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| J R Soc Med. 2003 March; 96(3): 139–143. | PMCID: PMC539424 |
Copyright © 2003, The Royal Society of Medicine Thomas Willis and the background to Cerebri Anatome James P B O'Connor, MA MB7 Millcroft Rise, Lofthouse Gate, Wakefield, West Yorkshire WF3 3TL,
UK |
In 1664 Thomas Willis (1621-1675) published a text on the brain and nerves
that was to be deeply influential for the next two centuries. Initially,
Cerebri Anatome had little impact on English medical practice, though
it enhanced Willis's reputation to the extent that he was able to become a
prosperous London
physician 1. Primitive descriptions of the arterial anastomosis at the base of the brain
already existed in 1664. Willis improved on these accounts, and made the first
attempt to attribute a function to the anatomy that he described. In the
eighteenth century his description of the brain became accepted as definitive,
appearing in the Bibliotheca Anatomica of 1774-1777 for the first
time as the famous ‘circle of Willis’. Modern historical
scholarship has highlighted the contribution that Willis made to neuroanatomy,
which had been previously eclipsed by contemporaries such as Thomas
Browne2. Although his description of the anatomy of the brain remains important for
contemporary neurological science, Willis's understanding of the brain was
very different from that of modern scientific thought. Willis wrote
Cerebri Anatome while Professor of Natural Philosophy in Oxford,
where he used the anatomy of the brain as a tool to investigate the nature of
the soul. He wrote at a time when England was in great political and religious
turmoil, following the Civil War and the execution of Charles I, and his work
reflects his allegiances during this turbulent period. In this paper, I
discuss the dependence of Willis's description of anatomy upon his concept of
the human soul. By considering Cerebri Anatome as a product of the
life that Willis led, it is possible to understand his anatomical descriptions
as a reflection of beliefs and practices in the mid-seventeenth century. |
WHY DID WILLIS WRITE ABOUT THE BRAIN? The early seventeenth century saw an unprecedented increase in learning and
scientific advancement. Certain Puritan sects held a radical apocalyptic view
that the end of the world was imminent and would be followed by a one thousand
year reign by Christ. This doctrine spread to all religious groups and became
the dominant concern among English academics. The study of God in the natural
world was encouraged, to gain deeper knowledge of the Creator and thus prepare
the reformers for the coming of Christ. This accelerated the growth of
‘natural philosophy’ as a discipline, so that by the Restoration
of the monarchy in 1660 scientific publishing had reached new
heights3. The
mechanistic philosophies typified by Cartesian dualism had begun to permeate
continental philosophy and were rapidly absorbed in England. They carried
atheistic elements, and theologians such as Henry More responded with
anti-atheist writings. More and his fellow Platonist Ralph Cudworth were
strongly critical of medicophilosophical work with any atheistic
implications4. Thomas Willis (Figure 1)
received his medical degree in 1646 but initially had difficulty establishing
a practice. Consequently, he spent much of the next decade among the
scientific dilettanti of the ‘experimental philosophical club’ in
Oxford, working on fermentation and chemical theories concerning the
constituents of matter. In 1659 he published a series of small tracts,
Distribae duae medico-philosophiae, based on his research on matter
and the basic constituents of life, otherwise known as the ‘vital
soul’5. | Figure 1 Engraving of Thomas Willis by D Loggan, published in 1667
[Reproduced by permission from Hughes JT, Thomas Willis 1621-1675: His
Life and Works, RSM Press, 1991] |
Oxford remained a staunchly Royalist city during the Civil War. During the
Protectorate Willis remained true to the Crown and adhered tightly to his
Anglican beliefs. Services were said in his rooms during the Roundhead seizure
of Oxford, with worshippers including his friend and patient Gilbert
Sheldon6. During the
Commonwealth, men such as Willis were excluded from office. The Restoration
saw fortunes reverse, with Charles II rewarding loyalty. Sheldon was released
from prison and made Bishop of London in 1660 and Archbishop of Canterbury
three years later. Sheldon supported Willis and other Royalists, seeking to
replace scientific radicals and non-conformists with men loyal to the Crown
and Church. Restoration Oxford (Figure
2) was filled with loyal supporters of the King. Sheldon
patronized Willis and helped secure his appointment to the University in
16637. | Figure 2 Restoration Oxford, the site of Willis's research and lectureship
[Reproduced by permission from Fraser A, Charles II: his Life and
Times, Weidenfeld and Nicolson, 1979] |
As Sedlian Professor of Natural Philosophy, Willis would have been expected
to deliver a traditional lecture course, based on Aristotle. However, the
University was still unstable from the Civil War, and relaxed statutory
constraints enabled Willis to teach his own programme combining traditional
views with the new philosophies. Although required to teach on the nature of
the soul, he was able to build upon his chemistry from Oxford and develop
other disciplines. Before 1660 Willis had little experience in
anatomy8. However,
his belief was that anatomy held the key to understanding the rational soul,
which he considered to act upon the brain. In his dedication to Cerebri
Anatome he states that the study of anatomy can ‘unlock the secret
places of Man's Mind and [to] look into the living and breathing Chapel of the
Deity’9.
Willis conceived the brain and the nerves as part of an ordered system,
constructed by God, the Omnipotent Creator. Anatomy, he believed, would
demonstrate structural similarity between man and animals while showing a
difference in higher function, thus proving that man had an immortal soul in
addition to the soul held in common with
animals10. Willis had a comprehensive collection of anatomical studies and atlases at
his disposal. However, as he states in chapter nine of Cerebri
Anatome, they were inadequate for his lectures on the brain, since
‘among the various parts of an animated body which are subject to
Anatomical disquisition, none is presumed to be easier or better known than
the Brain; yet in the mean time, there is none less... perfectly
understood’9.
The problem was not simply that Galen and the ancients were lacking in
anatomical detail; they also erred in their theology. So, Willis sought new
material for his Oxford lectures to provide a sound basis for his
understanding of the brain and soul. The same material formed the basis for
the text of Cerebri Anatome and his subsequent publications,
Pathologiae cerebri et nervosi generis specimen in 1667 and De
anima brutorum in
16726. By publishing Cerebri Anatome, Willis spread his ideas beyond
Oxford to a wider readership, including members of the clergy and the Royal
College of Physicians. Printing restrictions had been imposed by Charles II in
1662, under the supervision of Sheldon, but Willis was exempt from the strict
censorship of the time. Willis staunchly upheld the position of the Crown and
the Church in his work, supporting the return of the
monarchy11 and
accepting the Church as head of the
nation12. Regarded
as conformist and traditional, Cerebri Anatome received an imprimatur
in 1663 and was published the following year. |
HOW DID WILLIS INVESTIGATE THE BRAIN? Willis recognized the importance of method in studying the brain. The first
(and longest) chapter of Cerebri Anatome was devoted to an account on
how best to analyse the brain and nerves, since previous anatomists were let
down by ‘flawed techniques’, producing artifactual results.
Several approaches were used in conjunction to prepare material for the
lectures and for Cerebri Anatome. Work on the material was a
collaborative effort between Willis, Richard Lower, Thomas Millington and
Christopher Wren, who had all worked together in Oxford during the
Commonwealth. The practice of autopsy was commonplace by the mid-seventeenth century in
England. Willis dissected bodies of deceased patients, adding information to
the animal dissections that he
performed13. He
seems to have directed most of the dissection, performed by Lower in the back
rooms of houses and inns. Wren and Millington were frequently present
‘to confer and reason about the uses of the parts’. The brain was
approached from below and removed from the skull before being sliced from the
base upwards, in contrast to traditional methods of in situ
dissection. The specimens were then examined through a magnifying glass and
drawn by
Wren14. Willis followed the Galenic tradition of describing parts of the body and
then suggesting a use to account for their appearance. In Cerebri
Anatome, Willis repeatedly cites the similarity in structure between man
and animals and the differences in ‘uses’ as evidence of an
immaterial God-given soul. Cerebri Anatome refers to some rudimentary experimentation,
although in 1660 the nature of an ‘experiment’ was not rigorously
defined. Willis had formerly collaborated with Robert Boyle, whose discourses
on the nature of experimental philosophy had been adopted by the Royal Society
as the way of obtaining knowledge. Wren used microscopy to analyse
brain specimens. Wren and Lower performed dye injections, and these were the
basis for Willis's discovery of the flow of blood in the cerebral arteries.
Most famously, injection studies on animals immediately after death
demonstrated that blockage of just one of the four main cerebral arteries
would not lead to apoplexy. Willis backed up his morbid anatomy and experimental philosophy by
recalling case histories from living patients. It was in this way that
‘the circle of Willis’, referring to the arterial supply at the
base of the brain, was described (Figure
3). On other occasions, Willis embellished his empirical data with
unsubstantiated speculation, incorporating theories on the compensation of
matter and the action of the ‘spirits’. Medical practice in the
latter half of the seventeenth century was still largely a mix of empiricism
and theory, with no clear division between the two. | Figure 3 Christopher Wren's famous depiction of the base of the human brain as
published in Cerebri Anatome [Reproduced by permission from
Hughes JT, Thomas Willis 1621-1675: His Life and Works, RSM Press,
1991] |
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BRAIN AND SOUL The nature of the soul was intensely debated during the Restoration. The
relation of man's immortal soul to the body and universe was questioned since
new philosophies had thrown doubt on the number of components of the soul and
their sites of operation. The answers had a profound bearing on the doctrine
of the Resurrection, an issue that dominated theology in the second half of
the seventeenth century. In England, natural philosophy grappled with William
Harvey's claim that the soul was a property of the blood—a notion
derived from Aristotle, who saw the heart as the prime mover. Continental
philosophers held different views: van Helmont located the soul in the pylorus
and Descartes favoured the pineal gland. Henry More doubted whether a soft,
curd-like substance such as the brain could allow for higher
faculties4. In his earlier work in Oxford, Willis had modified the theories of
Aristotelian elements, the Paracelsian concept of active particles, and a
version of Gassendi's atomism. He created a system composed of five elements
(spirits, sulphur and salt which were active, as well as earth and water which
bound the others together), from which all matter was
derived15. Although
Willis rejected the Galenic doctrine of the four humours, he did little more
than change the emphasis, still concentrating on imbalances and the
non-naturals. In chapter ten of Cerebri Anatome Willis described a
three-component soul. Like Harvey and the Paduan school, he argued that a
vital soul, the flamma vitalis, acted within the blood. A sensitive
soul arose from the vital soul, formed by the procreation of spirits in a
‘double fountain’ of arteries supplying the cerebrum and
cerebellum in a parallel neural circulation of spiritus. Both vital
and sensitive souls were, according to Willis, to be found in man and beast
alike. They were responsible for basic biological functions such as sensation
and motion, as well as some higher functions including knowledge and simple
reasoning. In addition, man alone had an immortal soul for higher thought,
will and judgment. Though immaterial it operated on the brain. Willis claimed
that the ‘rational soul variously moves the sensitive’, using it
as a vehicle9. His
view of the functioning body, and the anatomy of the brain and nervous system,
was formed by his understanding of the nature of the soul. |
FORMAT OF CEREBRI ANATOME The original publication of Cerebri Anatome in 1664 consists of a
title page (Figure 4),
dedicated to Sheldon, a Preface to the reader, 29 chapters on the uses and
parts of the brain and nerves, and a conclusion. In contrast to many of his
contemporaries such as Boyle, Willis published his work in Latin. The
Reformation had led to an increase in the use of the vernacular, and from the
mid-sixteenth century the liturgy, the Bible and theological works had started
to appear in English. But Latin remained the language of university, Monarchy
and the established Church. By writing in the language of the scholar, Willis
not only identified himself as an authority but also acted in defence of a
learned medical tradition. He sided with the Royal College of Physicians, who
were under attack from the newly formed Royal Society, and in the following
year Willis was elected as an honorary fellow of the College. Latin was also
the language of religious authority and political power; thus Cerebri
Anatome would have tacitly supported the Church and the Crown with the
language of God and the
King16. | Figure 4 Title page of Cerebri Anatome, 1664 [Reproduced by
permission from Hughes JT, Thomas Willis 1621-1675: His Life and
Works, RSM Press, 1991] |
One of Willis's favoured literary devices was metaphor—a commonplace
device in Restoration literature, sermons and philosophical
works17. With
simile it offered a way for Willis to express his opinions on the role of the
King and the Church while writing on the
brain18. The brain
was a ‘kingdom’, a ‘den’, a ‘chest’, a
‘vault’, the capital of the empire and the ‘chapel of the
deity’. It was the primary organ of the body, divided up into
‘provinces’ and ‘villages’ and was separated by
‘waters’ (blood vessels). Nerves were like ‘silver and
gold’, containing spirits, who acted as ‘many distinct troops or
companies of soldiers’ causing muscular movements ‘like the
explosion of gunpowder’. The brain rules over the other parts of the
body and the nerves (soldiers) carried out the actions. It is difficult to
avoid concluding that Willis was commenting on the right of the King to rule
over his land, under the watchful eye of the Church of England. In the preface
to Cerebri Anatome, Willis describes awaking from a sad dream and
ends the book talking of a ‘long and tiresome’ journey, in which
he has laid a foundation for future work. It is possible that he was speaking
of the journey through the Civil War and Commonwealth, and that he had now
woken in the Restoration, watching the return of a former glory. Willis used the macrocosm—microcosm metaphor of God ruling the world
as the soul rules the body. God is portrayed as an ‘artist’ and
‘divine workman’, but Willis went further in his dedication,
stating that in nature there was ‘no page... which shews not the Author
and his Power, Goodness, Trust and Wisdom... [and the]... Providence of the
Great
Creator’9.
Willis ended his dedication with the claim that even the most ‘perverse
atheist’, having studied the brain, must acknowledge God or reject not
only religion but also reason. |
CONCLUSION It is instructive to read Cerebri Anatome as a whole, rather than
as a collection of anatomical descriptions. Although certain of the
observations were the basis for current understanding of cerebral blood flow,
Cerebri Anatome is above all else a work of philosophy. Anatomy was
for Willis part of philosophy and provided a way of investigating the human
soul. |
Acknowledgments I thank David Harley for his suggestions on the text, and Christina Bastow
and Nicola Winter for their help in preparing the typescript. The passages
from Cerebri Anatome are reproduced by permission of the Syndics of
Cambridge University Library. Quotations in English are from the translation
by S Pordage in Practice of Physick, London, 1681. |
References 1. Dewhurst K. Some letters of Dr Thomas Willis. Med
Hist 1972; 16:
63-76 [PubMed]. 2. Compston A. Dr Thomas Willis and the Origins of Clinical
Neuroscience. Cambridge: Plumridge, 1997. 3. Webster C. The Great Instauration: Science, Medicine and
Reform, 1626-1660. London: Duckworth,
1975. 4. Henry J. The matter of souls: medical theory and theology in
seventeenth century England. In: French R, Wear A, eds. The Medical
Revolution of the Seventeenth Century. Cambridge: Cambridge
University Press, 1989:
87-113. 5. Porter R. The Greatest Benefit to Mankind: a Medical
History of Humanity from Antiquity to the Present. London: Harper
Collins, 1997. 6. Hughes JT. Thomas Willis 1621-1675: His Life and
Works. London: Royal Society of Medicine Services,
1991. 7. Cook H. The Decline of the Old Medical Regime in Stuart
London. New York: Cornell University Press,
1986. 8. Frank RG. Thomas Willis and his circle: brain and mind in
seventeenth century medicine. In: Rousseau G, editor. The Languages
of Psyche. Berkeley: University of California Press,
1990: 107-46. 9. Willis T. Cerebri Anatome: cui accessit nervorum
descriptio et usus. London, 1664. 10. Bynum W. The anatomical method, natural theology and the functions
of the brain. Isis
1973; 64:
445-68 [PubMed]. 11. Shapin S, Shaffer S. Leviathan and the Air
Pump. Princeton: Princeton University Press,
1985. 12. Martensen RL. ‘Habit of reason’: anatomy and
Anglicanism in Restoration England. Bull Hist Med
1992; 66:
511-35 [PubMed]. 13. Harley DN. Political post-mortems and morbid anatomy in
seventeenth-century England. S Hist Med
1994;7:
1-28. 14. Dewhurst K, ed. Willis's Oxford Lectures.
London: Sandford, 1980. 15. Wright JP. Locke, Willis and the seventeenth-century Epicurean
soul. In: Osler MJ, ed. Atoms, Pneuma and
Tranquillity. Cambridge: Cambridge University Press,
1991: 239-58. 16. French RK. The languages of William Harvey's Natural Philosophy.
J Hist Med
1994;49:
24-51. 17. Harley DN. Medical metaphors in English moral theology, 1560-1660.
J Hist Med
1993;48:
396-435. 18. Niebyl P. Science and metaphor in the medicine of Restoration
England. Bull Hist Med
1973; 47:
356-74 [PubMed]. |
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