Andreas Vesalius’ book De Humani Corporis Fabrica, whose title is best translated as On the Workings of the Human Body, paved the way for modern scientific medicine.  The magnificently illustrated book published in 1543, combined science, technology, and culture in a way few other books have ever done. It sparked a scientific revolution that altered history and is arguably the best known book produced in the history of western medicine.  Vesalius was as interested in the functions of the human body as he was about anatomy and the book gave the world its first accurate knowledge of anatomy and a method by which it could be studied.  Just a few years later, in 1550, Ambroise Pare wrote a similar book, entitled Brief Collection of Anatomy.  Like Vesalius, Pare’s book provided a full description of the human body.  Modern medicine owes much to both writers as they debunked previous theories about anatomy  prevalent since the time of Galen beginning in the first century. (Galenism is a system of medicine consisting of 84 technical treatises and the theory of four bodily humors, blood, phlegm, black and yellow bile.)  Galenism was based on animal rather than human anatomy but his theories held sway for 14 centuries.  In addition to Vesalius and Pare, great artists like Da Vinci, Michaelangelo, Titian and Raphael were known for their work depicting the functioning human body. Each of them contributed to current knowledge about anatomy.

One would believe that after almost five hundred years of study, few secrets remain about the composition and structure of the human body.  Not so, in 2013, a team of Belgian scientists discovered a new ligament located just outside the knee.  To find and characterize this component, orthopedic surgeons Dr. Steven Claes and Dr. Johann Bellemans and their colleagues gathered 41 knee joints from human cadavers and began minutely dissecting them. Their discovery confirmed work done as far back as 1879, when Paul Segond, a French surgeon first speculated that in addition to the four obvious structural knee ligaments then known, the anterior cruciate, medial collateral,  posterior cruciate, and lateral collateral, other ligaments must exist in the knee or it would not be stable.  He wrote that during dissections he had noticed a “pearly, resistant fibrous band, originating at the outside, front portion of the thighbone, and continuing to the shinbone, which he felt stabilized the outer part of the knee.  He did not, however, give this pearly band a name and somehow, in the decades that followed, its existence was forgotten or ignored. It took almost 150 years for resolution.

Last year, there were two other surprising discoveries.  The first was a new ligament on the lateral side of the ankle.  According to the guidelines of human anatomy, the ligaments in the ankle are grouped by two ligament complexes: the lateral collateral ligament in the side of the joint and formed by three independent ligaments and the medial or deltoid collateral ligament.  In a new scientific study a research team defined a surprising anatomic structure in the ankle, the lateral fibulotalocalcaneal ligament complex.  This was possible thanks to the analysis of fibers that link two of the lateral collateral ligament compounds.  The discovery changes the understanding of the ankle joint and could explain why many ankle injuries produce chronic pain.

For the second, researchers in Sweden identified four types of neurons in the peripheral auditory system of the ear, three of which are new to science.  The analysis of these cells can lead to new therapies for various kinds of hearing disorders, such as tinnitus and age-related hearing loss.  It also opens the way for developing genetic tools than can be used for new treatments for other disorders and that influence the function of individual nerve cells.

This year, a network of very fine blood vessels that connects bone marrow directly with the blood supply of the periosteum (connective tissue covering bone) that was previously overlooked was discovered by researchers in Germany.  Although bones are very hard substances they also have a dense network of blood vessels inside them where the bone marrow is located as well as on the outside that is covered by the periosteum.  (This is the reason why bone fractures often cause serious bleeding.)  These researchers have found previously unknown blood vessels in the bones of mice that that travel across the entire length of cortical bone.  This newly discovered system of vessels is used by the immune cells in bone marrow to reach the blood stream and key to allowing immune cells to reach the site of inflammation quickly. 

There may, of course, be other surprises in the future.  Discovery techniques and instrumentation continue to improve as does the means of communicating scientific information.

Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels.  Eclectic Science, the title of his column,  touches on famed doctors and scientists, human senses, aging,  various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at  [email protected].