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. |
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 (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
.
ETIOLOGY AND PATHOGENESIS
Comments
Post a Comment