The Works of William Harvey 9780812208627

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THE WORKS OF W I L L I A M HARVEY

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THE WORKS OF

WILLIAM HARVEY Translated by Robert Willis, M.D. Introduction by Arthur C. Guyton, M.D.

University of Pennsylvania Press Philadelphia

UNIVERSITY OF PENNSYLVANIA PRESS

CLASSICS IN MEDICINE AND BIOLOGY SERIES Edited by ALFRED P. FISHMAN, M.D. William Maul Measey Professor of Medicine University of Pennsylvania

Introduction by Arthur Guyton copyright © 1989 by the University of Pennsylvania Press ALL RIGHTS RESERVED

Printed in the United States of America Library of Congress Cataloging-in-Publication Data Harvey, William, 1578-1657. [Works. 1989] The works of William Harvey / translated by Robert Willis; introduction by Arthur C. Guyton. p. cm.—(University of Pennsylvania Press classics in medicine and biology series) Reprint Originally published: New York : Johnson Reprint Corp., 1965. Bibliography: p. ISBN 0-8122-8166-7 1. Physiology—Early works to 1800. 2. Blood—Circulation—Early works to 1800. 3. Embryology—Early works to 1800. I. Willis, Robert, 1799-1878. II. Title. III. Series. QP29.H37A2 1989 612—dc!9 88-28081 CIP

INTRODUCTION

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W I L L I A M HARVEY, HIS TIMES, AND HIS ACHIEVEMENTS* ARTHUR C. GUYTON, M.D.

William Harvey's book on the circulation, published in 1628, demonstrated clearly that the heart pumps blood in a circle through the body. Strange as it seems to us today, this concept was so revolutionary to Harvey's contemporaries that the world's basic understanding of how the body functions was thrown into turmoil. Only after another half century did the immediate aftershocks clear, leaving a legacy that affected forever all of medical science. This book, written in Latin, was entitled Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, and commonly referred to as de Motu Cordis. Its English translation is Anatomical Studies on the Motion of the Heart and Blood in Animals. Probably no other scientific work in history so changed the fundamental knowledge of physiology, changing also the essential bases of medical practice. Yet, Harvey's life goals were even loftier than merely to revise circulatory physiology, for during the last two-thirds of his career an inner fire drove him incessantly to explain the origin of life itself; what could be more gratifying to one's intellect, even to one's soul? His eventual book on this subject, entitled Anatomical Exercises on the Generation of Animals, was published in 1851. Reprinted in this volume are these two monumental works, along with various letters and sundry other writings that tell much about Harvey as a man. Harvey wrote both his books in

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Latin, and there is no evidence that he personally ever translated them into English. The first English translation of his book on the circulation was not published until 1653, twenty-five years after the Latin version. The translator is unknown, but subsequent scholars have found this early translation to be so inadequate that it is rarely if ever quoted or reproduced. Since that time there have been at least five other English translations. The translation most often reprinted, the one reprinted here as well, is that of Robert Willis, M.D. Willis also translated the other writings of Harvey that are reprinted here. These translations were completed in 1847, as a work of love on the part of Willis, but also for the specific purpose of publication in the Sydenham Society of London's scientific historical series entitled The Sources of Science. There are many reasons for this new reprinting of Harvey's works, but they are especially to keep before all of us the historical perspective of Harvey's revolutionaiy achievements—especially to let everyone remember that only a short while ago our knowledge of the circulatory system, indeed of the whole body, was based more on whimsical fancy than on truth. And equally important, we again remind ourselves how difficult it is to remold the thinking of even the most astute scientist when doctrines from the past are so often repeated that they achieve the infinite authority of age. Harvey's greatness in history rests almost exclusively on his discovery of the circulation. However, it could have rested equally securely on his work and discoveries on the generation of life, had he lived but a few years later when the necessary scientific tools, especially the microscope, had become available. Harvey's book on this subject displays the same genius that was the basis of his success in studying the circulation, though it did not have the same fortune. Harvey almost certainly was not the only person of his times who contemplated the circulation of the blood. In particular, some historians interpret the fifteenth-century writings of Caesalpinus to have postulated in general terms not only a pulmonary circulation but a peripheral circulation as well, even suggesting the presence of anastomoses between the arteries and the veins, vasa in capillamenta resoluta. Therefore, it is clear that at least a few others besides Harvey were beginning

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to understand that the newer knowledge of the heart and blood vessels was incompatible with older concepts. However, the difference between Harvey and these others was that Harvey marshaled a vast amount of experimental evidence, accurately observed and forcefully presented, which painted a composite picture of a heart pumping large quantities of arterial blood continuously throughout the entire body, thence back by way of the veins to the right heart and lungs and around the circulation again. Only this concept could fit the large amounts of evidence that Harvey amassed. The fact that blood flows in a circuitous route through the body is so much second nature to us now, and seems to be so elementary, that it is very difficult to conceive of anything different. Yet, less than 400 years ago, a few years after the first European settlement of America, it was still almost inviolate doctrine that blood did not flow in a circuit through the body; instead, it ebbed to and fro in the arteries from the heart to the tissues, and in the veins from the liver to the tissues. The purpose of the heart was more to warm the blood and to add "vital spirits" than to pump the blood, if indeed it pumped blood at all. Where did these previous concepts come from? The answer: most of them went all the way back to Galen in the second century A.D., perpetuating fourteen centuries of dogma repeated from generation to generation. In turn, a few of Galen's own concepts came from Aristotle, and even from Hippocrates and Plato five centuries earlier in the fourth century B.C. Thus, the science of the circulation had been almost static for nearly 2,000 years.

Harvey's Times Harvey was born in 1578 during the latter part of the Renaissance. In England the revival of literature, philosophy, public discussion, and free thought had already been underway for over a hundred years, brought about partly through mass dissemination of knowledge as an aftermath of the invention of the printing press in 1439. Medical knowledge, however, lagged generations behind, partly because medical learning was strongly dominated by a fanatic, almost religious devotion to the teach-

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ings of Galen that had been made almost sacred by the strictures on free thought during medieval times. Also, the force of the Inquisition still remained in many areas of Europe, insuring that new writings be consistent with the doctrine of truth as held by the church from antiquity. The goal of the medieval scholar was mainly to perpetuate this truth, not to inquire into its validity. Under Greek and Roman cultures, from the time of Aristotle (384-322 B.C.) through the life of Galen, a period of over five centuries, thought and scientific inquiry had enjoyed a period of relative freedom. An understanding of the anatomical structure of the body took form, and beginning theories of bodily function were born, finding their greatest flowering in the hands of Galen (131-201). Galen was an exceptional talent among the Graeco-Roman physicians. He summarized in prolific writings virtually all the physiological knowledge gained from the early Greek and Alexandrian sources, as well as greatly expanding this with numerous personal anatomical dissections and physiological experiments. Galen's observational methods included vivisection, from which he studied the motions of living internal oi-gans, including the heart and arteries. But, wherever his observational knowledge ended, he had few qualms about supplementing it with vivid imagination. Thus, he was able to provide detailed treatises on the function of almost any part of the body, including exact accounts of the roles of the heart and vascular structures in the life of the body. Though Galen was often seriously wrong, especially so in his description of the function of the heart and blood vessels, his advances were still monumental. Not long after Galen's time, church doctrinairism began to shroud free thought and inquiry. Therefore, it is no wonder that Galen's physiological teachings, by far the greatest that had yet been achieved, should become enshrined as the ultimate of medical knowledge. And as long as the oppressive rule of the medieval times held sway, so also did Galen remain the supreme physiological authority of western culture, spanning a period of fourteen centuries. Beginning in the 1400s the Renaissance of literature, philosophy, and public debate led the way out of the medieval strait jacket. In England, King Henry VIII (1491-1547), who lived almost a century before Harvey, blazed the way in breaking with

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supreme ecclesiastical authority, and in 1558, only eleven years after the end of Henry YIU's reign, Elizabeth I (1533-1603) came to the throne. Her rule, coupled after 1603 with that of her successor James I (1566-1625), provided three-quarters of a century of dynamic progress in British life, leading to the world exploits of Sir Francis Drake (15407-1596), the literary works of Shakespeare (1564-1616), and the philosophy of Sir Francis Bacon (1561-1626). But after Charles I (1600-1649) came to power in 1625, a turbulent period of public activism began, characterized by religious conflicts pitting Roman Catholics against Protestants, and by political conflicts between opposing advocates of divine right of the king and parliamentary rule. These conflicts eventuated in England's First Civil War from 1642 to 1646, in which Harvey, as personal physician to the king, was deeply involved. At the beginning of this war, Harvey was already 64 years old, and the havoc of the war years followed by their aftermath of Cromwellian reforms plus several other smaller wars trod heavily on his life, as we shall see. The world of science during the 1500s likewise saw a dawn of dramatic changes, but certain scientific discoveries also became the cause of serious religious backlash, delaying development in at least some areas of science until several generations after literature and philosophy had already reached full flowering. Especially revolutionary were the studies of Copernicus (1473-1543), a Prussian astronomer who lived a century before Harvey. He succeeded in mapping the motions of the planets with respect to the earth and sun and stars, and came to the inescapable conclusion that earth and the other planets move in orbits around the sun, a direct contradiction to strict literal interpretation of the Bible that ascribed to earth the central position. Then, during Harvey's lifetime, Kepler (15711630) added mathematical precision to the Copernican system of planetary motion, and Galileo (1564-1642), from his study of the heavens with his telescope, gave undeniable experimental proof to the theories of both Copernicus and Kepler. Galileo was a teacher of mathematics at Padua, Italy, where Harvey studied medicine from the years 1600 to 1602. Though evidence is lacking that Harvey had significant direct contact with Galileo, nevertheless, the climate of changing thought was everywhere about Harvey. Yet, restrictions were also still alive.

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This was emphasized by the Inquisitional trial of Galileo in 1633, followed by enforced suppression of many of his ideas, as well as by house imprisonment for the last eight years of his life. It was in this same period of time that M. Servetus (15091553) provided the first written description (1553) of blood flow through the lungs. Servetus was burned at the stake at the instigation of Calvin, a strict Protestant reformer, only a few months thereafter, not specifically for his description of blood flow in the lungs but for a totality of heretical thinking. Thus, Harvey was born into a time of blossoming yet restricted thought, with science still under many restrictions of medieval doctrine. He was born into a landed family of moderate to wellto-do means near Folkestone, England, in 1578. His father was later mayor of Folkestone on four separate occasions. Otherwise, not much is known about Harvey's early life except that his preuniversity education was in a private school of good repute and that he entered Cambridge University at the age of 15. Four years later, in 1597, he received a BA. degree from Cambridge, but remained there another two years studying mainly pre-medical subjects. In early 1600 he traveled to Padua, Italy, to study medicine at the greatest scientific university of the day. He received his medical certificate with at least some level of honors in 1602. On returning to London after his medical schooling in Padua, he began the practice of medicine in 1603; he rose rapidly in the medical world, helped at least partly by his marriage to Elizabeth Browne, the daughter of Dr. Lancelot Browne, Physician to Queen Elizabeth and later to King James. By the year 1607 Harvey had been admitted to the Royal College of Physicians, but only after a series of four stiff examinations. In 1615 he was given a lifetime appointment by the Royal College of Physicians as Lumleian Lecturer, and in 1616 he was appointed as Physician to St. Bartholomew's Hospital, which made him chief of the medical program of that hospital as well, a position he held until 1646. It was in his inaugural series of Lumleian lectures in 1616 that he first described the circulation of the blood in many of the same terms that he later used in his book. Yet, it was another twelve years before he collected all his arguments and experimental evidence, and published these in his book de Motu Cor-

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dis as undeniable bases for believing that the blood does indeed circulate. Throughout his professional life, Harvey had close associations with royalty, beginning in 1616 in the footsteps of his father-in-law as a Physician to King James I and his court and eventually serving in the special position of Principal Physician to Charles I. He continued in this capacity through England's Civil War (1642-1646) and, though less actively so, even until Charles was hanged in 1649. Harvey had real personal affection for Charles. In turn Charles was clearly a personal friend and patron of Harvey's scientific inquiry. Both James and Charles, especially the latter, observed some of Harvey's experiments and were keenly interested in Harvey's scholarship and philosophy. In fact, Charles participated actively in some of Harvey's experiments. When Charles was deposed in 1646, imprisoned in 1647, and hanged in 1649 as an aftermath of the Civil War, Harvey indeed lost a great supporter, and he retreated into melancholic solace among his thoughts and work for the remaining eight years of his life, dying at the age of 79 in 1657. To understand fully how Harvey was affected by these times, it is worth reading carefully his own feelings as expressed in 1650 to his friend George Ent: "And truly, did I not find solace in my studies, and a balm for my spirit in the memory of my observations of former years, I should feel little desire for longer life." Because of Harvey's loyalty to Charles through and after the Civil War (1642-1646), he was fined 2000 pounds. Also, he was legally banished for two years from within twenty miles of London, though in reality he remained in the homes of his brothers only a few miles from London. The Scientific Background for Harvey's Discoveries On graduating in medicine in 1602, Harvey inherited a fourteen-century-old legacy of almost sacred anatomical and physiological truth as originally expressed by Galen. Medical science even in the seventeenth century was still fearful of challenging this truth. Harvey reflected this fear at several points in de Motu

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Cordis, but he also pleaded for open minds. He did not blame Galen for this state of medical science; the blame was on the nature of man himself. In fact, Harvey revered Galen for his achievements, especially for the fact that Galen, like himself, contributed to medical science through experiments and observation. The genius of both these men was that they trusted their senses of observation and contrived new and novel ways to demonstrate observational truth rather than accepting hearsay from the past as ultimate authority. Yet, with all that Galen had accomplished, the unknowns in medical science remained vast. Unfortunately, as we noted above, many of Galen's more speculative theses on the mysteries of the body had been repeated so often over the centuries that they had become almost inviolable truth. The mysteries of the circulatory system, as formulated in Galen's teachings and still so interpreted at the time of Harvey, were that the blood did not circulate through the body at all but instead was formed centrally and carried peripherally to the outlying tissues by both the arteries and the veins. There, great portions of the blood were eventually consumed. The teachings were basically the following. An initial portion of the blood came from the stomach where "raw aliment" was concocted from the food. The stomach refined this aliment to form "chyle" that went by way of the portal vein to the liver. In the liver, the chyle was freed of impurities and further concocted to form venous blood. In turn, the venous blood was considered to be the "natural spirit" that provided the body's nourishment. From the liver a portion of the venous blood went by way of the vena cava to the right heart And lungs, giving nourishment to both of these. A small amount of this blood passed from the right ventricle through "porosities" in the interventricular septum into the left ventricle. In the meantime, air was pulled by respiration into the lungs. This air contained "prieuma," another basic necessity of life. From the lungs, pneuma entered the pulmonary veins and, after passing through the left atrium, entered the left ventricle. Here pneuma and venous blood were mixed, and the heart itself added heat to this mixture, providing an ultimate concoction containing "vital spirits." The vital spirits in turn were carried in the arteries to all parts of the body. Pulsation in the arteries was believed to

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be the result of ebbing of blood forward and backward, carrying vital spirits to all the body's tissues and then returning "fuliginous vapors" from the tissues back to the heart and lungs to be breathed out into the air. The remaining venous blood from the liverflowedto the tissues in the reverse direction through the veins, directly providing nourishment, the "natural spirits," in addition to the "vital spirits" provided by the arteries. Some believed that the venous blood traveled only in the outward direction to the tissues, though other variations of the theory had blood ebbing to and fro in the veins in a manner similar to that in the arteries. Thus, the Galenic system provided for transfer of nourishment, heat, and "pneuma" to the tissues, so that most of the mystery of how food and air sustained the living body was resolved. Galen had come to these conclusions because he could not demonstrate direct connections between the arteries and the veins either in the lungs or in the peripheral tissues. Yet, strangely, his thesis required blood toflowfromthe right ventricle to the left ventricle through porosities in the interventricular septum of the heart. He thought that he had observed such porosities, though perhaps what he saw were instead the nonpenetrating spaces among the intraventricular trabeculae. Thus, the science of the circulatory system was a morass of almost mystical musings. Even so, it is not correct to believe that before Harvey there were no significant changes in medical science affecting this area. Many anatomists, in particular, were adding intricate structural detail to our knowledge of gross anatomy, and writing books and publishing anatomical drawings that made this detail available to all. The most famous of these anatomists was Vesalius (1514—1564) who preceded Harvey by three-quarters of a century. Equally learned and adding much more to Vesalius's anatomy was his pupil Fabricus (1536-1619). Fabricus was one of Harvey's teachers at Padua, and probably the person who had the single greatest influence on Harvey's subsequent career. Even Leonardo da Vinci (1452—1519), the great scientist-artist of the fifteenth and early sixteenth centuries, who preceded Vesalius by two generations and Harvey by a full century, had left intricate drawings of many structures of the body, including very detailed drawings of the heart valves. Yet, despite all the advances in the study of anatomy, most

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scholars adapted their anatomical thought to fit with Galen's explanation of the physiology of the heart and blood vessels. Still, a few chinks in the Galenic armour were beginning to appear. For instance, Vesalius stated that he had not been able to find the Galen-postulated "porosities" in the interventricular septum of the heart. But he was careful not to state that they did not exist, thus not challenging directly the Galenic scheme. In addition, when Fabricus described the venous valves, he fitted their function to Galenic principles by stating that their purpose was only to delay the peripheral flow of blood in the veins, not to prevent it. In other words, Fabricus's idea of the venous valves was simply that they provided resistance to peripherally-directed flow of venous blood, thereby promoting more appropriate distribution of blood to the different tissues. A few anatomists were more adventurous and were willing to state flatly that there were no interventricular porosities between the right and left ventricles through which blood could flow. The only other way in which blood could pass from the right ventricle to the left heart and aorta would therefore have to be by way of the lungs. This idea was first expressed in writing by M. Servetus in 1553, but was embedded in a fanatical religious treatise that in its entirety was found by the Calvinist church to be heretical. As a result, only a few months after the printing of his book, Servetus was burned at the stake along with all the copies of the book that could be found. At about the same time, Realdus Columbus (1516-1559) was beginning also to state definitively the non-existence of porosities in the interventricular septum, and he proposed that blood flowed from the right heart through a pulmonary circulation and thence into the left heart (published posthumously in 1560). A pupil-colleague of Columbus, Andreas Caesalpinus (1524-1603), further popularized the discoveries and thoughts of Columbus and added others of his own during the 44 years that he lived after the death of Columbus. The evidence for blood flow through the pulmonary circulation, though expressed by these authors in different ways, was mainly threefold. (1) There were no openings through the interventricular septum by which blood could go directly from the right ventricle into the left ventricle. (2) The pulmonary artery was filled with blood and not with air, and the pulmonary venous

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blood also had characteristics different from the blood in the vena cava because of addition of air in the lungs, not in the heart. (3) The mitral valve allowed blood to flow only unidirectionally from the lungs into the left ventricle without any flow in the backward direction to deliver to the lungs the arterial "fuliginous vapors" of Galen. Thus, the arguments of all these anatomists served rather to prove the lack of logic of the Galenic scheme than to give positive proof of bloodflowthrough the lungs. Some of the other very famous anatomists of the day, including especially Fallopius (1523-1562), for whom the fallopian tubes are named, continued to ridicule the idea of blood flowing from the right heart to the left heart by way of the lungs. Thus was the state of knowledge of the circulation when Harvey studied medicine, and thus it remained for another quarter century until Harvey published de Motu Cordis in 1628.

Harvey's Achievement I do not wish to detract from Harvey's achievement by pretelling the arguments, experiments, and observations presented in his book. Mainly, I will allow the reader to judge these for him- or herself from Harvey's own writing. However, the essence of Harvey's achievement was that he brought forth in one book massive amounts of experimental evidence, including human clinical observation, observation on multiple forms of lower animals, and for the first time significant advances in quantitative thinking, logic, and even physiological measurement, all this evidence supporting from multiple different directions the inescapable conclusion that the heart is basically a muscular pump, pumping large quantities of blood in only one direction in a continuous circuit again and again around the vascular system. Some of the special points of his argument included: (1) absolute denial of any porosities through the interventricular septum between the right ventricle and the left ventricle; (2) demonstration of total competence of the heart valves, so that any compressive action of the heart whatsoever would of necessity cause the blood to flow only in the forward direction as dictated by the valves;

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(3) quantitative calculations, based on heart rate and degree of ventricular wall excursion, of the minimum amount of blood pumped by the heart, showing this minimum to be so vast that it could not possibly be contributed by continuous liver concoction of new blood as required by the Galenic scheme; (4) demonstration of total competence of the venous valves, denying that these could function merely as resistances in the Fabricus sense to delay peripherally-directed blood flow in the veins; (5) demonstration that when a vein is squeezed empty and then compressed peripherally but not centrally, the emptied vein will not fill from its central connection because valves block any backflow; yet, when the peripheral compression is released the vein fills instantly because the peripheral valves open in the central direction; furthermore the rapidity with which the vein fills attests to a rate of blood flow several hundred times as great as the dribbling flow allowed by the Galenic schemes; (6) observation that when an animal is bled to death by opening an artery, not only are the left heart and arteries emptied of blood but also the veins as well; (7) likewise, when an animal is bled to death by opening a vein, the left heart and all the arteries are emptied of blood, the same as occurs when bleeding to death through the arteries; (8) when a vein is severed but is occluded peripherally, the animal bleeds hardly at all; when the severed vein is occluded centrally but not peripherally, blood loss is rapid and can readily lead to death; (9) when the root of the aorta is clamped in a living openchested animal, all chambers of the heart fill within seconds to the bursting point—quantitatively, this effect could occur only with extremely rapid unidirectional flow of blood into the heart chambers from the venous reservoirs, the only direction allowed by the venous valves and heart valves-, and (10) if a small puncture wound is made in the left ventricle, blood is ejected under great force from the wound with each beat of the heart.

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Again and again, quantification played a major role in Harvey's thinking. And Harvey was exceedingly inventive in devising new experiments and searching for new observations that would tell the truth about blood flow in the circulatory system. Often, this truth could not be observed in studies on human beings nor even by vivisection in large mammals. Therefore, he learned still much in addition from observations in lower forms of animals, a scientific habit inherited partly from his teacher Fabricus, who was also an outstanding comparative anatomist. To give an example, Harvey observed carefully the beating hearts of cold blooded animals in which the heart rate was slow enough that the sequence of contraction, beginning in the atria and followed by contraction of the ventricles, was unmistakable— in contrast, this sequence was not easily apparent from observing the dog's heart, which beat too rapidly for one to separate the sequential events. Also, using a magnifying glass, Harvey even studied a type of transparent shrimp that he found in the Thames estuary, observing the beating heart without disturbing its natural function. Finally, he observed wounded or sick human beings and larger mammals in the last throes of life when the heart beat slowed enough that the pumping action was then unmistakable. Thus, from almost every direction imaginable within the limits of the scientific technology of the day, Harvey marshaled his arguments. Regardless whence the arguments stemmed, all of them led to the undeniable conclusion not only that blood circulates from arteries to veins throughout the body, but also that the quantity circulating each hour and each day is enormous in comparison with that previously believed. It is true, as many historians have pointed out, that Harvey's estimates of the cardiac output were much lower than presentday measurements. Yet, if one will study carefully Harvey's own words, it will be evident that he took great pains to impress upon the reader that he was using absolute minimum estimations. He did this so that there could be no room for doubt that the amount of blood flowing in the circulation had to be far greater than could possibly be accounted for by the oozing amounts of flow allowed in the Galenic scheme. One final word on Harvey's achievement. Certainly, at least some other persons of Harvey's time and before had considered

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the concept that blood flows in a circuit through the body. In fact, the writings of Hippocrates, Plato, and Aristotle all speak of a circular flow of blood, though never explained in the sense meant by Harvey; even Shakespeare, writing decades before Harvey's book, referred to "rivers of flowing blood" in the body. Furthermore, it is almost inconceivable that Servetus, Columbus, and Caesalpinus, when they proposed the flow of blood through the pulmonary circulation, would not also have at least imagined a generalized scheme of blood flow by way of a circuit throughout the entire body. Even John Hunter, the great English surgeon of the 1700s, pointed out that, once Realdus Columbus and the others a half century before Harvey had proposed blood flow through the lungs, it was but a small step to complete the circuit concept of flow throughout the entire body. Thus, it was not Harvey's discovery of the circuit flow of blood that was so remarkable, for undoubtedly others were considering this at least as a possibility. Harvey's achievement, instead, was the vast amount of solid quantitative evidence that he collected into one living treatise, evidence so thorough and convincing that the conclusions were inescapable—evidence so compelling that it literally demolished within one generation fourteen centuries of Galenic thought. When Harvey had completed his reconstruction of the circulatory scheme, virtually all the elements of modern circulatory physiology were present, for he spoke of the pumping volume of the heart (cardiac output); the force, the impelling power, the tuigor associated with heart contraction and arterial pulsations (pressure); and the resistance to the movement of blood in the vessels and especially through the tissues. He spoke of selective ventricular hypertrophy under the respective loads of the two sides of the heart, and thickening of the arterial walls in comparison to the veins because of the greater force that they must endure. He recounted the control capabilities of the circulation, that the cardiac output varies according to the needs of the body—according to temperament, age, sleep, rest, and food— and that exercise and even affections of the mind can greatly increase the cardiac output. And he noted that following the onset of hemorrhage one sees immediate control reactions that limit the degree of hemorrhage, as well as other reactions occurring within minutes to give 'Vitality" back to the pumping

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action of the heart and flow of blood. He even recognized the concept of vis a tergo, a concept not too easily grasped by most modern circulatory physiologists, when he wrote that in the veins "the blood is thus more disposed to move from the circumference to the centre," and therefore an impeller (the heart) is required to return it continually to the periphery. How much more have we added to this scheme in the three and a half centuries since Harvey's time?

The Missing Link in Harvey's Scheme of the Circulation The great missing link in Harvey's scheme of the circulation was lack of visual proof that either blood capillaries or any other connections exist between the arteries and the veins. In reality, this was not a serious detriment to Harvey's arguments, for he pointed out very rightly that water percolates through the earth even though one cannot see the channels, that urine flows through the kidneys without channels, and absorbates from the gut pass through the liver. Furthermore, his description of blood flow patterns in the body provided such firm evidence of functionalflowfrom the arteries to the veins that no other conclusion could be reached except that blood in some way percolates through the tissues, either through minute vessels or through open channels or pores too small to be seen. Yet the logical mind always wishes to close the last missing link. Therefore, absence of anatomical proof of blood capillaries or other channels from the arteries to the veins gave solace for several more decades to many anatomists and physiologists who still wished to adhere to the Galenic scheme of blood distribution. Available to Harvey was a magnifying glass, but not a microscope that would allow him to see the capillaries. Yet, in 1661, only four years after Harvey's death, Marcello Malpighi (16281694), one of the earliest to use the microscope to study tissues, published two letters describing anatomically the capillaries of the lung as well as visual observation of blood flow in these capillaries. Indeed, it was Malpighi's desire to affirm Harvey's scheme of blood flow that led him to his studies. This was 45 years after Harvey first proposed the circulation of blood in his

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Lumleian lectures in 1616, and 33 years after publication of his book in 1628. The missing link had been demonstrated.

The Period of Controversy Surrounding Harvey's Concepts, and the Test of His Spirit When Harvey published de Motu Cordis in 1628, he knew in advance that his new ideas on the circular motion of blood in the body would cause consternation. In his book he expressed this fear by stating that the concept "is of so novel and unheardof character, that I fear not only injury to myself from the envy of a few, but I tremble lest I have mankind at large as enemies, so much doth wont and custom, that become as another nature, and doctrine once sown and that hath struck deep root, and respect for antiquity influence all men." True enough, Harvey did have his detractors, some of whom rose to the attack almost immediately. In fact, soon after Harvey's book was published, James Primrose wrote an entire book specifically to attack Harvey's ideas, stating that his own book had taken only "fourteen days" to write. It is clear that this attack was one of emotion, based exactly on Harvey's own observation that "respect for antiquity" influences all men. But Harvey had also written in his book, "My hope is in the love of truth and in the integrity of intelligence." Harvey's main response to his critics was silence, except that he did continue teaching without apology the circular motion of the blood in his oft-repeated anatomical lectures at the Royal College of Physicians. In addition, he demonstrated experiments on multiple occasions, sometimes even to King Charles and others of the court. In fact, Charles himself once joined Harvey in investigating the motion of the human heart through a chronic open wound in a man's chest into which Harvey and Charles could pass their fingers and actually feel the heart beating. Even so, many of the prominent anatomists of the day, principally those on the Continent but even some who were closely associated with Harvey personally, simply ignored Harvey's teachings. For instance, in the anatomy books of two fellow Englishmen—Thomas Winston, whose book was published in 1659, 31 years after Harvey's book on the circulation, and Alexander Reed, whose book was published in multiple editions

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between 1634 and 1658—Harvey's concept of the circular motion of blood through the body was not given credence. To only one critic did Harvey ever make a major response: in 1649, 21 years after his book was published, he wrote two long letters which are reprinted in this volume to Jean Riolan, a Regius Professor in Paris and Dean of the Faculty of Medicine. Riolan had written a book in 1648, in which he criticized several aspects of Harvey's concepts. Riolan accepted circular motion of blood in the major arteries and veins but not in some of the smaller vessels, especially in the portal system, still arguing for the older concept of back and forth blood movement in these vessels to transfer nutrients in the peripheral direction and tissue waste in the central direction. In Harvey's first letter he merely countered Riolan's own arguments with experimental observations that he, Harvey, had made during his life's work. In his second letter, he added new thoughts and experiments that gave new substance to the original observations in his book. But, most important, Harvey lectured Riolan on the importance of experimental observation in contrast to repetition of unproved theory. Yet, despite Harvey's usual avoidance of open controversy, the turmoil caused by his concepts was a trial to him for the remainder of his life. The depths of his concern are best understood by reading Harvey's own words in the preamble of his second letter to Riolan: It is now many years, most learned Riolan us, since, with the aid of the press, I published a portion of my work. But scarce a day, scarce an hour, has passed since the birth-day of the Circulation of the blood, that I have not heard something for good or for evil said of this my discovery. Some abuse it as a feeble infant, and yet unworthy to have seen the light; others, again, think the bantling deserves to be cherished and cared for; these oppose it with much ado, those patronize it with abundant commendation; one party holds that I have completely demonstrated the circulation of the blood by experiment, observation, and ocular inspection, against all force and array of argument; another thinks it scarcely yet sufficiently illustrated—not yet cleared of all objections. There are some, too, who say that I have shown a vainglorious love of vivisections, and who scoff at and deride the introduction of frogs and serpents, flies, and others of the lower animals upon the scene, as a piece of puerile levity, not even refraining from opprobrious epithets. To return evil speaking with evil speaking, however, I hold to be

[20] HIS TIMES AND ACHIEVEMENTS

unworthy in a philosopher and searcher after truth; I believe that I shall do better and more advisedly if I meet so many indications of ill breeding with the light of faithful and conclusive observation. It cannot be helped that dogs bark and vomit their foul stomachs, or that cynics should be numbered among philosophers; but care can be taken that they do not bite or inoculate their mad humours, or with their dogs' teeth gnaw the bones and foundations of truth.

Again, in 1650 when Harvey's friend George Ent urged him to publish his quarter-of-a-centuiy work on the Generation of Animals, Harvey at first demurred and gave as his reasons: And would you be the man who should recommend me to quit the peaceful haven, where I now pass my life, and launch again upon the faithless sea? You know full well what a storm my former lucubrations raised. Much better is it oftentimes to grow wise at home and in private, than by publishing what you have amassed with infinite labour, to stir up tempests that may rob you of peace and quiet for the rest of your days.

These reactions of the medical world in Harvey's day are not very surprising, for modern day medical scientists have changed very little. Suppose, for instance, that you, a prominent physician or anatomist, have spent your life studying a medical subject, and at last have become thoroughly satisfied that you know all there is to know in your field; then someone comes along with a completely new view that explodes your lifetime's work. Imagine your emotions. Those were the reactions of many of Harvey's contemporaries; the medical scientists who did in fact know the current doctrines most thoroughly were Harvey's greatest critics. Indeed, it was said that Harvey failed to convince any medical scientist who was already past the age of 40. But others who knew little were often ready to accept Harvey's views with only mild convincing, including even his special benefactor Charles I. The same psychology of acceptance or rejection of revolutionary thoughts is true today. Those who have much to lose quite understandably vent their emotions; those who can look more impartially from a distance with a fresh point of view are often much more susceptible to new arguments. Yet, one cannot totally deprecate the human mind's natural resistance to change, for we in science all experience vast numbers of exorbitant claims that later prove to be totally invalid.

HIS TIMES AND ACHIEVEMENTS [21]

Therefore, it is almost second nature to resist new and disturbing concepts. I must confess that I, personally, have had many occasions to wish for much more open-mindedness among my scientific peers even though I respect and understand resistance to new ideas. Once, early in my career, I proposed that many of the slowly cycling waves in blood pressure recordings were caused by oscillation of the baroreceptor pressure control mechanism. I felt that I had marshaled enough arguments to prove this beyond doubt; indeed, subsequent evidence from many corners of the world now seems to have established the concept as truth. But the editorial reviewer of my paper used the expression "poppycock" to describe what he thought of the idea, which was truly devastating to a young researcher. I wondered whether physiological research was a field worth my life's work. In subsequent years, I and my colleagues have collected what we considered to be strong evidence for other new concepts some of which require significant changes in quantitative understanding of circulatory physiology. Among these have been: (1) a concept that, except when the heart fails, the long-term cardiac output is controlled almost entirely by the summation of local blood flow controls in the tissues and not by the heart itself; and (2) a concept that long-term arterial pressure control is quite different from short-term control, that long-term control is based almost entirely on the body's salt and water balance and the role of the kidneys in this. Each of these concepts has trod heavily on long-time, deeply held beliefs, such beliefs as, "It is the heart that pumps the blood; therefore, it is clear that the heart and nervous control of heart activity together are the principal controllers of cardiac output," and, "Virtually all persons who have hypertension have high total peripheral resistance; therefore, it is fundamental that arterial pressure is controlled by blood vessels that alter total peripheral resistance, not by the kidneys and salt and water balance." These types of elemental and historical thinking are powerful adversaries. Therefore, it is not surprising that concepts which are new or different, but which each of us might construe to be our most important achievements, virtually always evoke the same counter-responses as those experienced by Harvey: the

[22]

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highest of praise from some, but the ultimate of deprecation from others. And, most chilling of all is the interminable slowness of acceptance of new ideas even when unopposed. Thus, it is easy to understand why a scientist often experiences melancholy, as did Harvey, for want of open minds.

Harvey's Luck of the Genius There are many geniuses in science who never have the luck to make a great discovery. And many other scientists have luck but unfortunately do not have the genius to succeed. In Harvey's studies of the circulation, the two were juxtaposed. From what little evidence is available, Harvey's intellect already clearly showed even during his period of education, especially so in his medical education in Padua, Italy, where he completed the entire medical course in only two years despite stringencies of learning a new language, yet graduating with honors. As further evidence of his scholarship, his published writings are punctuated with abundant references to the world of the then-current medical literature as well as to the work of the ancients, displaying an especially profound knowledge of the works of Aristotle and Galen. Thus, his was a prepared mind. And, too, Harvey was born not in the city but in a farming community where it is to be expected that he would know the ways of nature. Then, there was the luck to be born in a family never to be wanting in the necessities of life, with fully adequate means to provide all the education that Harvey required. Perhaps it was also luck that he married the daughter of a very prominent physician, a physician to both Elizabeth and James. Indeed, his father-in-law did attempt to promote Harvey's medical career, though it is equally true that there is no evidence that this help mattered. Then there was another element of chance—perhaps this time it was negative luck—for his marriage was barren of children, and Harvey spoke of "solace in his work," suggesting that his work was truly his life. But undoubtedly his greatest luck of all was the special juncture in history in which he found himself. The most important of all concepts of the circulation was still to be discovered and proved, the circulation of the blood itself. The needed meth-

HIS TIMES AND ACHIEVEMENTS [23]

odology and background information were at precisely that time beginning to coalesce so that someone somewhere with appropriate genius and love of truth and time to give to the work should be bound to make the great discovery that was Harvey's. If Harvey had had only his genius and not his luck as well, would his greatness have been the same that we acclaim today? Let us answer this indirectly. Most of us forget that Harvey had other scientific interests besides the circulation of the blood. In fact, his most prodigious work was not his book on the circulation but instead his book on reproduction entitled Exercitationes de Generatione Animalium, first published in 1651 and also reprinted in its English translation in this volume. Into this book went as much genius as into de Motu Cordis. Indeed, it was a much longer book, developed from notes and research that spanned a quarter of a century. Harvey's great purpose in this book was to explain the origin of life itself, which was an even more laudable goal than his earlier goal to prove the circulation of the blood. But all the elements required for great success did not come together for these studies. Most importantly, the technology was not available to discover the initial stages of conception, which was the crucial question to be answered. Therefore, the basic explanation of the generation of life escaped Harvey. By the time of publication of this book, Harvey was 73 years old. The earliest microscope had been invented 50 years before that time, but had rarely as yet been used in medicine, and there is no evidence that Harvey had become familiar with its use. Furthermore, the mammalian ovum, because it is only a speck in a wide expanse of uterine fluid, has always been very elusive and difficult to find even with the microscope. Therefore, it was not until 200 years later that the ovum released from the ovary was eventually discovered to be the focal point for the origin of the fetus. Thus, for this prodigious work of Harvey's, his genius was as much at work as it had been for de Motu Cordis, but the luck of coalescence of all the elements required for great achievement was not at hand.

When a Scientist Challenges the Insolvable Harvey's book on the Generation of Animals was almost five times as long as de Motu Cordis. Yet its place in history will

[24] HIS TIMES AND ACHIEVEMENTS

never be the scientific landmark achieved by de Motu Cordis, for it failed in its goal. Its historical importance is as a lasting monument to the mind of any great scientist who challenges an unknown that is insolvable. Yet, one cannot conceive of a more noble quest than to explain the origin of life. It was this same quest that had also dominated much of Aristotle's thoughtful energy; and hardly any progress had come from the efforts of a myriad of other scientists on the same topic during the 2000 years between the lives of Aristotle and of Harvey. Harvey's approach was to let his mind roam endlessly and obsessively through any and all knowledge even remotely related to animal reproduction, knowledge that was firm and unchallengeable from scientific history or from colloquial understanding of the processes involved. And his own scientific nature drove him to clear and precise experimental observations, beginning with detailed and intricate characterization of the development of the chick from the fertilized egg, followed by painstaking serial dissections and description of each stage of gestation in the doe, and finally by pathological studies in the human female. Harvey considered incessantly the act of procreation between the cock and hen, and the buck and doe, and the male and female of the human species. And he mulled over the role of sexual desire as, or as not, a necessary accompaniment to successful fertilization. Indeed, he seemed to have much more information on this subject than would have been expected of a circumspect scientist, stating: "Even during the season of jocund masking in Venus's domains, male animals in general are depressed by intercourse, and become submissive and pusillanimous, as if reminded that in imparting life to others, they were contributing to their own destruction." And observing about the human female, "although some of warmer temperament shed a fluid in the sexual embrace, still that this is fruitful semen, or is a necessary requisite to conception, I do not believe." Yet, there always remained a gaping, unexplained hiatus between the act of copulation and the first, slightest physical evidence of a newly developed being—a period of five days from the beginning of incubation of the egg until the slightest speck of an embryo could be seen even with a magnifying glass; and a minimum period of six to eight weeks after fertilization of the

HIS TIMES AND ACHIEVEMENTS [25]

doe before even a trace of a conceptus could be found in the uterus. Nor could Harvey find any evidence that the female testes (the ovaries) played any role in reproduction, observing that "the female testicles, as they are called, whether they be examined before or after intercourse, neither swell nor vary from their usual condition; they show no trace of being of the slightest use either in the business of intercourse or in that of generation." Nor could he find a material role for semen in fertilization, stating: "And repeated examination led me to the conclusion that none of the semen whatsoever reached this seat [the seat of fertilization in the cavity of the uterus]." Also: "I therefore regard it as demonstrated that after fertile intercourse among viviparous as well as oviparous animals, there are no remains in the uterus either of the male or female emitted in the act, nothing produced by any mixture of these two fluids..." Therefore, whence came the embryo? Harvey could only hypothesize that "the woman, after contact with the spermatic fluid in coitu, seems to receive influence, and to become fecundated without the co-operation of any sensible corporal agent, in the same way as iron touched by the magnet is endowed with its powers and can attract other iron to itself. When this virtue is once received the woman exercises a plastic power of generation..." Thus, Harvey imagined that there resided in woman a "vital principle," always there but set to the motion of generating a new being only in response to the act of the male. This vital principle was passed from mother to daughter, for, as Harvey philosophized, "The eternity of things is connected with the reciprocal interchange of generation and decay; and as the sun, now in the east and then in the west, completes the measure of time by ceaseless revolutions, so are the fleeting things of mortal existence made eternal through incessant change, and kinds and species are perpetuated though individuals die." Yet, since the embryo begins only in a prescribed point in the woman's body and always begins as an isolated speck, then it follows that the woman's vital principle first gives rise to "a particular genital particle, in virtue of which, as from a beginning all the other parts proceed... which is the author and original of sense and motion, and every manifestation of life."

[26] HIS TIMES AND ACHIEVEMENTS

But what was this primary vital principle, the thread of life? Harvey believed, "that the privilege of priority belongs to the blood alone; the blood being that which is first seen of the newly engendered being—I have indeed ascertained by numerous experiments—that the blood is the element of the body in which, so long as the vital heat has not entirely departed, the power of returning to life is continued." Harvey was wrong, but he was also partly right. There is a thread of life passed successively from generation to generation, but through the primordial genital epithelium, not the blood. There is a primordial particle, the fertilized ovum, from which all other parts of the generated being are engendered as night follows day. And there is that magic influence of the male semen to set into motion the female vital principle to generate the baby. But so much of this occurs below the visual minimum of the naked eye that Harvey's speculative role of blood to replace the germinal epithelium is to be excused. After all, Harvey had proved to virtually everyone of reason that the blood circulates through the body even though he had never seen the capillaries!

Harvey's Place in History There is no doubt that the greatest discovery ever in the science of circulatory physiology was the discovery that blood is pumped in a circuitous manner through the body. Would this discovery have come about in a few years without Harvey? The answer is: undoubtedly it would have. In fact, only 33 years after publication of Harvey's book Marcello Malpighi was able to see with his crude microscope the actual flow of blood in capillaries of the lungs. Also, almost three-quarters of a century before the publication of Harvey's book, Servetus, Columbus, and Caesalpinus had all put forth strong logical evidence for blood flow through the lungs from the right heart to the left heart. Yet, it was Harvey alone who synthesized these many new tides of thinking into a total picture of circulatory function, not dwelling on a single segment of the circulation but discussing it in the whole, both giving evidence that the heart does indeed pump blood, and adding quantification to the amounts of blood

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pumped, amounts far greater than could fit with any of the previous theories—also giving evidence for equally large amounts of bloodflowthrough the porosities of the tissues, which Harvey calledporositates camis, and which were the yet unseen tissue capillaries that by force of Harvey's logic had to exist. Thus, in this beginning period of new ideas about the function of the circulation, the totality of Harvey's efforts stood out conspicuously above those of all others. This is what was required to break through the entrenched thought of antiquity that began in Aristotelian times almost 400 years before the birth of Christ and extended for 2000 years, first through the age of Galen, then through the entire period of the Middle Ages, and even surviving the first 100 years of the Renaissance until the time of Harvey. The date 1628, when Harvey's book on the circulation of blood appeared, truly marks the Renaissance for circulatory science, leading during the next generation to thorough devastation of the Galenic scheme that blood ebbs forth and backward in the arteries and veins, substituting forever thereafter the continuous circulation of the blood around the body. If we add a few other basic essentials to Harvey's concept of circulatory function, we have today's physiology of the circulation. For instance, it was up to Ludwig, Starling, and Landis to explain and quantity the principles of capillary exchange, which told us how it was possible for blood to remain in the circulatory system without leaking into the tissues. With Cannon, Dale, and Heymans came nervous and endocrine control of the heart and circulation. And more recently, a horde of quantitative physiologists, representing a coalescence of physiology, engineering, physics, and chemistry, have led to at least speculative understanding of the systems aspects of overall circulatory regulation—regulation of local tissue blood flow, regulation of cardiac output, regulation of arterial pressure, and regulation of the body fluid volumes. All the newer knowledge of the circulation simply adds to Harvey's own fundamental concept that the circulation system is to serve the body—that every small structure and every slightest function of the circulation has a purpose. For Harvey frequently alluded to the essentiality of nature's purpose by stating

[28] HIS TIMES AND ACHIEVEMENTS

at multiple points in his text, "for nature, doing nothing in vain," "nature, ever perfect and divine, doing nothing in vain," "as perfect nature does nothing in vain." NOTE *This account of Harvey's work and times is a condensation from several detailed books and articles written by medical historians who have spent years studying Harvey and his work. Because of the large number of separate facts presented in this condensation, and because most of the facts have come from several different ones of the sources, it has not been practical to reference each separately. Instead, at the end of this introductory chapter is a concise Additional Reading List of books and articles that cover thoroughly the life of Harvey, his achievements, and his place in medical history.

A D D I T I O N A L R E A D I N G LIST Leake, Chauncey D. Translation of William Harvey's Anatomical Studies on the Motion of the Heart and Blood, with extensive annotation and prefatorial comments. Fourth edition, 150 pp. Springfield, 111.: Charles C. Thomas, 1958. O'Malley, C. D., Poynter, F. N. L., and Russel, K. F. William Harvey— Lectures on the Whole of Anatomy, a translation with extensive annotation. 239 pp. Berkeley: University of California Press, 1961. Whitteridge, Gweneth. The Anatomical Lectures of William Harvey, a translation with extensive annotation and introductory material. 504 pp. London: E. & S. Livingstone Ltd. Keynes, Geoffrey. The Life of William Harvey. 483 pp. Oxford: Oxford University Press, 1966. Pagel, Walter. William Harvey's Biological Ideas, Selected Aspects and Historical Background. 394 pp. Basel/New York: S. Karger AG, 1967. Whitteridge, Gweneth. William Harvey and the Circulation of the Blood. 269 pp. New York: American Elsevier Inc., 1971. Whitteridge, Gweneth. "William Harvey—The Man and His Work." Pp. 317-34 in C. J. Dickinson and J. Marks, eds., Developments in Cardiovascular Medicine, to celebrate the 400th anniversary of the birth of William Harvey Lancaster.: MTP Press Limited, 1978.

THE

SYDENHAM SOCIETY INSTITUTED MDCCCXLIII

LONDON MDCCCXIjVII.

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THE WORKS OF

WILLIAM HARVEY, M.D. PHYSICIAN TO THE KING, PROFESSOR OF ANATOMY AND SURGERY TO THE. COLLEGE OF PHYSICIANS

TRANSLATED FROM THE LATIN

WITH

A LIFE

OF THE A U T H O R BY

ROBERT WILLIS, M.D. MEMBER OF THE ROYAL COLLEGES OF PHYSICIANS AND SURGEONS OF ENGLAND, CORRESPONDING MEMBER OF THE ROYAL ACADEMY OF SCIENCES OF GOTTINGEN, OF THE IMPERIAL SOCIETY OF PHYSICIANS AND SURGEONS OF VIENNA, AND OF THE NATIONAL INSTITUTE OF AMERICA, ETC. ETC.

LONDON PRINTED FOR THE SYDENHAM SOCIETY MF/CCCXLVII.

JOHNSON REPRINT CORPORATION New York and London

1965

First reprinting, 1965, Johnson Reprint Corporation

Printed in the United States of America

PREFACE.

WHEN, at the instance of the governing body of the Sydenham Society, I undertook to edit the Works of the immortal Discoverer of the Circulation of the Blood, in English, I believed that the chief of these Works were already extant in our language, in such a shape as would make little more from an editor necessary than a careful revision of the text. I had unwarily adopted the idea, very gratuitously originated by Aubrey, that Harvey was what is called an indifferent scholar, and that the English versions of his writings were the proper originals, the Latin versions the translations. Having access to the handsome edition of Harvey's Works in Latin, revised by Drs. Lawrence and Mark Akenside, and published by the College of Physicians in 1766, I had always referred to that when the course of my studies led me to consult Harvey. Of the English versions, or any other edition, I knew little or nothing. On proceeding to my new duty of English editor, however, I immediately saw that the masterwork of Harvey on the MOTIONS of the HEART and BLOOD, far from having the character of an originally English writing, must have been rendered into English by one but little conversant with the subject, that it was both extremely rebutting in point of style and full of egregious errors, and that nothing short of an entirely new translation could do justice to this admirable treatise, or secure for it, at the present day, the attention it deserved. Full of zeal, and

vi

PREFACE.

making of my task a labour of love, I had soon completed a new translation of the Exercises on the Heart and Blood, with equal pleasure and profit to myself. The work on GENERATION came next under review. """The English version of this I had heard it positively asserted was the original, was Harvey's own; here therefore my business of editor would properly begin. But I had not gone through a couple of pages of the text, before difficulties like those already experienced met me again. That the statement above referred to was erroneous, speedily became apparent; and a little inquiry enabled me to discover that the English version of the Exercises on Generation was the work of a physician named Llewellen. Though not incorrect generally, there was, nevertheless, a great deal that I wished had been otherwise rendered; and then the scientific and professional language of two centuries back looked strangely when examined by the eye, and had an unusual sound when tried upon the ear. Only anxious to present to my brethren in the most appropriate and attractive form possible, the writings of him who had still met me in his Works and with his contemplative look in his Portrait as a kind of divinity in medicine, I even girded myself up for the long and laborious enterprise of translating anew into our mother tongue the work on Generation, and at length achieved my task, not without difficulty. The short paper on the ANATOMY of THOMAS PARR appears in the Philosophical Transactions in English; but it stands there as a translation; and having now translated so much myself, I even thought it would be well to translate that also, and so it was achieved. The LETTERS, though frequently quoted, have never ap-

PREFACE.

vii

peared in English before. They will be found both highly interesting and important. To render them was a light and pleasant task. — In a word, the English reader is now presented with an entirely new translation of the writings of William Harvey; everything of our illustrious countryman worthy of publication that has come down to us, being here included.1 The reader will perceive that I have abstained from annotation and commentary in the course of my labour. The purpose of the Council of the Sydenham Society, as I understood it, was to give the Works of William Harvey in English now, as he himself gave them in Latin two centuries ago. Entirely approving of this intention, I felt that anything like corrections of statements and opinions, which could so readily have been made under the lights of modern physiology, would have been impertinencies, and I therefore abstained from them. To have carried out and completed the history of Harvey's two grand subjects, would also have been easy; but ! A certain MS. of Harvey's, frequently referred to as bearing the date of 1616, and containing the heads of his first course of Lectures at the College of Physicians on the Heart and Blood, is not now in existence, or at all events is not now to be found. At the present time there are only two MSS. at the British Museum which bear Harvey's name. Of these, one contains notes on the Muscles, Vessels, and Nerves, and on the Locomotion of Animals ; the other may be characterized as a book of Receipts or Prescriptions, and though partly the work of a contemporary, contains notes of cases that occurred after Harvey's death. The former MS. is as certainly in Harvey's handwriting as the latter is not. In Dr. Lawrence's* time there must have been a third MS. entitled * De Anatomia Universa,' and it was here, in the index viz. which referred to the principal facts in the anatomy of the heart and of the circulation of the blood, that the dates April 16, 17, 18, an. 1616, were encountered. Mr. Pettigrew (Portrait Gallery, vol. iv, Harvey, p. 8), with the assistance of Sir Fred. Madden, made search for this MS. a few years ago, but failed to meet with it. A renewed search for this important document has been attended with no better success.

* Vide his Life of Harvey, prefixed to the edition by the College of Physicians p. xxxi.

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PREFACE.

this would have been almost as obviously out of place as commentary, and the inclination towards such an agreeable undertaking was also resisted. It appeared, nevertheless, that the Works of our great physiological discoverer might be advantageously prefaced by some account of his Life and Writings. One great motive with me, indeed, for undertaking the office of Editor of the Works of Harvey was, that I might thus find a fitting opportunity for writing his life, a task which, in other circumstances than those that now surround me, it had still been a cherished purpose with me to perform. The Life of Harvey, by one who had maintained a familiarity with anatomy and physiology, had always seemed to me a desideratum in our medical literature. This portion of my work I have only achieved with an effort, and at something like disadvantage. Incessantly engaged by night and by day in the laborious and responsible duties of a country practice, enjoying nothing of learned leisure, but snatching from the hours that should rightfully be given to rest, the time that was necessary to composition, remote too from means of information which I must nevertheless send for and consult—for I could not draw entirely upon memory and old recollections of Harvey, I have been much longer about this work than its length might indicate. In spite of many disadvantages, however, I trust it will be found that I have included everything of moment in my narrative of the life of Harvey; that I have set his claims to the whole and sole merit of the discovery of the Circulation in a new and clearer light than they have yet been seen; and that I have done more than any preceding biographer in exhibiting his moral nature; for truly he was as noble in nature as he was intellectually great.

PREFACE.

ix

The Wills of great men have always been looked on as calculated to throw light on the character of their authors; and I have, therefore, great pleasure in presenting to the medical world, for the first time, the Will of William Harvey. It only remains for me, in conclusion, to explain and to apologise for the long delay that has taken place in the appearance of this volume. The work was, in fact, nearly threefourths done more than a year ago; but with the change made in my sphere of action about that time, all aptitude for literary labour seemed to forsake me,—the bow, to use a common metaphor, became unbent, and for a while resisted every effort to string it anew; and, then, when restrung at length, how constantly was I hindered in my purpose to use it! With this brief explanation, which will be so well appreciated by the great majority of my fellow members of the Sydenham Society, I confidently throw myself on their kind consideration, and pray them to pardon the delay that has occurred. R. WILLIS. BARNES, SURREY; Feb. 15M, 1847.

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TABLE OF CONTENTS.

PAGE

Preface Life of William Harvey Last Will and Testament of William Harvey

v xv lxxxv

AN ANATOMICAL DISQUISITION ON THE MOTION OF THE HEART AND BLOOD IN ANIMALS. Dedication " Introduction CHAPTER I. The author's motives for writing II. Of the Motions of the Heart, as seen in the Dissection of Living Animals . . . . : . . . . III. Of the Motions of Arteries, as seen in the Dissection of Living Animals IV. Of the Motion of the Heart and its Auricles, as seen in the Bodies of Living Animals V. Of the Motion, Action, and Office of the Heart . . . VI. Of the Course by which the Blood is carried from the Vena Cava into the Arteries, or from the Right into the Left Ventricle of the Heart VII. The Blood percolates the Substance of the Lungs from the Right Ventricle of the Heart into the Pulmonary Veins and Left Ventricle

3 9 19 21 24 26 .31

35

40

xii

CONTENTS.

CHAPTER

PAGE

VIII. Of the Quantity of Blood passing through the Heart from the Veins to the Arteries; and of the Circular Motion of the Blood 45 IX. That there is a Circulation of the Blood is confirmed from the first proposition 48 X. The First Position: of the Quantity of Blood passing from the Veins to the Arteries. And that there is a Circuit of the Blood, freed from objections, and farther confirmed by Experiment .......... 52 XI. The Second Position is demonstrated XII. That there is a Circulation of the Blood is shown from the Second Position demonstrated 60 XIII. The Third Position is confirmed: and the Circulation of the Blood is demonstrated from it 62 XIV. Conclusion of the Demonstration of the Circulation ... 68 XV. The Circulation of the Blood is further confirmed by probable reasons . . . . . . . . . . . ib. XVI. The Circulation of the Blood is further proved from certain consequences 71 XVII. The Motion and Circulation of the Blood are confirmed from the particulars apparent in the Structure of the Heart, and from those things which Dissection unfolds ..... 75

THE FIRST ANATOMICAL DISQUISITION ON THE CIRCULATION OF THE BLOOD, ADDRESSED TO JOHN RIOLAN . 89 A SECOND DISQUISITION TO JOHN RIOLAN; IN WHICH MANY OBJECTIONS TO THE CIRCULATION OF THE BLOOD ARE REFUTED

109

CONTENTS.

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ANATOMICAL EXERCISES ON THE GENERATION OF ANIMALS ; TO WHICH ARE ADDED, ESSAYS ON PARTURITION ; ON THE MEMBRANES, AND FLUIDS OF THE UTERUS; AND ON CONCEPTION. PAGE

Dedication 145 Introduction 151 Of the manner and order of acquiring knowledge . . . .154 Of the same matters, according to Aristotle 158 Of the method to be pursued in studying Generation . . . .163

ON ANIMAL GENERATION. Wherefore we begin with the history of the hen's egg . . . . 169 Of the seat of generation 171 Of the upper part of the hen's uterus, or the ovary . . . . 172 Of the infundibulum 179 Of the external portion of the uterus of the common fowl . . . 180 Of the uterus of the fowl 190 Of the abdomen of the common fowl and of other birds . . . 195 Of the situation and structure of the remaining parts of the fowl's uterus . 198 Of the extrusion of the egg, or parturition of the fowl, in general . . 201 Of the increase and nutrition of the egg 202 Of the covering or shell of the egg 204 Of the remaining parts of the egg 211 Of the diversities of eggs 216 Of the production of the chick from the egg of the hen .... 225 The first examination of the egg ; or of the effect of the first day's incubation upon the egg 228 Second inspection of the egg 232 The third inspection of the egg 234 The fourth inspection of the egg 243 The fifth inspection of the egg The sixth inspection The inspection after the tenth day The inspection after the fourteenth day Of the exclusion of the chick, or the birth from the egg . . .

252 256 257 259 264

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Of twin-bearing eggs 268 Certain deductions from the preceding history of the egg . . . 270 Of the nature of the egg ib. The egg is not the product of the uterus, but of the vital principle . • 279 The egg is not produced without the hen 284 Of the manner, according to Aristotle, in which a perfect and fruitful egg is produced by the male and female fowl . . . . 287 Of the uses of this disquisition on fecundity 291 The egg is not produced by the cock and hen in the way Aristotle would have it 293 Nor in the manner imagined by physicians 294 The male and the female are alike efficient in the business of generation . 296 Of the matter of the egg, in opposition to the Aristotelians and the medical writers .297 In how far is the fowl efficient in the generation of the egg, according to Aristotle ? And wherefore is the concurrence of the male required ? 300 The perfect hen's egg is of two colours . 303 Of the manner in which the egg is increased by the albumen . . . 305 Of what the cock and hen severally contribute to the production of the egg 307 Of the cock and the particulars most remarkable in his constitution . 309 Of the hen 313 Of the sense in which the hen may be called the "prime efficient:" and of her parturition 318 Of the manner in which the generation of the chick takes place from the egg . 323 In how many ways the chick may be said to be formed from the egg . 325 Fabricius is mistaken with regard to the matter of the generation of the chick in ovo 327 What is the material of the chick, and how it is formed in the egg . 333 Of the efficient cause of the generation of the chick and foetus . . . 340 Of the manner in which the efficient cause of the chick acts, according to Aristotle 344 The opinion of Fabricius on the efficient cause of the chick is refuted . • 350 The inquiry into the efficient cause of the chick is one of great difficulty . 355 Of the efficient cause of animals, and its conditions 360 Of the order of generation; and, first, of the primary genital particle . 372 Of the blood as prime element in the body . 379 Of the inferences deducible from the course of the umbilical vessel in the egg 392

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Of the order of the parts in generation from an egg, according to Fabricius 397 Of the order of the parts according to Aristotle 407 Of the order of the parts in generation as it appears from observation . . 414 Of certain paradoxes and problems to be considered in connexion with this subject 423 Of the nutrition of the chick in ovo 434 Of the uses of the entire egg 442 Of the uses of the yelk and albumen ....... 444 Of the uses of the other parts of the egg 454 An egg is the common origin of all animals 456 Of the generation of viviparous animals 461 The generation of viviparous animals in general is illustrated from the history of that of the hind and doe, and the reason of this selection . 466 Of the uterus of the hind and doe 467 Of the intercourse of the hind and doe .474 Of the constitution or change that takes place in the uterus of the deer in the course of the month of September Of what takes place in the month of October

476 478

Of what takes place in the uterus of the doe during the month of November 482 Of the conception of the deer in the course of the month of December . 492 Of the innate heat 501 Of the primigenial moisture . 513 ON PARTURITION OF THE UTERINE MEMBRANES AND HUMOURS .... Of the Humours Of the Membranes Of the Placenta Of the Acetabula Of the Umbilical Cord .

521 551 557 560 563 566 567

ON CONCEPTION

573

ANATOMICAL EXAMINATION OF THE BODY OF THOMAS PARR

589

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LETTERS. PAGE To Caspar Hofmann, M.D. 595 To Paul Marquard Slegel, of Hamburg 596 To the very excellent John Nardi, of Florence 603 In reply to R. Morison, M.D., of Paris 604 To the most excellent and learned John Nardi, of Florence . . . .610 To John Daniel Horst, principal Physician of Hesse-Darmstadt . . 612 To the distinguished and learned John Dan. Horst, principal Physician at the Court of Hesse-Darmstadt 613 To the very learned John Nardi, of Florence, a man distinguished alike for his virtues, life, and erudition 615 To the distinguished and accomplished John Vlackveld, Physician of Harlem 616

THE LIFE OF WILLIAM HARVEY, M.D.

WILLIAM HARVEY, the immortal discoverer of the Circulation of the Blood, was the eldest son of Thomas Harvey and Joan Halke, of Folkstone, in Kent, where he was born on the 1st of April, 1578.1 Of the parents of Harvey, little is known. His father, in our printed accounts, is generally designated Gentleman,2 and must have been in easy circumstances ; inasmuch as he had a numerous family, consisting of seven sons and two daughters, all the males of which he felt himself competent to launch upon life in courses that imply the possession of money wealth. William, the first-born, adopted the profession of physic. Five of his brothers,— Thomas, Daniel, Eliab, Michael, and Matthew—were merchants, and not merchants in a small and niggardly way— non tenues et sordidi, as Dr. Lawrence has it in his Life of Harvey,3 but of weight and substance — magni et copiosi, trading especially with Turkey or the Levant, then the main channel through which the wealth of the East flowed into Europe. The Harveys were undoubtedly men of consideration in the city of London, and several of them, in the end, 1

The birthday in some of the lives is stated to be the 2d of April, for no better reason apparently than that All-fools' Day should not lose its character by giving birth to a great man. William Harvey, I believe, was born on the 1st of April. 2 In the register of William Harvey's matriculation at Cambridge his father is styled Yeoman Cantianus—Kentish yeoman. 3 Prefixed to the Latin edition of Harvey's Works published by the Royal College of Physicians, in two vols. 4to, 1766. b

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became possessed of the most ample independent fortunes.1 The son, whose name does not appear in the list given above, was John, the immediate junior to William. He, too, was a man of note in his day, having been one of the King's receivers for Lincolnshire, having sat as member of parliament for Hythe, and for some time held the office of King's footman. Of the two sisters—Sarah died young; of the fate of Anne, or Amy, nothing is known. Great men seem, in almost all authenticated instances, to have had noble-minded women for their mothers. We have not a word of his age or generation to assist us in forming an estimate of Harvey's male progenitor; but the inscription on his mother's monumental tablet, in Folkstone church, assures us that she, at least, was a woman of such mark and likelihood, that it was held due to her memory to leave her moral portrait to posterity in these beautiful words, penned, it may be, by her illustrious eldest son: " A. D. 1605, Nov. 8th, dyed in ye 50th yeere of her age, JOAN, Wife of THO : HARVEY. Mother of 7 Sones & 2 Daughters. A Godly harmles Woman: A chaste loveing Wife: A charitable quiet Neighbour: A comfortable frendly Matron: A p~ovident diligent Huswyfe: A careful te~der-harted Mother. Deere to her Husband; Reverensed of her Children: Beloved of her Neighbours: Elected of God. Whose Soule Rest in Heaven: her Body in this Grave: To Her a Happy Advantage: to Hers an Unhappy Loss." 1 To show the esteem in which the Brothers Harvey were held, I may mention among other things that Ludovic Roberts dedicates his excellent and comprehensive work entitled ' The Merchant's Mapp of Commerce' (Folio, London, 1638) to " The thrice worthy and worshipful William Harvey, Dr. of Physic, John Harvey, Esq., Daniel Harvey, Mercht., Michael Harvey, Mercht., Mathew Harvey, Mercht., Brethren, and John Harvey, Mercht., onely sonne to Mr. Thomas Harvey, Mercht., deceased." The dedication is quaint, in the spirit of the times, but full of right-mindedness, respectfulness, and love for his former masters and present friends, in which relations the Harveys stood to Roberts. Thomas Harvey died in 1622, as appears by his monumental tablet in St. Peter-le-Poore's church, in the city of London. Eliab and Daniel lived rich and respected, the former near Chigwell, co. Essex, the latter at Combe, near Croydoo, co. Surrey. Michael Harvey retired to Longford, co. Essex. Matthew Harvey died in London.

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Epitaphs may not always be authorities implicitly to be relied on; but we unhesitatingly accept of everything to the credit of William Harvey's mother as a portion of our faith. At ten years of age, Harvey was put to the grammar school of Canterbury, having, doubtless, already imbibed the rudiments of his English education at home under the eye of his excellent mother. In the grammar school of Canterbury he was, of course, initiated into a knowledge of the Latin and Greek languages—the routine practice then as now; and there he seems to have remained until he was about fifteen years of age. At sixteen he was removed to Caius-Gonvil College, Cambridge,1 where he spent from three to four years in the study of classics, dialectics, and physics, such discipline being held peculiarly calculated to fit the mind of the future physician for entering on the study of the difficult science of medicine. At nineteen (1597) he took his degree of B.A. aud quitted the University. Cambridge, in Harvey's time, was a school of logic and divinity rather than of physic. Then, even as at the present day, the student of physic obtained the principal part of his medical education from another than his alma mater. In the 16th and 17th centuries, France and Italy boasted medical schools of higher repute than any in Europe; and to one or other of these must the young Englishman who dedicated himself to physic repair, in order to furnish himself with the lore that was indispensable in his profession. Harvey chose Italy; and Padua, about the year 1598, numbering such men as Fabricius of Aquapendente, Julius Casserius, and Jo. Thomas Minadous among its professors, Harvey's preference of that school was well founded. There, then, it was, under these and other able masters, that our Harvey 1

" GuL Harvey, Filius Thomae Harvey, Yeoman Cantianus, ex Oppido Folkston, educatus in Ludo Literario Cantuar.; natus annos 16, admissus pensionarius minor in commeatum scholarium ultimo die Mai, 1593." (Regist. Coll. Caii Cantab. 1593.)

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drank in the elementary knowledge which served him as a foundation for that induction which has made his name immortal ; for without detracting from the glory of Harvey, but merely in recognizing the means to an end, we may admit that, but for the lessons of his master, Fabricius, Harvey might have passed through life, not unnoticed, indeed,—for such as Harvey was in himself, he must still have been remarkable,— but his name unconnected with one of the most admirable and useful inferences ever given to the world. Having passed five years at Padua, Harvey, then in the twenty-fourth year of his age (1602), finally obtained his diploma as doctor of physic, with licence to practise and to teach arts and medicine in every land and seat of learning. Having returned to England in the course of the same year, and submitted to the requisite forms, he also received his doctor's degree from his original University of Cambridge; and then coming to London, and taking to himself a wife in his six and twentieth year, he entered on the practice of his profession. History is all but silent in regard to the woman of our great anatomist's choice. We only know that she was the daughter of a physician of the day, Dr. Lancelot Browne, and that Harvey's union with her proved childless. He himself mentions his wife incidentally as having a remarkable pet parrot, which must also, if we may infer so much from the pains he takes in specifying its various habits and accomplishments, have been a particular favorite of his own.1 In 1604, Harvey joined the College of Physicians, his name appearing on the roll of candidates for the fellowship in that year; and three years afterwards, 1607, the term of his pro1 Vide On Generation, p. 186. That Harvey outlived his wife is certain from his Will, in which she is affectionately mentioned as his " deare deceased loving wife." She must have been alive in 1645, the year in which Harvey's brother John died, and left her £50.

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bation having passed, he was duly admitted to the distinction to which he aspired. We do not now lose sight of Harvey for any length of time : for a number of years, in the beginning of his career, he was probably occupied, like young physicians of the present day, among the poor in circumstance and afflicted in body, taking vast pains without prospect of pecuniary reward, but actuated by the ennobling sense of lightening the sum of human misery, and carried away, uncaring personal respects, by that ardent love of his profession which distinguishes every true votary of the art medical. Harvey, however, had not only zeal, talents, and accomplishments; he had, what was no less needful to success : powerful friends, united brothers, with the will and the ability to help him forward in the career he had chosen. In the beginning of 1609, he made suit for the reversion of the office of physician to St. Bartholomew's Hospital, then held by Dr. Wilkinson, and backing his suit by such powerful missives as the king's letters recommendatory to the governors of the house, and farther, producing testimonials of competency from Dr. Adkinson, President of the College of Physicians, and others, his petition was granted, and he was regularly chosen physician in futuro of St. Bartholomew's Hospital. Dr. Wilkinson having died in the course of the year, Harvey was first appointed to discharge the physician's duties ad interim, and by and by he was formally elected to the vacant office, 14th October, 1609. In his new position Harvey must have found ample scope for acquiring tact and readiness in the practical details of his profession; though St. Bartholomew's Hospital in his day appears to have borne a nearer resemblance to the dispensary of these times than to the hospital as we now understand the term. Harvey was now in his thirty-second year, and, brought before the public at so suitable an age, in an office of such responsibility, he must soon have risen into eminence as a

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physician and come into practice. Harvey, indeed, appears subsequently to have been physician to many of the most distinguished men of his age, among others to the Lord Chancellor Bacon, to Thomas Howard, Earl of Arundel, &c. In the year 1615, Harvey, then in the thirty-seventh year of his age, was happily chosen to deliver the lectures on anatomy and surgery at the College of Physicians, founded by Dr. Richard Caldwal, and it is generally allowed that in the very first course he gave, which commenced m the month of April of the following year, he presented a detailed exposition of the views concerning the circulation of the blood, which have made his name immortal. Long years had indeed been labouring at the birth which then first saw the light; civilized Europe, ancient and modern, had been slowly contributing and accumulating materials for its production; Harvey at length appeared, and the idea took fashion in his mind and emerged complete, like Pallas, perfect from the brain of Jove. The circulation, it would seem, continued to form one of the subjects in the lectures on anatomy, which Harvey went on delivering for many years afterwards at the College of Physicians; but it was not till 1628 that he gave his views to the world at large in his celebrated treatise on the 'Motion of the Heart andBlood/1 having already, as he tells us in his preface, for nine years and more, gone on demonstrating the subject before his learned auditory, illustrating it by new and additional arguments, and freeing it from the objections raised by the skilful among anatomists. Some few years after his appointment as their lecturer by the College of Physicians, Harvey must have been chosen one of the physicians extraordinary to the reigning sovereign, James I. The fame of Harvey's new views of the motions !

Exercitatio Anatomica de Motu Cordis ct Sanguinis, 4to, Francof. ad Moen., 1628.

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of the heart and blood could not but speedily have reached the wide-open ears of King James, and this of itself, to lay no stress on the powerful city interest of the illustrious anatomist, might suffice to ensure him such a mark of distinction as that just named. Of the precise date of his appointment as physician extraordinary to the king we are not informed; but in the letter of James bearing date the 3d of February, 1623, it is spoken of as a thing foregone—that had taken place some time ago; for in this letter Doctor Harvey is charged in common with the physicians in ordinary, with the care of the king's health; and he is further guaranteed the reversion of the office of ordinary physician whenever, by death or otherwise, a vacancy should occur. To the promised dignity, however, Harvey did not attain for several years, not till after the demise of James, and when Charles had already occupied the throne of his father for some five or six years. Harvey may now be said to have become rather closely connected with the court; but whether this connexion proved truly advantageous to him as a philosopher and physiologist may fairly be questioned. The time and service which the court physician must necessarily give to royalty and greatness interfere materially with the leisure and privacy that are indispensable to study and meditation. But Harvey, who appears to have been a man of singular self-possession, not to be diverted from his purpose by trifling or merely ceremonial considerations, always speaks of his master Charles in terms of unfeigned love and respect; and everything induces us to believe that Charles in turn loved and honoured his physician. The sovereign seems even to have taken a remarkable interest in the inquiries of the physiologist ; to have had several exhibitions prepared of the punctum saliens in the embryo chick and deer, and to have witnessed the dissections of many of the does which he so liberally placed at Harvey's disposal whilst the anatomist was prosecuting his inquiries into the subject of

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generation. Whatever the defects in Charles's public and political character, he must always be admitted to have been a man of elegant tastes, and of amiable temper and refined manners in private. It was certainly worthy of the Prince who appreciated, whilst he commanded, the talents of a Vandyke and a Rubens, that he also prized and encouraged the less brilliant, but not less useful genius of a Harvey. Harvey, as a physician, must now have been at the zenith of his reputation; he was physician in ordinary to the king, and we have seen him in the same position towards some of the foremost men of the age. His general practice, too, must have been extensive, and, if we look at the sum he is stated to have left behind him in money, his emoluments large. But he had not any lengthened harvest for all his early pains; his connexion with the court by and by came in the way of his continuing to improve his position; and then, grievous to relate, the appearance of the admirable Exercises on the Heart and Blood gave a decided and severe check to his professional prosperity. John Aubrey tells us he had " heard him (Harvey) say, that after his book on the ' Circulation of the Blood' came out, he fell mightily in his practice; 'twas believed by the vulgar that he was crack-brained, and all the physitians were against him."1 Writing many years afterwards, when the cause particularly indicated above had conspired to make Harvey's practice less, Aubrey informs us further, that "though all his profession would allow him to be an excellent anatomist, I never heard any that admired his therapeutique way. I knew several practitioners in this town that would not have given threepence for one of his bills (prescriptions), and [who said] that a man could hardly tell by his bills what he did aim at."2 So has it mostly been with those who have added to the sum of human knowledge! 1 a

Aubrey, Lives of Eminent Persons, 8vo, London, 1813. Ib., vol. ii, p. 383.

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The empiric under the title of the practical man, in his unsuspecting ignorance, sets himself up and is admitted as arbiter wherever there is difficulty: blind himself, he leads the blinded multitude the way he lists. He who laid the foundation of modern medical science lost his practice for his pains, and the routineer, with an appropriate salve for every sore, a pill and potion for each particular ache and ail, would not give threepence for one of his prescriptions ! did not admire his therapeutique way!! and could not tell what he did aim at! ! ! Ignorance and presumption have never hesitated to rend the veil that science and modesty, all in supplying the means, have still owned their inability to raise. If Harvey faltered, who of his contemporaries could rightfully presume to walk secure ? And yet did each and all of them, unconscious of the darkness, tread their twilight paths assuredly; whilst he, the divinity among them, with his eyes unsealed, felt little certain of his way. So has it still been with medicine; and the world must make many a lusty onward stride in knowledge before it can be otherwise. The first interruption to his ordinary professional pursuits and avocations which Harvey seems to have suffered through his connexion with the court, occurred in the beginning of 1630, when he was engaged "to accompany the young Duke of Lenox in his travels beyond seas." In anticipation of a removal from London, apparently, Harvey had already, in December 1629, resigned his office of treasurer to the College of Physicians, which he seems to have filled for several years. Of the course of Harvey's travels with the Duke of Lennox we have not been able to gain any information. Their way probably led them to the Continent, and it may have been on this occasion and in this company that he visited Venice, as we know from himself that he did in the course of one of his journeys. Harvey must have been in England again in 1632 and 1633; for in the former year he was formally chosen physician

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to Charles, and in the latter we find his absence, "by reason of his attendance on the king's majesty/' from St. Bartholomew's Hospital complained of by the surgeons of that institution, and Dr. Andrews appointed by the governors as his substitute, but " without prejudice to him in his yearly fee or in any other respect."l Such considerate treatment satisfies us of the esteem in which Harvey was held. In the early part of 1633 Charles determined to visit his ancient kingdom of Scotland, for the ostensible purpose of being crowned King of Scots. Upon this occasion Harvey accompanied him, as matter of course, we may presume. But the absence of the court from London* was not of long duration; and in the early autumn of the same year we are pleased to find Harvey again at his post in St. Bartholomew's Hospital, engaged in his own province and propounding divers rules and regulations for the better government of the house and its officers/ which of themselves give us an excellent insight into the state of the hospital, as well as of the relative positions of the several departments of the healing art two centuries ago. The doctor's treatment of the poor chirurgeons in these rules is sufficiently despotic it must be admitted; but the chirurgeons in their acquiescence showed that they merited no better handling. The only pdint on which they proved restive, indeed, was the revealment of their SECRETS to the physician; a great outrage in days when every man had his secrets, and felt fully justified in keeping them to himself. But surgery in the year 1633 had not shown any good title to an independent existence. The surgeon of those days was 1 Vide Records of Harvey from the Journals of St. Bartholomew's Hospital, pub. by James Paget, 8vo, London, 1846. Harvey, on his appointment to attend the Duke of Lennox, applied to have Dr. Smith chosen his substitute; but the governors proved recusant: " It was thought fit that they should have further knowledge and satisfaction of the sufficiency of the said Mr. Smith;" and they very shortly afterwards gave Dr. Andrews, first, the reversion of Harvey's office, and by and by they formally appointed him Harvey's deputy or substitute. 2 Vide Mr. Paget's publication already quoted, p. 13.

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but the hand or instrument of the physician; the dignitary mostly applied to his famulus when he required a wen removed, or a limb lopped, or a broken head plastered; though Harvey it seems did not feel himself degraded by taking up the knife or practising midwifery.1 Nevertheless, in these latter days Royal Colleges of Physicians have been seen arrogating superiority over Royal Colleges of Surgeons, and Royal Colleges both of Physicians and Surgeons combining to keep the practitioner of obstetrics under. From the year 1633 Harvey appears to have devoted much of his time to attendance upon the king and retainers of the court, so that we have little or no particular information of his movements for several years. We know, however, from Aubrey, that he accompanied Thomas Howard, Earl of Arundel, whose physician he was, in his extraordinary embassy to the emperor, in the year 1636.2 In the course of this journey, Harvey had an opportunity of visiting several of the principal cities of Germany, and of making the acquaintance of many of the leading medical men of the time. The place of date of one of Harvey's letters, that namely to Caspar Hofmann, from Nuremberg, in the month of May, 1636, has not been noticed; but his presence with the Earl of Arundel at once accounts for it; and we therefore see that Harvey's offer to demonstrate to the distinguished professor of Nuremberg, the anatomical particulars which made the circulation of the blood a necessary conclusion was no vain boast, made at a distance, 1

Vide his procedure for the removal of a sarcocele,«On Generation,' p. 254. " My Lady Howard had a cancer in her breast, which he did cut off and seared." (Aubrey, Lives, p. 386.) He speaks of having been called to a young woman in labour in a state of coma (On Generation, p. 534); and in another place (Ib. p. 437) he says, in connexion with the subject of labour, ' Haud inexpertus loquuor,1— I speak not without experience. Vide also p. 545, where he passes his fingers into the uterus and brings away " a mole of the size of a goose's egg;" and p. 546, where he dilates the uterine orifice with an iron instrument, and uses a speculum, &c. 2 The embassy left England the 7th of April, and returned about Christmas of the same year. Vide Crowne's ' True Relation/ &c., 4to, London, 1637.

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but a substantial proposition in presence of his opponent, and which there is tradition at least to assure us he was called upon to fulfil.—Harvey is reported to have made a public demonstration of his anatomical views at Nuremberg, satisfactory to all present save Caspar Hofmann himself; to whom, as he still continued to urge objections, the futile nature of which we in these days can readily understand, Harvey is further related to have deigned no other answer than by laying down the scalpel and retiring, conduct which we find in entire conformity with our estimate of the character of the man.1 On his return to England, in the winter of 1636, Harvey must have resumed his place near the person of the sovereign, and by and by, as in duty bound, accompanied him on his first hostile expedition into Scotland in 1639, when matters were happily accommodated between the King and his Scottish subjects, whom he had driven to take up arms so righteously in defence of their religious liberties. Harvey, as physician to the person, may be further presumed to have been with Charles when he marched towards the Border the following year, so memorable in the annals of English history, when the war with the Scots was renewed, when the king's authority received the first check at the battle of Newbury, and when Charles, returning to his capital after his defeat, encountered the still more formidable opposition of the English Parliament. Harvey may now be said to have become fairly involved with the Court. Prom the total absence of his name in the transactions of the times, it is nevertheless interesting to observe how completely he kept himself aloof from all the intrigues 1

Slegel (P. M.) De Sanguinis Motu Comment., 4to, Hamb. 1650, informs us in his Preface, that, whilst living with Hofmann in 1638, he had sedulously tried to bring him to admit the circulation; Slegel goes on to say, however, that it was in vain, and indeed that Harvey himself had failed to convince him: " Neque tantum valuit Harveus, vel coram (i. e. in 'his presence) cum salutaret Hofmannum in itinere Germanico, vel literis," &c. The old man, nevertheless, seems not to have been altogether deaf to reason; Slegel had hopes of him at last had he but lived: " Nee dubito quin concessisset tandem in nostra castra."

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and dealings of the party with which he was connected. He must have held himself exclusively to the discharge of his professional duties. In the course of these he doubtless attended Charles in his third visit to Scotland in the summer of 1641, when he essayed the arts of diplomacy with little better effect than he had already attempted the weight of prerogative in the first, and the force of arms in the second visit. On returning to London in the autumn of the same year, Charles soon brought matters to a crisis between himself and his English subjects, in the persons of their representatives, and nothing soon remained for him but to unfurl his standard and proclaim himself at war with his people. This was accordingly done in the course of the ensuing summer. But the Parliament did not yet abandon a seeming care of the royal person, and Harvey informs us himself, that he now attended the king, not only with the consent, but by the desire, of the parliament. The battle of Edge-hill, which followed, and in which the sun of fortune shone with a partial and fitful gleam upon the royal arms, is especially interesting to us from our Harvey having been present, though he still took no part in the affair, and seems indeed to have felt very little solicitude either about its progress or its issue, if the account of Aubrey may be credited. " When King Charles," says Aubrey, " by reason of the tumults, left London, he (Harvey) attended him, and was at the fight of Edge-hill with him; and during the fight the Prince and Duke of York were committed to his care. He told me that he withdrew with them under a hedge, and tooke out of his pockett a booke and read. But he had not read very long before a bullet of a great gun grazed on the ground neare him, which made him remove his station."1 The act of reading a book pending an important battle, the result of which was greatly to influence his master's fortunes, certainly shows a wonderful degree of coolness and a remarkable indifference 1

Lives, &c., vol. ii, p. 379.

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to everything like military matters. Harvey's own candid character, and the confidence so obviously reposed in him when he was intrusted with the care of the Prince and the Duke of York, forbid us to interpret the behaviour into any lukewarmness or indifference as to the issue; but Harvey, throughout his whole career, was a most peaceful man : he never had the least taste for literary controversy, and can scarcely be said to have replied to any of those who opposed his views; and in his indifference about the fight of Edge-hill he only further shows us that he was not " Of those who build their faith upon The holy text of pike and gun, And prove their doctrine orthodox By apostolic blows and knocks/'

With his fine understanding and freedom from party and sectarian views of every kind, he probably saw that an appeal to arms was not the way for political right to be elicited, or for a sovereign to settle matters with his subjects. Harvey had certainly no turn for politics,1 and when we refer to Aubrey we find that the fight of Edge-hill was hardly ended before our anatomist had crept back into his shell, and become absorbed in the subjects that formed the proper business of his life. " I first saw him (Harvey) at Oxford, 1642, after Edgehill fight," says our authority, " but was then too young to be acquainted with so great a doctor. I remember he came several times to our college (Trin.) to George Bathurst, B.D., who had a hen to hatch eggs in his chamber, which they opened dayljr to see the progress and way of generation/' The zealous political partisan would have found no leisure for researches like these in such stirring times as marked the out1 The author of the life of Harvey in the ' General Dictionary, Historical and Critical' (folio, Lond. 1738), the original of all our other lives of Harvey, is certainly in error when he recognizes Harvey as the type of the Physician who takes part in the Dialogue of Hy. Neville's Plato Redivivus, and assumes that he " relieved his abstruser studies by conversations in politics." In a third edition of Neville's work I find it stated that the physician who did so was Dr. Lower.

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break of the civil war iri England; the politician had then other than pullets' eggs to hatch. The king's physician, not to speak of the author of a new doctrine of the motions of the heart and blood, was sure to find favour in the eyes of the high church dignitaries of Oxford; and we accordingly find that, besides being everywhere handsomely received and entertained, Harvey had the honorary degree of Doctor of Physic conferred on him. Oxford, indeed, when the king and court were driven from the metropolis, which was now wholly in the hands of the popular party, became the head-quarters of the royal army and principal residence of the king for several years. And here Harvey seems to have quietly settled himself down and again turned his attention to his favorite subjects. Nor was the honorary distinction of doctor of physic from the university, which has been mentioned, the only mark of favour he received. Sir Nathaniel Brent, Warden of Merton College, yielding to his natural bias, forsook Oxford when it was garrisoned by the king, and began to take a somewhat active part in the proceedings of the popular party; he came forward in especial as a witness against Archbishop Laud, on the trial of that dignitary. Merton College being thus left without a head, upon the suggestion, as it is said, of the learned antiquary and mathematician, John Greaves, and in virtue of a letter of the king, Harvey was elected warden some time in the course of 1645. This appointment was doubtless merited by Harvey for his constant and faithful service to Charles; but it may also have been bestowed in some measure as a retort upon the Parliament, which, the year before, had entertained a motion for the supercession of Harvey in his office of physician to St. Bartholomew's Hospital.1 1 Feb. 12, an. 164|. "A motion this day made for Dr. Mieklethwayte to be recommended to the warden and masters of St. Bartholomew's Hospital, to be physician, in the place of Dr. Harvey, who hath withdrawn himself from his charge, and is retired to the party in arms against the Parliament." (Journals of the House of Commons, iii, 397.)

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Harvey, however, did not long enjoy his new office or its emoluments; for Oxford having surrendered to the Parliamentary forces under Fairfax the following year, Harvey, of course, resigned his charge, and immediately afterwards betook himself to London. Sir Nathaniel Brent, on the contrary, returned to Oxford; and the star of the Parliamentarians being now in the ascendant, Merton College was not slow to reinstate its old Presbyterian warden in the room of its late royalist head.1 From the date of the surrender of Oxford (July, 1646), Harvey followed the fortunes of Charles no longer. Of his reasons for quitting the service of his old master we know nothing. He probably felt anxious for repose; at sixty-eight, which was Harvey's age, a man begins to find that an easy chair is a fitter resting-place than the bare ground, a ceiled roof more suitable covering than the open sky—prospects which a continuance of the strife held out. Harvey, besides, as we have seen, had no stomach for contention in any shape or form, not even in the 1 I find a kind of obloquy commonly thrown on the memory of Nathaniel Brent for what is styled his desertion of Charles; but he never deserted Charles; he never belonged to him. Brent, forsooth, had received knighthood at the royal hands in former years; but knighthoods were sometimes forced upon men in those days for the sake of the fees, and often as means of attaching men of mark and likelihood. The truth is that Brent, who was a profound lawyer and scholar, as well as a traveller, was greatly attached to Archbishop Abbott, who had patronized and ad. vanced him through the whole course of his life. In the differences that took place between Abbott, in common with all moderate men, and Archbishop Laud, Brent naturally sided with his friend, led to do so, however, not by blind attachment only, but by natural constitution of mind, which appears to have abhorred the notion of a theocracy in the civil government of England, and to have been unfitted to comprehend the divinity that some conceive to inhere in despotism. Brent was, in fact, a man of such note, that Charles had tried to win him to his party many years before by various attentions and the free gift of knighthood; but this was in times when men were not required to take a side, when they stood naturally neutral. When the time came that it behoved him to show under what flag he meant to fight, Brent was not wanting to his natural bias and to independence. He therefore left Oxford when it was taken possession of by the royal forces, among other adherents of the popular cause, and was simply true to his principles, in nothing false to a patron or benefactor.

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literary arena; and he now probably resolved himself to follow the advice he had once given to his young friend Charles Scarborough, " to leave off gunning,"1 and dedicate himself wholly to more congenial pursuits. And then Charles had long made it apparent, even to the most ardent of his adherents, that no faith was to be put in his promise, no trust to be reposed in his royal word. The wise old man, verging on the age of threescore years and ten, doubtless saw that it was better for him to retire from a responsible office, now become most irksome and thankless, and seek privacy and leisure for the remainder of his days. These Harvey found awaiting him in the houses of his affectionate brothers—now in the house of Eliab, in the City, or at Roehampton, and then in the house of Daniel, in the (suburban' village of Lambeth, or at Combe near Croydon in Surrey, in each of which Harvey had his own apartments. The Harveys appear to have been united from first to last in the closest bonds of brotherly love,2 and to have had a common interest in many of their undertakings; and Eliab, as we shall see, employed the small capital, 1 " Prithee leave off thy gunning and stay here; I will bring thee into practice." (Aubrey, Op- cit. p. 381.) 2 On the monumental tablet of Thomas, the first of the brothers who died, in the church of St. Peter's-le-Poore, the mottos, doubtless supplied by a surviving member of the family, show this feeling. The inscription is as follows: As in a Sheafe of Arrows. Vis unita fortior. The band of Love The Unitor of Brethren. Here Lyeth the body of Thomas Harvey, Of London, Merchant, Who departed this life The 2nd of Feby. An. Dom. 1622. (Stow's London, third edit., fol. Lond. 1633.) John Harvey, Esq., who died in 1645, left his brother William's wife £50. Eliab Harvey attended particularly to his brother William's interests; and William at his death returned Eliab's kindness by leaving him his residuary legatee.

C

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which his brother William must have accumulated^ before the civil wars broke out, to such purpose, that the doctor actually died a rich man. With his brothers, then, retreating now to the " leads" of the house in the heart of the metropolis, now to the " caves" of the one at Combe, did Harvey continue to pass his days—but not in idleness; for the work on Generation, with the subject of which we saw him busied at Oxford several years before, must have found him in ample occupation. Nor was the love of ease so great in William Harvey, even at the advanced age of seventy-one, if we may credit some of the accounts, as to hinder him from again visiting the Continent, and making his way as far as Italy, a journey in which it is said he was attended by his friend the accomplished scholar and gentleman, Dr. Ent.1 In the beginning of 1651 appeared the second of Harvey's great works, that, namely, On Animal Generation.2 In this publication we have abundant proof of our author's unabated industry and devotion to physiological science; and in the long and admirable letter to P. M. Slegel, of Hamburg, written shortly after the appearance of the work, we have pleasing evidence of the integrity of Harvey's faculties at the advanced age of seventy-three. The year after the publication of the work on Generation, i. e. 1652, when Harvey was looked up to by common consent as the most distinguished anatomist and physician of his age, the College of Physicians came to the resolution of placing his statue in their hall then occupying a site at Amen-corner; and measures being immediately taken in conformity with this purpose, it was carried into effect by the end of the year, 1

This rather arduous undertaking in those days was accomplished, according to Aubrey, about the year 1649. But I have found so much to excite doubt in Aubrey's Notes, that I greatly suspect the accuracy of his statement about the journey to Italy. 2 De Generatione Animalium, 4to, London, 1651.

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when the statue, with the following complimentary inscription on the pedestal, was displayed : GULIELMO HARVEIO Viro monumentis suis immortal! Hoc insuper Collegium Medicorum Londinense posuit. Qui enim Sanguini motum ut et Animalibus ortum dedit, Meruit esse Stator Perpetuus.1

Harvey, in acknowledgment, it may have been, of the distinguished honour done him by his friends and colleagues, appears about this time to have commenced the erection at his own cost of a handsome addition to the College of Physicians. It was, as Aubrey informs us, " a noble building of Roman architecture (of rustic work, with Corinthian pilasters), comprising a great parlour, a kind of convocation house for the fellows to meet in below, and a library above. On the outside, on the frieze, in letters three inches long, was this inscription : Suasu et cura Fran. Prujeani, Prsesidis, et Edmundi Smith, elect, inchoata et perfecta est hsec fabrica, An. MDCLiii."2 Nor was Harvey content merely to erect this building; he, further, furnished the library with books, and the museum with numerous objects of curiosity and a variety of surgical instruments. On the ceremony of this handsome addition to the College of Physicians being opened, which took place on the 2d of February, 1653, a sumptuous entertainment was provided at Harvey's expense, at which he received the pre1 This statue perished with the building, in the great fire of London in 1666, and seems never to have been replaced. The hall of the present College of Physicians is not graced as was the old one in Harvey's time. The only sculptures of Harvey that I know of are busts, in the theatre of the College of Physicians and on his monument in Hempstead church, but of dates posterior to their subject, that at the College of Physicians being apparently after the portrait by Jansen in the library, and, as I am informed, by a sculptor of the name of Seemacher. 2 Aubrey, 1. c. p. 378.

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sident and fellows, and made over to them, on the spot, his whole interest in the structure. Dr. Prujean, the president of the college, going out of office, as usual, at Michaelmas the next year (1654), Harvey was unanimously chosen to fill the vacant chair. Having been absent when the election took place, a deputation proceeded to his apartments to apprize him of the honour his colleagues had done themselves and him, and to say that they awaited his answer on the following day. Every act of Harvey's public life that has come down to us is marked not merely by propriety but by grace. He attended the comitia or assembly of the college next day; thanked his colleagues for the distinguished honour of which they had thought him worthy— the honour, as he said, of filling the foremost place among the physicians of England; but the concerns of the college, he proceeded, were too weighty to be intrusted to one like him, laden with years and infirm in health; and if he might be acquitted of arrogance in presuming to give advice in such circumstances, he would say that the college could not do better than reinstate in the authority which he had but just laid down, their late president, Dr. Prujean, under whose prudent management and fostering care the affairs of the college had greatly prospered. This noble counsel had fitting response: Harvey's advice being adopted by general consent, Dr. Prujean was forthwith re-elected president. The College of Physicians were justly proud of their great associate, and Harvey, in his turn, was undoubtedly attached to the college. Here, indeed, as their lecturer on anatomy and surgery, he had first propounded the views which had won him such distinguished credit in his life, and which have left his name as a deathless word on the lips of men; here he consorted with his nearest and dearest friends, receiving from all those remarks of respectful consideration that were so justly his due; and here, in fine, the first place among the first men

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of his profession had been tendered to him, and gracefully declined. To a mind like Harvey's, and with the opportunity afforded him of making so graceful a concession, the foremost place was certainly a higher distinction unaccepted, than it had been enjoyed.—The excuse for declining the office of president was not merely personal: it was not alone that he was an old man, infirm in health, and incompetent for so great a trust; but, the affairs of the college had greatly thriven under the prudent management and constant care of the late president, and it was no more than right that he who had but just laid down should be re-established in authority. Harvey, we have said, was childless ; his wife, though we have not the date of her death, he had certainly lost by this time. His only surviving brother Eliab was rich ; his nephews were prosperous merchants and on the road to the independence and titles which several of them afterwards achieved: he, therefore, determined to make the College of Physicians not only heirs to his paternal estate, worth, at that time, 56Z. per annum, but to bestow it on them in free gift during his life. This purpose he carried into effect by means of a formal instrument, which he delivered to the college in the month of July, 1656; the special provisions in the deed settling one sum, by way of salary for the librarian, and another sum, for the delivery of a solemn oration annually, in commemoration of those who had approved themselves benefactors to the college, and, by extension, who had added aught to the sum of medical science in the course of the bygone year.1 1 There is much information on the life of Harvey in the inscription upon the copper-plate which was attached to his portrait in the old College of Physicians. I give it entire, anxious to set before the reader every authentic word of his times that was uttered of Harvey. This inscription, but, unless I mistake, abbreviated, may be found in printed letters under the bust of Harvey in the theatre of the Royal College of Physicians: GULIELMUS HARV^EUS, Anglus natus, Gallias, Italiae, Germanise hospes, Ubique Amor et Desiderium, Quern omnis terra expetisset Civem,

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Having thus accompanied Harvey over so much of the way in his mortal career, let us, before proceeding further, briefly advert to his WRITINGS, to the influence they had in the republic of letters during his life-time, to the fruits they have since produced, and to the impression still made on the mind that holds communion through their means with the mind that dictated them so many years ago.—The intellectual endowment of a man necessarily appears in his writings; it is not always from them that so true a conception of his moral character can be formed. Harvey, however, though in his long life he accomplished but a small fraction of all his literary designs, has still left us sufficient from which to form an estimate of him as a philosopher, as a physiologist, and it Medicinae Doctor, Coll. Med. Lond. Socius et Consiliarius, Anatomes, Chirurgiaeque Professor, Regis Jacobi Familiae, Caroloque Regi Medicus, Gestis clarus, omissisque honoribus, Quorum alios tulit, oblatos renuit alios, Omnes meruit. Laudatis priscorum ingeniis par; Quos honoravit maxime imitando, Docuitque posteros exemplo. Nullius lacessivit famam, Veritatis studens magis quam gloriae, Hanc tamen adeptus Industria, sagacitate, successu nobilis Perpetuos sanguinis sestus Circular! gyro fugientis, seque sequentis, Primus promulgavit mundo. Nee passus ultra mortales sua ignorare primordia, Aureum edidit de ovo atque pullo librum, Albae gallinse filium. Sic novis inventis Apollineam ampliavit art em, Atque nostrum Apollinis sacrarium augustius esse Tandem voluit; Suasu enim et cura D. D. D ni - Francisci Prujeani Praesidis Et Edmundi Smith Electoris An. MDCLIII, Senaculum, et de nomine suo Musaeum horto superstruxit, Quorum alterum plurimis libris et Instruments Chirurgicis, Alterum omnigena supellecLile ornavit et instruxit, Medicinae Patron us simul et Alumnus.

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may also be said as a man. Let us take a brief survey of his writings, then, and wind up our account of his life with such personal notices as we can gather from contemporaries, or as we can infer from his own conduct and written word. ON THE HEART AND BLOOD.

Harvey's great work, though by no means the largest in bulk, is the one on the Motions of the Heart and Blood. It has been said, happily, by a recent critical writer, that " men were already practising what Bacon came to inculcate," viz. induction upon data carefully collected and considered; and it would not be easy to adduce a more striking example of Non hie anliela substitit Herois Virtus, impatiens vinci Accessit porro Munificentiae decus: Suasu enim et consilio D ui - D lis - Edv. Alstoni Praesidis, Anno MDCLVI Rem nostram angustam prius, annuo LVI. 1. reditu auxit, Paterni Fundi ex asse haeredem collegium dicens; Quo nihil Illi cliarius Nobisve honestius. Unde aedificium sartum tectum perennare, Unde Bibliothecario honorarium suum, suumque Oraton Quotannis pendi; Unde omnibus sociis annuum suum convivium, Et suum denique (quot menses) conviviolum censoribus parari, Jussit. Ipse etiam pleno theatre gestiens se haereditate exuere, In manus Praesidis syngrapham tradidit. interfuitque Orationi veterum Benefactorum novorumque lilicio, Et Philotesio Epulo; Illius auspicium et pars maxima; Hujus conviva simul et convivator. Sic uostquam satis sibi, satis nobis, satis gloriae, Amicis solum non satis, nee satis patrite, vixerat, Ccelicolum atria subiit Jun. iii, MDCLVII. Quern pigebat superis reddere, sed pudebat negare: Ne mireris igitur Lector, Si quern marmoreum iilic stare vides, Hie totam implevit tabu lam. Abi et mererc alteram.

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the way in which ultimate rational truth is arrived at by a succession of inferences than is contained in Harvey's Essay on the Heart and Blood. Had Bacon written his Novum Organum from Harvey's work as a text, he would scarcely have expressed himself otherwise than as he has done, or given different rules for philosophizing than those which he has laid down in his celebrated treatise.1 In his introduction, and by way of clearing the ground, Harvey exposes the views of preceding physiologists, ancient and modern, in regard to the motions of the heart, lungs, and blood, to the state of the arteries, &c.—in short, he gives the accredited physiology of the thoracic viscera, with comments, which prove it a mass of unintelligible and irreconcilable confusion. There is room, therefore, for another interpretation, consonant with reason and with anatomical fact, and susceptible of demonstration by the senses. When he first essayed himself to comprehend the motions of the heart, and to make out the uses of Jihe organ from the dissection of living animals, he found the subject so beset with difficulties that he was almost inclined at one time to say with Fracastorius, that these motions and their purpose could be comprehended by God alone. By degrees, however, by repeating his observations, using greater care, and giving more concentrated attention, he at last discovers a way out of the labyrinth, and a means of explaining simply all that had previously appeared so obscure. Hence the occasion of his writing. Such is the burthen of the proem and first chapter. With Harvey's admirable work now put in an accessible shape into his hands, we should (did we proceed with an analysis) but anticipate the intelligent reader in the great pleasure he will have in following the author through the different steps of his argument 1 The Novum Organum appeared in 1620. Though Harvey's work was not published till 1628, he had developed his subject in 1616, and there is every reason to believe, actually written the 'Exercit. de Motu Cordis et Sanguiriis' before 1619.

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until the conclusion is reached, and the inference presents itself as inevitable, namely, that the blood must circle round and round in one determinate course, in the body as in the lungs, incessantly. For Harvey, it must be here observed, left the doctrine of the circulation as an inference or induction only, not as a sensible demonstration. He adduced certain circumstances, and quoted various anatomical facts which made a continuous transit of the blood from the arteries into the veins, from the veins into the arteries, a necessary consequence; but he never saw this transit; his idea of the way in which it was accomplished was even defective; he had no notion of the one order of sanguiferous vessels ending by uninterrupted continuity, or by an intermediate vascular network, in the other order. This was the demonstration of a later day, and of one who first saw the light in the course of the very year when Harvey's work on the Heart was published.1 The appearance of Harvey's book on the Motion of the Heart and Blood seems almost immediately to have attracted the attention of all the better intellects among the medical men of Europe. The subject was not one, indeed, greatly calculated to interest the mass of mere practitioners; had it been a book of receipts it would have had a better chance with them; but the anatomists and physiologists and scientific physicians would seem at once to have taken it up and canvassed its merits. The conclusions come to in the work, there can be no question, took the medical world by surprise; it was not prepared for such a proposition as a ceaseless circular movement of the blood, with the heart for the propelling organ; for the latter point, be it understood, was even as great a novelty as the former. Coming unexpectedly, and differing so widely from the ancient and accepted notions, we cannot wonder that Harvey's views were at first rejected almost universally. The older 1 Malpighi, born at Crevalcuore, Bologna, the 10th of March, 1628.

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intellects, in possession of the seats and places of authority, regarded them as idle dreams; and upon the faith of this conclusion, their author was set down and treated by the vulgar as a crackbrained innovator. Two years, however, elapsed before aught in contravention of the new doctrines saw the light, and this came at length not from any of the more mature anatomists of Europe—their minds were made up, the thing was absurd—but from a young physician, of the name of Primerose, of Scottish descent, but French by birth. Primerose had been a pupil of Joannes Riolanus, professor of anatomy in the University of Paris; he had doubtless listened to his master's demonstration of the absurdity of the Harveian doctrine of the circulation, and by and by he set himself down, by way apparently of exercising his ingenuity, to try the question, not by fact and experiment, but by the precepts he had imbibed from his teacher and the texts of the ancients The essay of Primerose1 may be regarded as a defence of the physiological ideas of Galen against the innovations of Harvey It is remarkable for any characteristic rather than that of a candid spirit in pursuit of truth; it abounds in obstinate denials, and sometimes in what may be termed dishonest perversions of simple matters of fact, and in its whole course appeals not once to experiment as a means of investigation.—Harvey, having already, and in the very outset of his work, demonstrated the notions untenable which it was Primerose's purpose to reassert and defend, of course deigned him no reply; he could never dream of going over the barren ground he had already trodden, in the hope of convincing such an antagonist. .JUmylius Parisanus, a physician of Venice, was the next to assail the Harveian doctrine of the circulation,2 and still with 1 Entitled ' Exercitationes et Animadversiones in Librum Harvei de Motu Cordis et Sanguinis,' 4to, London, 1630. 2 In his work entitled ' Lapis Lydius de Motu Cordis et Sanguinis,' folio, Venet. 1635.

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the old instruments,—the authority of Galen and the ancients generally. Parisanus perceived Harvey's views as directly contravening an hypothesis to which he had formerly committed himself, namely, that the spleen was the organ of sanguification and the furnisher of nutriment to the heart; on this ground may Parisanus have been led to enter the lists against the new opinions. But he proved a most flimsy antagonist. Ignorant of some of the commonest points of anatomy, and frequently misinterpreting the writer he combats, writing himself in a style the most elaborately involved, and consequently obscure, it is frequently difficult even to guess at his meaning. Like his countryman of the poet, Signor Gratiano, he " Speaks an infinite deal of nothing; more than any man in all Venice: his reasons are two grains of wheat hid in two bushels of chaff; you shall seek all day ere you find them ; and when you have them they are not worth the search."

Had not Dr. Ent, in his Apology for the Circulation, given the name a place on his title-page, Parisanus's opposition would scarcely have merited mention here. Nearly at the same time with Parisanus, Caspar Hofmann, the learned and laborious professor of Nuremberg, attracted particular attention, both in his teaching and his writings, as the opponent of the Harveian doctrine. The opposition here is the more remarkable from Hofmann's having shaken himself wholly free from the authority of Galen, and, as Slegel says, even admitted the lesser circulation of the blood through the lungs; but this must have been at a later period of his life, for in his works, up to Harvey's time, the idea he had of the motion of the blood may be gathered from his likening it to a lake or sea agitated by the wind, the veins being the conduits of the nutrient blood, the arteries of the vital spirits. Hofmann was an adversary whom Harvey held worthy of notice; and accordingly we have seen that our immortal countryman took advantage of the opportunity, whilst attending the Earl of Arundel and his party, to visit Hofmann at Nuremberg,

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and make a demonstration of the new views before him. Unhappily this was done in vain, for Hofmann continued unconvinced, though, towards the end of his very long life, he did show some signs of yielding.1 Joannes Veslingius, professor in the University of Padua, and one of the best anatomists of the age, about this time, addressed two letters to Harvey, in which he politely but candidly states his objections to the new doctrine. One great difficulty with Veslingius was the remarkable difference between the colour of the arterial and the venous blood. It did not seem possible to him that the fluid, which was of a bright scarlet in the arteries, could be the same as the dark-coloured fluid which is found in the veins. In the course of his letter, Veslingius takes occasion to animadvert on the uncivil tone and indifferent style of the productions of Primerose and Parisanus.2 But the theory of the double circulation was not now to meet with opposition only; the comprehensive intellect that had seized and worked that theorem to a rational demonstration was no longer to be left alone against the world in its defence. Roger Drake, a young Englishman, had the honour of appearing in his inaugural dissertation, proposed under the auspices of Joannes Walseus, the distinguished professor of Leyden, in 1639, as the enlightened advocate of the Harveian views ; and in the course of the same year, H. Regius (Leroy) also came forward at Utrecht with certain Theses favorable to the' doctrine of the circulation. Ten years had not lessened Primerose's enmity to Harvey and his views; for, on the appearance of these academical essays, he speedily showed himself again in the field as their opponent, publishing distinct animadver1

Vide Slegel, De Sang. Motu in Prsef. Veslingius's letters may be found in his Observations Anatomic® et Epist. Med. ex schedis pothumis, 12mo, Hafn. 1664. It is much to be regretted that the replies which Harvey doubtless wrote to these epistles have not been preserved. 8

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sions upon each of the inaugural dissertations in the course of the year.1 Regius (Leroy), a man of much less mind and information than Drake, if we may decide from their works, was, in turn, not slow to encounter Primerose ;2 and the spirit in which he did so, as well as the temper and taste of the reply which Primerose, true to his controversial nature, very soon produced,3 may, to a certain extent, be imagined from the titles of their several productions, which are given below. Still more illustrious advocates of the Harveian circulation presented themselves in Werner Rolfink,4 professor of anatomy at Jena, and the celebrated Renatus Descartes. Rolfink, from his position and his popularity as a teacher, had immense influence in disseminating the new doctrine over Europe; and Descartes, under the aegis of his powerful name, was no less effective by means of his writings.5 Opposed in his advocacy of the Harveian views by Yopiscus Fortunatus Plempius, professor of Louvain, Descartes made himself still more thoroughly master of the subject, and when he next appears as its advocate, which he does by and by, he even appeals to the experiments he had made on living animals in support of his convictions and conclusions. The controversy on the circulation had been carried on up to this time abroad rather than at home; Harvey seems to have won over to his side all the men of his own country who, by their education and acquirements, might have been fitted to array themselves against him : his lectures at the College of Physicians had apparently satisfied all his contemporaries. But now one of Harvey's own countrymen made his appear1 Animadversiones in J. Walaei (Drake) Disputationem quam pro Circulatione Sanguinis proposuit, 4to, Amst. 1639. Animad. in Theses quas pro Circulat. Sang. Hen. Regius proposuit, 4to, Leidae, 1640. 2 Spongia qua eluuntur sordes Animad. quas Jac. Primirosius advers. Theses, &c., edidit. 4to, Leidae, 1640. 3 Antidotum adversus Spongiam Venenatam Hen. Regii, 4to, Leidae, 1640. 4 Epist. duae ad Th. Bartholinum de Motu Chyli et Sanguinis, 8vo, Leid. 1641. 5 Epist. Cartesii, 4to, Amst. 1668.

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ance as the vindicator of the circulation from the misrepresentations and misapprehensions of its adversaries. This was Dr. afterwards Sir George Ent, a good scholar, a respectable anatomist, conversant with physical science generally, a gentleman by his position and profession, acquainted with all the leading men of letters and science of his time, and in particular, enjoying the friendship of William Harvey. Ent's work is entitled € An Apology for the Circulation of the Blood, with a Reply to JSmylius Parisanus/1 In his letter to Harvey, which stands in front of the work, Ent lets it appear that he was anxious to come before the world as the advocate of the circulation; he first thought of making Primerose the particular object of his animadversions, but as this opponent had already been very effectually handled by Henry Leroy, he preferred taking Parisanus to task, the rather as in dealing with him he could also controvert Primerose where it was necessary.—Ent's Apology is, undoubtedly, a learned, though perhaps a somewhat pompous and pedantic book ; still the writer occasionally shows both wit and fancy in handling his antagonist, and always learning enough in dealing with his subject. " Nothing, indeed," to quote Dr. Lawrence,2 " can be more unlike than Parisanus and Ent; and it is not wonderful, therefore, that one utterly ignorant of physical science confronted by one thoroughly conversant therein—that one, without power of utterance, opposed by one gifted with eloquence—that one, sluggish and inert, in the hands of one active and full of energy, should be effectually vanquished and overcome." We may imagine, nay, we may be certain, that Harvey was not unacquainted with Ent's purpose to appear as the advocate of his discovery, nor with the Apology before it saw the light. Having observed the appearance of certain academical dis1

Apologia pro Circuitione Sanguinis, qua respondetur ^Emylio Parisano, 8vo, Lond. 1641. 2 Harvei vita, ad cap. Operum, London, 1766.

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sertations in defence of the circulation, we perceive the apostles of all new truths, namely, the youthful, at work. Were there not successive generations of men, the world would stand still; the death of the individual was not merely a necessary condition to the enjoyment of life by successive generations, but essential also to the onward progress of mankind. No man who had attained to the age of 40 years, it is said, was found to adopt the doctrine of the circulation; it had to win its way under the safeguard of the Drakes and Leroys especially, that is to say, of the youthful and unprejudiced spirits of the age. Twenty years after the publication of the 'Exercitatio de Motu Cordis et Sanguinis/ Joannes Riolanus, the younger, was delivered of his ' Encheiridium Anatomicum' (8vo. Lugd. Batav. 1648), in which he makes a vain attempt to supplant the Harveian doctrine by a new and most extraordinary one of his own, so incongruous and unlikely, that in these days we are irresistibly led to form no very high estimate of the intellect that could have engendered it. It looks to us, indeed, at this time, like condescension on the part of the great English anatomist, that he noticed the abortion of such a tyro in animal physics as the French professor here approves himself. Harvey's genius could surely have felt no real respect for the illogical intellect of Eiolan. But Harvey, when he noticed Riolan's publication, was in want of a good occasion for a farther development of his own views; and so he seized on the Parisian professor, respectable from his position in the university, and as physician to the queen mother of France, and made him his vehicle—his placard bearer. Harvey, besides, was personally acquainted with Riolan, who had accompanied Mary de Medicis to England on a visit to her daughter the Queen of Charles the First; on which occasion Harvey and Riolan had even held conversations on

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the subject of the circulation, to which it is said that Riolan when face to face with the propounder, made no objection. Riolan is by no means totally opposed to a circulation of the blood; he would only limit it to certain arbitrary regions, into which he divides the body: whilst it goes forward in one, it has no existence in another. The nature of his ideas can be gathered from Harvey's comments on them in his First Disquisition, addressed to the Coryphaeus of Anatomists, as he politely designates the Parisian professor. Having disposed of the original notions of the author of the 'Encheiridium Anatomicum,' in this first disquisition, Harvey, in his second, returns to his own views, which he proceeds still further to illustrate and confirm by additional arguments, observations, and experiments. In this admirable essay, we obtain innumerable glimpses of the clearness of Harvey's judgment, of his admirable powers of observation, and the diligent and excellent use he made of them; we at the same time become aware of the great loss we have sustained through the destruction of his Medical Observations. Riolan, in his Encheiridium, proposed to point out in the structure of the healthy body the seats of the various diseases, and to discuss their nature in conformity with the opinions that had been entertained of them. This was obviously at once a barren and an impracticable route: the matters he had in hand could never have been other than abstractions, and his own observations criticisms on opinions, never on facts. How much more natural and judicious the course which Harvey proposes to himself, when he informs us that in his € Medical Anatomy' he meant, " from the many dissections he had made of the bodies of persons worn out by serious and strange affections, to relate how and in what way the internal organs were changed in their situation, size, structure, figure, consistency, and other sensible qualities, from their natural

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forms and appearances, such as they are usually described by anatomists; and in what various and remarkable ways they were affected. For even as the dissection of healthy and wellconstituted bodies contributes essentially to the advancement of philosophy and sound physiology, so does the inspection of diseased and cachectic subjects powerfully assist philosophical pathology/' This was precisely what Morgagni lived, in some considerable measure, to achieve, and it is that which it has been the business of modern pathology, through the illustrious line of the Baillies, Laennecs, Andrals, Louis, Cruveilhiers, Carswells, Richard Blights, and many others, to render more and more complete. Riolan never replied to Harvey; but neither did the Parisian Professor attempt to vindicate his views, nor did he exhibit such candour as to own himself otherwise convinced or converted. His doctrine had no abettors, and never bore fruit; it stood a barren ear amidst the lusty, green, and copious harvest, that had already sprung up and overspread the lands. Harvey must now, indeed, have seen his views assured of general reception at no distant date. The same year in which he himself answered Riolan, Dr. James de Back, of Amsterdam, published his work on the Heart,1 which is written entirely in harmony with the Harveian doctrines, and the celebrated Lazarus Riverius, Professor of Medicine in the University of Montpellier, publicly defended and taught the circulation of the blood.2 The following year, Paul Marquard Slegel, of Hamburg, produced his commentary on the Motion of the Blood,3 in which he addresses himself particularly to a refutation of Riolanus, whose scholar he had been, and at the same time shows himself so thoroughly at home in the general ques1

De Corde, Amst. 1649; in English, 12mo, Lond. 1653. A candour for which he was hy and by summoned by an adherent of the old school to resign his chair. 3 De Sanguinis Motu Commentamis, 4to, Hamb. 1650. 2

d

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tion, that he is able to throw additional light on it by new and ingenious considerations and experiments. Harvey appears to have been pleased with Slegel's production ; for by and by he sends the Hamburger his new work on Generation, accompanied by an admirable letter, which has happily been preserved.1 No one in reading that remarkable epistle could suppose that the pen which set it down was in the hand of a man in the 75th year of his age. The young men of 1628 and 1630, who had been educated in unbelief of the circulation, were now coming into possession of professorial chairs and places of distinction; and having long escaped from leading-strings and made inquiry for themselves, were beginning in many of the European universities to proclaim the better faith through further knowledge that had sprung up within them. Harvey had himself received the seeds of his discovery in Italy; but the fructifying mother was slow to recognize him whom she had so powerfully concurred to form. It was not till 1651 that Harvey's views were in any way admitted beyond the Alps, when Trullius, a Roman professor, expounded and taught them. About the same time, John Pecquet,2 of Dieppe, and Thomas Bartholin, the Dane,s men of original mind in the one case, of extensive learning and great research in the other, gave in their adhesion to the new doctrine, and spread it far and near by their writings. The victory for the circulation may finally be said to have been won, when Plempius, of Louvain, the old antagonist of Descartes on the subject, retracted all he had formerly written against it, convinced of its truth, as he so candidly informs us, by the very pains he took to satisfy himself of its erroneousness, and publicly proclaimed his conversion : " Primum mihi hoc inventum non 1

Vide p. 596. Experimenta nova Anatomica. Acced. de Motu Sanguinis Diss.,8vo, Paris, 1651. 3 Anatomia ex Gasp. Bartholini Parent. Institut. ad Sanguinis Circulationem, tertium Reformata, 8vo, Leid. 1651. 2

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placuit," says the worthy Plempius—" This discovery did not please me at all at first, as I publicly testified both by word of mouth and in my writings; but by and by, when I gave myself up with firmer purpose to refute and expose it, lo ! I refute and expose myself, so convincing, not to say merely persuasive, are the arguments of the author : I examine the whole thing anew and with greater care, and having at length made the dissection of a few live dogs, I find that all his statements are most true."1 From the first promulgation of the doctrine of the circulation, its progress towards ultimate general acknowledgment can scarcely be said for a moment to have been interrupted. The hostility of the Primeroses and Parisanuses and Riolans never interfered with it in fact; the more candid spirits were rather led to inquire, by the virulence of these weak and inconsistent opponents, who thus hastened the catastrophe of their own discomfiture, and the triumph of the truth. If men's minds were once in danger of being led astray, it was only for an instant, and not so much through the opposition of enemies, as by an erroneous generalization, which a short interval of time sufficed to correct. Caecilius Folius, a Venetian physician, having met with one of those anomalous instances of pervious foramen ovale in an adult, immediately and without looking farther, jumped to the conclusion that this structure or arrangement was normal, and that the blood passed in all cases by the route he had discovered, from the right to the left side of the heart. Many Italians received with favour the account which Folius immediately published of his discovery ;3 and the natural philosopher, Gassendi, having about the same period had another instance of the kind which Folius encountered, shown to him, concurred with this writer in his views, and by a variety of arguments and objections, strove to damage, and did temporarily damage, 1

Plempius, Fundamenta Medicinae, fol. Lovan. 1652, p. 128. Sanguinis a dextro in sinistrum Cordis Ventriculum defluentis facilis rcpcrta via, fol. Venet. 1639. 2

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the Harveian doctrine.1 But this was only for a brief season ; for Domenic de Marchettis2 soon after showed that Folius had mistaken an extremely rare occurrence for a general fact, and that if the open foramen ovale might afford a passage from the right to the left side of the heart in one case, closed it would suffer no such transit in hundreds of other instances. Gassendi, moreover, by getting still more out of his depth, soon afterwards showed that familiarity with general physics did not imply a particular knowledge of anatomy, nor give the power of reasoning sagely on subjects of special physiology; so that in his eagerness to assail Harvey he did injury in the end only to his own reputation. In short, Harvey in his lifetime had the high satisfaction of witnessing his discovery generally received, and inculcated as a canon in most of the medical schools of Europe; he is, therefore, one of the few—his friend Thomas Hobbes says, he was the only one within his knowledge—" Solus quod sciam,"3 who lived to see the new doctrine which he had promulgated victorious over opposition, and established in public opinion. Harvey's views, then, were admitted; the circulation of the blood, through the action of the heart, was received as an established fact ; but envy and detraction now began their miserable work. The fact was so; but it was none of Harvey's discovering; the fact was so, but it was of no great moment in itself, and the merit of arriving at it was small; the way had been amply prepared for such a conclusion. Let us look as impartially as we may at each of these statements. They who deny the originality of Harvey's induction, very commonly confound the idea of a Motion of the blood, with the idea of a Continuous Motion in a Circle. It would seem 1

Gassendi, 'De Septo Cordis pervio/published in a collection by Severinus Pinaeus, 12mo, Leid. 1640. 2 D. de Marchettis, Anatomia, 8vo, Padova, 1652. 3 Elementa Philosophise in Praefat.

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that even from remote antiquity, and by common consent, mankind had recognized the blood to be in motion. We have this fact declared to us by all antiquity, and it is even particularly referred to in various passages of the grand observer of his age, the depositary of the popular science of all preceding ages—Shakespeare. Brutus speaks thus to Portia: " You are my true and honourable wife; As dear to me as are the ruddy drops That visit my sad heart;"

language not more touching and beautiful than physiologically correct. And again, with more of involution and ellipsis, yet with a meaning that is unmistakable, Warwick, by the bedside of the murdered Gloster, proceeds,— " See how the blood is settled in his face! —Oft have I seen a timely-parted ghost, Of ashy semblance, meagre, pale and bloodless, —Being all descended to the labouring heart, Who in the conflict that he holds with death, Attracts the same for aidance gainst the enemy ; Which with the heart there cools, and ne'er returneth To blush and beautify the cheek again— —But see, his face is black and full of blood," &c.

These passages have actually been cited, to prove that Shakespeare was not unacquainted with the circulation; and there have not been wanting some1 who have even argued that Shakespeare had his knowledge direct from the fountain-head— from Harvey himself, with whom, for several years at least, he was contemporaneous.2 The passages quoted above are referred to all the more willingly, from their having preceded the teaching of Harvey by a few years only; but Shakespeare probably referred to 1 Thomas Nimmo, Esq., of New Amsterdam, Berbice: " On a passage in Shakespeare's Julius Caesar." The Shakespeare Society's Papers, vol. ii, p. 109. 2 Shakespeare died in 1616, the year when Harvey began to lecture at the College of Physicians. Harvey and Shakespeare may very well have been acquainted, —let us hope that they were,—but there is no authority for saying that they were friends.

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nothing more than the accredited opinion that the blood was in motion within the vessels, particularly the veins of the body. In ancient times, indeed, the veins were regarded, as they are esteemed by the vulgar at the present hour, as the principal vessels of the body ; they only were once believed to contain true blood; the arteries were held to contain at best but a little blood, different from that of the veins, and mixed accidentally in some sort with the vital spirits, of which they were the proper conduits. In former times, farther,—times anterior to Harvey whether more remotely or more nearly,—the liver, as the organ of the haemapoesis, was regarded as the source of all the veins, i. e. of all the proper blood-vessels; the heart, as the generator of heat and the vital spirits, was viewed as the mere cistern of the blood, whence it was propelled by the act of inspiration, and whither it reverted during the act of expiration, its flow to this part of the body or to that, being mainly determined by certain excitations there inherent or specially set up. By and by, however, the liver was given up as the origin of the venous system generally; but such anatomists as Jacobus Sylvius, Realdus Columbus, Bartholomseus Eustachius, and Gabriel Fallopius, may be found opposing Vesalius in regard to the origin of the vena cava, and asserting that it takes its rise from the liver, not from the heart, as the great reformer in modern anatomy had maintained. In the progress of anatomical investigation, the valves in the interior of the heart, at the roots of the two great cardiac arterial trunks, and in the course of the veins at large, were perceived and their probable uses and actions canvassed. The general and prevalent notion was that they served to break or moderate the force of the current in the interior of the vessels or parts where they were encountered; though Berengarius of Carpi,1 in describing the cardiac valves, had already said that the effect of the tricuspid valves, between the right auricle and ventricle, must be to prevent the blood in the former cavity 1

Comment, super Auatomium Muudiiii, Ito*, Bonou. 1521.

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from escaping into the latter; whilst the office of the semilunar valves, at the origins of the pulmonic artery and aorta, lie declared, from their position, must be to prevent the entrance of the blood of the great arterial trunks into the heart. Fabricius, the master of Harvey, may be said to have perfected anatomical knowledge in regard to the valves of the veins—for he by no means first directed attention to their existence, or discovered them, as is generally asserted. Fabricius believed that their function was to act as obstacles to congestions of blood, as strengthened of the veins and preventives to their becoming over-distended. Another long and much agitated point in the anatomy of the sanguiferous system, was the state of the septum ventriculorum of the heart, in respect of permeability or impermeability. The reason of the vast importance attached to this point was connected with the ancient, and, in Harvey's time, generally accredited hypothesis of the Three Spirits—the natural, the vital, and the animal. The hypothesis to be brought into play, was presumed to require the intermixture in the heart of the two kinds of blood that were held appropriate to the two ventricles and to the arteries and veins respectively, and that were farther believed to meet in the cavities of the cranium, thorax, and abdomen, from which they returned to the heart by the way they came, for a fresh supply of the spirits (now exhausted or enfeebled), under the agency of which all the important operations of the body were believed to be accomplished. Now, Galen, the author of this hypothesis, in order to obtain an admixture of the two kinds of blood, feigned and described the partition between the two ventricles, either as perforated like a sieve, or as filled with depressions of depth sufficient to entitle them to be viewed as constituting a kind of third ventricle—the last assumption doubtless to accommodate each order of spirits with its own particular omciiic or workshop.

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With the revival of anatomical knowledge in modern Europe, however, the partition of the ventricles was soon perceived not to be porous or cribriform, but, as was first said, to be so nearly solid that any filtration of blood through it was well nigh impossible (Berengarius, 1521), and next, to be so completely solid that all permeation of blood was impossible (Vesalius, 1555), and another means must therefore be found for securing the necessary admixture of the two kinds of blood in order to effect the engenderment of the natural, animal, and vital spirits. Such was the state of anatomical science and physiological belief on this particular point when Michael Servetus came upon the stage, and suggested the transit of the blood through the lungs from the right side of the heart to the left, with a view of meeting the difficulty which the undeniable solidity of the septum ventriculorum opposed to the presumed necessary admixture of the two kinds of blood. Servetus's idea, consequently—if at the distance of three hundred years we may presume to follow the mental process that led to the penning of the remarkable and often-quoted passage which occurs in his works—appears to be nothing more than a suggestion or proposition as a means of meeting a difficulty; it is very much as though he had said : If you cannot go straight through, you must even go round about. To so much and to no more, do Servetus's claims to be considered a discoverer, in the sense we would attach to that word, amount. The passage from the 'Restitutio Christianismi' of Servetus, 1553, if viewed from the point proposed, will not fail to set his title to be regarded as the discoverer of the lesser circulation in its true light—in a light under which it has not yet been seen. We translate so much of the passage as bears on the question under review. " The vital spirit has its origin in the left ventricle, the lungs assisting especially in its generation. It is a subtile spirit * * * It is engendered from the mixture that takes place in the lungs of the inspired air with the elaborated subtile blood which

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the right ventricle of the heart communicates to the left. But this communication takes place, not by the middle septum of the heart, as is commonly believed, but by a remarkable artifice ; the subtile blood of the right side of the heart is agitated in a lengthened course through the lungs, whereby it is elaborated, from which it is thrown of a crimson colour, and from the vena arteriosa (pulmonary artery) is transfused into the arteria venosa (pulmonary veins); it is then, mixed in the arteria venosa itself with the inspired air, and by the act of expiration is purified from fuliginous vapours, when, having become the fit recipient of the vital spirit, it is at length attracted by the diastole. Now, that the communication and preparation take place as stated through the lungs, is proclaimed by the various conjunctions and communications of the arterial vein with the venous artery. The remarkable size of the arterial vein (pulmonary artery) confirms this, a vessel which could neither have its actual constitution nor dimensions, nor transmit such a quantity of the purest blood direct from the heart itself, for the mere nourishment of the lungs. Neither would the heart supply the lungs in such proportion, (especially when we see the lungs in the embryo nourished from another source) by reason of those membranes or valves which remain unopened until the hour of birth, as Galen teaches. The blood, consequently, from the moment of birth, is sent, and in such quantity is sent, for another purpose from the heart into the lungs; from the lungs also it is not simple air that is sent to the heart, but air mixed with blood is transmitted through the arteria venosa (pulmonary vein). In the lungs consequently does the mixture take place. The crimson colour is imparted to the spirituous blood by the lungs, not by the heart. There is not room enough in the left ventricle of the heart for so important and so great an admixture; neither is there space there for the elaboration into the crimson colour. Finally, the septum medium, seeing

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that it is without vessels and properties, is not adapted to accomplish that communication and elaboration, although something may transude through it." The discussion in this passage from Servetus obviously concerns the generation of the vital spirit, not the pulmonic circulation properly so called—that is altogether secondary and subordinate. His mention of "numerous communications between the vena arteriosa and the arteria venosa," is plainly conjectural; neither he, nor any one else for a century after him, saw such communications. The course through the lungs, then, as suggested by Servetus, was a mere hypothetical proposal for getting over the difficulty of the solid, or nearly solid, septum ventriculorum. As to the means by which such a transfusion as he suggests, is effected, Servetus, as he was profoundly ignorant himself, so does he leave his readers entirely in the dark. The transmission of the blood from the right to the left side of the heart, which Servetus proposed, is in fact, no great improvement on the old efflux and reflux, like the tides of Euripus, betwixt Attica and Euboea. He had no conception of a circle of the blood beginning and ending in the heart. On the contrary, he regarded the liver as the fountain-head of the blood; and if he has any reference to a moving power in connexion with the heart, it is nothing more than the diastole or dilatation of the organ that is named—a passive state therefore considered as an active and efficient cause, which is absurd. The first modern anatomist of high repute, who treats particularly of the motion of the blood, may be said to be Realdus Columbus ;T for Servetus, though educated to the medical profession, had long forsaken it for divinity, and only uses his old anatomical knowledge as a means of illustrating a theological dogma. Columbus, in treating of the heart and lungs, has certainly much that is remarkable, and much that is true; 1

De Re Anatomica, fo!. Vciict. 1559.

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and had he said nothing more than we find in single detached sentences or paragraphs of his book, he must have been regarded as having gone a great length in the right direction. The blood, he says, once it has entered the right ventricle from the vena cava, can in no way again get back; for the tricuspid valves are so placed that whilst they give a ready passage to the stream inwards, they effectually oppose its return. The blood continuing to advance from the right ventricle into the vena arteriosa or pulmonary artery, once there cannot flow back upon the ventricle, for it is opposed by the sigmoid valves situate at the root of the vessel. The blood, therefore, agitated and mixed with the air in the lungs, and having thus in some sort acquired the nature of spirit, is carried by the arteria venosa or pulmonary vein into the left ventricle, from whence, being received into the aorta, it is, by the ramifications of this vessel, transmitted to all parts of the body. This much taken by itself looks very like an exposition of the circulation of the blood as understood at the present time, though we still see that the blood must be made to participate in the nature of spirit before it enters the arteries, and is not the blood which is contained in the veins, and which nourishes the body; but when we go farther and turn to other parts of his writings, we see that Columbus could never have conceived any proper idea of the circulation. For example, he continues, with Galen, to regard the liver as the origin of all the veins. The vena portae, he says, arising by innumerable roots from the concavity of the liver, proceeds to carry blood from this organ by different branches to the stomach, spleen, and intestines, to the end that it may convey nourishment in the first case, black bile in the second, and in the third serve a double function—viz. supply nourishment to the intestines at once, and by a kind of imbibition, obtain nutritive matter, which is forthwith sent back to the liver for elaboration into blood. The vena cava again, he describes as arising from the convex aspect of the

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liver, whence, by its ramifications, it carries the blood that is requisite to nourish and maintain every part of the body. This of itself is enough. But when, in addition, we find that Columbus denies the muscular nature of the heart, we are fully qualified to form a true estimate of the conception which he could have had of the motion of the blood, and of his right to be regarded as the discoverer of its ceaseless circular movement. The next who is brought upon the scene with the imputed honour of having had a knowledge, not only of the lesser, but of the greater or systemic circulation also, is Andreas Csesalpinus,1 of Arezzo. The account which this celebrated peripatetic philosopher gives of the passage of the blood from the right to the left side of the heart is essentially the same as that given by Columbus. From the right ventricle the blood passes into the pulmonic artery, and from this, by numerous anastomoses, into the pulmonic veins, which transmit it to the left ventricle. Csesalpinus says well that it is absurd to call the pulmonary artery by the name of vena arteriosa, on the mere ground of its taking its departure, like the vena cava, from the right ventricle; it is a true artery, and is, in all respects, analogous to the aorta. The title of arteria venosa, again, given to the pulmonic vein is not less ridiculous; inasmuch as this vessel, though it end in the left ventricle, has all the properties of the veins at large. So far it looks as if Caesalpinus had an exact idea of the pulmonary circulation; indeed, he uses the word Circulation in reference to the transit of the blood through the lungs; but when we discover him still speaking of the permeation of the septum ventriculorum by the blood, our faith in the extent and accuracy of his knowledge begins to waver. With reference to the greater or systemic circulation, again, 1 Quastiones Peripateticae, fol. Florent. 1569; Quaest. Medicinales, fol. Venet. 1593; De Plantis, Florent. 1583.

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Csesalpinus speaks of the swelling of the veins between the circle of pressure and the extremities of the vessels, when a ligature is thrown round a limb; and he even goes so far as to state that the common opinion which admitted a progressive motion—i. e. a motion from trunks to branches—of the blood in the veins was erroneous. Did we go no farther we should be led to conclude, as in Columbus's case, that Csesalpinus believed in the continuous movement of the blood in the veins in one direction only; and, as he has already spoken of the exit of the blood from the left ventricle, and of its reception by the aorta for general distribution, it might forthwith be inferred that, possessed of the essential elements of the greater circulation, he must, as matter of course, have been familiar with this as an ultimate result. And such an inference has indeed been drawn for him by high authority; but Csesalpinus came not himself to any such conclusion; it was arrived at by others in his behalf, and after the lapse of almost a century from the date of his first publication. When we find Csesalpinus, in other and closely connected passages of his writings, singing the old cuckoo note about a flux and reflux of the blood in the veins, and even using the accredited word—Euripus —to express his idea of its tide-like nature; when we further perceive that he was ignorant of the existence of the valves of the veins, and finally arrive at his explanation of the cause of the swelling which takes place in the veins of an extremity beyond a ligature,—the cause with him consisting in an effort of the blood to get back to the focus or centre, lest, through the compression of the veins, it should be cut off and suffocated, —we not only feel that we were warranted in entertaining a wholesome scepticism of the conclusion come to by the admirers of Csesalpinus in regard to his knowledge of a circulation of the blood; but waxing in our infidelity as we become farther acquainted with his thoughts on the constitution of

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the blood, we find everything opposed to the likelihood of his having arrived at the same result as Harvey; and, at length, we discover that he neither had nor could have had any true knowledge of the circulation. Starting from the Aristotelian doctrines of growth and nutrition (of which so much will be found in Harvey's work on Generation), Csesalpinus held that there were two kinds of blood, one for the growth, another for the nourishment of the body. The blood which went to augment the body, and which he designated alimentum auctivum, or aliment of increase, flowed from the liver into the vena cava, which he seems to have thought was connected with the heart only, ut inde virtus omnis a corde descendat— that a sufficiency of virtue might be thereby communicated to it. The auctive blood, he farther thought, was attracted into the ventricles of the heart by the inherent heat of the organ. The dilatation of the heart and arteries he imagined to be due to " an effervescence of the spirit •" and the cause of their " collapse"—not systole, be it observed, in the active sense— was the appropriation by the parts of the body of the nutritive and augmentative matter. Again, though Caesalpinus speaks of the intercommunication of the minute arteries and veins, he still thought that it was only during sleep that the blood mixed with the spirits passed from the former into the latter class of vessels; for it is during sleep, he says, that the veins become distended, whilst the pulsations of the arteries are then moderated. He plainly sees no connexion between a delivery by the artery and a filling by the vein. It is along with all this, and as if to settle the question of the kind of knowledge Caesalpinus had of the movement of the blood, that he uses the old word Euripus, to express his idea of its alternating or tide-like motion. Csesalpinus, let us add, had no conception of the heart as the efficient cause of any motion which the blood might have.

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In the often-quoted passage from the work ' De Plantis/1 it is still the spirit inherent in, or associated with, the blood, that is the cause of its motion. Caesalpinus, consequently, tried by a very moderately searching criticism, presents himself to us as but very little farther advanced than the ancients in his ideas on the motion of the blood.—The interpretation which successive generation? of men give to a passage in a writer, some century or two old, is very apt to be in consonance with the state of knowledge at the time, in harmony with the prevailing ideas of the day, and, doubtless, often differs signally from the meaning that was in the mind of the man who composed it. The world saw nothing of the circulation of the blood in Servetus, Columbus, Caesalpinus, or—Shakespeare, until after William Harvey had taught and written. The truth is, that some of the foremost grounds of Harvey's claims to rank as a discoverer are very commonly overlooked. We always associate his name and fame with the development of the ultimate fact of the circulation of the blood. But Harvey, as a step to this conclusion, first demonstrated the heart as the means by which the circulation was effected; and he farther showed that there was but one kind of blood, common to both the arteries and the veins. Up to his time the heart was regarded as the passive cistern of the blood; and the elaboratory of the vital spirits; it was not known as the moving instrument in any efflux or reflux of the blood, or even of any lesser circulation that had been previously asserted or conjectured. The moving power was still the respiratory act. Harvey may be said to have first broached, as he also essentially completed the physiology of the heart's actions. The circular motion of the blood followed as a necessary corollary from these. The "motion of the heart" has even precedence in the title of his immortal work; the chapter in which 1 Qua autem ratione fiat alimenti attractio, &c. De Plantis, lib. i, cap. 2, p. 3, 4to, Florent. 1583.

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he first enters properly on his subject (Chap. 2), is devoted to its consideration. And then, no physiologist up to Harvey's time had questioned the existence of two kinds of blood, one appropriate to each order of vessels, and answering different ends in the economy. The only name still wanting in this historical sketch, till we come to Harvey, is that of Fabricius of Aquapendente, his teacher in anatomy. Fabricius had given particular attention, among other subjects, to the anatomy of the valves of the veins, which he entitled ostila venarum. Fabricius, indeed, possessed so thorough a knowledge of the valvular elements of the vascular system, that it is really astonishing, as an able writer1 has remarked, that he should not have had clearer ideas on the functions, among other things, of the pulmonary veins, and should have continued a rigid adherent to the prejudices which prevailed before his time. Fabricius could observe, and he could describe; but he wanted the combining intellect that infers, the imagination that leads to new ideas—to discovery. Though he did little himself, however, to advance the sum of human knowledge, he proved a tooth in the wheel that has since put in motion the whole machinery of modern medical science. He it was who sowed the seed, little dreaming of its kind, which, finding one spot of congenial soil, sprung up a harvest that has continued to nurture the world of physiological science to the present hour.2 1

Sprengel, Geschichte der Arzneikunde, ii Abschnitt, 4 Kapitel. I pass by unnoticed in my text several names that have been very gratuitously associated with the discovery of the circulation, such as that of Father Paul the Venetian, Walter Warner and Mr. Prothero, Honoratus Faber, &c. The claims of Father Paul have been satisfactorily explained by Dr. Ent in his * Apology,' who has shown that instead of Harvey borrowing from the Monk, the Monk, through the Venetian ambassador to London, who was Harvey's friend, had borrowed from Harvey. The others do not require serious mention. Dr. Freind has given an excellent summary of the entire doctrine of the circulation in his Harveian Oration, to which it is with much pleasure that I refer the reader for other information. I also pass by the still-recurring denials by obtuse and ill-informed individuals of the truth, or of the sufficiency of the evidence of the truth, of the Harveian cir2

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Having now disposed of the claims that have been set up in behalf of one or another as the discoverer of the circulation, and shown, we trust satisfactorily, that these are all alike untenable, we should now proceed to discuss the question of the cui bono?—but this meets us in so forbidding an aspect, brimful as is our mind with a sense of the all-importance of the knowledge we had from Harvey, and seems so little to belong to our subject, that we gladly pass it by unnoticed; though it be only to find ourselves encountered by that other topic, but little more congenial to our mood of mind and intimate persuasion: The merit of Harvey as a discoverer. Few, very few have been found to question this; but as one man of undeniable learning and eminence in his profession,1 has very strangely, as it seems to us, been led to do so, it will not be impertinent if we cast away a few words on this matter. Discovery is of several, particularly of two kinds: one sensible or perceptive; another rational or inductive; the former an act of simple consciousness through an impression made on one or more of the senses; the latter a conclusion come to by the higher powers of the understanding dealing with data previously acquired by the senses and perceptive faculties.—We look through a telescope, for example, and we perceive a star which no one else had seen before; we note the fact, and so become discoverers of a new star. The merit here is not, surely, very great, though the added fact may be highly important. Again, one of the planets is subject to such perturbations in its course that to compose exact tables of its orbit is held impossible. These perturbations are referable to none of the known perturbing causes. A great astronomer suggests the influence of an exterior and unknown planet as their cause. A culation. Those who can not c je, must, contrary to the popular adage, be admitted to be still blinder than those who will not see. 1 Dr. William Hunter. Introductory Lectures, p. 59, (4to. Lond. 1784,) to which the reader is referred for a singularly inconsistent and extraordinary string of passages.

e

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consummate mathematician and physical astronomer makes tri*il of this suggestion : he assumes the ascertained perturbations as elements, he combines these under the guidance of knowledge and reason, and at length he says, if the cause suggested be well founded, there or thereabouts must it exist; and lo ! on turning the far-seeing tube to the point in space which he had indicated, there in verity gleams a new world, then first seen, though launched by God from Eternity to circle on the verge of our creation; and he who bade us look becomes the discoverer of a new planet. Who will dispute the merit here ? Truly3 man does show the God within him when he uses his faculties —God-like in themselves—in such God-like fashion. But Harvey's merit, according to our idea, was of the selfsame description in another sphere. The facts he used were familiarly known, most of them to his predecessors for nearly a century, all of them to his teachers and immediate contemporaries; yet did no one, mastering these facts in their connexion and sequence, rising superior to prejudice, groundless hypothesis, and erroneous reasoning, draw the inference that now meets the world as irresistible, until the combining mind of Harvey gave it shape and utterance. To our apprehension Harvey was as far above his Bellows as the eye of poetic intelligence, that exultingly absorbs the beauties of the starry sky and the green earth, is above the mere physical sense that distinguishes light from dark. The late Dr. Barclay, a fervent admirer of Harvey, whose name he never uttered without the epithet immortal, has put the question of Harvey's merit both happily and eloquently, and it affords us pleasure to quote the passage from the writings of our old and honoured teacher in anatomy. "The late Dr. Hunter/' says Dr. Barclay,1 "has rather invidiously introduced Harvey along with Copernicus and Columbus, to show that his merit as a discoverer was comparatively low. But what did Copernicus, and what did 1

On the Arteries, Introduction, p. ix.

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Columbus ? Not in possession of more numerous facts than their contemporaries, but endowed with nobler and more vigorous intellects, the one developed the intricate system of the heavenly bodies and the other discovered an unheard-of continent. Was it not in the same way, by the exertion of superior intellect, that Harvey made his immortal discovery ? I know not what has happened in the world unseen; but if I may judge from the records of history and the annals of fame, the spirit of Bacon, the spirits of Columbus, Copernicus and Newton have not been ashamed to welcome and associate with the congenial spirit of Harvey." To this fine passage there is little to be added: Harvey's discovery was of the rational and inductive and therefore higher class, according to our estimate; it was made in virtue of the intellectual powers which peculiarly distinguish man, possessed in a state of the highest perfection. THE WORK ON GENERATION.

In our account of Harvey's public career we found him busy with the subject of Generation at Oxford in 1642; but he had certainly turned his attention that way at a much earlier period, for one of the chief causes of his regret, as expressed to Dr. Ent, for the destruction of his papers during the civil war, is the loss of his Observations on the Generation of Insects, which could only have been made and reduced to form many years previously, probably before his engagement to accompany the Duke of Lennox on his travels. And then we see that all his notes on the gestation of the hind or doe were made in the palmy days of the first Charles, before the differences between him and the people of these countries had come to the arbitrement of arms. Harvey probably occupied a good deal of his leisure in arranging and writing the work on Generation, after quitting the service of Charles in 1646 ; his practice

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at this period was not extensive, and he seems to have passed much of his time in the country. Harvey appears to have been little inclined to the publication of this work, and only to have ventured it out of his hands with reluctance. Without the solicitations of Ent, indeed, it would certainly have been left unpublished during his lifetime. Ent, however, succeeded in carrying off the prize which his illustrious friend had showed him, and lost no time in getting it into types, taking on himself the task of correcting the press, and sending it forth according to his own ideas in fitting form, with a frontispiece, and a highflown dedication to the President and Fellows of the College of Physicians. Ent's account of his interview with Harvey on the occasion of obtaining his consent to the publication, though highly theatrical, is still extremely interesting. Saluting the great anatomist, and asking if all were well with him, Harvey answers, somewhat impatiently as it seems: " Hov can it, whilst the Commonwealth is full of distractions, and I myself am still in the open sea ? And truly," he continues, " did I not find solace in my studies, and a balm for my spirit in the memory of my observations of former years, I should feel little desire for longer life." (p. 145.) Let the reader turn to the page from which the above quotation is taken, and to the one which follows it, for thoughts and views that clearly bespeak the greatness of intellect, the nobleness of sentiment that distinguished William Harvey. When Ent proceeds to say that the learned world, aware of his indefatigable industry, were eagerly looking for other works at his hands, the fervid genius of the poet or discoverer still appears in his reply: " And would you be the man," said Harvey, smiling, "who should recommend me to quit the peaceful haven, where I now pass my life, and launch again upon the faithless sea ? You know full well what a storm my former lucubrations raised. Much better is it oftentimes to grow wise at home and in private, than by pub-

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lishing what you have amassed with infinite labour, to stir up tempests that may rob you of peace and quiet for the rest of your days." (p. 147.) By and by, however, he produces his Exercises on the Generation of Animals, and though he makes many difficulties at first, urging, among other things, that the work must be held incomplete, as containing nothing on the generation of insects, Ent, nevertheless, prevails in the end, and receives the papers with full authority, either speedily to commit them to the press, or to delay their publication to a future time. Ent set about his office of midwife, as he has it, forthwith, and the following year (1651) saw the birth of the work on Generation. Physiological science generally was not sufficiently advanced in Harvey's time to admit of a truly great and enduring work being produced on a subject so abstruse, and involving so many particulars as that of Generation. On the doctrine of the circulation the dawn had long been visible; Harvey came and the sun arose. On the subject of animal reproduction, all was night and darkness two centuries ago; and though the light has still been waxing in strength since Harvey wrote, it is only in these times that we have seen it brightening into something like the day. In Harvey's time the very means and instruments that were indispensable to the investigation were not yet known, or were used of powers inadequate to bring the prime facts within the cognizance of the senses. Harvey doubtless did as much as any man living could have accomplished when he wrote. He announced the general truth: Omne animal ex ovo; he showed the cicatricula of the egg as the point where the reproductive process begins; he corrected numerous errors into which his master Fabricius had fallen; he further pointed out the path of observation and experiment as the only one that could lead to satisfactory results in the investigation of a subject which gradually displayed itself as one of natural history; and, it may be added, by his wan-

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derings in the labyrinth of the metaphysics of physiological science, he did enough to deter any one from attempting to tread such barren ground again. In his work on the Heart and Blood, Harvey had all the essential facts of the subject clearly before him, and he used them at once in such masterlywise, that he left little or nothing for addition either by himself or others. Secure of his footing here, he could well dispense with " vital spirits," " innate heat," and other inscrutable agencies, he could leave " adequate and efficient causes," and other metaphysical phantoms on one side—it was physics that he was dealing with, and the physician was at home. With the information we now possess, we see clearly how indifferently weaponed was the physiologist of the year 1647 for encountering such a subject as Animal Generation; a Leeuwenhoek and a De Graaf, a Spallanzani and a Haighton, a Wolff, a Purkinje, a Von Baer, a Valentin, a Rudolph Wagner, a Bischoff, and many more, had successively to appear, before the facts of the subject could be ascertained, and a Sclileiden and a Schwanii were further necessary as ultimate interpreters of the things observed before they could be either rightly or wholly understood. No wonder then that The Physiologist of the 17th century, meets us in the guise of one rather* puzzled with the burthen he has made up his mind to bear, and, contrary to his former wont, eking out the lack of positive knowledge by reiterated disquisitions on topics where certainty is unattainable. It is rather curious, moreover, to find Harvey, in his work on Generation, not entirely escaping the pitfall of which he was so well aware, and which he shunned so successfully in his earlier production. In the work on the Heart, he sets out with the certainty that the whole of the notions of the ancients on the heart and blood are untenable; and then, taking Nature for his guide, his fine intellect never once suffers him to stray from the right path. In the book on Generation, on the other hand, he begins by putting himself in some sort

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into the harness of Aristotle, and taking the bit of Fabricius between his teeth; and then, either assuming the ideas of the former as premises, or those of the latter as topics of discussion or dissent, he labours on endeavouring to find Nature in harmony with the Stagyrite, or at variance with the professor of Padua—for, in spite of many expressions of respect and deference for his old master, Harvey evidently delights to find Fabricius in the wrong. Finally, so possessed is he by scholastic ideas, that he winds up some of his opinions upon animal reproduction by presenting them in the shape of logical syllogisms. The age of Harvey, then, was not competent to produce a work on generation,—it was still an impossible undertaking. Yet has Harvey written a remarkable book ; one that teems with interesting observation, and that presents the author to us in the character of the elegant writer, the scholar, and the poet as well as the discoverer—if, indeed, poet and discoverer, though variously applied, be not identical terms. Besides the points already referred to, as immediately connected with his subject, we here find Harvey anticipating modern surgery, by applying a ligature to the main artery of a tumour which he wished to extirpate, and so making its subsequent removal much more easy. Here, too, we find him, \i century and a half before his contemporaries, in the most rapidly progressive period in the history of human knowledge, throwing out the first hint of the true use of the lungs. Hitherto the lungs had been regarded as surrounding the heart for the purpose of ventilating the blood and tempering or moderating its heat, the heart being viewed as the focus or hearth of the innate heat; and Harvey himself generally uses language in harmony with these ideas; but in one instance, the lightning of genius giving him a glimpse of the truth, he says, " Air is given neither for the cooling nor the nutrition of animals * * *

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it is as if heat were rather enkindled within the foetus [at birth] than repressed by the influence of the air."1 Had William Harvey possessed this idea in his earlier years, and pursued it as he did that of the blood never moving in the veins but in one recurrent course, he would at least have prepared the way for another grand discovery in physiology : demonstrating the erroneousness of the current physiological notions on the use of the lungs, he would have led the van in the investigation of their proper office; and, had everything else permitted, he might even have anticipated Joseph Black in explaining the source of animal heat. But this was an impossibility at the time: chemistry, in Harvey's day, mostly in the hands of adepts and charlatans, transmuters of the base metals, and searchers after the philosopher's stone and the elixir of life, could have no attractions for the clear intellect of the demonstrator of the circulation of-the blood. No wonder, therefore, that Harvey " did not care for chymistrey," or that " he was wont to speak against the chymists" (Aubrey, 1. c. p. 385); this anecdote is but another proof of Harvey's sagacity. Harvey then could only show himself in advance of his age by questioning its opinions on the office of the lungs as he does; the state of chemical science in the middle of the 17th century did not admit of his doing more. Harvey, however, well knew the vivifying force of heat: he saw it the immediate indispensable agent in the reproduction of a living sentient being, as it is probably employed by the Creator as mainspring in the elaborate mechanism of the automatic animal body. The short piece on the ANATOMY of THOMAS PARE, is interesting in itself; and in giving us a glimpse of Harvey's style of pathological reasoning, confirms us in our faith in the 1

On Generation, p. 530.

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great physiologist as a practitioner of medicine. If knowledge will not help, how should the want of it avail ? The LETTERS of Great men generally serve to make us more intimately acquainted with them than without such aid we could have become. This is more especially the case as respects the letters that are written in the ease and confidence of private friendship. It is greatly to be regretted that so few of the letters of this description that flowed from the pen of Harvey should have come down to us. Those addressed to Giovanni Nardi, however, show us what an affectionate and elegant mind our Harvey possessed; how mindful he always appears of former kindnesses to himself and to those that were near to him; how anxious that he should be cherished in the memory of his friends, even as he cherishes them in his own ! The other letters we possess are mostly upon professional —physiological topics; though the one addressed from Nuremberg to Caspar Hofmann may, perhaps, be held an exception; for in this letter the manly and candid character of Harvey displays itself conspicuously. In his own city he challenges the Nuremberg professor to the proof. " If you would see with your own eyes the things I assert of the circulation, I promise to show them to you with the opportunity afforded me." We have seen that Harvey accompanied the Earl of Arundel in his extraordinary embassy to the Emperor, in 1636, and may probably have been one of the party of which three members were barbarously murdered on their way, from Nuremberg to Ratisbon, as Crowne1 informs us. Hence the solicitude which Hollar, the artist, who also accompanied the ambassador, informed Aubrey the Earl of Arundel expressed for his physician's safety: "For he would still be making of excursions into the woods, making observations of strange trees, plants, earths, &c., and sometimes like to be lost; so that my 1

A True Relation, &c., p. 46.

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lord ambassador would be really angry with him, for there was not only danger of wild beasts but of thieves/'1 The burthen of the long and able letter to Slegel, of Hamburg, is still the Circulation. The one addressed to Morison, and the two to Horst, treat of the discovery of the receptaculum chyli and thoracic duct by Pecquet. Harvey has been held wanting to his greatness in having refused his assent to the facts of the distinct existence and special office of the lymphatic system. But, non omnia possumus omnes; Harvey had his own work laid out for him, and the lymphatic system was not a part of it. Aselli's book on the ' Lacteal Viens/3 was even published before Harvey's own Exercises on the Heart and Blood had appeared, and must have been familiar to our physiologist; but that he failed to perceive the import of that discovery, and never inquired particularly into it, cannot surely be rightly laid to him as a charge; and then, when the newlydiscovered system of vessels acquired extension from the researches of Pecquet, Rudbeck, and Bartholin, Harvey felt that he was both too old and too infirm to enter on the examination of so extensive and delicate an anatomical question. In entire consistency with his noble nature, however, and in striking contrast with his own opponents, he nowhere formally denies the existence of the new lymphatic vessels; nor does he once oppose the authority of his name to the investigation of the truth. On the contrary, he states his objections, " not as being obstinately wedded to his own opinion, but that he may show what can readily be urged in opposition to the advocates of the new ideas. Nor do I doubt/' he proceeds, "but that many things now hidden in the well of Democritus, will by and by be drawn up into day by the ceaseless industry of a coming age/'3 1

Aubrey, Op. cit. p. 384. In the printed work the phrase runs thus: " Not only danger of thieves, but of wild beasts." Crowne's anecdote suggests the proper reading. 2 De Venis Lacteis. 4to, Milan, 1022. 3 First Letter to J. D. Ilorst.

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The letter to Vlackveld was written the very year, within a few weeks indeed, of his death. It is even touching—it is in vain, he says, to his correspondent, that he would apply the spur; he has already felt his right to demand his release from duty; yet would he still be honorably considered by his contemporaries, and he begs his friend Vlackveld to love him to the last. We have taken occasion from time to time in the course of our narrative, to glance at the mental and moral constitution, and also at the personal character, of Harvey, principally by way of inference from his conduct on particular occasions, and from what appears in his writings. Happily we have in addition a few particulars from the pen of a contemporary, John Aubrey,1 which, though perchance they do not harmonize in every respect with the facts in his public life and the portrait he gives us of himself in his works, are nevertheless extremely interesting, and cannot be left unnoticed in a Life of Harvey, " In person," Aubrey informs us, " Harvey was not tall, but of the lowest stature; round faced; olivaster (like wainscot) complexion; little eye, round, very black, full of spirit; his hair black as a raven, but quite white 20 years before he died." The portrait we have of Harvey by Cornelius Jansen, in the library of the Royal College of Physicians, as well as of one, we presume by Beinmel, now in the possession of Dr. Richard Bright, corresponds with this account: the temperament is nervous-bilious; the forehead is compact and square, and of greater width than usual between the temples; the expression is highly intellectual, contemplative, and manly. " In temper," Aubrey says, " he was like the rest of his brothers, very choleric, and, in his younger days, he wore a dagger, as the fashion then was, which he would be apt to draw 1

Letters and Lives of Eminent Persons, 2 vols. 8vo, London, 1813.

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out upon every occasion." We cannot suppose that this was offensively, but merely in the way of gesticulation, and to lend force to his words; for in his public and literary life, Harvey showed everything but a choleric nature : he seems, indeed, at all times to have had his temper under entire control. The way in which Harvey himself speaks of the robbery of his apartments and the destruction of his papers, has nothing of bitterness or acrimony in it. With the opportunity presenting itself to him— as when he sends Nardi the books on the Troubles in England —he is not tempted to utter even a splenetic word against the party which had been all along opposed to his friends, and by which he had suffered so severely. Harvey was, probably, a marked man by Cromwell and his adherents; but had he been so disposed he could have indulged in a little vituperation without risk of molestation. The government of England in the Protector's time was still no tyranny. Harvey appears not to have esteemed the fair sex very highly. He would say, that " we Europeans knew not how to order or govern our women, and that the Turks were the only people who used them wisely." But, indeed, if Aubrey may be trusted, he did not think very much of mankind in general: he was wont to say, that " man was but a great mischievous baboon." Harvey, however, wived young, and in his age he seems still to have thought that the old man was best tended by the gentle hand of a woman not too far striken in years.1 Harvey, in his own family circle, must have been affectionate and kind,—characteristics of all his brothers—who appear as we have said to have lived together through their lives in perfect amity and peace. But our Harvey's sympathies were not limited to his immediate relatives : attachment, friendship was an essential ingredient in his nature. His will from first to last is a piece of beautiful humanity, and more than one widow and helpless woman is there provided for. 1 Vide Aubrey, Op. cit. p. 381.

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He seems to have been very anxious to live in the memory of his sisters-in-law and of his nephews and nieces, whose legacies are mostly given to the end that they may buy something to keep in remembrance of him. To Dr. Ent he was much attached, and, besides his bookcases, there are 'fivepounds to buy a ring/ Dr. Scarborough, who also stood high in Harvey's favour, has his s silver instruments of surgery and his best velvet gown/ We cannot fancy that Harvey was at any time very eager in the pursuit of wealth. Aubrey tells us that, " For twenty years before he died, he took no care of his worldly concerns; but his brother Eliab, who was a very wise and prudent manager, ordered all, not only faithfully, but better than he could have done for himself." The effect of this good management was that Harvey lived, towards the end of his life, in very easy circumstances. Having no costly establishment to maintain, for he always lived with one or other of his brothers in his latter days, and no family to provide for, he could afford to be munificent, as we have seen him, to the College of Physicians, and at his death he is reported to have left as much as 20,000/. to his faithful steward and kind brother Eliab, who always meets us as the guardian angel of our anatomist, in a worldly and material point of view. Honoured be the name and the memory of Eliab Harvey for his good offices to one so worthy ! Though of competent estate, in the enjoyment of the highest reputation, and trusted by two sovereign Princes in succession, Harvey never suffered his name to be coupled with any of those lower-grade titles that were so freely conferred in the time of both the First and Second Charles. When we associate Harvey's name with a title at all, it is with the one he fairly won from his masters of Padua: by his contemporaries he is always spoken of as Dr. Harvey; we in the present day rightly class him with our Shakespeares, and our Miltons, and speak of him as Harvey. Harvey, indeed, had no love of ostentation or

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display. The very buildings lie erected, were built " at the suggestion and under the auspices" of others. Harvey's mind was largely imbued with the imaginative faculty : how finely he brings in the classical allusion to " the Sicilian sea, dashing among the rocks around Charybdis, hissing and foaming and tossed hither and thither," in illustration of those who reason against the evidence of their senses, (p. 130.) And then what unbounded confidence he has in Nature (p. 153), and how keenly alive he is to her beauties in every sphere: Nature has not been sedulous to deck out animals only with ornaments; she has further thrown an infinite variety of beautiful dyes over the lowly and insensate herbs and flowers, (p. 426.) In Harvey the religious sentiments appear to have been active; the exordium to his will is unusually solemn and grand. He also evinces true and elevated piety throughout the whole course of his work on Generation, and seizes every opportunity of giving utterance to his sense of the immediate agency and omnipotence of Deity. He appears, with the ancient philosophers, to have regarded the universe and its parts as actuated by a Supreme and all-pervading Intelligence. He was a great admirer of Virgil, whose works were frequently in his hands, and whose religious philosophy he seems also, in a great measure, to have adopted. The following beautiful and oft en-quoted passage of his favorite author may be said to embody his ideas on this subject, as they appear repeatedly in the course of the work on Generation:— " Principle coelum ac terras camposque liquentes, Lucentemque globum lunae, Titaniaque astra, Spiritus intus alit, totamque infusa per artus Mens agitat molem, et magno se corpore miscet." —The heavens and earth, and ocean's liquid plains, The moon's bright orb, and the Titanian stars, Are fed by intrinsic spirit: deep infused Through all, mind mingles with and actuates the mass.

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Upon the purely Deistic notions of antiquity, however, Harvey unquestionably ingrafted the special faith in Christianity. In connexion with the subject of the " term utero-gestation," he adduces the highest recorded examples as the rule, and speaks of "Christ, our Saviour, of men the most perfect;"1 in the will he farther "most humbly renders his soul to Him that gave it, and to his blessed Lord and Saviour Christ Jesus." Harvey was very inquisitive into natural things and natural phenomena. When he accompanied the Earl of Arundel, we have seen that he would still be wandering in the woods, making observations on the strange trees and herbs, and minerals he encountered. His industry in collecting facts was unwearied, and the accuracy with which he himself observed appears in every page of his writings; though we sometimes meet him amiably credulous in regard to the observations of others,—as in that instance where he suffers himself to be imposed upon by the traveller's tale of the " Genus humanum caudatum"—the race of the human kind with tails.2 Harvey was the first English comparative anatomist; in other words, he was the first physiologist England produced whom superiority of natural endowment led to perceive the relations between the meanest and the highest of created things, and who made the simplicity of structure and of function in the one, a means of explaining the complexity of structure and of function in the other. " Had anatomists," he says, "only been as conversant with the dissection of the lower animals as they are with that of the human body, many matters that have hitherto kept them in a perplexity of doubt would, in my opinion, have met them freed from every kind of difficulty." (On the Heart, p. 35.) Harvey makes frequent and most effectual use of his knowledge of comparative anatomy in his earlier work; and if the reader will turn to the one on 1

On Generation, p. 529.

2

Ib. p. 182.

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Generation (p. 423), and peruse what is said on the subject of ' parts not essential to the being of the individual/ and will then visit the Hunterian Museum in Lincoln's Inn Fields, he will find that the great comparative anatomist and physiologist of the 19th century had a herald in the great comparative anatomist and physiologist of the 17th century. Aubrey mentions particularly Harvey's having " often said that of all the losses he sustained, no grief was so crucifying to him as the loss of his papers (containing notes of his dissections of the frog, toad, and other animals,) which, together with his goods in his lodgings at Whitehall, were plundered at the beginning of the rebellion," Harvey's store of individual knowledge must have been great; and he seems never to have flagged in his anxiety to learn more. He made himself master of Oughtred's ' Clavis Mathematica* in his old age, according to Aubrey, who found him " perusing it, and working problems not long before he dyed." Aubrey says "he understood Greek and Latin pretty well, but was no critique, and he wrote very bad Latin. The Circuitus Sanguinis was, as I take it, done into Latin by Sir George Ent, as also his booke de Generatione Animalium; but a little booke, in 12mo, against Eiolan (I thinke) wherein he makes out his doctrine clearer, was writ by himself, and that, as I take it, at Oxford."1 Aubrey, in his gossiping, is doing injustice both to the scholarship and to the candour of Harvey. He heard or knew that Harvey wrote an indifferent hand, and this forsooth he turns into writing indifferent Latin. Everything points to the year 1619 as the period when the book De Motu Cordis et Sanguinis (Aubrey does not even know the title !) was written; Ent, born in 1603, was then a lad of sixteen, and in all likelihood had never heard of Harvey's name; in 1628, when the work came forth at Frankfort, he was but twenty-five, and scarcely emancipated from the leading 1

Aubrey, 1. c. p. 383.

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strings of his instructors. The Exercises to Riolan, which Aubrey cites as a specimen of Harvey's own latinity, are at least as well written as the Exercises 011 the Heart. And then our authority evidently speaks at random in regard to the time and place when these Exercises were composed. Harvey never resided at Oxford after 1046, and Riolan's Encheiridium Anatomicum, to which Harvey's Two Exercises were an answer, did not appear till 1618 ! Harvey's reply could not have been written by anticipation. It came out at Cambridge the year after Riolan's work—in 1649. With regard to the work on Generation, again, had Ent received it in English and turned it into Latin, this fact would certainly have been stated; whereas, there is only the information that he played the midwife's part, and overlooked the press. More than this, from what Ent says, it is evident that the printer worked from Harvey's own MS. " As our author writes a bad hand," says Ent, " which no one without practice can easily read, I have taken some pains to prevent the printer committing any very grave blunders through this,—a point which, I observe, has not been sufficiently attended to in a small work of his (The Exercitatio ad Riolanum) which lately appeared."1 Harvey was a man of the most liberal education, and lived in an age when every man of liberal education wrote and conversed in Latin with ease at least, if not always with elegance. Harvey's Latin is generally easy, often elegant, and not unfrequently copious and imaginative; he never seems to feel in the least fettered by the language he is using, Harvey, if eager in the acquirement of knowledge, was also ready at all times to communicate what he knew, " and," as Aubrey has it,'' to instruct any that were modest and respectful to him. In order to my journey (I was at that time bound for 1

Epistle Dedicatory to the work on Generation.

/

Ixxxii

THE LIFE OF HARVEY.

Italy) he dictated to me what to see, what company to keep, what bookes to read, how to manage my studies—in short, he bid me go to the fountain head and read Aristotle, Cicero, Avicenna, and did call the Neoteriqucs s—t-breeches."l Harvey was not content merely to gather knowledge; he digested and arranged it under the guidance of the faculties which compare and reason. " He was always very contemplative," pursues Aubrey, " and was wont to frequent the leads of Cockaine-house, which his brother Eliab had bought, having there his several stations in regard to the sun and the wind, for the indulgence of his fancy. At the house at Combe, in Surrey," which, by the way, appears to have been purchased of Mr. Cockaine, as well as the mansion in the city, " he had caves made in the ground, in which he delighted in the summer time to meditate. He also loved darkness," telling Aubrey, " 'that he could then best contemplate/ His thoughts working, would many times keep him from sleeping, in which case his way was to rise from his bed and walk about his chamber in his shirt, till he was pretty cool, and then return to his bed and sleep very comfortably." He treated the principal bodily ailment with which he was afflicted (gout) somewhat in the same manner. The fever of the mind being subdued by the application of cold air to the body at large, the fever in the blood, induced by gout, was abated by the use of cold water to the affected member: " He would then sitt with his legges bare, though it were frost, on the leads of Cockainehouse, putt them into a payle of water till he was almost dead with cold, and betake himself to his stove, and so 'twas gone."2 Harvey, besides being physician to the king and household, held the same responsible situation in the families of many of the most distinguished among the nobles and men of eminence 1

Aubrey, p. 383.

2

Ibid., p. 384.

HIS CHARACTER.

Ixxxiii

of his time—among others to the Lord Chancellor Bacon, whom, Aubrey informs us, " he esteemed much for his witt and style, but would not allow to be a great philosopher. Said he to me, e He writes philosophy like a Lord Chancellor' —speaking in derision." Harvey's penetration never failed him : the philosopher of fact cared not for the philosopher of prescription; he who was dealing with the Things, and, through his own inherent powers, exhibiting the Rule, thought little of him who was at work upon abstractions, and who only inculcated the Rule from the use which he saw others making of it. Bacon has many admirers, but there are not wanting some in these present times who hold, with his illustrious contemporary, that " he wrote philosophy like a Lord Chancellor." Harvey was also acquainted with all the men of letters and science of his age—with Hobbes, Dry den, Cowley, Boyle, and the rest. Dryden, in his metrical epistle to Dr. Charleton, has these lines, of no great merit or significance :— " The circling streams once thought but pools of blood, (Whether life's fuel or the body's food,) From dark oblivion Harvey's name shall save."

Cowley is more happy in his ode on Dr. Harvey:— " Thus Harvey sought for truth in Truth's own book —Creation—which by God himself was writ; And wisely thought 'twas fit Not to read comments only upon it, But on th' original itself to look. Methinks in Art's great circle others stand Lock'd up together hand in hand: Every one leads as he is led, The same bare path they tread, A dance like that of Fairies, a fantastic round, With neither change of motion nor of ground. Had Harvey to this road confined his wit, His noble circle of the blood had been untrodden yot."

Cowley and Harvey must often have encountered ; both

kxxiv

THE LIFE OF HARVEY.

had the confidence of the king, but in very different ways: Cowley lent himself to the privacies and intrigues of the royal family and its adherents, for whom he even consented to play the base part of spy upon their opponents. He was also the cypherletter writer, and the decypherer of the royal correspondence, and thus mixed up with all the littlenesses of the court party, by whom he must have been, as matter of course, despised, as he was subsequently neglected. Harvey was a man of another stamp, composed of a different clay; and it gives us a high sense of his independence and true nobility of nature that in the midst of faction and intrigue, he is never found associated with- aught that is unworthy of the name of man in his best estate. The war of party and the work of destruction might be going on around; Harvey, under a hedge, and within reach of shot, was cooly engaged with his book, or in the chamber of his friend Dr, Bathurst, wrapt in contemplation of the mysteries of Generation. Harvey appears to have possessed, in a remarkable degree, the power of persuading and conciliating those with whom he came in contact. In the whole course of his long life we hear nothing either of personal enemies or personal enmities; "Man" he says "comes into the world naked and unarmed, as if nature had destined him for a social creature and ordained that he should live under equitable laws and in peace; as if she had desired that he should be guided by reason rather than be driven by force/'1 The whole of the opposition to his new views on the circulation was got up at a distance; all within his own sphere were of his way of thinking. His brethren of the College of Physicians appear to have revered him. The congregated fellows must have risen to their feet by common consent as he came among them on the memorable occasion after they had elected him their president. 1

On Generation, p. 425.

HIS CHARACTER.

Ixxxv

Among other tastes or habits which Harvey had, Aubrey informs us that "he was wont to drink coffee, which he and his brother Eliab did before coffee-houses were in fashion in London/'1 This was probably a cherished taste with Harvey. In his will he makes a special reservation of his " coffey-pot;" —his niece Mary West and her daughter have all his plate except this precious utensil, which, with the residue, he evidently desired should descend to his brother Eliab as a memorial doubtless of the pleasure they had often enjoyed together over its contents—the brewage from the ' sober berry/ In visiting his patients, Harvey " rode on horseback with a foot-cloath, his men following on foot, as the fashion then was, which was very decent, now quite discontinued. The judges rode also with their foot-cloathes to Westminster Hall, which ended at the death of Sir Robert Hyde, Lord Chief Justice; Anthony Earl of Shaftesbury would have revived it, but several of the judges being old and ill horsemen would not agree to it/'2 Harvey appears to have preserved his faculties unimpaired to the very last. Aubrey, as we have seen, found the anatomist perusing Oughtred's ' Clavis Mathematica/ and working the problems not long before he died ; and the registers of the College of Physicians further assure us that Harvey, when very far stricken in years, still lost little or nothing of his old activity of mind. He continued to deliver his lectures till within a year or two of his death, when he was succeeded by his friend Sir Charles Scarborough, and he never failed at the comitia of the college when anything of moment was under consideration. Accumulating years, however, and repeated attacks of gout, to which Harvey had long been a martyr, at length asserted their mastery over the declining body, and William Harvey, the great in intellect, the noble in nature, finally ceased to be, 1

Op. cit. p. 384.

2

Aubrey, ib. p. 386.

Ixxxvi

THE LIFE OF HARVEY.

on the 3d of June, 1657, in the eightieth year of his age. About ten o'clock in the morning, as Aubrey tells us, on attempting to speak, he found that he had lost the power of utterance, that, in the language of the vulgar, he had the dead palsy in his tongue. He did not lose his other faculties, however; but knowing that his end was approaching, he sent for his nephews, to each of whom he gave some token of remembrance,—his watch to one, his signet ring to another, and so on. He farther made signs to Sambroke, his apothecary, to let him blood in the tongue; but this did little or no good, and by and by, in the evening of the day on which he was stricken, he died; " the palsy," as Aubrey has it, " giving him an easy passport."1 The funeral took place a few days afterwards, the body being attended far beyond the walls of the city by a long train of his friends of the College of Physicians, and the remains were finally deposited "in a vault at Hempstead, in Essex, which his brother Eliab had built; he was lapt in lead, and on his breast, in great letters, his name—DR. WILLIAM HARVEY. * * * I was at his funeral," continues Aubrey, " and helpt to carry him into the vault." And there, at this hour, he lies, the lead that laps him little changed, and showing indisJ

Anbrey gives a positive denial to " the scandall that ran strongly against him (Harvey), viz. that he made himself away, to put himself out of his paine, by opium." Aubrey proceeds: "The scandall aforesaid is from Sir Charles Scarborough's saying that he (Harvey) had, towards his latter end, a preparation of opium and I know not what, which he kept in his study to take if occasion should serve, to put him out of his paine, and which Sir Charles promised to give him. This I believe to be true; but do not at all believe that he really did give it him. The palsey did give him an easie passeport." (1. c. p. 385.) Harvey, if he meditated anything of the kind above alluded to, would not be the only instance on record of even a strong-minded man shrinking from a struggle which he knows must prove hopeless, from which there is no issue but one. Nature, as the physician knows, does often kill the body by a very lingering and painful process. In his practice he is constantly required to smooth the way for the unhappy sufferer. In his own cast: he may sometimes wish to shorten it. Such requests as Harvey may be presumed to have made to Scarborough, are frequently enough preferred to medical men: it is needless to say that they are never granted.

HIS CHARACTER.

Ixxxvii

tinctly the outline of the form within; for he lies not in an ordinary coffin, but the cerements that surround the body immediately invested in their turn by the lead. So lived, so died one of the great men whom God, in virtue of his eternal laws, bids to appear on earth from time to time to enlighten, and to ennoble mankind.1 1

On the Tablet placed in Hempstead church to Harvey's memory are inscribed these words: GULIELMUS HARVEIUS, Cui tarn colendo Nomini assurguut onines Academic; Qui diuturnum sanguinis motum Post tot annoruin Millia, Primus invenit; Orbi salutem, sibi immortalitatem Consequutus. Qui ortuni et generationem Animalium solus omnium A Pseudo-philosophia liberavit. Cui debet Quod sibi innotuit humanum Genus, seipsam Medichw. Screniss. Majestat. Jacobi et Carolo Britanniarum Monarchis Arcliiatrus et charissimus. Collegii Med. Lend. Anatomes et Chirurgia: Professor Assiduus et felicissimus: Quilms illiistrem cimstruxit IVibliothecuni, Suoque dotavil et ditavit I'atrimonio. Taudein Post triurnjiliales Cuuteinplaiido, sanatido, invciiumdo Sudores, \ arias doini forisquc statuas, Quuni totuin circuit Microcosmum, Medicirisc Doctor et Medicorum, liuproles obdormivit, 111 Junii ariiio balutis CIOIOCLVII, /Etat. LXXX. Annorum et Fani?e satur.

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THE LAST WILL AND TESTAMENT OF WILLIAM HARVEY. M.D. Extracted from the Registry of the Prerogative Court of Canterbury. IN the name of the Almighty and Eternal God Amen I WILLIAM HARVEY of London Doctor of Physicke doe by these presents make and ordaine this my last Will and testament in manner and forme following Revoking hereby all former and other wills and testaments whatsoever Imprimis I doe most humbly render my soule to Him that gave it and to my blessed Lord and Saviour Christ Jesus and my bodie to the Earth to be buried at the discretion of my executor herein after named The personall estate which at the time of rny decease I shalbe in any way possessed of either in Law or equitie be it in goods householdstuffe readie moneys debts duties arrearages of rents or any other waycs whatsoever and whereof I shall not by this present will or by some Codicill to be hereunto annexed make a particular gift and disposition I doe after my debts Funeralls and Legacies paid and discharged give and bequeath the same vnto my loving brother Mr. Eliab Harvey merchant of London whome I make Executor of this my last will and testament And whereas I have lately purchased certaine lands in Northamptonshire or thereabouts commonly knowne by the name of Oxon grounds and formally belonging vnto to the Earl of Manchester and certaine other grounds in Leicestershire commonly called or knowne by the name of Baron Parke and sometime heretofore belonging vnto Sir Henry Hastings

xc

THE WILL OF HARVEY.

Knight both which purchases were made in the name of several persons nominated and trusted by me and by two severall deeds of declaracon vnder the hands and scales of all persons any waye parties or privies to the said trusts are declared to be first vpon trust and to the intent that I should be permitted to enioye all the rents and profits and the benefit of the collaterall securitie during my life and from and after my decease Then upon trust and for the benefit of such person and persons and of and for such estate and estates and Interests And for ray sing and payment of such summe and summes of Money Rents Charges Annuities and yearly payments to and for such purposes as from time to time by any writing or writings to be by me signed and sealed in the presence of Two or more credible witnesses or by my last will and testament in writing should declare limit direct or appoint And further in trust that the said Maiiuors and lands and everie part thereof together Avith the Collaterall sccuritie should be assigned conveyed and assured vrito such persons and for suchc Estates as the same should by me be limited and directed charged and chargeable uevertheles with all Annuities routs and summes of money by me limited and appointed if any such shalbe And in default of such appointment then to Eliab Harvey his hcires executors and Assigncs or to such as he or they shall nominate as by the said two deeds of declaracon both of them bearing date the tenth day of July in the year of our Lord God one Thousand sixe hundred Fiftie and one more at large it doth appeare I doe now hereby declare limit direct and appoint that with all convenient speed after my decease there shalbe raised satisfied and paid these severall summes of money Rents Charges and Annuities herein after expressed and likewise all such other summes of Money Rents Charges or Annuities which at any time hereafter in any Codicill to be hereunto uimcxed shall luipjjcn to be limited or expressed

THE WILL OF HARVEY.

xci

And first I appoint so much money to be raised and laid out vpon that building which I have already begun to erect within the Colledge of Physicians in London as will serve to finish the same according to the designe already made Item I give and bequeath vnto my lo sister in Law Mrs Eliab Harvey one hundred pounds to buy something to keepe in remembrance of me Item I give to my Niece Mary Pratt all that Linnen householdstuffe and furniture which I have at Coome neere Croydon for the vse of Will Foulkes and to whom his keeping shalbe assigned after her death or before me at any time Item I give vnto my Niece Mary West and her daughter Amy West halfe the Linnen I shall leave at London in 'my chests and Chambers together with all my plate excepting my Coffey pot Item I give to my lo sister Eliab all the other halfe of my Linnen which I shall leave behind me Item I give to my lo sister Daniell at Lambeth and to everie one of her children severally the summe of fiftie pounds Item I give to my lo Coosin Mr Heneage Finch for his paines counsell and advice about the contriving of this my will one hundred pounds Item 1 give to all my little Godchildren Nieces and Nephews severally to everie one Fiftie pounds Item I give and bequeath to the towne of Foulkestone where I was borne two hundred pounds to be bestowed by the advice of the Mayor thereof and my Executor for the best vse of the poore Item I give to the poore of Christ hospitall in Smithfield thirtie pounds Item I give to Will Harvey my godsonne the sonrie of my brother Mich Harvey deceased one hundred pounds and to his brother Michaell Fiftie pounds Item I give to my Nephew Tho Cullen and his children one hundred pounds and to his brother my godsonne Will Cullen one hundred pounds Item I give to my Nephew Jhon Harvey the sonne of my lo brother Tho Harvey deceased two hundred pounds Item I give to nay Servant John liaby for his diligence in my ser-

xcii

THE WILL OF HARVEY.

vice and sicknesse twentie pounds And to Alice Garth my Servant Tenne pounds over and above what I am already owing unto her by my bill which was her mistresses legacie Item I give among the poor children of Amy Rigdon daughter of my lo vncle Mr Tho Halke twentie pounds Item among other my poorest kindred one hundred pounds to be distributed at the appointment of my Executor Item I give among the servants of my sister Dan at my Funeralls Five pounds And likewise among the servants of my Nephew Dan Harvey at Coome as much Item I give to my Cousin Mary Tomes Fifty pounds Item I give to my lo Friend Mr Prestwood one hundred pounds Item I give to everie one of my lo brother Eliab his sonnes and daughters severally Fiftie pounds apiece All which legacies and gifts aforesaid are chiefly to buy something to keepe in remembrance of me Item I give among the servants of my brother Eliab which shalbe dwelling with him at the time of my decease tenne pounds Furthermore I give and bequeath vnto my Sister Eliabs Sister Mrs Coventrey a widowe during her natural life the yearly rent or summe of twentie pounds Item I give to my Niece Mary West during her naturall life the yearly rent or summe of Fortie pounds Item I give for the vse and behoofe and better ordering of Will Foulkes for and during the term of his life vnto my Niece Mary Pratt the yearly rent of tenne pounds which summe if it happen my said Niece shall dye before him I desire may be paid to them to whome his keeping shalbe appointed Item I will that the twentie pounds which I yearly allowe him my brother Galen Browne may be continued as a legacie from his sister during his naturall life Item I will that the payments to Mr Samuel Fentons children out of the profits of Buckholt Lease be orderly performed as my deere deceased lo wife gave order so long as that lease shall stand good Item I give vnto Alice Garth during her naturall life the yearly rent or

THE WILL OF HARVEY.

xciii

summe of twentie pounds Item To John Raby during his naturall life sixteene pounds yearly rent All which yearly rents or summes to be paid halfe yearly at the two most vsuall feasts in the yeare viz Michaelmas and our Lady day without any deduction for or by reason of any manner of taxes to be any way hereafter imposed The first payment of all the said rents or Annuities respectively to beginne at such of those feasts which shall first happen next after my decease Thus I give the remainder of my lands vnto my lo brother Eliab and his heires All my legacies and gifts &c. being performed and discharged Touching my bookes and householdstuffe Pictures and apparell of which I have not already disposed I give to the Colledge of Physicians all my bookes and papers and my best Persia long Carpet and my blue sattin imbroyedyed Cushion one paire of brasse Andirons with fireshovell and tongues of brasse for the ornament of the meeting roome I have erected for that purpose Item I give my velvet gowne to my lo friend Mr Doctor Scarbrough desiring him and my lo friend Mr Doctor Ent to looke over those scattered remnant of my poore Librarie and what bookes papers or rare collections they shall thinke fit to present to the Colledge and the rest to be Sold and with the money buy better And for their paines I give to Mr Doctor Ent all the presses and shelves he please to make use of and five pounds to buy him a ring to keepe or weare in remembrance of me And to Doctor Scarbrough All my little silver instruments of surgerie Item I give all my Chamber furniture tables bed bedding hangings which I have at Lambeth to my Sister Dan and her daughter Sarah And all that at London to my lo Sister Eliab and her daughter or my godsonne Eliab as she shall appoint Lastly I desire my executor to assigne over the custode of Will Fowkes after the death of my Niece Mary Pratt if she happen to dye before him vnto the Sister of the said William my Niece Mary West Thus I have finished my last

xciv

THE WILL OF HARVEY.

Will in three pages two of them written with own hand and my name subscribed to everie one with my hand and seal to the last WILL HARVEY Signed sealed and published as the last will and testament of me William Harvey In the presence of us Edward Dering Henneage Finch Richard Hud Francis Finchc Item I have since written a Codicill with my owne hand in a sheet of paper to be added hereto with my name thereto subscribed and my seale. ITEM I will that the sumes and charges here specified be added and annexed vnto my last will and testament published heretofore in the presence of Sir Edward Dering and Mr Henneage Finch and others and as a Codicill by my Executor in like manner to be performed whereby I will and bequeath to John Denn sonne of Vincent Denne the summe of thirtie pounds. Item to my good friend Mr Tho Hobbs to buy something to keepe in remembrance of me tenne pounds and to Mr Kennersley in like manner twentie pounds Item what moneys shalbe due to me from Mr Hen Thompson his fees being discharged I give to my friend Mr Prestwood Item what money is of mine viz one hundred pounds in the hands of my Cosin Eigdon I give halfe thereof to him towards the marriage of his niece and the other halfe to be given to Mrs Coventrey for her sonne Walter when he shall come of yeares and for vse my Cosin Rigdon giving securitie I would he should pay none Item what money shalbe due to me and Alice Garth my servant on a pawne now in the hands of Mr Prestwood I will after my decease shall all be given my said servant for her diligence about me in my siknesse and service both interest and principall Item if in case it so fall out that my good friend Mrs Coventrey during her widowhood shall not dyet on freecost with my brother or Sister Eliab

THE WILL OF HARVEY

xcv

Harvey Then I will and bequeath to her one hundred marke yearly during her widowhood Item I will and bequeath to my loving Cosin Mr Heimeage Finch (more than heretofore) to be for my godsonne Will Finche one hundred pounds Item I will and bequeath yearly during her life a rent of thirtie pounds vnto Mrs Jane Nevison Widdowe in case she shall not preferre her selfe in marriage to be paid quarterly by even porcons the first to begimi at Christmas Michaelmas or Lady day or Midsummer which first happens after my decease Item I give to my Goddaughter Mrs Eliz Glover daughter of my Cosin Toomes the yearly rent of tenne pounds from my decease vnto the end of five years Item to her brother Mr Rich Toomes thirty pounds as a legacie Item I give to John Cullen sonne of Tho Cullen deceased all what I have formerly given his father and more one hundred pounds Item I will that what I have bequeathed to my Niece Mary West be given to her husband my Cosin Rob West for his daughter Amy West Item what should have bene to my Sister Dan deceased I will be given my lo Niece her daughter in Law Item I give my Cosin Mrs Mary Ranton fortie pounds to buy something to keep in remembrance of me Item to my nephews Michaell and Will the sonnes of my brother Mich one hundred pounds to either of them Item all the furniture of my chamber and all the hangings I give to my godsonne Mr Eliab Harvey at his marriage and all my red damaske furniture and plate to my Cosin Mary Harvey Item I give my best velvet gowne to Doctor Scarbrowc. WILL HARVEY. Memorandum that upon Sunday the twentie eighth clay of December in the yeare of our Lord one thousand sixe hundred fiftie sixe I did againe peruse my last will which formerly conteined three pages and hath now this fourth page added to it And I doft now this present Sunday

xcvi

THE WILL OF HARVEY.

December 28 1656 publish and declare these foure pages whereof the three last are written with my owne hand to be my last will In the presence of Henneage Finch John Baby. THIS WILL with the Codicill annexed was proved at London on the second day of May In the yeare of our Lord God one Thousand six hundred fiftie nine before the Judge for probate of wills and granting Adcons lawfully authorized By the oath of Eliab Harvey the Brother and sole executor therein named To whom Administracon of all and singular the goods Chattells and debts of the said deceased was granted and committed He being first sworne truely to administer.1 CHAS. DYNELEY "j

JOHN IGGULDEN / * **

W. F. GOSTLINOJ*^"1'-

1 The will of Harvey is without date. But was almost certainly made some time in the course of 1652. He speaks of certain deeds of declaration bearing date the 10th of July, 1651; and he provides money for the completion of the buildings which he has " already begun to erect within the College of Physicians." Now these structures were finished in the early part of 1653. The will was, therefore, written between July 1651, and Febraruy 1653. The codicil is also undated : but we may presume that it was added shortly before Sunday the 28th of December 1656, the day on which Harvey reads over the whole document and formally declares and publishes it as his last will and testament in the presence of his friend Henneage Finch, and his faithful servant John Raby.

AN ANATOMICAL DISQUISITION ON THE

MOTION OF THE HEART AND BLOOD IN ANIMALS.

1

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TO

THE MOST ILLUSTRIOUS AND INDOMITABLE PRINCE,

CHARLES, KING OF GREAT BRITAIN, FRANCE, AND IRELAND, DEFENDER OF THE FAITH.

MOST ILLUSTRIOUS PRINCE !

The heart of animals is the foundation of their life, the sovereign of everything within them, the sun of their microcosm, that upon which all growth depends, from which all power proceeds.

The King, in like manner, is the foundation

of his kingdom, the sun of the world around him, the heart of the republic, the fountain whence all power, all grace doth flow. What I have here written of the motions of the heart I am the more emboldened to present to your Majesty, according to the custom of the present age, because almost all things human are done after human examples, and many things in a King are after the pattern of the heart.

The knowledge of

his heart, therefore, will not be useless to a Prince, as embracing a kind of Divine example of his functions,—and it has still been

4

usual with men to compare small things with great.

Here, at

all events, best of Princes, placed as you are on the pinnacle of human affairs, you may at once contemplate the prime mover in the body of man, and the emblem of your own sovereign power. Accept therefore, with your wonted clemency, I most humbly beseech you, illustrious Prince, this, my new Treatise on the Heart; you, who are yourself the new light of this age, and indeed its very heart; a Prince abounding in virtue and in grace, and to whom we gladly refer all the blessings which England enjoys, all the pleasure we have in our lives. Your Majesty's most devoted servant, WILLIAM HARVEY. [LONDON . . . . 1628.]

To his very dear Friend, DOCTOR ARGENT, the excellent and accomplished President of the Royal College of Physicians, and to other learned Physicians, his most esteemed Colleagues. I have already and repeatedly presented you, my learned friends, with my new views of the motion and function of the heart, in my anatomical lectures; but having now for nine years and more confirmed these views by multiplied demonstrations in your presence, illustrated them by arguments, and freed them from the objections of the most learned and skilful anatomists, I at length yield to the requests, I might say entreaties, of many, and here present them for general consider* ation in this treatise. Were not the work indeed presented through you, my learned friends, I should scarce hope that it could come out scatheless and complete; for you have in general been the faithful witnesses of almost all the instances from which I have either collected the truth or confuted error; you have seen my dissections, and at my demonstrations of all that I maintain to be objects of sense, you have been accustomed to stand by and bear me out with your testimony. And as this book alone declares the blood to course and revolve by a new route, very different from the ancient and beaten pathway trodden for so many ages, and illustrated by such a host of learned and distinguished men, I was greatly afraid lest I might be charged with presumption did I lay my work before the public at home,

6

DEDICATION.

or send it beyond seas for impression, unless I had first proposed its subject to you, had confirmed its conclusions by ocular demonstrations in your presence, had replied to your doubts and objections, and secured the assent and support of our distinguished President. For I was most intimately persuaded, that if I could make good my proposition before you and our College, illustrious by its numerous body of learned individuals, I had less to fear from others; I even ventured to hope that I should have the comfort of finding all that you had granted me in your sheer love of truth, conceded by others who were philosophers like yourselves. For true philosophers, who are only eager for truth and knowledge, never regard themselves as already so thoroughly informed, but that they welcome further information from whomsoever and from whencesoever it may come; nor are they so narrow-minded as to imagine any of the arts or sciences transmitted to us by the ancients, in such a state of forwardness or completeness, that nothing is left for the ingenuity and industry of others; very many, on the contrary, maintain that all we know is still infinitely less than all that still remains unknown; nor do philosophers pin their faith to others' precepts in such wise that they lose their liberty, and cease to give credence to the conclusions of their proper senses. Neither do they swear such fealty to their mistress Antiquity, that they openly, and in sight of all, deny and desert their friend Truth. But even as they see that the credulous and vain are disposed at the first blush to accept and to believe everything that is proposed to them, so do they observe that the dull and unintellectual are indisposed to see what lies before their eyes, and even to deny the light of the noonday sun. They teach us in our course of philosophy as sedulously to avoid the fables of the poets and the fancies of the vulgar, as the false conclusions of the sceptics. And then the studious, and good, and true, never suffer their minds to be warped by the passions of hatred and envy,

DEDICATION.

7

which unfit men duly to weigh the arguments that are advanced in behalf of truth, or to appreciate the proposition that is even fairly demonstrated ; neither do they think it unworthy of them to change their opinion if truth and undoubted demonstration require them so to do; nor do they esteem it discreditable to desert error, though sanctioned by the highest antiquity; for they know full well that to err, to be deceived, is human; that many things are discovered by accident, and that many may be learned indifferently from any quarter, by an old man from a youth, by a person of understanding from one of inferior capacity. My dear colleagues, I had no purpose to swell this treatise into a large volume by quoting the names and writings of anatomists, or to make a parade of the strength of my memory, the extent of my reading, and the amount of my pains; because I profess both to learn and to teach anatomy, not from books but from dissections; not from the positions of philosophers but from the fabric of nature; and then because I do not think it right or proper to strive to take from the ancients any honour that is their due, nor yet to dispute with the moderns, and enter into controversy with those who have excelled in anatomy and been my teachers. I would not charge with wilful falsehood any one who was sincerely anxious for truth, nor lay it to any one's door as a crime that he had fallen into error. I avow myself the partisan of truth alone ; and I can indeed say that I have used all my endeavours, bestowed all my pains on an attempt to produce something that should be agreeable to the good, profitable to the learned, and useful to letters. Farewell, most worthy Doctors, And think kindly of your Anatomist, WILLIAM HARVEY. 1§

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AN ANATOMICAL DISQUISITION ON THE

MOTION OF THE HEART AND BLOOD IN ANIMALS.

INTRODUCTION. As we are about to discuss the motion, action, and use of the heart and arteries, it is imperative on us first to state what has been thought of these things by others in their writings, and what has been held by the vulgar and by tradition, in order that what is true may be confirmed, and what is false set right by dissection, multiplied experience, and accurate observation. Almost all anatomists, physicians, and philosophers, up to the present time, have supposed, with Galen, that the object of the pulse was the same as that of respiration, and only differed in one particular, this being conceived to depend on the animal, the respiration on the vital faculty; the two, in all other respects, whether with reference to purpose or to motion, comporting themselves alike. Whence it is affirmed, as by Hieronymus Fabricius of Aquapendente, in his book on ' Respiration/ which has lately appeared, that as the pulsation of the heart and arteries does not suffice for the ventilation and refrigeration of the blood, therefore were the lungs fashioned to surround the heart. From this it appears, that whatever has hitherto been said upon the systole and diastole, on the motion of the heart and arteries, has been said with especial reference to the lungs. But as the structure and movements of the heart differ from those of the lungs, and the motions of the arteries from those of the chest, so seems it likely that other ends and offices will thence arise, and that the pulsations and uses of the heart, likewise of the arteries, will differ in many respects from the heavings and uses of the chest and lungs. For did the arterial pulse and the respiration serve the same ends; did the arteries

10

ON THE HEART AND BLOOD.

in their diastole take air into their cavities, as commonly stated, and in their systole emit fuliginous vapours by the same pores of the flesh and skin ; and further, did they, in the time intermediate between the diastole and the systole, contain air, and at all times either air, or spirits, or fuliginous vapours, what should then be said to Galen, who wrote a book on purpose to show that by nature the arteries contained blood, and nothing but blood; neither spirits nor air, consequently, as may be readily gathered from the experiments and reasonings contained in the same book ? Now if the arteries are filled in the diastole with air then taken into them (a larger quantity of air penetrating when the pulse is large and full), it must come to pass, that if you plunge into a bath of water or of oil when the pulse is strong and full, it ought forthwith to become either smaller or much slower, since the circumambient bath will render it either difficult or impossible for the air to penetrate. In like manner, as all the arteries, those that are deep-seated as well as those that are superficial, are dilated at the same instant, and with the same rapidity, how were it possible that air should penetrate to the deeper parts as freely and quickly through the skin, flesh, and other structures, as through the mere cuticle ? And how should the arteries of the foetus draw air into their cavities through the abdomen of the mother and the body of the womb ? And how should seals, whales, dolphins and other cetaceans, and fishes of every description, living in the depths of the sea, take in and emit air by the diastole and systole of their arteries through the infinite mass of waters ? For to say that they absorb the air that is infixed in the water, and emit their fumes into this medium, were to utter something very like a mere figment. And if the arteries in their systole expel fuliginous vapours from their cavities through the pores of the flesh and skin, why not the spirits, which are said to be contained in these vessels, at the same time, since spirits are much more subtile than fuliginous vapours or smoke ? And further, if the arteries take in and cast out air in the systole and diastole, like the lungs in the process of respiration, wherefore do they not do the same thing when a wound is made in one of them, as is done in the operation of arteriotomy ? When the windpipe is divided, it is sufficiently obvious that the air enters and returns through the wound by two opposite movements; but when an

INTRODUCTION.

11

artery is divided, it is equally manifest that blood escapes in one continuous stream, and that 110 air either enters or issues. If the pulsations of the arteries fan and refrigerate the several parts of the body as the lungs do the heart, how comes it, as is commonly said, that the arteries carry the vital blood into the different parts, abundantly charged with vital spirits, which cherish the heat of these parts, sustain them when asleep, and recruit them when exhausted ? and how should it happen that, if you tic the arteries, immediately the parts not only become torpid, and frigid, and look pale, but at length cease even to be nourished ? This, according to Galen, is because they are deprived of the heat which flowed through all parts from the heart, as its source; whence it would appear that the arteries rather carry warmth to the parts than serve for any fanning or refrigeration. Besides, how can the diastole [of the arteries] draw spirits from the heart to warm the body and its parts, and, from without, means of cooling or tempering them ? Still further, although some affirm that the lungs, arteries, and heart have all the same offices, they yet maintain that the heart is the workshop of the spirits, and that the arteries contain and transmit them; denying, however, in opposition to the opinion of Columbus, that the lungs can either make or contain spirits; and then they assert, with Galen, against Erasistratus, that it is blood, not spirits, which is contained in the arteries. These various opinions are seen to be so incongruous and mutually subversive, that every one of them is not unjustly brought under suspicion. That it is blood and blood alone which is contained in the arteries is made manifest by the experiment of Galen, by arteriotomy, and by wounds; for from a single artery divided, as Galen himself affirms in more than one place, the whole of the blood may be withdrawn in the course of half an hour, or less. The experiment of Galen alluded to is this : " If you include a portion of an artery between two ligatures, and slit it open lengthways, you will find nothing but blood;" and thus he proves that the arteries contain blood only. And we too may be permitted to proceed by a like train of reasoning: if we find the same blood in the arteries that we find in the veins, which we have tied in the same way, as I have myself repeatedly ascertained, both in the dead body and in living animals, we may fairly conclude that the arteries con-

12

ON THE HEART AND BLOOD.

tain the same blood as the veins, and nothing but the same blood. Some, whilst they attempt to lessen the difficulty here, affirming that the blood is spirituous and arterious, virtually concede that the office of the arteries is to carry blood from the heart into the whole of the body, and that they are therefore filled with blood; for spirituous blood is not the less blood on that account. And then no one denies that the blood as such, even the portion of it which flows in the veins, is imbued with spirits. But if that portion which is contained in the arteries be richer in spirits, it is still to be believed that these spirits are inseparable from the blood, like those in the veins; that the blood and spirits constitute one body (like whey and butter in milk, or heat [andwater] in hot water), with which the arteries are charged, and for the distribution of which from the heart they are provided, and that this body is nothing else than blood. But if this blood be said to be drawn from the heart into the arteries by the diastole of these vessels, it is then assumed that the arteries by their distension are filled with blood, and not with the ambient air, as heretofore; for if they be said also to become filled with air from the ambient atmosphere, how and when, I ask, can they receive blood from the heart ? If it be answered : during the systole; I say, that seems impossible; the arteries would then have to fill whilst they contracted; in other words, to fill, and yet not become distended. But if it be said: during the diastole, they would then, and for two opposite purposes, be receiving both blood and air, and heat and cold; which is improbable. Further, when it is affirmed that the diastole of the heart and arteries is simultaneous, and the systole of the two is also concurrent, there is another incongruity. For how can two bodies mutually connected, which are simultaneously distended, attract or draw anything from one another; or, being simultaneously contracted, receive anything from each other? And then, it seems impossible that one body can thus attract another body into itself, so as to become distended, seeing that to be distended is to be passive, unless, in the manner of a sponge, previously compressed by an external force, whilst it is returning to its natural state. But it is difficult to conceive that there can be anything of this kind in the arteries. The arteries dilate, because they are filled like bladders or leathern bottles; they are not filled because they

INTRODUCTION.

13

expand like bellows. This I think easy of demonstration; and indeed conceive that I have already proved it. Nevertheless, in that book of Galen headed ' Quod Sanguis continetur in Arteriis/ he quotes an experiment to prove the contrary: An artery having been exposed, is opened longitudinally, and a reed or other pervious tube, by which the blood is prevented from being lost, and the wound is closed, is inserted into the vessel through the opening. " So long," he says, " as things are thus arranged, the whole artery will pulsate; but if you now throw a ligature about the vessel and tightly compress its tunics over the tube, you will no longer see the artery beating beyond the ligature." I have never performed this experiment of Galen's, nor do I think that it could very well be performed in the living body, on account of the profuse flow of blood that would take place from the vessel which was operated on; neither would the tube effectually close the wound in the vessel without a ligature; and I cannot doubt but that the blood would be found to flow out between the tube and the vessel. Still Galen appears by this experiment to prove both that the pulsative faculty extends from the heart by the walls of the arteries, and that the arteries, whilst they dilate, are filled by that pulsific force, because they expand like bellows, and do not dilate because they are filled like skins. But the contrary is obvious in arteriotomy and in wounds; for the blood spurting from the arteries escapes with force, now farther, now not so far, alternately, or in jets; and the jet always takes place with the diastole of the artery, never with the systole. By which it clearly appears that the artery is dilated by the impulse of the blood; for of itself it would not throw the blood to such a distance, and whilst it was dilating; it ought rather to draw air into its cavity through the wound, were those things true that are commonly stated concerning the uses of the arteries. Nor let the thickness of the arterial tunics impose upon us, and lead us to conclude that the pulsative property proceeds along them from the heart. For in several animals the arteries do not apparently differ from the veins; and in extreme parts of the body, where the arteries are minutely subdivided, as in the brain, the hand, &c., no one could distinguish the arteries from the veins by the dissimilar characters of their coats; the tunics of both are identical. And then, in an aneurism proceeding from a wounded or eroded artery, the pulsation is pre-

14

ON THE HEART AND BLOOD.

cisely the same as in the other arteries, and yet it has no proper arterial tunic. This the learned Riolanus testifies to, along with me, in his Seventh Book. Nor let any one imagine that the uses of the pulse and the respiration are the same, because under the influence of the same causes, such as running, anger, the warm bath, or any other heating thing, as Galen says, they become more frequent and forcible together. For, not only is experience in opposition to this idea, though Galen endeavours to explain it away, when we see that with excessive repletion the pulse beats more forcibly, whilst the respiration is diminished in amount; but in young persons the pulse is quick, whilst respiration is slow. So is it also in alarm, and amidst care, and under anxiety of mind; sometimes, too, in fevers, the pulse is rapid, but the respiration is slower than usual. These and other objections of the same kind may be urged against the opinions mentioned. Nor are the views that are entertained of the offices and pulse of the heart, perhaps, less bound up with great and most inextricable difficulties. The heart, it is vulgarly said, is the fountain and workshop of the vital spirits, the centre from whence life is dispensed to the several parts of the body; and yet it is denied that the right ventricle makes spirits; it is rather held to supply nourishment to the lungs; whence it is maintained that fishes are without any right ventricle (and indeed every animal wants a right ventricle which is unfurnished with lungs), and that the right ventricle is present solely for the sake of the lungs. 1. Why, I ask, when we see that the structure of both ventricles is almost identical, there being the same apparatus of fibres, and braces, and valves, and vessels, and auricles, and in both the same infarction of blood, in the subjects of our dissections, of the like black colour, and coagulated—why, I say, should their uses be imagined to be different, when the action, motion, and pulse of both are the same ? If the three tricuspid valves placed at the entrance into the right ventricle prove obstacles to the reflux of the blood into the vena cava, and if the three semilunar valves which are situated at the commencement of the pulmonary artery be there, that they may prevent the return of the blood into the ventricle; wherefore,when we find similar structures in connexion with the left ventricle, should we deny that they are

INTRODUCTION.

15

there for the same end, of preventing here the egress, there the regurgitation of the blood ? 2. And again, when we see that these structures, in point of size, form, and situation, are almost in every respect the same in the left as in the right ventricle, wherefore should it be maintained that things are here arranged in connexion with the egress and regress of spirits, there, i.e. in the right, of blood. The same arrangement cannot be held fitted to favour or impede the motion of blood and of spirits indifferently. 3. And when we observe that the passages and vessels are severally in relation to one another in point of size, viz., the pulmonary artery to the pulmonary veins; wherefore should the one be imagined destined to a private or particular purpose, that to wit, of nourishing the lungs, the other to a public and general function ? 4. And, as Realdus Columbus says, how can it be conceived that such a quantity of blood should be required for the nutrition of the lungs; the vessel that leads to them, the vena arteriosa or pulmonary artery being of greater capacity than both the iliac veins ? 5. And I ask further; as the lungs are so close at hand, and in continual motion, and the vessel that supplies them is of such dimensions, what is the use or meaning of the pulse of the right ventricle? and why was nature reduced to the necessity of adding another ventricle for the sole purpose of nourishing the lungs ? When it is said that the left ventricle obtains materials for the formation of spirits, air to wit, and blood, from the lungs and right sinuses of the heart, and in like manner sends spirituous blood into the aorta, drawing fuliginous vapours from thence, and sending them by the arteria venosa into the lungs, whence spirits are at the same time obtained for transmission into the aorta, I ask how, and by what means, is the separation effected ? and how comes it that spirits and fuliginous vapours can pass hither and thither without admixture or confusion? If the mitral cuspidate valves do not prevent the egress of fuliginous vapours to the lungs, how should they oppose the escape of air? and how should the semilunars hinder the regress of spirits from the aorta upon each supervening diastole of the heart ? and, above all, how can they say that the spirituous blood is sent from the arteria venalis (pulmonary veins) by the left ventricle into the lungs without

16

ON THE HEART AND BLOOD.

any obstacle to its passage from the mitral valves, when they have previously asserted that the air entered by the same vessel from the lungs into the left ventricle, and have brought forward these same mitral valves as obstacles to its retrogression? Good God ! how should the mitral valves prevent regurgitation of air and not of blood ? Further, when they dedicate the vena arteriosa (or pulmonary artery), a vessel of great size, and having the tunics of an artery, to none but a kind of private and single purpose, that, namely, of nourishing the lungs, why should the arteria venalis (or pulmonary vein), which is scarcely of similar size, which has the coats of a vein, and is soft and lax, be presumed to be made for many—three or four, different uses ? For they will have it that air passes through this vessel from the lungs into the left ventricle; that fuliginous vapours escape by it from the heart into the lungs\ and that a portion of the spirituous or spiritualized blood is distributed by it to the lungs for their refreshment. If they will have it that fumes and air—fumes flowing from, air proceeding towards the heart—are transmitted by the same conduit, I reply, that nature is not wont to institute but one vessel, to contrive but one way for such contrary motions and purposes, nor is anything of the kind seen elsewhere. If fumes or fuliginous vapours and air permeate this vessel, as they do the pulmonary bronchia, wherefore do we find neither air nor fuliginous vapours when we divide the arteria venosa ? why do we always find this vessel full of sluggish blood, never of air ? whilst in the lungs we find abundance of air remaining. If any one will perform Galen's experiment of dividing the trachea of a living dog, forcibly distending the lungs with a pair of bellows, and then tying the trachea securely, he will find, when he has laid open the thorax, abundance of air in the lungs, even to their extreme investing tunic, but none in either the pulmonary veins, or left ventricle of the heart. But did the heart either attract air from the lungs, or did the lungs transmit any air to the heart, in the living dog, by so much the more ought this to be the case in the experiment just referred to. Who, indeed, doubts that, did he inflate the lungs of a subject in the dissecting-room, he would instantly see the air making its way by this route, were there actually any such passage for it ? But this office of the pulmonary veins, namely, the transference of air from the lungs to the heart, is held of such importance, that

INTRODUCTION.

17

Hieronymus Fabricius, of Aquapendente, maintains the lungs were made for the sake of this vessel, and that it constitutes the principal element in their structure. But I should like to be informed wherefore, if the pulmonary vein were destined for the conveyance of air, it has the structure of a blood-vessel here. Nature had rather need of annular tubes, such as those of the bronchia, in order that they might always remain open, not have been liable to collapse; and that they might continue entirely free from blood, lest the liquid should interfere with the passage of the air, as it so obviously does when the lungs labour from being either greatly oppressed or loaded in a less degree with phlegm, as they are when the breathing is performed with a sibilous or rattling noise. Still less is that opinion to be tolerated which (as a two-fold matter, one aereal, one sanguineous, is required for the composition of vital spirits,) supposes the blood to ooze through the septum of the heart from the right to the left ventricle by certain secret pores, and the air to be attracted from the lungs through the great vessel, the pulmonary vein; and which will have it, consequently, that there are numerous pores in the septum cordis adapted for the transmission of the blood. But, in faith, no such pores can be demonstrated, neither in fact do any such exist. For the septum of the heart is of a denser and more compact structure than any portion of the body, except the bones and sinews. But even supposing that there were foramina or pores in this situation, how could one of the ventricles extract anything from the other—the left, e. g. obtain blood from the right, when we see that both ventricles contract and dilate simultaneously ? Wherefore should we not rather believe that the right took spirits from the left, than that the left obtained blood from the right ventricle, through these foramina ? But it is certainly mysterious and incongruous that blood should be supposed to be most commodiously drawn through a set of obscure or invisible pores, and air through perfectly open passages, at one and the same moment. And why, I ask, is recourse had to secret and invisible porosities, to uncertain and obscure channels, to explain the passage of the blood into the left ventricle, when there is so open a way through the pulmonary veins? I own it has always appeared extraordinary to me that they should have chosen to make, or rather to imagine, a way through 2

18

MOTION OF THE

the thick, hard, and extremely compact substance of the septum cordis, rather than to take that by the open vas venosum or pulmonary vein, or even through the lax, soft and spongy substance of the lungs at large. Besides, if the blood could permeate the substance of the septum, or could be imbibed from the ventricles, what use were there for the coronary artery and vein, branches of which proceed to the septum itself, to supply it with nourishment ? And what is especially worthy of notice is this: if in the foetus, where everything is more lax and soft, nature saw herself reduced to the necessity of bringing the blood from the right into the left side of the heart by the foramen ovale, from the vena cava through the arteria venosa, how should it be likely that in the adult she should pass it so commodiously, and without an effort, through the septum ventriculorum, which has now become denser by age ? Andreas Laurentius,1 resting on the authority of Galen^ and the experience of Hollerius, asserts and proves that the serum and pus in empyema, absorbed from the cavities of the chest into the pulmonary vein, may be expelled and got rid of with the urine and faeces through the left ventricle of the heart and arteries. He quotes the case of a certain person affected with melancholia, and who suffered from repeated fainting fits, who was relieved from the paroxysms on passing a quantity of turbid, fetid, and acrid urine; but he died at last, worn out by the disease ; and when the body came to be opened after death, no fluid like that he had micturated was discovered either in the bladder or in the kidneys; but in the left ventricle of the heart and cavity of the thorax plenty of it was met with; and then Laurentius boasts that he had predicted the cause of the symptoms. For my own part, however, I cannot but wonder, since he had divined and predicted that heterogeneous matter could be discharged by the course he indicates, why he could not or would not perceive, and inform us that, in the natural state of things, the blood might be commodiously transferred from the lungs to the left ventricle of the heart by the very same route. Since, therefore, from the foregoing considerations and many others to the same effect, it is plain that what has heretofore been said concerning the motion and function of the heart and 1 2

Lib. ix, cap. xi, quest. 12. De Locis Affectis., lib. vi, cap. 7.

HEART AND BLOOD.

19

arteries must appear obscure, or inconsistent or even impossible to him who carefully considers the entire subject; it will be proper to look more narrowly into the matter; to contemplate the motion of the heart and arteries,, not only in man, but in all animals that have hearts; and further, by frequent appeals to vivisection, and constant ocular inspection, to investigate and endeavour to find the truth.

CHAPTER I. THE AUTHOR'S MOTIVES FOR WRITING. WHEN I first gave my mind to vivisections, as a means of discovering the motions and uses of the heart, and sought to discover these from actual inspection, and not from the writings of others, I found the task so truly arduous, so full of difficulties, that I was almost tempted to think, with Fracastorius, that the motion of the heart was only to be comprehended by God. For I could neither rightly perceive at first when the systole and when the diastole took place, nor when and where dilatation and contraction occurred, by reason of the rapidity of the motion, which in many animals is accomplished in the twinkling of an eye, coming and going like a flash of lightning; so that the systole presented itself to me now from this point, now from that; the diastole the same; and then everything was reversed, the motions occurring, as it seemed, variously and confusedly together. My mind was therefore greatlyunsettled, nor did I know what I should myself conclude, nor what believe from others; I was not surprised that Andreas Laurentius should have said that the motion of the heart was as perplexing as the flux and reflux of Euripus had appeared to Aristotle. At length, and by using greater and daily diligence, having frequent recourse to vivisections, employing a variety of animals for the purpose, and collating numerous observations, I thought that I had attained to the truth, that I should extricate myself and escape from this labyrinth, and that I had discovered what I so much desired, both the motion and the use of the heart and arteries; since which time I have not hesitated to expose my views upon these subjects, not only in private to my friends,

20

MOTION OF THE

but also in public, in my anatomical lectures, after the manner of the Academy of old. These views, as usual, pleased some more, others less; some chid and calumniated me, and laid it to me as a crime that I had dared to depart from the precepts and opinion of all anatomists; others desired further explanations of the novelties, which they said were both worthy of consideration, and might perchance be found of signal use. At length, yielding to the requests of my friends, that all might be made participators in my labours, and partly moved by the envy of others, who, receiving my views with uncandid minds and understanding them indifferently, have essayed to traduce me publicly, I have been moved to commit these things to the press, in order that all may be enabled to form an opinion both of me and my labours. This step I take all the more willingly, seeing that Hieronymus Fabricius of Aquapendente, although he has accurately and learnedly delineated almost every one of the several parts of animals in a special work, has left the heart alone untouched. Finally, if any use or benefit to this department of the republic of letters should accrue from my labours, it will, perhaps, be allowed that I have not lived idly, and, as the old man in the comedy says: For never yet hath any one attained To such perfection, hut that time, and place, And use, have brought addition to his knowledge; Or made correction, or admonished him, That he was ignorant of much which he Had thought he knew; or led him to reject What he had once esteemed of highest price.

So will it, perchance, be found with reference to the heart at this time; or others, at least, starting from hence, the way pointed out to them, advancing under the guidance of a happier genius, may make occasion to proceed more fortunately, and to inquire more accurately.

HEART AND BLOOD.

?1

CHAPTER II. OF THE MOTIONS OF THE HEART, AS SEEN IN THE DISSECTION OF LIVING ANIMALS.

IN the first place, then, when the chest of a living animal is laid open and the capsule that immediately surrounds the heart is slit up or removed, the organ is seen now to move, now to be at rest;—there is a time when it moves, and a time when it is motionless. These things are more obvious in the colder animals, such as toads, frogs, serpents, small fishes, crabs, shrimps, snails and shell-fish. They also become more distinct in warm-blooded animals, such as the dog and hog, if they be attentively noted when the heart begins to flag, to move more slowly, and, as it were, to die: the movements then become slower and rarer, the pauses longer, by which it is made much more easy to perceive and unravel what the motions really are, and how they are performed. In the pause, as in death, the heart is soft, flaccid, exhausted, lying, as it were, at rest. In the motion, and interval in which this is accomplished, three principal circumstances are to be noted: 1. That the heart is erected, and rises upwards to a point, so that at this time it strikes against the breast and the pulse is felt externally. 2. That it is everywhere contracted, but more especially towards the sides, so that it looks narrower, relatively longer, more drawn together. The heart of an eel taken out of the body of the animal and placed upon the table or the hand, shows these particulars; but the same things are manifest in the heart of small fishes and of those colder animals where the organ is more conical or elongated. 3. The heart being grasped in the hand, is felt to become harder during its action. Now this hardness proceeds from tension, precisely as when the forearm is grasped, its tendons are perceived to become tense and resilient when the fingers are moved. 4. It may further be observed in fishes, and the colder blooded animals, such as frogs, serpents, &c., that the heart,

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MOTION OF THE

when it moves, becomes of a paler colour, when quiescent of a deeper blood-red colour. From these particulars it appeared evident to me that the motion of the heart consists in a certain universal tension—both contraction in the line of its fibres, and constriction in every sense. It becomes erect, hard, and of diminished size during its action; the motion is plainly of the same nature as that of the muscles when they contract in the line of their sinews and fibres; for the muscles, when in action, acquire vigour and tenseness, and from soft become hard, prominent and thickened: in the same manner the heart. We are therefore authorized to conclude that the heart, at the moment of its action, is at once constricted on all sides, rendered thicker in its parietes and smaller in its ventricles, and so made apt to project or expel its charge of blood. This, indeed, is made sufficiently manifest by the fourth observation preceding, in which we have seen that the heart, by squeezing out the blood it contains becomes paler, and then when it sinks into repose and the ventricle is filled anew with blood, that the deeper crimson colour returns. But no one need remain in doubt of the fact, for if the ventricle be pierced the blood will be seen to be forcibly projected outwards upon each motion or pulsation when the heart is tense. These things, therefore, happen together or at the same instant: the tension of the heart, the pulse of its apex, which is felt externally Ly its striking against the chest, the thickening of its parietes, and the forcible expulsion of the blood it contains by the constriction of its ventricles. Hence the very opposite of the opinions commonly received, appears to be true; inasmuch as it is generally believed that when the heart strikes the breast and the pulse is felt without, the heart is dilated in its ventricles and is filled with blood; but the contrary of this is the fact, and the heart, when it contracts [and the shock is given], is emptied. Whence the motion which is generally regarded as the diastole of the heart, is in truth its systole. And in like manner the intrinsic motion of the heart is not the diastole but the systole; neither is it in the diastole that the heart grows firm and tense, but in the systole, for then only, when tense, is it moved and made vigorous.

HEART AND BLOOD.

23

Neither is it by any means to be allowed that the heart only moves in the line of its straight fibres, although the great Vesalius, giving this notion countenance, quotes a bundle of osiers bound into a pyramidal heap in illustration; meaning, that as the apex is approached to the base, so are the sides made to bulge out in the fashion of arches, the cavities to dilate, the ventricles to acquire the form of a cupping-glass and so to suck in the blood. But the true effect of every one of its fibres is to constringe the heart at the same time that they render it tense; and this rather with the effect of thickening and amplifying the walls and substance of the organ than enlarging its ventricles. And, again, as the fibres run from the apex to the base, and draw the apex towards the base, they do not tend to make the walls of the heart bulge out in circles, but rather the contrary; inasmuch as every fibre that is circularly disposed, tends to become straight when it contracts; and is distended laterally and thickened, as in the case of muscular fibres in general, when they contract, that is, when they are shortened longitudinally, as we see them in the bellies of the muscles of the body at large. To all this let it be added, that not only are the ventricles contracted in virtue of the direction and condensation of their walls, but farther, that those fibres, or bands, styled nerves by Aristotle, which are so conspicuous in the ventricles of the larger animals, and contain all the straight fibres, (the parietes of the heart* containing only circular ones,) when they contract simultaneously, by an admirable adjustment all the internal surfaces are drawn together, as if with cords, and so is the charge of blood expelled with force. Neither is it true, as vulgarly believed, that the heart by any dilatation or motion of its own, has the power of drawing the blood into the ventricles; for when it acts and becomes tense, the blood is expelled; when it relaxes and sinks together it receives the blood in the manner and wise which will by and by be explained.

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CHAPTER

III.

OF THE MOTIONS OF ARTERIES, AS SEEN IN THE DISSECTION OF LIVING ANIMALS.

IN connexion with the motions of the heart these things are further to be observed having reference to the motions and pulses of the arteries : 1. At the moment the heart contracts, and when the breast is struck, when in short the organ is in its state of systole, the arteries are dilated, yield a pulse, and are in the state of diastole. In like manner, when the right ventricle contracts and propels its charge of blood, the arterial vein [the pulmonary artery] is distended at the same time with the other arteries of the body. 2. When the left ventricle ceases to act, to contract, to pulsate, the pulse in the arteries also ceases; further, when this ventricle contracts languidly, the pulse in the arteries is scarcely perceptible. In like manner, the pulse in the right ventricle failing, the pulse in the vena arteriosa [pulmonary artery] ceases also. 3. Further, when an artery is divided or punctured, the blood is seen to be forcibly propelled from the wound at the moment the left ventricle contracts; and, again, when the pulmonary artery is wounded, the blood will be seen spouting forth with violence at the instant when the right ventricle contracts. So also in fishes, if the vessel which leads from the heart to the gills be divided, at the moment when the heart becomes tense and contracted, at the same moment does the blood flow with force from the divided vessel. In the same way, finally, when we see the blood in arteriotomy projected now to a greater, now to a less distance, and that the greater jet corresponds to the diastole of the artery and to the time when the heart contracts and strikes the ribs, and is in its state of systole, we understand that the blood is expelled by the same movement. From these facts it is manifest, in opposition to commonly received opinions, that the diastole of the arteries corresponds with the time of the heart's systole; and that the arteries are

HEART AND BLOOD.

25

filled and distended by the blood forced into them by the eontraction of the ventricles; the arteries, therefore, are distended, because they are filled like sacs or bladders, and are not filled because they expand like bellows. It is in virtue of one and the same cause, therefore, that all the arteries of the body pulsate, viz. the contraction of the left ventricle; in the same way as the pulmonary artery pulsates by the contraction of the right ventricle. Finally, that the pulses of the arteries are due to the impulses of the blood from the left ventricle, may be illustrated by blowing into a glove, when the whole of the fingers will be found to become distended at one and the same time, and in their tension to bear some resemblance to the pulse. For in the ratio of the tension is the pulse of the heart, fuller, stronger, more frequent as that acts more vigorously, still preserving the rhythm and volume, and order of the heart's contractions. Nor is it to be expected that because of the motion of the blood, the time at which the contraction of the heart takes place, and that at which the pulse in an artery (especially a distant one,) is felt, shall be otherwise than simultaneous: it is here the same as in blowing up a glove or bladder; for in a plenum, (as in a drum, a long piece of timber, &c.) the stroke and the motion occur at both extremities at the same time. Aristotle,1 too, has said, '' the blood of all animals palpitates within their veins, (meaning the arteries,) and by the pulse is sent everywhere simultaneously " And further,2 " thus do all the veins pulsate together and by successive strokes, because they all depend upon the heart; and, as it is always in motion, so are they likewise always moving together, but by successive movements." It is well to observe with Galen, in this place, that the old philosophers called the arteries veins. I happened upon one occasion to have a particular case under my care, which plainly satisfied me of this truth: A certain person was affected with a large pulsating tumour on the right side of the neck, called an aneurism, just at that part where the artery descends into the axilla, produced by an erosion of the artery itself, and daily increasing in size; this tumour was visibly distended as it received the charge of blood brought to 1

De Animal, iii, cap. 9.

2

De Respirat. cap. 20.

26

MOTION OF THE

it by the artery, with each stroke of the heart: the connexion of parts was obvious when the body of the patient came to be opened after his death. The pulse in the corresponding arm was small, in consequence of the greater portion of the blood being diverted into the tumour and so intercepted. Whence it appears that wherever the motion of the blood through the arteries is impeded, whether it be by compression or infarction, or interception, there do the remote divisions of the arteries beat less forcibly, seeing that the pulse of the arteries is nothing more than the impulse or shock of the blood in these vessels. CHAPTER IV. OF THE MOTION OF THE HEART AND ITS AURICLES, AS SEEN IN THE BODIES OF LIVING ANIMALS.

BESIDES the motions already spoken of, we have still to consider those that appertain to the auricles. Caspar Bauhin and John Riolan,1 most learned men and skilful anatomists, inform us from their observations, that if we carefully watch the movements of the heart in the vivisection of an animal, we shall perceive four motions distinct in time and in place, two of which are proper to the auricles, two to the ventricles. With all deference to such authority I say, that there are four motions distinct in point of place, but not of time; for the two auricles move together, and so also do the two ventricles, in such wise that though the places be four, the times are only two. And this occurs in the following manner: There are, as it were, two motions going on together; one of the auricles, another of the ventricles; these by no means taking place simultaneously, but the motion of the auricles preceding, that of the heart itself following; the motion appearing to begin from the auricles and to extend to the ventricles. When all things are becoming languid, and the heart is dying, as also in fishes and the colder blooded animals, there is a short pause between these two motions, so that the heart aroused, as it were, appears to respond to the motion, now more quickly, 1

Bauhin, lib. ii, cap. 21.

Riolan, lib. viii, cap. 1.

HEART AND BLOOD.

27

now more tardily; and at length, and when near to death, it ceases to respond by its proper motion, but seems, as it were, to nod the head, and is so obscurely moved that it appears rather to give signs of motion to the pulsating auricle, than actually to move. The heart, therefore, ceases to pulsate sooner than the auricles, so that the auricles have been said to outlive it, the left ventricle ceasing to pulsate first of all; then its auricle, next the right ventricle; and, finally, all the other parts being at rest and dead, as Galen long since observed, the right auricle still continues to beat; life, therefore, appears to linger longest in the right auricle. Whilst the heart is gradually dying, it is sometimes seen to reply, after two or three contractions of the auricles, roused as it were to action, and making a single pulsation, slowly, unwillingly, and with an effort. But this especially is to be noted, that after the heart has ceased to beat, the auricles however still contracting, a finger placed upon the ventricles perceives the several pulsations of the auricles, precisely in the same way and for the same reason, as we have said, that the pulses of the ventricles are felt in the arteries, to wit, the distension produced by the jet of blood. And if at this time, the auricles alone pulsating, the point of the heart be cut off with a pair of scissors, you will perceive the blood flowing out upon each contraction of the auricles. Whence it is manifest how the blood enters the ventricles, not by any attraction or dilatation of the heart, but thrown into them by the pulses of the auricles. And here I would observe, that whenever I speak of pulsations as occurring in the auricles or ventricles, I mean contractions : first the auricles contract, and then and subsequently the heart itself contracts. When the auricles contract they are seen to become whiter, especially where they contain but little blood; but they are filled as magazines or reservoirs of the blood, which is tending spontaneously and, by the motion of the veins, under pressure towards the centre; the whiteness indicated is most conspicuous towards the extremities or edges of the auricles at the time of their contractions. In fishes and frogs, and other animals which have hearts with but a single ventricle, and for an auricle have a kind of bladder much distended with blood, at the base of the organ,

28

MOTION OF THE

you may very plainly perceive this bladder contracting first, and the contraction of the heart or ventricle following afterwards. But I think it right to describe what I have observed of an opposite character: the heart of an eel, of several fishes, and even of some [of the higher] animals taken out of the body, beats without auricles; nay, if it be cut in pieces the several parts may still be seen contracting and relaxing; so that in these creatures the body of the heart may be seen pulsating, palpitating, after the cessation of all motion in the auricle. But is not this perchance peculiar to animals more tenacious of life, whose radical moisture is more glutinous, or fat and sluggish, and less readily soluble ? The same faculty indeed appears in the flesh of eels, generally, which even when skinned and embowelled, and cut into pieces, are still seen to move. Experimenting with a pigeon upon one occasion, after the heart had wholly ceased to pulsate, and the auricles too had become motionless, I kept my finger wetted with saliva and warm for a short time upon the heart, and observed, that under the influence of this fomentation it recovered new strength and life, so that both ventricles and auricles pulsated, contracting and relaxing alternately, recalled as it were from death to life. Besides this, however, I have occasionally observed, after the heart and even its right auricle had ceased pulsating,—when it was in articulo mortis in short, that an obscure motion, an undulation or palpitation, remained in the blood itself, which was contained in the right auricle, this being apparent so long as it was imbued with heat and spirit. And indeed a circumstance of the same kind is extremely manifest in the course of the generation of animals, as may be seen in the course of the first seven days of the incubation of the chick: A drop of blood makes its appearance which palpitates, as Aristotle had already observed; from this, when the growth is further advanced and the chick is fashioned, the auricles of the heart are formed, which pulsating henceforth give constant signs of life. When at length, and after the lapse of a few days, the outline of the body begins to be distinguished, then is the ventricular part of the heart also produced; but it continues for a time white and apparently bloodless, like the rest of the animal; neither does it pulsate or give signs of motion. I have seen a similar condition of the heart in the human foetxis about the beginning of

HEART AND BLOOD.

29

the third month, the heart being then whitish and bloodless, although its auricles contained a considerable quantity of purple blood. In the same way in the egg, when the chick was formed and had increased in size, the heart too increased and acquired ventricles, which then began to receive and to transmit blood. And this leads me to remark, that he who inquires very particularly into this matter will not conclude that the heart, as a whole, is the primum vivens, ultimum moriens—the first part to live, the last to die, but rather its auricles, or the part which corresponds to the auricles in serpents, fishes, &c., which both lives before the heart1 and dies after it. Nay, has not the blood itself or spirit an obscure palpitation inherent in it, which it has even appeared to me to retain after death? and it seems very questionable whether or not we are to say that life begins with the palpitation or beating of the heart. The seminal fluid of all animals—the prolific spirit, as Aristotle observed, leaves their body with a bound and like a living thing; and nature in death, as Aristotle2 further remarks, retracing her steps, reverts to whence she had set out, returns at the end of her course to the goal whence she had started; and as animal generation proceeds from that which is not animal, entity from non-entity, so, by a retrograde course, entity, by corruption, is resolved into non-entity; whence that in animals, which was last created, fails first; and that which was first, fails last. I have also observed, that almost all animals have truly a heart, not the larger creatures only, and those that have red blood, but the smaller, and [seemingly] bloodless ones also, such as slugs, snails, scallops, shrimps, crabs, crayfish, and many others; nay, even in wasps, hornets and flies, I have, with the aid of a magnifying glass, and at the upper part of what is called the tail, both seen the heart pulsating myself, and shown it to many others. But in the exsanguine tribes the heart pulsates slugglishly and deliberately, contracting slowly as in animals that are moribund, a fact that may readily be seen in the snail, whose 1 [The reader will observe that Harvey, when he speaks of the heart, always means the ventricles or ventricular portion of the organ.—ED.] 2 De Motu Animal, cap. 8.

30

MOTION OF THE

heart will be found at the bottom of that orifice in the right side of the body which is seen to be opened and shut in the course of respiration, and whence saliva is discharged, the incision being made in the upper aspect of the body, near the part which corresponds to the liver. This, however, is to be observed: that in winter and the colder season, exsanguine animals, such as the snail, show no pulsations; they seem rather to live after the manner of vegetables, or of those other productions which are therefore designated plant-animals. It is also to be noted that all animals which have a heart, have also auricles, or something analogous to auricles; and further, that wherever the heart, has a double ventricle there are always two auricles present, but not otherwise. If you turn to the production of the chick in ovo, however, you will find at first no more than a vesicle or auricle, or pulsating drop of blood; it is only by and by, when the development has made some progress, that the heart is fashioned: even so in certain animals not destined to attain to the highest perfection in their organization, such as bees, wasps, snails, shrimps, crayfish, &c., we only find a certain pulsating vesicle, like a sort of red or white palpitating point, as the beginning or principle of their life.1 We have a small shrimp in these countries, which is taken in the Thames and in the sea, the whole of whose body is transparent; this creature, placed in a little water, has frequently afforded myself and particular friends an opportunity of observing the motions of the heart with the greatest distinctness, the external parts of the body presenting no obstacle to our view, but the heart being perceived as though it had been seen through a window. I have also observed the first rudiments of the chick in the course of the fourth or fifth day of the incubation, in the guise of a little cloud, the shell having been removed and the egg immersed in clear tepid water. In the midst of the cloudlet in question there was a bloody point so small that it disappeared during the contraction and escaped the sight, but in the re1

[The Editor begs here to be allowed to remark on Harvey's obvious perception of the correspondence between that permanent condition of an organ in the lower, and its transitory condition in the higher animals.—ED.]

HEART AND BLOOD.

31

laxation it reappeared again, red and like the point of a pin; so that betwixt the visible and invisible, betwixt being and not being, as it were, it gave by its pulses a kind of representation of the commencement of life.1

CHAPTER V. OF THE MOTION, ACTION, AND OFFICE OF THE HEART.

FROM these and other observations of the like kind, I am persuaded it will be found that the motion of the heart is as follows: First of all, the auricle contracts, and in the course of its contraction throws the blood, (which it contains in ample quantity as the head of the veins, the store-house and cistern of the blood,) into the ventricle, which being filled, the heart raises itself straightway, makes all its fibres tense, contracts the ventricles, and performs a beat, by which beat it immediately sends the blood supplied to it by the auricle into the arteries; the right ventricle sending its charge into the lungs by the vessel which is called vena arteriosa, but which, in structure and function, and all things else, is an artery; the left ventricle sending its charge into the aorta, and through this by the arteries to the body at large. These two motions, one of the ventricles, another of the auricles, take place consecutively, but in such a manner that there is a kind of harmony or rhythm preserved between them, the two concurring in such wise that but one motion is apparent, especially in the warmer blooded animals, in which the movements in question are rapid. Nor is this for any other reason than it is in a piece of machinery, in which, though one wheel gives motion to another, yet all the wheels seem to move simultaneously ; or in that mechanical contrivance which is adapted to firearms, where the trigger being touched, down comes the flint, strikes against the steel, elicits a spark, which falling among the 1

[At the period Harvey indicates, a rudimentary auricle and ventricle exist, but are so transparent that unless with certain precautions their parietes cannot be seen. The filling and emptying of them, therefore, give the appearance of a speck of blood alternately appearing and disappearing.—ED.]

32

MOTION OF THE

powder, it is ignited, upon which the flame extends, enters the barrel, causes the explosion, propels the ball, and the mark is attained—all of which incidents, by reason of the celerity with which they happen, seem to take place in the twinkling of an eye. So also in deglutition: by the elevation of the root of the tongue, and the compression of the mouth, the food or drink is pushed into the fauces, the larynx is closed by its own muscles, and the epiglottis, whilst the pharynx, raised and opened by its muscles no otherwise than is a sac that is to be filled, is lifted up, and its mouth dilated; upon which, the mouthful being received, it is forced downwards by the transverse muscles, and then carried farther by the longitudinal ones. Yet are all these motions, though executed by different and distinct organs, performed harmoniously, and in such order, that they seem to constitute but a single motion and act, which we call deglutition. Even so does it come to pass with the motions and action of the heart, which constitute a kind of deglutition, a transfusion of the blood from the veins to the arteries. And if any one, bearing these things in mind, will carefully watch the motions of the heart in the body of a living animal, he will perceive not only all the particulars I have mentioned, viz., the heart becoming erect, and making one continuous motion with its auricles; but farther, a certain obscure undulation and lateral inclination in the direction of the axis of the right ventricle, [the organ] twisting itself slightly in performing its work. And indeed every one may see, when a horse drinks, that the water is drawn in and transmitted to the stomach at each movement of the throat, the motion being accompanied with a sound, and yielding a pulse both to the ear and the touch; in the same way it is with each motion of the heart, when there is the delivery of a quantity of blood from the veins to the arteries, that a pulse takes place, and can be heard within the chest. The motion of the heart, then, is entirely of this description, and the one action of the heart is the transmission of the blood and its distribution, by means of the arteries, to the very extremities of the body; so that the pulse which we feel in the arteries is nothing more than the impulse of the blood derived from the heart. Whether or not the heart, besides propelling the blood, giving it motion locally, and distributing it to the body, adds anything

HEART AND BLOOD.

33

else to it,—heat, spirit, perfection,—must be inquired into by and by, and decided upon other grounds. So much may suffice at this time, when it is shown that by the action of the heart the blood is transfused through the ventricles from the veins to the arteries, and distributed by them to all parts of the body. So much, indeed, is admitted by all [physiologists], both from the structure of the heart and the arrangement and action of its valves. But still they are like persons purblind or groping about in the dark; and then they give utterance to diverse, contradictory, and incoherent sentiments, delivering many things upon conjecture, as we have already had occasion to remark. The grand cause of hesitation and error in this subject appears to me to have been the intimate connexion between the heart and the lungs. When men saw both the vena arteriosa [or pulmonary artery] and the arterise venosse [or pulmonary veins] losing themselves in the lungs, of course it became a puzzle to them to know how or by what means the right ventricle should distribute the blood to the body, or the left draw it from the vense cavse. This fact is borne witness to by Galen, whose words, when writing against Erasistratus in regard to the origin and use of the veins and the coction of the blood, are the following :l " You will reply," he says, " that the effect is so; that the blood is prepared in the liver, and is thence transferred to the heart to receive its proper form and last perfection; a statement which does not appear devoid of reason; for no great and perfect work is ever accomplished at a single effort, or receives its final polish from one instrument. But if this be actually so, then show us another vessel which draws the absolutely perfect blood from the heart, and distributes it as the arteries do the spirits over the whole body." Here then is a reasonable opinion not allowed, because, forsooth, besides not seeing the true means of transit, he could not discover the vessel which should transmit the blood from the heart to the body at large ! But had any one been there in behalf of Erasistratus, and of that opinion which we now espouse, and which Galen himself acknowledges in other respects consonant with reason, to have pointed to the aorta as the vessel which distributes the blood from 1

De Placitis Hippocratis et Platonis, vi.

3

34

MOTION OF THE

the heart to the rest of the body, I wonder what would have been the answer of that most ingenious and learned man ? Had he said that the artery transmits spirits and not blood, he would indeed sufficiently have answered Erasistratus, who imagined that the arteries contained nothing but spirits; but then he would have contradicted himself, and given a foul denial to that for which he had keenly contended in his writings against this very Erasistratus, to wit, that blood in substance is contained in the arteries, and not spirits; a fact which he demonstrated not only by many powerful arguments, but by experiments. But if the divine Galen will here allow, as in other places he does, " that all the arteries of the body arise from the great artery, and that this takes its origin from the heart; that all these vessels naturally contain and carry blood; that the three semilunar valves situated at the orifice of the aorta prevent the return of the blood into the heart, and that nature never connected them with this, the most noble viscus of the body, unless for some most important end •" if, I say, this father of physic admits all these things,—and I quote his own words,—I do not see how he can deny that the great artery is the very vessel to carry the blood, when it has attained its highest term of perfection, from the heart for distribution to all parts of the body. Or would he perchance still hesitate, like all who have come after him, even to the present hour, because he did not perceive the route by which the blood was transferred from the veins to the arteries, in consequence, as I have already said, of the intimate connexion between the heart and the lungs ? And that this difficulty puzzled anatomists not a little, when in their dissections they found the pulmonary artery and left ventricle full of thick, black, and clotted blood, plainly appears, when they felt themselves compelled to affirm that the blood made its way from the right to the left ventricle by sweating through the septum of the heart. But this fancy I have already refuted. A new pathway for the blood must therefore be prepared and thrown open, and being once exposed, no further difficulty will, I believe, be experienced by any one in admitting what I have already proposed in regard to the pulse of the heart and arteries, viz. the passage of the blood from the veins to the arteries, and its distribution to the whole of the body by means of these vessels.

HEART AND BLOOD.

35

CHAPTER VI. OP THE COURSE BY WHICH THE

BLOOD IS CARRIED FROM THE

V E N A CAVA INTO THE ARTERIES, OR FROM

THE

RIGHT INTO

THE LEFT VENTRICLE OF THE HEART.

SINCE the intimate connexion of the heart with the lungs, which is apparent in the human subject, has been the probable cause of the errors that have been committed on this point, they plainly do amiss who, pretending to speak of the parts of animals generally, as anatomists for the most part do, confine their researches to the human body alone, and that when it is dead. They obviously act no otherwise than he who, having studied the forms of a single commonwealth, should set about the composition of a general system of polity; or who, having taken cognizance of the nature of a single field, should imagine that he had mastered the science of agriculture; or who, upon the ground of one particular proposition, should proceed to draw general conclusions. Had anatomists only been as conversant with the dissection of the lower animals as they are with that of the human body, the matters that have hitherto kept them in a perplexity of doubt would, in my opinion, have met them freed from every kind of difficulty. And, first, in fishes, in which the heart consists of but a single ventricle, they having no lungs, the thing is sufficiently manifest. Here the sac, which is situated at the base of the heart, and is the part analogous to the auricle in man, plainly throws the blood into the heart, and the heart, in its turn, conspicuously transmits it by a pipe or artery, or vessel analogous to an artery; these are facts which are confirmed by simple ocular inspection, as well as by a division of the vessel, when the blood is seen to be projected by each pulsation of the heart. The same thing is also not difficult of demonstration in those animals that have either nomore, or, as itwere, no more than a single ventricle to the heart, such as toads, frogs, serpents, and lizards, which, although they have lungs in a certain sense, as they have a voice, (and I have many observations by me on the admirable structure of the lungs of these animals, and matters appertain-

36

MOTION OF THE

ing, which, however, I cannot introduce in this place,) still their anatomy plainly shows that the blood is transferred in them from the veins to the arteries in the same manner as in higher animals, viz., by the action of the heart; the way, in fact, is patent, open, manifest; there is no difficulty, no room for hesitating about it; for in them the matter stands precisely as it would in man, were the septum of his heart perforated or removed, or one ventricle made out of two; and this being the case, I imagine that no one will doubt as to the way by which the blood may pass from the veins into the arteries. But as there are actually more animals which have no lungs than there are which be furnished with them, and in like manner a greater number which have only one ventricle than there are which have two, it is open to us to conclude, judging from the mass or multitude of living creatures, that for the major part, and generally, there is an open way by which the blood is transmitted from the veins through the sinuses or cavities of the heart into the arteries. I have, however, cogitating with myself, seen further, that the same thing obtained most obviously in the embryos of those animals that have lungs; for in the foetus the four vessels belonging to the heart, viz., the vena cava, the vena arteriosa or pulmonary artery, the arteria venalis or pulmonary vein, and the arteria magna or aorta, are all connected otherwise than in the adult; a fact sufficiently known to every anatomist. The first contact and union of the vena cava with the arteria venosa or pulmonary veins, which occurs before the cava opens properly into the right ventricle of the heart, or gives off the coronary vein, a little above its escape from the liver, is by a lateral anastomosis; this is an ample foramen, of an oval form, communicating between the cava and the arteria venosa, or pulmonary vein, so that the blood is free to flow in the greatest abundance by that foramen from the vena cava into the arteria venosa or pulmonary vein, and left auricle, and from thence into the left ventricle; and farther, in this foramen ovale, from that part which regards the arteria venosa, or pulmonary vein, there is a thin tough membrane, larger than the opening, extended like an operculum or cover; this membrane in the adult blocking up the foramen, and adhering on all sides, finally closes it up, and almost obliterates every trace of it. This

HEART AND BLOOD.

37

membrane, however, is so contrived in the foetus, that falling loosely upon itself, it permits a ready access to the lungs and heart, yielding a passage to the blood which is streaming from the cava, and hindering the tide at the same time from flowing back into that vein. All things, in short, permit us to believe that in the embryo the blood must constantly pass by this foramen from the vena cava into the arteria venosa, or pulmonary vein, and from thence into the left auricle of the heart; and having once entered there, it can never regurgitate. Another union is that by the vena arteriosa, or pulmonary artery, and is effected when that vessel divides into two branches after its escape from the right ventricle of the heart. It is as if to the two trunks already mentioned a third were superadded, a kind of arterial canal, carried obliquely from the vena arteriosa, or pulmonary artery, to perforate and terminate in the arteria magna or aorta. In the embryo, consequently, there are, as it were, two aortas, or two roots of the arteria magna, springing from the heart. This canalis arteriosus shrinks gradually after birth, and is at length and finally almost entirely withered, and removed, like the umbilical vessels. The canalis arteriosus contains no membrane or valve to direct or impede the flow of the blood in this or in that direction: for at the root of the vena arteriosa, or pulmonary artery, of which the canalis arteriosus is the continuation in the foetus, there are three sigmoid or semilunar valves, which open from within outwards, and oppose no obstacle to the blood flowing in this direction or from the right ventricle into the pulmonary artery and aorta; but they prevent all regurgitation from the aorta or pulmonic vessels back upon the right ventricle; closing with perfect accuracy, they oppose an effectual obstacle to everything of the kind in the embryo. So that there is also reason to believe that when the heart contracts, the blood is regularly propelled by the canal or passage indicated from the right ventricle into the aorta. What is commonly 3aid in regard to these two great communications, to wit, that they exist for the nutrition of the lungs, is both improbable and inconsistent; seeing that in the adult they are closed up, abolished, and consolidated, although the lungs, by reason of their heat and motion, must then be presumed to require a larger supply of nourishment. The same may

38

MOTION OF THE

be said in regard to the assertion that the heart in the embryo does not pulsate, that it neither acts nor moves, so that nature was forced to make these communications for the nutrition of the lungs. This is plainly false; for simple inspection of the incubated egg, and of embryos just taken out of the uterus, shows that the heart moves precisely in them as in adults, and that nature feels no such necessity. I have myself repeatedly seen these motions, and Aristotle is likewise witness of their reality. " The pulse," he observes, " inheres in the very constitution of the heart, and appears from the beginning, as is learned both from the dissection of living animals, and the formation of the chick in the egg,"1 But we further observe, that the passages in question are not only pervious up to the period of birth in man, as well as in other animals, as anatomists in general have described them, but for several months subsequently, in some indeed for several years, not to say for the whole course of life; as, for example, in the goose, snipe, and various birds, and many of the smaller animals. And this circumstance it was, perhaps, that imposed upon Botallus, who thought he had discovered a new passage for the blood from the vena cava into the left ventricle of the heart; and I own that when I met with the same arrangement in one of the larger members of the mouse family, in the adult state, I was myself at first led to something of a like conclusion. From this it will be understood that in the human embryo, and in the embryos of animals in which the communications are not closed, the same thing happens, namely, that the heart by its motion propels the blood by obvious and open passages from the vena cava into the aorta through the cavities of both the ventricles; the right one receiving the blood from the auricle, and propelling it by the vena arteriosa, or pulmonary artery, and its continuation, named the ductus arteriosus, into the aorta; the left, in like manner, charged by the contraction of its auricle, which has received its supply through the foramen ovale from the vena cava, contracting, and projecting the blood through the root of the aorta into the trunk of that vessel. In embryos, consequently, whilst the lungs are yet in a state of inaction, performing no function, subject to no motion any 1

Lib. de Spiritu, cap. v.

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more than if they had not been present, nature uses the two ventricles of the heart as if they formed but one, for the transmission of the blood. The condition of the embryos of those animals which have lungs, whilst these organs are yet in abeyance and not employed, is the same as that of those animals which have no lungs. So clearly, therefore, does it appear in the case of the foetus, viz., that the heart by its action transfers the blood from the vena cava into the aorta, and that by a route as obvious and open, as if in the adult the two ventricles were made to communicate by the removal of their septum. Since, then, we find that in the greater number of animals, in all, indeed, at a certain period of their existence, the channels for the transmission of the blood through the heart are so conspicuous, we have still to inquire wherefore in some creatures—those, namely, that have warm blood, and that have attained to the adult age, man among the number—we should not conclude that the same thing is accomplished through the substance of the lungs, which in the embryo, and at a time when the function of these organs is in abeyance, nature effects by the direct passages described, and which, indeed, she seems compelled to adopt through want of a passage by the lungs; or wherefore it should be better (for nature always does that which is best) that she should close up the various open routes which she had formerly made use of in the embryo and foetus, and still uses in all other animals; not only opening up no new apparent channels for the passage of the blood, therefore, but even entirely shutting up those which formerly existed. And now the discussion is brought to this point, that they who inquire into the ways by which the blood reaches the left ventricle of the heart and pulmonary veins from the vena cava, will pursue the wisest course if they seek by dissection to discover the causes why in the larger and more perfect animals of mature age, nature has rather chosen to make the blood percolate the parenchyma of the lungs, than as in other instances chosen a direct and obvious course—for I assume that no other path or mode of transit can be entertained. It must be either because the larger and more perfect animals are warmer, and when adult their heat greater—ignited, as I might say, and requiring to be damped or mitigated; therefore it may be that

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the blood is sent through the lungs, that it may he tempered by the air that is inspired, and prevented from boiling up, and so becoming extinguished, or something else of the sort. But to determine these matters, and explain them satisfactorily, were to enter on a speculation in regard to the office of the lungs and the ends for which they exist; and upon such a subject, as well as upon what pertains to eventilation, to the necessity and use of the air, &c., as also to the variety and diversity of organs that exist in the bodies of animals in connexion with these matters, although I have made a vast number of observations, still, lest I should be held as wandering too wide of my present purpose, which is the use and motion of the heart, and be charged with speaking of things beside the question, and rather complicating and quitting than illustrating it, I shall leave such topics till I can more conveniently set them forth in a treatise apart. And now, returning to my immediate subject, I go on with what yet remains for demonstration, viz., that in the more perfect and warmer adult animals, and man, the blood passes from the right ventricle of the heart by the vena arteriosa, or pulmonary artery, into the lungs, and thence by the arterise venosse, or pulmonary veins, into the left auricle, and thence into the left ventricle of the heart. And, first, I shall show that this may be so, and then I shall prove that it is so in fact.

CHAPTER VII. THE BLOOD PERCOLATES THE SUBSTANCE OF THE LUNGS FROM THE RIGHT VENTRICLE OF THE HEART INTO THE PULMONARY VEINS AND LEFT VENTRICLE.

THAT this is possible, and that there is nothing to prevent it from being so, appears when we reflect on the way in which water percolating the earth produces springs and rivulets, or when we speculate on the means by which the sweat passes through the skin, or the urine through the parenchyma of the kidneys. It is well known that persons who use the Spa waters, or those of La Madonna, in the territories of Padua, or others of an acidulous or vitriolated nature, or who simply swallow drinks by the gallon, pass all off again within an hour or two by urine. Such

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a quantity of liquid must take some short time in the concoction : it must pass through the liver; (it is allowed by all that the juices of the food we consume pass twice through this organ in the course of the day;) it must flow through the veins, through the parenchyma of the kidneys, and through the ureters into the bladder. To those, therefore, whom I hear denying that the blood, aye the whole mass of the blood may pass through the substance of the lungs, even as the nutritive juices percolate the liver, asserting such a proposition to be impossible, and by no means to be entertained as credible, I reply, with the poet, that they are of that race of men who, when they will, assent full readily, and when they will not, by no manner of means; who, when their assent is wanted, fear, and when it is not, fear not to give it. The parenchyma of the liver is extremely dense, so is that of the kidney; the lungs, again, are of a much looser texture, and if compared with the kidneys are absolutely spongy. In the liver there is no forcing, no impelling power; in the lungs the blood is forced on by the pulse of the right ventricle, the necessary effect of whose impulse is the distension of the vessels and pores of the lungs. And then the lungs, in respiration, are perpetually rising and falling; motions, the effect of which must needs be to open and shut the pores and vessels, precisely as in the case of a sponge, and of parts having a spongy structure, when they are alternately compressed and again are suffered to expand. The liver, on the contrary, remains at rest, and is never seen to be dilated and constricted. Lastly, if no one denies the possibility of the whole of the ingested juices passing through the liver, in man, oxen, and the larger animals generally, in order to reach the vena cava, and for this reason, that if nourishment is to go on, these juices must needs get into the veins, and there is no other way but the one indicated, why should not the same arguments be held of avail for the passage of the blood in adults through the lungs ? Why not, with Columbus, that skilful and learned anatomist, maintain and believe the like, from the capacity and structure of the pulmonary vessels; from the fact of the pulmonary veins and ventricle corresponding with them, being always found to contain blood, which must needs have come from the veins, and by no other passage save through the lungs ? Columbus, and

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we also, from what precedes, from dissections, and other arguments, conceive the thing to be clear. But as there are some who admit nothing unless upon authority, let them learn that the truth I am contending for can be confirmed from Galen's own words, namely, that not only may the blood be transmitted from the pulmonary artery into the pulmonary veins, then into the left ventricle of the heart, and from thence into the arteries of the body, but that this is effected by the ceaseless pulsation of the heart and the motion of the lungs in breathing. There are, as every one knows, three sigmoid or semilunar valves situated at the orifice of the pulmonary artery, which effectually prevent the blood sent into the vessel from returning into the cavity of the heart. Now Galen, explaining the uses of these valves, and the necessity for them, employs the following language :l " There is everywhere a mutual anastomosis and inosculation of the arteries with the veins, and they severally transmit both blood and spirit, by certain invisible and undoubtedly very narrow passages. Now if the mouth of the vena arteriosa, or pulmonary artery, had stood in like manner continually open, and nature had found no contrivance for closing it when requisite, and opening it again, it would have been impossible that the blood could ever have passed by the invisible and delicate mouths, during the contractions of the thorax, into the arteries; for all things are not alike readily attracted or repelled; but that which is light is more readily drawn in, the instrument being dilated, and forced out again when it is contracted, than that which is heavy; and in like manner is anything drawn more rapidly along an ample conduit, and again driven forth, than it is through a narrow tube. But when the thorax is contracted, the pulmonary veins, which are in the lungs, being driven inwardly, and powerfully compressed on every side, immediately force out some of the spirit they contain, and at the same time assume a certain portion of blood by those subtile mouths; a thing that could never come to pass were the blood at liberty to flow back into the heart through the great orifice of the pulmonary artery. But its return through this great opening being prevented, when it is compressed on every side, a certain portion of it distils into the pulmonary veins 1

De Usu partium, lib. vi, cap. 10.

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by the minute orifices mentioned." And shortly afterwards, in the very next chapter, he says : " The more the thorax contracts, the more it strives to force out the blood, the more exactly do these membranes (viz., the sigmoid valves) close up the mouth of the vessel, and suffer nothing to regurgitate." The same fact he has also alluded to in a preceding part of the tenth chapter: " Were there no valves, a three-fold inconvenience would result, so that the blood would then perform this lengthened course in vain; it would flow inwards during the diastoles of the lungs, and fill all their arteries; but in the systoles, in the manner of the tide, it would ever and anon, like the Euripus, flow backwards and forwards by the same way, with a reciprocating motion, which would nowise suit the blood. This, however, may seem a matter of little moment; but if it meantime appear that the function of respiration suffer, then I think it would be looked upon as no trifle, &c." And again, and shortly afterwards : " And then a third inconvenience, by no means to be thought lightly of, would follow, were the blood moved backwards during the expirations, had not our Maker instituted those supplementary membranes [the sigmoid valves]." Whence, in the eleventh chapter, he concludes: " That they have all a common use, (to wit, the valves,) and that it is to prevent regurgitation or backward motion; each, however, having a proper function, the one set drawing matters from the heart, and preventing their return, the other drawing matters into the heart, and preventing their escape from it. For nature never intended to distress the heart with needless labour, neither to bring aught into the organ which it had been better to have kept away, nor to take from it again aught which it was requisite should be brought. Since, then, there are four orifices in all, two in either ventricle, one of these induces, the other educes." And again he says : " Farther, since there is one vessel, consisting of a simple tunic, implanted in the heart, and another, having a double tunic, extending from it, (Galen is here speaking of the right side of the heart, but I extend his observations to the left side also,) a kind of reservoir had to be provided, to which both belonging, the blood should be drawn in by the one, and sent out by the other." This argument Galen adduces for the transit of the blood by the right ventricle from the vena cava into the lungs; but we

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can use it with still greater propriety, merely changing the terms, for the passage of the blood from the veins through the heart into the arteries. From Galen, however, that great man, that father of physicians, it clearly appears that the blood passes through the lungs from the pulmonary artery into the minute branches of the pulmonary veins, urged to this both by the pulses of the heart and by the motions of the lungs and thorax; that the heart, moreover, is incessantly receiving and expelling the blood by and from its ventricles, as from a magazine or cistern, and for this end is furnished with four sets of valves, two serving for the induction and two for the eduction of the blood, lest, like the Euripus, it should be incommodiously sent hither and thither, or flow back into the cavity which it should have quitted, or quit the part where its presence was required, and so the heart be oppressed with labour in vain, and the office of the lungs be interfered with.1 Finally, our position that the blood is continually passing from the right to the left ventricle, from the vena cava into the aorta, through the porous structure of the lungs, plainly appears from this, that since the blood is incessantly sent from the right ventricle into the lungs by the pulmonary artery, and in like manner is incessantly drawn from the lungs into the left ventricle, as appears from what precedes and the position of the valves, it cannot do otherwise than pass through continuously. And then, as the blood is incessantly flowing into the right ventricle of the heart, and is continually passed out from the left, as appears in like manner, and as is obvious both to sense and reason, it is impossible that the blood can do otherwise than pass continually from the vena cava into the aorta. Dissection consequently shows distinctly what takes place [in regard to the transit of the blood] in the greater number of animals, and indeed in all, up to the period of their [foetal] maturity; and that the same thing occurs in adults is equally certain, both from Galen's words, and what has already been said on the subject, only that in the former the transit is effected by open and obvious passages, in the latter by the obscure porosities of the lungs and the minute inoscula1

See the Commentary of the learned Hofmann upon the Sixth Book of Galen, ' De Usu partium/ a work which I first saw after I had written what precedes.

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tions of vessels. Whence it appears that, although one ventricle of the heart, the left to wit, would suffice for the distribution of the blood over the body, and its eduction from the vena cava, as indeed is done in those creatures that have no lungs, nature, nevertheless, when she ordained that the same blood should also percolate the lungs, saw herself obliged to add another ventricle, the right, the pulse of which should force the blood from the vena cava through the lungs into the cavity of the left ventricle. In'this way, therefore, it may be said that the right ventricle is made for the sake of the lungs, and for the transmission of the blood through them, not for their nutrition; seeing it were unreasonable to suppose that the lungs required any so much more copious a supply of nutriment, and that of so much purer and more spirituous a kind, as coming immediately from the ventricle of the heart, than either the brain with its peculiarly pure substance, or the eyes with their lustrous and truly admirable structure, or the flesh of the heart itself, which is more commodiously nourished by the coronary artery.

CHAPTER VIII. OF THE QUANTITY OF BLOOD PASSING THROUGH THE HEART FROM THE VEINS TO THE ARTERIES; AND OF THE CIRCULAR MOTION OF THE BLOOD.

THUS far I have spoken of the passage of the blood from the veins into the arteries, and of the manner in which it is transmitted and distributed by the action of the heart; points to which some, moved either by the authority of Galen or Columbus, or the reasonings of others, will give in their adhesion. But what remains to be said upon the quantity and sourceof the blood which thus passes, is of so novel and unheard-of character, that I not only fear injury to myself from the envy of a few, but I tremble lest I have mankind at large for my enemies, so much doth wont and custom, that become as another nature, and doctrine once sown and that hath struck deep root, and respect for antiquity influence all men: Still the die is cast, and my trust is in my love of truth, and the candour that inheres in cultivated minds. And sooth to say, when I surveyed my mass of evidence, whe-

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ther derived from vivisections, and my various reflections on them, or from the ventricles of the heart and the vessels that enter into and issue from them, the symmetry and size of these conduits,—for nature doing nothing in vain, would never have given them so large a relative size without a purpose,—or from the arrangement and intimate structure of the valves in particular, and of the other parts of the heart in general, with many things besides, I frequently and seriously bethought me, and long revolved in my mind, what might be the quantity of blood which was transmitted, in how short a time its passage might be effected, and the like; and not finding it possible that this could be supplied by the juices of the ingested aliment without the veins on the one hand becoming drained, and the arteries on the other getting ruptured through the excessive charge of blood, unless the blood should somehow find its way from the arteries into the veins, and so return to the right side of the heart; I began to think whether there might not be A MOTION, AS IT WERE, IN A CIRCLE. Now this I afterwards found to be true; and I finally saw that the blood, forced by the action of the left ventricle into the arteries, was distributed to the body at large, and its several parts, in the same manner as it is sent through the lungs, impelled by the right ventricle into the pulmonary artery, and that it then passed through the veins and along the vena cava, and so round to the left ventricle in the manner already indicated. Which motion we may be allowed to call circular, in the same way as Aristotle says that the air and the rain emulate the circular motion of the superior bodies; for the moist earth, warmed by the sun, evaporates; the vapours drawn upwards are condensed, and descending in the form of rain, moisten the earth again; and by this arrangement are generations of living things produced; and in like manner too are tempests and meteors engendered by the circular motion, and by the approach and recession of the sun. And so, in all likelihood, does it come to pass in the body, through the motion of the blood; the various parts are nourished, cherished, quickened by the warmer, more perfect, vaporous, spirituous, and, as I may say, alimentive blood; which, on the contrary, in contact with these parts becomes cooled, coagulated, and, so to speak, effete; whence it returns to its sovereign the heart, as if to its source, or to the inmost

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home of the body, there to recover its state of excellence or perfection. Here it resumes its due fluidity and receives an infusion of natural heat—powerful, fervid, a kind of treasury of life, and is impregnated with spirits, and it might be said with balsam; and thence it is again dispersed; and all this depends on the motion and action of the heart. The heart, consequently, is the beginning of life; the sun of the microcosm, even as the sun in his turn might well be designated the heart of the world; for it is the heart by whose virtue and pulse the blood is moved, perfected, made apt to nourish, and is preserved from corruption and coagulation; it is the household divinity which, discharging its function, nourishes, cherishes, quickens the whole body, and is indeed the foundation of life, the source of all action. But of these things we shall speak more opportunely when we come to speculate upon the final cause of this motion of the heart. Hence, since the veins are the conduits and vessels that transport the blood, they are of two kinds, the cava and the aorta; and this not by reason of there being two sides of the body, as Aristotle has it, but because of the difference of office; nor yet, as is commonly said, in consequence of any diversity of structure, for in many animals, as I have said, the vein does not differ from the artery in the thickness of its tunics, but solely in virtue of their several destinies and uses* A vein and an artery, both styled vein by the ancients, and that not undeservedly, as Galen has remarked, because the one, the artery to wit, is the vessel which carries the blood from the heart to the body at large, the other or vein of the present day bringing it back from the general system to the heart; the former is the conduit from, the latter the channel to, the heart; the latter contains the cruder, effete blood, rendered unfit for nutrition; the former transmits the digested, perfect, peculiarly nutritive fluid.

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CHAPTER IX. THAT THEEE IS A CIRCULATION OF THE BLOOD IS CONFIRMED FROM THE FIRST PROPOSITION.

BUT lest any one should say that we give them words only, and make mere specious assertions without any foundation, and desire to innovate without sufficient cause, three points present themselves for confirmation, which being stated, I conceive that the truth I contend for will follow necessarily, and appear as a thing obvious to all. First,—the blood is incessantly transmitted by the action of the heart from the vena cava to the arteries in such quantity, that it cannot be supplied from the ingesta, and in such wise that the whole mass must very quickly pass through the organ; Second,—the blood under the influence of the arterial pulse enters and is impelled in a continuous, equable, and incessant stream through every part and member of the body, in much larger quantity than were sufficient for nutrition, or than the whole mass of fluids could supply; Third,—the veins in like manner return this blood incessantly to the heart from all parts and members of the body. These points proved, I conceive it will be manifest that the blood circulates, revolves, propelled and then returning, from the heart to the extremities, from the extremities to the heart, and thus that it performs a kind of circular motion. Let us assume either arbitrarily or from experiment, the quantity of blood which the left ventricle of the heart will contain when distended to be, say two ounces, three ounces, one ounce and a half—in the dead body I have found it to hold upwards of two ounces. Let us assume further, how much less the heart will hold in the contracted than in the dilated state; and how much blood it will project into the aorta upon each contraction; —and all the world allows that with the systole something is always projected, a necessary consequence demonstrated in the third chapter, and obvious from the structure of the valves; and let us suppose as approaching the truth that the fourth, or fifth, or sixth, or even but the eighth part of ita charge is thrown into the artery at each contraction; this would give either half an ounce, or three drachms, or one drachm of blood as

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propelled by the heart at each pulse into the aorta; which quantity, by reason of the valves at the root of the vessel, can by no means return into the ventricle. Now in the course of half an hour, the heart will have made more than one thousand beats, in some as many as two, three, and even four thousand. Multiplying the number of drachms propelled by the number of pulses, we shall have either one thousand half ounces, or one thousand times three drachms, or a like proportional quantity of blood, according to the amount which we assume as propelled with each stroke of the heart, sent from this organ into the artery; a larger quantity in every case than is contained in the whole body! In the same way, in the sheep or dog, say that but a single scruple of blood passes with each stroke of the heart, in one half hour we should have one thousand scruples, or about three pounds and a half of blood injected into the aorta; but the body of neither animal contains above four pounds of blood, a fact which I have myself ascertained in the case of the sheep. Upon this supposition, therefore, assumed merely as a ground for reasoning, we see the whole mass of blood passing through the heart, from the veins to the arteries, and in like manner through the lungs. But let it be said that this does not take place in half an hour, but in an hour, or even in a day; any way it is still manifest that more blood passes through the heart in consequence of its action, than can either be supplied by the whole of the ingesta, or than can be contained in the veins at the same moment. Nor can it be allowed that the heart in contracting sometimes propels and sometimes does not propel, or at most propels but very little, a mere nothing, or an imaginary something: all this, indeed, has already been refuted; and is, besides, contrary both to sense and reason. For if it be a necessary effect of the dilatation of the heart that its ventricles become filled with blood, it is equally so that, contracting, these cavities should expel their contents; and this not in any trifling measure, seeing that neither are the conduits small, nor the contractions few in number, but frequent, and always in some certain proportion, whether it be a third or a sixth, or an eighth, to the total capacity of the ventricles, so that a like proportion 4

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of blood must be expelled, and a like proportion received with each stroke of the heart, the capacity of the ventricle contracted always bearing a certain relation to the capacity of the ventricle when dilated. And since in dilating, the ventricles cannot be supposed to get filled with nothing, or with an imaginary something; so in contracting they never expel nothing or aught imaginary, but always a certain something, viz. blood, in proportion to the amount of the contraction. Whence it is to be inferred, that if at one stroke the heart in man, the ox or the sheep, ejects but a single drachm of blood, and there are one thousand strokes in half an hour, in this interval there will have been ten pounds five ounces expelled: were there with each stroke two drachms expelled, the quantity would of course amount to twenty pounds and ten ounces; were there half an ounce, the quantity would come to forty-one pounds and eight ounces; and were there one ounce it would be as much as eighty-three pounds and four ounces; the whole of which, in the course of one half hour, would have been transfused from the veins to the arteries. The actual quantity of blood expelled at each stroke of the heart, and the circumstances under which it is either greater or less than ordinary, I leave for particular determination afterwards, from numerous observations which I have made on the subject. Meantime this much I know, and would here proclaim to all that the blood is transfused at one time in larger, at another in smaller quantity; and that the circuit of the blood is accomplished now more rapidly, now more slowly, according to the temperament, age, &c. of the individual, to external and internal circumstances, to naturals and non-naturals,—sleep, rest, food, exercise, affections of the mind, and the like. But indeed, supposing even the smallest quantity of blood to be passed through the heart and the lungs with each pulsation, a vastly greater amount would still be thrown into the arteries and whole body, than could by any possibility be supplied by the food consumed; in short it could be furnished in no other way than by making a circuit and returning. This truth, indeed, presents itself obviously before us when we consider what happens in the dissection of living animals; the great artery need not be divided, but a very small branch only, (as Galen even proves in regard to man,) to have the whole

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of the blood in the body, as well that of the veins as of the arteries, drained away in the course of no long time—some half hour or less. Butchers are well aware of the fact and can bear witness to it; for, cutting the throat of an ox and so dividing the vessels of the neck, in less than a quarter of an hour they have all the vessels bloodless—the whole mass of blood has escaped. The same thing also occasionally occurs with great rapidity in performing amputations and removing tumours in the human subject. Nor would this argument lose any of its force, did any one say that in killing animals in the shambles, and performing amputations, the blood escaped in equal, if not perchance in larger quantity by the veins than by the arteries. The contrary of this statement, indeed, is certainly the truth; the veins, in fact, collapsing, and being without any propelling power, and further, because of the impediment of the valves, as I shall show immediately, pour out but very little blood; whilst the arteries spout it forth with force abundantly, impetuously, and as if it were propelled by a syringe. And then the experiment is easily tried of leaving the vein untouched, and only dividing the artery in the neck of a sheep or dog, when it will be seen with what force, in what abundance, and how quickly, the whole blood in the body, of the veins as well as of the arteries, is emptied. But the arteries receive blood from the veins in no other way than by transmission through the heart, as we have already seen; so that if the aorta be tied at the base of the heart, and the carotid or any other artery be opened, no one will now be surprised to find it empty, and the veins only replete with blood. And now the cause is manifest, wherefore in our dissections we usually find so large a quantity of blood in the veins, so little in the arteries; wherefore there is much in the right ventricle, little in the left; circumstances which probably led the ancients to believe that the arteries (as their name implies) contained nothing but spirits during the life of an animal. The true cause of the difference is this perhaps: that as there is no passage to the arteries, save through the lungs and heart, when an animal has ceased to breathe and the lungs to move, the blood in the pulmonary artery is prevented from passing into the pulmonary veins, and from thence into the left ventricle of the heart; just as we have already seen the same transit prevented in the embryo, by the want of movement in the lungs and the alternate

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opening and shutting of their minute orifices and invisible pores. But the heart not ceasing to act at the same precise moment as the lungs, but surviving them and continuing to pulsate for a time, the left ventricle and arteries go on distributing their blood to the body at large and sending it into the veins; receiving none from the lungs, however, they are soon exhausted, and left, as it were, empty. But even this fact confirms our views, in no trifling manner, seeing that it can be ascribed to no other than the cause we have just assumed. Moreover it appears from this that the more frequently or forcibly the arteries pulsate, the more speedily will the body be exhausted in an hemorrhagy. Hence, also, it happens, that in fainting fits and in states of alarm, when the heart beats more languidly and with less force, hemorrhages are diminished or arrested. Still further, it is from this that after death, when the heart has ceased to beat, it is impossible by dividing either the jugular or femoral veins and arteries, by any effort to force out more than one half of the whole mass of the blood. Neither could the butcher, did he neglect to cut the throat of the ox which he has knocked on the head and stunned, until the heart had ceased beating, ever bleed the carcass effectually. Finally, we are now in a condition to suspect wherefore it is that no one has yet said anything to the purpose upon the anastomosis of the veins and arteries, either as to where or how it is effected, or for what purpose. I now enter upon the investigation of the subject.

CHAPTER X. THE FIRST POSITION : OP THE QUANTITY OF BLOOD PASSING FROM THE VEINS TO THE ARTERIES.

AND THAT THERE IS A CIR-

CUIT OF THE BLOOD, FREED FROM OBJECTIONS, AND FARTHER CONFIRMED BY EXPERIMENT.

So far our first position is confirmed, whether the thing be referred to calculation or to experiment and dissection, viz., that the blood is incessantly infused into the arteries in larger quantities than it can be supplied by the food; so that the

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whole passing over in a short space of time, it is matter of necessity that the blood perform a circuit, that it return to whence it set out. But if any one shall here object that a large quantity may pass through and yet no necessity be found for a circulation, that all may come from the meat and drink consumed, and quote as an illustration the abundant supply of milk in the mammae—for a cow will give three, four, and even seven gallons and more in a day, and a woman two or three pints whilst nursing a child or twins, which must manifestly be derived from the food consumed ; it may be answered, that the heart by computation does as much and more in the course of an hour or two. And if not yet convinced, he shall still insist, that when an artery is divided a preternatural route is, as it were, opened, and that so the blood escapes in torrents, but that the same thing does not happen in the healthy and uninjured body when no outlet is made; and that in arteries filled, or in their natural state, so large a quantity of blood cannot pass in so short a space of time as to make any return necessary;—to all this it may be answered, that from the calculation already made, and the reasons assigned, it appears, that by so much as the heart in its dilated state contains in addition to its contents in the state of constriction, so much in a general way must it emit upon each pulsation, and in such quantity must the blood pass, the body being healthy and naturally constituted. But in serpents, and several fishes, by tying the veins some way below the heart, you will perceive a space between the ligature and the heart speedily to become empty; so that, unless you would deny the evidence of your senses, you must needs admit the return of the blood to the heart. The same thing will also plainly appear when we come to discuss our second position. Let us here conclude with a single example, confirming all that has been said, and from which every one may obtain conviction through the testimony of his own eyes. If a live snake be laid open, the heart will be seen pulsating quietly, distinctly, for more than an hour, moving like a worm, contracting in its longitudinal dimensions, (for it is of an oblong shape,) and propelling its contents; becoming of a paler colour in the systole, of a deeper tint in the diastole; and almost all things else by which I have already said that the truth I contend for

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is established, only that here everything takes place more slowly, and is more distinct. This point in particular may be observed more clearly than the noon-day sun: the vena cava enters the heart at its lower part, the artery quits it at the superior part; the vein being now seized either with forceps or between the finger and thumb, and the course of the blood for some space below the heart interrupted, you will perceive the part that intervenes between the fingers and the heart almost immediately to become empty, the blood being exhausted by the action of the heart; at the same time the heart will become of a much paler colour, even in its state of dilatation, than it was before; it is also smaller than at first, from wanting blood; and then it begins to beat more slowly, so that it seems at length as if it were about to die. But the impediment to the flow of blood being removed, instantly the colour and the size of the heart are restored. If, on the contrary, the artery instead of the vein be compressed or tied, you will observe the part between the obstacle and the heart, and the heart itself, to become inordinately distended, to assume a deep purple or even livid colour, and at length to be so much oppressed with blood that you will believe it about to be choked; but the obstacle removed, all things immediately return to their pristine state—the heart to its colour, size, stroke, &c. Here then we have evidence of two kinds of death: extinction from deficiency, and suffocation from excess. Examples of both have now been set before you, and you have had opportunity of viewing the truth contended for with your own eyes in the heart.

CHAPTER XI. THE SECOND POSITION IS DEMONSTRATED.

THAT this may the more clearly appear to every one, I have here to cite certain experiments, from which it seems obvious that the blood enters a limb by the arteries, and returns from it by the veins; that the arteries are the vessels carrying the blood from the heart, and the veins the returning channels of the blood to the heart; that in the limbs and extreme parts of the body the blood passes either immediately by anastomosis from the arteries into the veins, or mediately by the pores of

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the flesh, or in both ways, as has already been said in speaking of the passage of the blood through the lungs; whence it appears manifest that in the circuit the blood moves from thence hither, and from hence thither; from the centre to the extremities, to wit; and from the extreme parts back again to the centre. Finally, upon grounds of calculation, with the same elements as before, it will be obvious that the quantity can neither be accounted for by the ingesta, nor yet be held necessary to nutrition. The same thing will also appear in regard to ligatures, and wherefore they are said to draw; though this is neither from the heat, nor the pain, nor the vacuum they occasion, nor indeed from any other cause yet thought of; it will also explain the uses and advantages to be derived from ligatures in medicine, the principle upon which they either suppress or occasion hemorrhage; how they induce sloughing and more extensive mortification in extremities; and how they act in the castration of animals and the removal of warts and fleshy tumours. But it has come to pass, from no one having duly weighed and understood the causes arid rationale of these various effects, that though almost all, upon the faith of the old writers, recommend ligatures in the treatment of disease, yet very few comprehend their proper employment, or derive any real assistance from them in effecting cures. Ligatures are either very tight or of middling tightness. A ligature I designate as tight or perfect when it is drawn so close about an extremity that no vessel can be felt pulsating beyond it. Such a ligature we use in amputations to control the flow of blood; and such also are employed in the castration of animals and the removal of tumours. In the latter instances, all afflux of nutriment and heat being prevented by the ligature, we see the testes and large fleshy tumours dwindle, and die, and finally fall off. Ligatures of middling tightness I regard as those which compress a limb firmly all around, but short of pain, and in such a way as still suffers a certain degree of pulsation to be felt in the artery beyond them. Such a ligature is in use in bloodletting, an operation in which the fillet applied above the elbow is not drawn so tight but that the arteries at the wrist may still be felt beating under the finger. Now let any one make an experiment upon the arm of a man,

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either using such a fillet as is employed in bloodletting, or grasping the limb lightly with his hand, the best subject for it being one who is lean, and who has large veins, and the best time after exercise, when the body is warm, the pulse is full, and the blood carried in larger quantity to the extremities, for all then is more conspicuous; under such circumstances let a ligature be thrown about the extremity, and drawn as tightly as can be borne, it will first be perceived that beyond the ligature, neither in the wrist nor anywhere else, do the arteries pulsate, at the same time that immediately above the ligature the artery begins to rise higher at each diastole, to throb more violently, and to swell in its vicinity with a kind of tide, as if it strove to break through and overcome the obstacle to its current; the artery here, in short, appears as if it were preternaturally fait The hand under such circumstances retains its natural colour and appearance; in the course of time it begins to fall somewhat in temperature, indeed, but nothing is drawn into it. After the bandage has been kept on for some short time in this way, let it be slackened a little, brought to that state or term of middling tightness which is used in bleeding, and it will be seen that the whole hand and arm will instantly become deeply suffused and distended, and the veins show themselves tumid and knotted; after ten or fifteen pulses of the artery, the hand will be perceived excessively distended, injected, gorged with blood, drawn, as it is said, by this middling ligature, without pain, or heat, or any horror of a vacuum, or any other cause yet indicated. If the finger be applied over the artery as it is pulsating by the edge of the fillet, at the moment of slackening it, the blood will be felt to glide through, as it were, underneath the finger; and he, too, upon whose arm the experiment is made, when the ligature is slackened, is distinctly conscious of a sensation of warmth, and of something, viz., a stream of blood suddenly making its way along the course of the vessels and diffusing itself through the hand, which at the same time begins to feel hot, and becomes distended. As we had noted, in connexion with the tight ligature, that the artery above the bandage was distended and pulsated, not below it, so, in the case of the moderately tight bandage, on the contrary, do we find that the veins below, never above,

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the fillet, swell, and become dilated, whilst the arteries shrink; and such is the degree of distension of the veins here, that it is only very strong pressure that will force the blood beyond the fillet, and cause any of the veins in the upper part of the arm to rise. From these facts it is easy for every careful observer to learn that the blood enters an extremity by the arteries; for when they are effectually compressed nothing is drawn to the member ; the hand preserves its colour; nothingflowsinto it, neither is it distended; but when the pressure is diminished, as it is with the bleeding fillet, it is manifest that the blood is instantly thrown in with force, for then the hand begins to swell; which is as much as to say, that when the arteries pulsate the blood is flowing through them, as it is when the moderately tight ligature is applied; but where they do not pulsate, as, when a tight ligature is used, they cease from transmitting anything; they are only distended above the part where the ligature is applied. The veins again being compressed, nothing can flow through them; the certain indication of which is, that below the ligature they are much more tumid than above it, and than they usually appear when there is no bandage upon the arm. It therefore plainly appears that the ligature prevents the return of the blood through the veins to the parts above it, and maintains those beneath it in a state of permanent distension. But the arteries, in spite of its pressure, and under the force and impulse of the heart, send on the blood from the internal parts of the body to the parts beyond the bandage. And herein consists the difference between the tight and the medium bandage, that the former not only prevents the passage of the blood in the veins, but in the arteries also; the latter, however, whilst it does not prevent the pulsific force from extending beyond it, and so propelling the blood to the extremities of the body, compresses the veins, and greatly, or altogether impedes the return of the blood through them. Seeing, therefore, that the moderately tight ligature renders the veins turgid, and the whole hand full of blood, I ask, whence is this ? Does the blood accumulate below the ligature coming through the veins, or through the arteries, or passing by certain secret pores ? Through the veins it cannot come; still less can it come by any system of invisible pores; it must needs arrive by the

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arteries, then, in conformity with all that has been already said. That it cannot flow in by the veins appears plainly enough from the fact that the blood cannot be forced towards the heart unless the ligature be removed; when on a sudden all the veins collapse, and disgorge themselves of their contents into the superior parts, the hand at the same time resuming its natural pale colour,—the tumefaction and the stagnating blood have disappeared. Moreover, he whose arm or wrist has thus been bound for some little time with the medium bandage, so that it has not only got swollen and livid but cold, when the fillet is undone is aware of something cold making its way upwards along with the returning blood, and reaching the elbow or the axilla. And I have myself been inclined to think that this cold blood rising upwards to the heart was the cause of the fainting that often occurs after bloodletting: fainting frequently supervenes even in robust subjects, and mostly at the moment of undoing the fillet, as the vulgar say, from the turning of the blood. Farther, when we see the veins below the ligature instantly swell up and become gorged, when from extreme tightness it is somewhat relaxed, the arteries meantime continuing unaffected, this is an obvious indication that the blood passes from the arteries into the veins, and not from the veins into the arteries, and that there is either an anastomosis of the two orders of vessels, or pores in the flesh and solid parts generally that are permeable to the blood. It is farther an indication that the veins have frequent communications with one another, because they all become turgid together, whilst under the medium ligature applied above the elbow; and if any single small vein be pricked with a lancet, they all speedily shrink, and disburdening themselves into this they subside almost simultaneously. These considerations will enable any one to understand the nature of the attraction that is exerted by ligatures, and perchance of fluxes generally; how, for example, the veins when compressed by a bandage of medium tightness applied above the elbow, the blood cannot escape, whilst it still continues to be driven in, to wit, by the forcing power of the heart, by which the parts are of necessity filled, gorged with blood. And how should it be otherwise ? Heat and pain and the vis vacui draw, indeed; but in such wise only that parts are filled, not pre-

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ternaturally distended or gorged, not so suddenly and violently overwhelmed with the charge of blood forced in upon them, that the flesh is lacerated and the vessels ruptured. Nothing of the kind as an effect of heat, or pain, or the vacuum force, is either credible or demonstrable. Besides, the ligature is competent to occasion the afflux in question without either pain, or heat, or vis vacui. Were pain in any way the cause, how should it happen that, with the arm bound above the elbow, the hand and fingers should swell below the bandage, and their veins become distended ? The pressure of the bandage certainly prevents the blood from getting there by the veins. And then, wherefore is there neither swelling nor repletion of the veins, nor any sign or symptom of attraction or afflux, above the ligature ? But this is the obvious cause of the preternatural attraction and swelling below the bandage, and in the hand and fingers, that the blood is entering abundantly, and with force, but cannot pass out again. Now is not this the cause of all tumefaction, as indeed Avicenna has it, and of all oppressive redundancy in parts, that the access to them is open, but the egress from them is closed ? Whence it comes that they are gorged and tumefied. And may not the same thing happen in local inflammations, where, so long as the swelling is on the increase, and has not reached its extreme term, a full pulse is felt in the part, especially when the disease is of the more acute kind, and the swelling usually takes place most rapidly. But these are matters for after discussion. Or does this, which occurred in my own case, happen from the same cause. Thrown from a carriage upon one occasion, I struck my forehead a blow upon the place where a twig of the artery advances from the temple, and immediately, within the time in which twenty beats could have been made, I felt a tumour the size of an egg developed, without either heat or any great pain: the near vicinity of the artery had caused the blood to be effused into the bruised part with unusual force and quickness. And now, too, we understand wherefore in phlebotomy we apply our fillet above the part that is punctured, not below it; did the flow come from above, not from below, the bandage in this case would not only be of no service, but would prove a positive hinderance; it would have to be applied below the orifice,

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in order to have the flow more free, did the blood descend by the veins from superior to inferior parts; but as it is elsewhere forced through the extreme arteries into the extreme veins, and the return in these last is opposed by the ligature, so do they fill and swell, and being thus filled and distended, they are made capable of projecting their charge with force, and to a distance, when any one of them is suddenly punctured; but the fillet being slackened, and the returning channels thus left open, the blood forthwith no longer escapes, save by drops; and, as all the world knows, if in performing phlebotomy the bandage be either slackened too much or the limb be bound too tightly, the blood escapes without force, because in the one case the returning channels are not adequately obstructed; in the other the channels of influx, the arteries, are impeded.

CHAPTER XII. THAT THERE IS A CIRCULATION OF THE BLOOD IS SHOWN FROM THE SECOND POSITION DEMONSTRATED.

IF these things be so, another point which I have already referred to, viz., the continual passage of the blood through the heart will also be confirmed. We have seen, that the blood passes from the arteries into the veins, not from the veins into the arteries; we have seen, farther, that almost the whole of the blood may be withdrawn from a puncture made in one of the cutaneous veins of the arm if a bandage properly applied be used; we have seen, still farther, that the blood flows so freely and rapidly that not only is the whole quantity which was contained in the arm beyond the ligature, and before the puncture was made, discharged, but the whole which is contained in the body, both that of the arteries and that of the veins. Whence we must admit, first, that the blood is sent along with an impulse, and that it is urged with force below the fillet; for it escapes with force, which force it receives from the pulse and power of the heart; for the force and motion of the blood are derived from the heart alone. Second, that the afflux proceeds from the heart, and through the heart by a course from the great veins [into the aorta] ; for it gets into the parts below the liga-

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ture through the arteries, not through the veins; and the arteries nowhere receive blood from the veins, nowhere receive blood save and except from the left ventricle of the heart. Nor could so large a quantity of blood be drawn from one vein (a ligature having been duly applied), nor with such impetuosity, such readiness, such celerity, unless through the medium of the impelling power of the heart. But if all things be as they are now represented, we shall feel ourselves at liberty to calculate the quantity of the blood, and to reason on its circular motion. Should any one, for instance, in performing phlebotomy, suffer the blood to flow in the manner it usually does, with force and freely, for some half hour or so, no question but that the greatest part of the blood being abstracted, faintings and syncopes would ensue, and that not only would the arteries but the great veins also be nearly emptied of their contents. It is only consonant with reason to conclude that in the course of the half hour hinted at, so much as has escaped has also passed from the great veins through the heart into the aorta. And further, if we calculate how many ounces flow through one arm, or how many pass in twenty or thirty pulsations under the medium ligature, we shall have some grounds for estimating how much passes through the other arm in the same space of time; how much through both lower extremities, how much through the neck on either side, and through all the other arteries and veins of the body, all of which have been supplied with fresh blood, and as this blood must have passed through the lungs and ventricles of the heart, and must have come from the great veins,—we shall perceive that a circulation is absolutely necessary, seeing that the quantities hinted at cannot be supplied immediately from the ingesta, and are vastly more than can be requisite for the mere nutrition of the parts. It is still further to be observed, that the truths contended for are sometimes confirmed in another way; for having tied up the arm properly, and made the puncture duly, still, if from alarm or any other causes, a state of faintness supervenes, in which the heart always pulsates more languidly, the blood does not flow freely, but distils by drops only. The reason is, that with the somewhat greater than usual resistance offered to the transit of the blood by the bandage, coupled with the weaker

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action of the heart, and its diminished impelling power, the stream cannot make its way under the fillet; and farther, owing to the weak and languishing state of the heart, the blood is not transferred in such quantity as wont from the veins to the arteries through the sinuses of that organ. So also, and for the same reasons, are the menstrual fluxes of women, and indeed hemorrhagies of every kind, controlled. And now, a contrary state of things occurring, the patient getting rid of his fear and recovering his courage, the pulsific power is increased, the arteries begin again to beat with greater force, and to drive the blood even into the part that is bound; so that the blood now springs from the puncture in the vein, and flows in a continuous stream.

CHAPTER XIII. THE THIRD POSITION IS CONFIRMED : AND THE CIRCULATION OF THE BLOOD IS DEMONSTRATED FROM IT.

THUS far have we spoken of the quantity of blood passing through the heart and the lungs in the centre of the body, and in like manner from the arteries into the veins in the peripheral parts and the body at large. We have yet to explain, however, in what manner the blood finds its way back to the heart from the extremities by the veins, and how and in what way these are the only vessels that convey the blood from the external to the central parts; which done, I conceive that the three fundamental propositions laid down for the circulation of the blood will be so plain, so well established, so obviously true, that they may claim general credence. Now the remaining position will be made sufficiently clear from the valves which are found in the cavities of the veins themselves, from the uses of these, and from experiments cognizable by the senses. The celebrated Hieronymus Fabricius of Aquapendente, a most skilful anatomist, and venerable old man, or, as the learned Biolan will have it, Jacobus Silvius, first gave representations of the valves in the veins, which consist of raised or loose portions of the inner membranes of these vessels, of extreme delicacy, and a sigmoid or semilunar shape. They are situ-

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ated at different distances from one another, and diversely in different individuals; they are connate at the sides of the veins; they are directed upwards or towards the trunks of the veins; the two—for there are for the most part two together—regard each other, mutually touch, and are so ready to come into contact by their edges, that if anything attempt to pass from the trunks into the branches of the veins, or from the greater vessels into the less, they completely prevent it; they are farther so arranged, that the horns of those that succeed are opposite the middle of the convexity of those that precede, and so on alternately. The discoverer of these valves did not rightly understand their use, nor have succeeding anatomists added anything to our knowledge: for their office is by no means explained when we are told that it is to hinder the blood, by its weight, from all flowing into inferior parts; for the edges of the valves in the jugular veins hang downwards, and are so contrived that they prevent the blood from rising upwards; the valves, in a word, do not invariably look upwards, but always towards the trunks of the veins, invariably towards the seat of the heart. I, and indeed others, have sometimes found valves in the emulgent veins, and in those of the mesentery, the edges of which were directed towards the vena cava and vena portse. Let it be added that there are no valves in the arteries [save at their roots], and that dogs, oxen, &c., have invariably valves at the divisions of their crural veins, in the veins that meet towards the top of the os sacrum, and in those branches which come from the haunches, in which no such effect of gravity from the erect position was to be apprehended. Neither are there valves in the jugular veins for the purpose of guarding against apoplexy, as some have said; because in sleep the head is more apt to be influenced by the contents of the carotid arteries. Neither are the valves present, in order that the blood may be retained in the divarications or smaller trunks and minuter branches, and not be suffered to flow entirely into the more open and capacious channels; for they occur where there are no divarications ; although it must be owned that they are most frequent at the points where branches join. Neither do they exist for the purpose of rendering the current of blood more slow from the centre of the body; for it seems likely that the blood would be disposed to flow with sufficient slowness of its own accord,

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as it would have to pass from larger into continually smaller vessels, being separated from the mass and fountain head, and attaining from warmer into colder places. But the valves are solely made and instituted lest the blood should pass from the greater into the lesser veins, and either rupture them or cause them to become varicose; lest, instead of advancing from the extreme to the central parts of the body, the blood should rather proceed along the veins from the centre to the extremities; but the delicate valves, while they readily open in the right direction, entirely prevent all such contrary motion, being so situated and arranged, that if anything escapes, or is less perfectly obstructed by the cornua of the one above, the fluid passing, as it were, by the chinks between the cornua, it is immediately received on the convexity of the one beneath, which is placed transversely with reference to the former, and so is effectually hindered from getting any farther. And this I have frequently experienced in my dissections of the veins : if I attempted to pass a probe from the trunk of the veins into one of the smaller branches, whatever care I took I found it impossible to introduce it far any way, by reason of the valves; whilst, on the contrary, it was most easy to push it along in the opposite direction, from without inwards, or from the branches towards the trunks and roots. In many places two valves are so placed and fitted, that when raised they come exactly together in the middle of the vein, and are there united by the contact of their margins; and so accurate is the adaptation, that neither by the eye nor by any other means of examination can the slightest chink along the line of contact be perceived. But if the probe be now introduced from the extreme towards the more central parts, the valves, like the floodgates of a river, give way, and are most readily pushed aside. The effect of this arrangement plainly is to prevent all motion of the blood from the heart and vena cava, whether it be upwards towards the head, or downwards towards the feet, or to either side towards the arms, not a drop