Tractatus de Fractura Calve sive Cranei

BERENGARIO da CARPI, Jacopo

Published by Hieronymus de Benedictis, Bologna, 1518

About this Item

THE FIRST SEPARATE TREATISE ON HEAD INJURIES. First edition of the first separate treatise on head injuries and their neurosurgical treatment. "The work originated in a dispute between Berengario (1460-1530) and some other physicians over the treatment of Lorenzo de Medici, who had suffered a skull fracture in battle. Berengario described several types of skull fractures and grouped the resulting lesions according to their symptoms, drawing from his own observations, as well as contemporary medical knowledge, to cite the relation between location and neurological effect. He also discussed prognosis, diagnosis and treatment, described the technique of craniotomy and provided detailed illustrations of contemporary neurosurgical instruments. The title illustration is a typical representation of the medieval cell doctrine, which localized mental functions in the ventricles or cells of the brain" (Norman). "The Tractatus was written in little more than two months, soon after Berengario s return to Bologna, and dedicated to Lorenzo de Medici. It opens with a short discussion of various sorts of skull fractures, followed by a grouping of the consequent lesions according to their symptoms. This is the most interesting and valuable portion of the work, for Berengario was able to cite from contemporary knowledge or from his own direct observation the relationship between the location of the lesions and the resulting neurological effects. Next, he discusses prognosis, diagnosis, treatment, the instruments to be employed, and the technique of craniotomy. Berengario s book was the most original neurosurgical treatise until then and was not surpassed until the appearance of Ambroise Paré s similar work in 1562, in which Paré expressed his appreciation of his predecessor s efforts and made use of them" (DSB). "Berengario da Carpi was one of the most famous physicians of the 16th century, a recognized master of anatomy and surgery, an emblematic Renaissance man who combined his medical experience and engineering knowledge to design new surgical instruments, and effectively used the arts of writing and drawing to describe state-of-the-art medicine and provide illustrations of anatomical structures. His greatest contribution to medicine was to write the most important work on craniocerebral surgery of the 16th century, the Tractatus de Fractura Calvae sive Cranei ( Treatise on Fractures of the Calvaria or Cranium ), in which he described an entire set of surgical instruments to be used for cranial operations to treat head traumas that became a reference for later generations of physicians. This was a systematic treatise covering the mechanisms, classification, and medical and surgical treatment of head traumas, and can be considered a milestone in the history of neurotraumatology" (Di Ieva et al.). ABPC/RBH lists four complete copies. "In modern terms, we would say that the Treatise on Fractures of the Calvaria or Cranium deals with the physiopathology, diagnosis, treatment, and prognosis of head injuries. It is essentially based on Berengario s personal experience, although it is presented as a true textbook complete with the most learned references and controversies, and cites many classic and medieval writers such as Hippocrates, Plato, Aristotle, Galen, Paul of Aegina, Cicero, Virgil, Seneca, Celsus, Avicenna, Abulcasis, Lanfranc, and many others. The book is divided into two parts: the first describes the causes of head injuries and proposes a classification system that is intended to be useful in everyday practice, whereas the second concentrates on symptoms, prognostic data, and treatment. "According to Berengario, the broken continuity of the head has intrinsic and extrinsic causes, with the latter divided into three distinct types: cutting objects (incision, according to Celsus definition), contusing objects, and perforating objects. In proposing his classification, Berengario discusses many classic references (Avicenna, Haly. Seller Inventory # 5182

Bibliographic Details

Title: Tractatus de Fractura Calve sive Cranei

Publisher: Hieronymus de Benedictis, Bologna

Publication Date: 1518

Edition: First edition.