قراءة كتاب William Harvey and the Discovery of the Circulation of the Blood

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William Harvey and the Discovery of the Circulation of the Blood

William Harvey and the Discovery of the Circulation of the Blood

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discovered what is loosely called the 'pulmonary circulation'; and it really is quite absurd, in the face of the fact, that twenty years afterwards we find Ambrose Pare, the great French surgeon, ascribing this discovery to him as a matter of common notoriety, to find that attempts are made to give the credit of it to other people. So far as I know, this discovery of the course of the blood through the lungs, which is called the pulmonary circulation, is the one step in real advance that was made between the time of Galen and the time of Harvey. And I would beg you to note that the word "circulation" is improperly employed when it is applied to the course of the blood through the lungs. The blood from the right side of the heart, in getting to the left side of the heart, only performs a half-circle—it does not perform a whole circle—it does not return to the place from whence it started; and hence the discovery of the so-called "pulmonary circulation" has nothing whatever to do with that greater discovery which I shall point out to you by-and-by was made by Harvey, and which is alone really entitled to the name of the circulation of the blood.

If anybody wants to understand what Harvey's great desert really was, I would suggest to him that he devote himself to a course of reading, which I cannot promise shall be very entertaining, but which, in this respect at any rate, will be highly instructive—namely, the works of the anatomists of the latter part of the 16th century and the beginning of the 17th century. If anybody will take the trouble to do that which I have thought it my business to do, he will find that the doctrines respecting the action of the heart and the motion of the blood which were taught in every university in Europe, whether in Padua or in Paris, were essentially those put forward by Galen, 'plus' the discovery of the pulmonary course of the blood which had been made by Realdus Columbus. In every chair of anatomy and physiology (which studies were not then separated) in Europe, it was taught that the blood brought to the liver by the portal vein, and carried out of the liver to the 'vena cava' by the hepatic vein, is distributed from the right side of the heart, through the other veins, to all parts of the body; that the blood of the arteries takes a like course from the heart towards the periphery; and that it is there, by means of the 'anastomoses', more or less mixed up with the venous blood. It so happens, by a curious chance, that up to the year 1625 there was at Padua, which was Harvey's own university, a very distinguished professor, Spigelius, whose work is extant, and who teaches exactly what I am now telling you. It is perfectly true that, some time before, Harvey's master, Fabricius, had not only re-discovered, but had drawn much attention to certain pouch-like structures, which are called the valves of the veins, found in the muscular parts of the body, all of which are directed towards the heart, and consequently impede the flow of the blood in the opposite direction. And you will find it stated by people who have not thought much about the matter, that it was this discovery of the valves of the veins which led Harvey to imagine the course of the circulation of the blood. Now it did not lead Harvey to imagine anything of the kind. He had heard all about it from his master, Fabricius, who made a great point of these valves in the veins, and he had heard the theories which Fabricius entertained upon the subject, whose impression as to the use of the valves was simply this—that they tended to take off any excess of pressure of the blood in passing from the heart to the extremities; for Fabricius believed, with the rest of the world, that the blood in the veins flowed from the heart towards the extremities. This, under the circumstances, was as good a theory as any other, because the action of the valves depends altogether upon the form and nature of the walls of the structures in which they are attached; and without accurate experiment, it was impossible to say whether the theory of Fabricius was right or wrong. But we not only have the evidence of the facts themselves that these could tell Harvey nothing about the circulation, but we have his own distinct declaration as to the considerations which led him to the true theory of the circulation of the blood, and amongst these the valves of the veins are not mentioned.

Fig. 4.—The circulation of the blood as demonstrated by Harvey (A.D. 1628).

Now then we may come to Harvey himself. When you read Harvey's treatise, which is one of the most remarkable scientific monographs with which I am acquainted—it occupies between 50 and 60 pages of a small quarto in Latin, and is as terse and concise as it possibly can be—when you come to look at Harvey's work, you will find that he had long struggled with the difficulties of the accepted doctrine of the circulation. He had received from Fabricius, and from all the great authorities of the day, the current view of the circulation of the blood. But he was a man with that rarest of all qualities—intellectual honesty; and by dint of cultivating that great faculty, which is more moral than intellectual, it had become impossible for him to say he believed anything which he did not clearly believe. This is a most uncomfortable peculiarity—for it gets you into all sorts of difficulties with all sorts of people—but, for scientific purposes, it is absolutely invaluable. Harvey possessed this peculiarity in the highest degree, and so it was impossible for him to accept what all the authorities told him, and he looked into the matter for himself. But he was not hasty. He worked at his new views, and he lectured about them at the College of Physicians for nine years; he did not print them until he was a man of fifty years of age; and when he did print them he accompanied them with a demonstration which has never been shaken, and which will stand till the end of time. What Harvey proved, in short, was this (see Fig. 4)—that everybody had made a mistake, for want of sufficiently accurate experimentation as to the actual existence of the fact which everybody assumed. To anybody who looks at the blood-vessels with an unprejudiced eye it seems so natural that the blood should all come out of the liver, and be distributed by the veins to the different parts of the body, that nothing can seem simpler or more plain; and consequently no one could make up his mind to dispute this apparently obvious assumption. But Harvey did dispute it; and when he came to investigate the matter he discovered that it was a profound mistake, and that, all this time, the blood had been moving in just the opposite direction, namely, from the small ramifications of the veins towards the right side of the heart. Harvey further found that, in the arteries, the blood, as had previously been known, was travelling from the greater trunks towards the ramifications. Moreover, referring to the ideas of Columbus and of Galen (for he was a great student of literature, and did justice to all his predecessors), Harvey accepts and strengthens their view of the course of the blood through the lungs, and he shows how it fitted into his general scheme. If you will follow the course of the arrows in Fig. 4 you will see at once that—in accordance with the views of Columbus—the blood passes from the right side of the heart, through the lungs, to the left side. Then, adds Harvey, with abundant proof, it passes through the arteries to all parts of the body; and then, at the extremities of their branches in the different parts of the body, it passes (in what way he could not tell, for his means of investigation did not allow him to say) into the roots of the veins—then from the roots of the veins it goes into the trunk veins—then to the right side of the heart—and then to the lungs, and so on.

That, you will observe, makes a complete circuit; and it was precisely here that the originality of Harvey lay. There never yet has been produced, and I do not believe there can be produced, a tittle of evidence to show that, before his

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