Unearthing the Forgotten Fluid: The History and Significance of Cerebrospinal Fluid

The awareness of a fluid enveloping the brain traces back to Hippocrates, while Galen referred to it as an "excremental liquid" within the ventricles, the central cavities. Astonishingly, cerebrospinal fluid (CSF) remained largely overlooked or unknown in the scientific community for nearly sixteen centuries.

It wasn't until the mid-1700s that interest in CSF was rekindled, thanks to Emanuel Swedenborg, a versatile Swedish figure encompassing science, metallurgy, theology, and mysticism. Swedenborg, who had ventured through Europe and returned to Sweden in 1715, spent two decades immersed in various scientific and engineering endeavors, even contemplating the nervous system. His 1741-1744 manuscript described CSF as "spirituous lymph" and a "highly gifted juice" flowing from the fourth ventricle's roof to the medulla oblongata and spinal cord. However, this work was only translated and published in 1887. At the age of 53, he experienced a spiritual awakening, devoting the rest of his life to theological matters, notably authoring "Heaven and Hell" in 1758.

Domenico Cotugno, an Italian physician and anatomy professor at the University of Naples, made a significant stride by illustrating the circulation of CSF through cadaver decapitations, positioning them upright to observe its flow. In his honor, CSF was later referred to as "Liquor Cotunni." This vital fluid originates in the choroid plexus, situated in the central part of the brain, before circulating to supply the brain and spinal cord with nutrients and eliminate metabolic waste. Notably, it acts as a cushion, safeguarding the head from sudden movements or impacts, thus preventing contact between the brain and skull. However, it may not always suffice to shield against brain injuries resulting from events like car accidents or sports-related impacts. Moreover, CSF provides buoyancy, supporting the weight of the brain within the skull.

One of the primary roles of cerebrospinal fluid is to act as a protective cushion, guarding the brain from potential harm caused by abrupt jolts and head impacts.