranæ apparatum: quis etenim artificum hactenus potuit ceraceam materiem ita impellere, ita dirigere, ut in intima hæc eo penetret impetus, ut abditiffima hæc, & remota ab Arteriis majoribus, vascula tam perfectê repleat? Attamen absque hâc felicitate fucceffus fruftra erit, quicumque vel membranulam hanc fubtiliffimam fpectare cupitlonge minus poffibile erit ulli vascula in hac tenuiffimà aliter detegere. Dolor coxarius ægrotantibus cruciatum, medicis verô opprobrium effe, triftis fæpe clamat experientia. Eft, ille fæpenumero incurabilis, nec levatur medicamentis, veficantibus non auscultate, ferro refiftit ipfi & igni. Coqueftus jam de hisce Divus Hippocrates, nec mirum videtur fedem tum fixiffe in vasculis profundiffimê fitis in diverticulo Acetabuli intra cavitatem ejus pofito. Nonne igitur difficillimum eft cô intactis viribus illibata medicamenta afferre? In icone cernis reptatus, & numerum, vasculorum fanguiferorum per hanc membranam. Monendus tamen es pictorem, artis fuæ peritiflimum licet, mirabilem naturæ ornatum haud fatis feliciter affecutum fuifle: quia tam numerofa, tam implicita, hæc funt, ut imitari fere fit impoffibile. Ideoque partem hanc ita præparatam, atque balfamo conditam, ita affervo in novo, quod jam iterum paro, gazophylacio Anatomico, ut unicuique idoneo fpectatori lubens illud contemplandum exhibere promtus fim.	I. About the membrane and blood vessels in the acetabular cavity of the hip joint. Anatomists wrote that all bones are enveloped in their own membrane called periosteum, and that teeth lack periosteum. However, those who meticulously examined the remarkable details in the ear's conch, discovered that these organs, like teeth, are completely devoid of any special membrane, and teach with such confidence that it almost seems like they are returning to childhood, when even the greatest anatomist finds it strange that I, in describing this, point out that these organs are indeed tightly covered by a true membrane, not periosteum, and at the same time acknowledge that blood vessels are laid out in order and penetrate through this membrane into the channels of these organs, carrying fluids into them, and even from there they again receive vessels, which, having fulfilled their function, return fluids from the middle of the bones. I did not consider it very improbable when I publicly described my discovery that the cerebral cortex consists only of a network of blood vessels. What will those who read me say when I assert that the cavity of the acetabulum in the innominate bone is partially covered with a very thin membrane, which is so amazingly dotted with blood vessels that the vessels filled with my skill paint this entire membrane with a bright red color: looking at this membrane from some distance, it looks completely red. One should not think that the membrane parts, made up of extremely thin capillaries in those places, should die, since they bear the weight of the upper body and with constant friction can easily destroy these delicate vessels, which is why inflammation, pain, purulent processes and other troubles constantly arise. For, in order to avoid inconvenience, the Creator arranged this cavity in such a way that it is impossible even for the head of the femur to come into contact with this membrane or its vessels. The place where it is safely located is behind the cavity of the hemispherical surface of the Acetabula, from where the head of the femur, moving within the described cavity, and very compatible with it, can never touch either the membrane or its capillaries, as will be clear to anyone who examines the image. No one should be surprised that this apparatus of the membrane has remained hidden and evaded all attention for so long amid the activities of all conscientious anatomists: after all, what artist could have directed wax material so far into the depths, so as to completely fill these vessels, which are so remote from the major arteries? Nevertheless, without this fortunate success, the attempts of anyone wishing to examine this extremely delicate membrane would be in vain, let alone the possibility of detecting other vessels in this extremely thin membrane. Hip pain is a torment for patients, even a reproach to doctors, and often evidence of a sad experience. This suffering is often incurable, cannot be mitigated by drugs, cannot be cauterized, and is not subject to either medical techniques or iron or fire. So, the wondrous Hippocrates already complained about this, and it is not surprising that he considered the vessels that were deeply located in the diverticulum of the acetabulum, located in its cavity, to be the place of refuge for him. Isn't it true that it is extremely difficult to deliver effective medicament there? In the picture you see the image and number of blood vessels in this membrane. However, it is worth warning the artist, although he is a master of his craft, that he could not fully capture the astonishing ornamentation of nature, as it is so numerous and intricate that it is almost impossible to recreate. Therefore, I keep this part prepared and soaked in balm, and in a new anatomical treasury I am ready to show it to every spectator who comes and is ready to look at it joyfully.
Tab. III
FIG. I. Exhibet portionem magnam innominati offis, osque facrum à latere, quæ perioftio adhuc cinguntur fuo. A. Os facrum periofteo, & vafis fanguiferis cinctum. B. Os Ilium. C. Magnus nervus, fupra offis femoris caput decurrens verfus femur. D. Caput offis femoris. FIG. II. Fruftulum mefenterii, cum innumerabilibus vafculis, inftar filamentorum telæ arancæ, quæ tamen repléta funt materiâ ceraceâ rubrâ. FIG. III. A. Acetabulum offis femoris ex juvene. B. Arteriola ad infima acetabuli repertæ. C. Ligamentum nerveo cartilagineum, quod nectit caput offis femoris cavo acetabuli, undique Vafis cinctum. D. Caput offis femoris. FIG. IV. Capfula facta ex inteftino jejuno pueri, & in illa eft, fegmentum Inteftini coli, & Ilei refertum ita dictis glandulis, & vafis fanguiferis. A. Capfula. B. Segmentum Inteftini cocci. C. Segmentum Ilei. D. Proceffus vermiformis, cum fuis ita dictis glandulis. FIG. V. Embryo humanus, cum rudimento funiculi umbilicalis, pendent in liquore, & demonftrant evidenter rudimentum illud ipfo embryone craffius; in hoc embryone nec nafus, nec os, nec oculi apparent fed modô rudis, indigeftaque moles. A. Rudimentum funiculi umbilicalis. B. Carina embryonis. C. Capitulum embryonis.	Figure I. Depicts a large portion of the unnamed bone and femur from the side, which are still covered by their periosteum. A. Femur surrounded by periosteum and blood vessels. B. Pelvis bone. C. Large nerve running above the femur head towards the thigh. D. Femur head. Figure II. A segment of the mesentery with numerous vessels resembling threads of orange peel, but filled with red wax-like substance. Figure III. A. Acetabulum of a young person's femur. B. Small arterioles found in the lower part of the acetabulum. C. Ligamentum nerveo-cartilagineum connecting the femur head to the acetabular cavity, surrounded by vessels on all sides. D. Femur head. Figure IV. Capsule made from the thin intestine of a boy, inside of which is a segment of the colon and ileum filled with so-called glands and blood vessels. A. Capsule. B. Segment of the colon. C. Segment of the ileum. D. Appendix vermiformis with its so-called glands. Figure V. Human embryo with a rudiment of the umbilical cord, suspended in fluid, and clearly demonstrating a larger rudiment of the embryo itself; in this embryo, neither the nose, mouth, nor eyes are apparent, only a rough and unformed mass. A. Rudiment of the umbilical cord. B. Carina of the embryo. C. Head of the embryo.
Illustrator's signature.
J. Wandelaar ad vivum feicit	J. Wandelaar brought it to life.

 

External links

Ruysch F. Adversarium anatomico-medico-chirurgicorum decas secunda. In quâ varia notatu digna recensentur. Cum figuris aeneis. Amsterdami: apud Janssonio-Waesbergios, MDCCXX [1720]. [books.google] 

Authors & Affiliations

Frederik Ruysch (1638–1731) was a Dutch botanist and anatomist, a praelector of the Amsterdam surgeon's guild, a professor of botany in the Hortus Botanicus Amsterdam. [wikipedia.org]

 

Portrait of Frederik Ruysch (1694) 
The author of the image is Juriaen Poo; 
original in the wikipedia.org collection (CC0 – Public Domain, color correction)

Jan Wandelaar (1690-1759), was an painter, illustrator and engraver from the Northern Netherlands. [wikipedia.org]

 

Jan Wandelaar (1743)
Self-portrait; original in the wikimedia.org collection
(CC 1.0 – Universal Public Domain, color correction)

Keywords

ligamentum capitis femoris, ligamentum teres, ligament of head of femur, anatomy, image, blood supply, vascularization, pathogenesis

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