BERENGARIO, Jacopo.

The scarce first edition of this ground-breaking medical work – ‘a milestone in the history of neurotraumatology’ (Di Ieva). Jacopo Berengario da Carpi (1470-1530) was professor of anatomy at Bologna for 24 years, and ‘he may be thought of as the immediate predecessor of Vesalius’ (Heirs of Hippocrates). ‘Tractatus’ was ‘a systematic treatise covering the mechanisms, classification, and medical and surgical treatment of head traumas’, where ‘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’ (Di Ieva et al.). Berengario dedicated this work to Lorenzo II de’ Medici, who had suffered a skull injury. The work begins with an overview of types of head injuries: internal, as a consequence of trauma; external, from an object cutting the surface of the skull, bruising or  npiercing it (incisio, contusio, perforatio). These can cause the damage to blood vessels in the skull, and be fatal. The early annotator was especially interested in ‘contusio’. Berengario suggests methods to determine whether specific skull bones are broken, e.g., asking the patient to chew on something and report any pain in the head as a consequence, and discusses odd circumstances, such as how trauma on one side of the head may cause the fracture of a bone on the opposite side, or anatomical questions (e.g., the membrane ‘dura mater’). He also lists important symptoms to determine prognosis (e.g., fever, tremor) as well as remedies to treat external trauma and the best ‘regimen sanitatis’ for recovery.

The final section is concerned with surgery, in particular craniotomy, with handsome illustrations of the neurosurgeon’s instruments, including an innovative interchangeable drill never before discussed in print. ‘Berengario’s interchangeable bit with a compound brace (“vertibulum”), known today as the Hudson brace, [was] a pivotal device in neurosurgery and medical tool design. This drill permitted surgeons to stock multiple bits, perform the craniotomy faster, and decrease equipment costs during a period of increased incidence of cranial fractures, attributable to the introduction of gunpowder. The inspiration stemmed from physicians trained as mathematicians, engineers, and astrologers prior to entering the medical profession. Berengario may have been the first to record the use of such a unique drill, but whether he invented this instrument or merely adapted its use for the craniotomy remains clouded’ (Chorney). A most important work in the history of cranial surgery and traumatology.

Ferdinando Palasciano (1815-91) was an Italian physician, who helped establish the Red Cross. Umberto Calamida (1871-1940) was an Italian otolaryngologist and professor at Milan, trained by G. Gradenigo. He was also a respected scholar of the history of medicine.