RESUMEN
OBJECTIVE: To describe representative Western philosophical, theological, and scientific ideas regarding the nature and location of the soul from the Egyptians to the contemporary period; and to determine the principal themes that have structured the history of the development of the concept of the soul and the implications of the concept of the soul for medical theory and practice. METHODS: We surveyed the ancient Egyptian, Greek, and Roman periods, the early, Medieval, and late Christian eras, as well as the Renaissance, Enlightenment, and Modern periods to determine the most salient ideas regarding the nature and location of the soul. RESULTS: In the history of Western theological, philosophical, and scientific/medical thought, there exist 2 dominant and, in many respects, incompatible concepts of the soul: one that understands the soul to be spiritual and immortal, and another that understands the soul to be material and mortal. In both cases, the soul has been described as being located in a specific organ or anatomic structure or as pan-corporeal, pervading the entire body, and, in some instances, trans-human and even pan-cosmological. Moreover, efforts to discern the nature and location of the soul have, throughout Western history, stimulated physiological exploration as well as theoretical understanding of human anatomy. The search for the soul has, in other words, led to a deepening of our scientific knowledge regarding the physiological and, in particular, cardiovascular and neurological nature of human beings. In addition, in virtually every period, the concept of the soul has shaped how societies thought about, evaluated, and understood the moral legitimacy of scientific and medical procedures: from performing abortions and autopsies to engaging in stem cell research and genetic engineering. CONCLUSION: Our work enriches our shared understanding of the soul by describing some of the key formulations regarding the nature and location of the soul by philosophers, theologians, and physicians. In doing so, we are better able to appreciate the significant role that the concept of the soul has played in the development of Western scientific, medical, and spiritual life. Although ideas about the soul have changed significantly throughout Western history, the idea of the soul as being real and essential to one's personhood has been, and remains, pervasive throughout every period of Western history.
Asunto(s)
Encéfalo/fisiología , Corazón/fisiología , Relaciones Metafisicas Mente-Cuerpo , Psicofisiología , Anatomía/historia , Disciplinas de las Ciencias Biológicas/historia , Europa (Continente) , Historia del Siglo XV , Historia del Siglo XVI , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Historia Antigua , Historia Medieval , Neurología/historia , Fisiología/historia , Filosofías Religiosas/historiaRESUMEN
OBJECTIVE: The lamina terminalis (LT) is a structure of considerable interest for microneurosurgery, and precise knowledge regarding its normal anatomic features and the variations thereof is required. The purpose of this study, which was based on microanatomic dissection of human cadaveric specimens, was to review the microsurgical anatomic features of the LT and its neurovascular relationships. The surgical implications of the morphometric data are discussed. METHODS: The region of the LT was examined in 10 human cadaveric heads, obtained from 8 fresh adult cadavers and 2 formalin-fixed adult cadavers, and in 10 formalin-fixed, isolated, adult brains. An operating microscope was used for all dissections and measurements. RESULTS: Assuming the LT to be a triangular structure, we performed measurements of the distance between the midportion of the upper edge of the chiasm and the lower edge of the anterior commissure (height), which averaged 8.25 mm. The distance between the medial edges of the optic tracts (base) averaged 12.81 mm. The area averaged 52.84 mm(2). A minimal amount of retraction was needed to fully expose the LT, and generally there was no need to mobilize the anterior cerebral artery-anterior communicating artery complex. Perforating branches to the hypothalamus and optic apparatus are laterally located and do not interfere with LT incision and/or fenestration. CONCLUSION: The LT constitutes a clearly identifiable microsurgical target. The allowable extent of LT opening is sufficient to provide wide access into and free cerebrospinal fluid flow from the third ventricle. Fenestration of the LT is a safe procedure, provided that the relevant anatomic landmarks are identified and respected.