Aulus Cornelius Celsus and the Head Injuries

Abstract

Aulus Cornelius Celsus lived in Rome during the reigns of Augustus and Tiberius. He developed the scientific Latin, and his work De Medicina was the first medical textbook to be written in Latin, and subsequently the first medical treatise to be printed. He perhaps was a simple medical writer rather than a real physician, but his contributions to medical knowledge are outstanding. He described the tetrad of inflammation (dolor, rubor, calor, tumor), coined the term cancer, and reported several revolutionary surgical techniques. His eighth book, almost entirely dedicated to dislocations and fractures, provides an extensive description of head injuries such as extradural hematomas, lesions distant from the impact point, and intracranial damage in cases with no overlying fractures. He also provided the first description of brain swelling exceeding the level of the skull, described several surgical indications and craniotomy techniques, recommended treatment for depressed fractures (which had been previously considered untreatable), and detailed the surgical instruments employed. De Medicina was based on the previous Greek medical knowledge, but Celsus also provided original innovations, personal observations, and even comments and criticisms. Despite the fact that he was almost forgotten during the Middle Age, most of his concepts and surgical advices remained in the medical background of the following 2 millennia.

Keywords: Celsus; Craniotomy; Extradural hematomas; Head injuries; History of neurosurgery; Neurotraumatology; Roman medicine.