The vessels of liver, spleen and kidneys, c.1508 (verso of 5455483)

In a famous note probably of 1508, Leonardo described witnessing, in the hospital of Santa Maria Nuova in Florence, the death of a man who claimed to be over a hundred years old, whereupon Leonardo conducted an autopsy ‘to see the cause of so sweet a death’. This double-sided sheet comes from the notebook compiled following that dissection, as an attempt to make sense of his findings; the actual dissection notes, which were presumably rapid, sketchy and stained with gore, do not survive. The paths of the vessels connecting the liver, spleen and kidneys to the aorta and vena cava are repeatedly drawn, both in chalk and in ink, and are thus rather confused in the upper two studies. Only in the third drawing does Leonardo arrive at a clear, if only partially correct, arrangement. In that drawing the aorta – on the right as we look at the sheet – gives off first the celiac axis, from which the common hepatic and splenic arteries arise (the left gastric is absent), then the superior mesenteric artery and lastly the renal arteries. The vena cava, alongside, receives the hepatic veins from the upper portion of the liver. The liver is small and the spleen enlarged, indicative of cirrhosis of the liver and associated portal hypertension in his elderly subject. Many of the notes are concerned with the increasing tortuosity and constriction of the vessels in the elderly, as shown in the small detail at the bottom of the page. For instance the passage at upper right asks: Why the veins in the aged should acquire great length, and those which used to be straight become so flexuous, and the coat thickens so much that it closes up and prevents movement of the blood. From this arises the death of the elderly without disease.