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The Maze of the Cerebrospinal Fluid Discovery

DOI: 10.1155/2013/596027

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Abstract:

The author analyzes a historical, long, and tortuous way to discover the cerebrospinal fluid. At least 35 physicians and anatomists described in the text have laid the fundamentals of recognition of this biological fluid’s presence. On the basis of crucial anatomical, experimental, and clinical works there are four greatest physicians who should be considered as equal cerebrospinal fluid’s discoverers: Egyptian Imhotep, Venetian Nicolo Massa, Italian Domenico Felice Cotugno, and French Fran?ois Magendie. 1. Introduction Cerebrospinal fluid (Latin: liquor cerebrospinalis) is a liquid occupying subarachnoid space (cavum subarachnoideale) and brain ventricles (ventricules cerebri) (see Figure 1). Cerebrospinal fluid was not really discovered in terms of its liquid state of matter until the early 16th century A.D. It took three more centuries for physicians to become aware of its cerebrospinal location. Previously, it was thought that cerebral ventricles contained “spiritus animalis” (spirit of the animal). According to Schaltenbrand, cerebrospinal fluid found in humans and other higher vertebrates replaced the ocean, where 3.5 billion years ago the life had begun [1, 2]. Robertson claims that cerebrospinal fluid comes from amniotic fluid by conversion of the colloidal molecules throughout the embryonic life [3]. It is known and generally accepted by medical historians that cerebrospinal fluid has been discovered by Domenico Cotugno. Figure 1: The MRI sagittal neural tube section. The cerebrospinal fluid surrounding the brain and the spine within subarachnoid space is red-colored on this image. 2. “Spiritus Animalis” Idea Resonating through Centuries From the ancient times to the 16th century, based on the beliefs of Hippocrates from Kos (460–370 B.C.) and Claudius Galen from Pergamon (130–200 A.D.), it was thought that “pneuma psychikon” (Greek: πνε?μα ?ψυχικóv, Latin: spiritus animalis) with its mental functions was located within the cerebral ventricles [4–7]. As far as Galen’s role in the history of medicine is undoubted, not necessarily all the scientists analyzed his texts literally. It was Irani who referring to the research of Torack ascribed the description of the cerebrospinal fluid to Galen [8]. Torack, in turn, gave full credit to Galen for the discovery of the choroid plexus as a site of production of cerebrospinal fluid in his publication of 1982, based on On the usefulness of parts of the body, Galen’s work translated into English in 1968 [9]. According to Conly and Ronald (although without providing the sources) it was Galen who described

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