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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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دار النشر: Project Gutenberg
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Well, all that must have been known from time immemorial—at least for 4,000 or 5,000 years before the commencement of our era—because we know that for as great a period as that the Egyptians, at any rate, whatever may have been the case with other people, were in the enjoyment of a highly developed civilisation. But of what knowledge they may have possessed beyond this we know nothing; and in tracing back the springs of the origin of everything that we call "modern science" (which is not merely knowing, but knowing systematically, and with the intention and endeavour to find out the causal connection of things)—I say that when we trace back the different lines of all the modern sciences we come at length to one epoch and to one country—the epoch being about the fourth and fifth centuries before Christ, and the country being ancient Greece. It is there that we find the commencement and the root of every branch of physical science and of scientific method. If we go back to that time we have in the works attributed to Aristotle, who flourished between 300 and 400 years before Christ, a sort of encyclopaedia of the scientific knowledge of that day—and a very marvellous collection of, in many respects, accurate and precise knowledge it is. But, so far as regards this particular topic, Aristotle, it must be confessed, has not got very far beyond common knowledge. He knows a little about the structure of the heart. I do not think that his knowledge is so inaccurate as many people fancy, but it does not amount to much. A very few years after his time, however, there was a Greek philosopher, Erasistratus, who lived about three hundred years before Christ, and who must have pursued anatomy with much care, for he made the important discovery that there are membranous flaps, which are now called "valves," at the origins of the great vessels; and that there are certain other valves in the interior of the heart itself.

Fig. 1.—The apparatus of the circulation, as at present known. The capillary vessels, which connect the arteries and veins, are omitted, on account of their small size. The shading of the "venous system" is given to all the vessels which contain venous blood; that of the "arterial system" to all the vessels which contain arterial blood.

I have here (Fig. 1) a purposely rough, but, so far as it goes, accurate, diagram of the structure of the heart and the course of the blood. The heart is supposed to be divided into two portions. It would be possible, by very careful dissection, to split the heart down the middle of a partition, or so-called 'septum', which exists in it, and to divide it into the two portions which you see here represented; in which case we should have a left heart and a right heart, quite distinct from one another. You will observe that there is a portion of each heart which is what is called the ventricle. Now the ancients applied the term 'heart' simply and solely to the ventricles. They did not count the rest of the heart—what we now speak of as the 'auricles'—as any part of the heart at all; but when they spoke of the heart they meant the left and the right ventricles; and they described those great vessels, which we now call the 'pulmonary veins' and the 'vena cava', as opening directly into the heart itself.

What Erasistratus made out was that, at the roots of the aorta and the pulmonary artery (Fig. 1) there were valves, which opened in the direction indicated by the arrows; and, on the other hand, that at the junction of what he called the veins with the heart there were other valves, which also opened again in the direction indicated by the arrows. This was a very capital discovery, because it proved that if the heart was full of fluid, and if there were any means of causing that fluid in the ventricles to move, then the fluid could move only in one direction; for you will observe that, as soon as the fluid is compressed, the two valves between the ventricles and the veins will be shut, and the fluid will be obliged to move into the arteries; and, if it tries to get back from them into the heart, it is prevented from doing so by the valves at the origin of the arteries, which we now call the semilunar valves (half-moon shaped valves); so that it is impossible, if the fluid move at all, that it should move in any other way than from the great veins into the arteries. Now that was a very remarkable and striking discovery.

But it is not given to any man to be altogether right (that is a reflection which it is very desirable for every man who has had the good luck to be nearly right once, always to bear in mind); and Erasistratus, while he made this capital and important discovery, made a very capital and important error in another direction, although it was a very natural error. If, in any animal which is recently killed, you open one of those pulsating trunks which I referred to a short time ago, you will find, as a general rule, that it either contains no blood at all or next to none; but that, on the contrary, it is full of air. Very naturally, therefore, Erasistratus came to the conclusion that this was the normal and natural state of the arteries, and that they contained air. We are apt to think this a very gross blunder; but, to anybody who is acquainted with the facts of the case, it is, at first sight, an exceedingly natural conclusion. Not only so, but Erasistratus might have very justly imagined that he had seen his way to the meaning of the connection of the left side of the heart with the lungs; for we find that what we now call the pulmonary vein is connected with the lungs, and branches out in them (Fig. 1). Finding that the greater part of this system of vessels was filled with air after death, this ancient thinker very shrewdly concluded that its real business was to receive air from the lungs, and to distribute that air all through the body, so as to get rid of the grosser humours and purify the blood. That was a very natural and very obvious suggestion, and a highly ingenious one, though it happened to be a great error. You will observe that the only way of correcting it was to experiment upon living animals, for there is no other way in which this point could be settled.

Fig.2,—The Course of the Blood according to Galen (A.D. 170).

And hence we are indebted, for the correction of the error of Erasistratus, to one of the greatest experimenters of ancient or modern times, Claudius Galenus, who lived in the second century after Christ. I say it was to this man more than any one else, because he knew that the only way of solving physiological problems was to examine into the facts in the living animal. And because Galen was a skilful anatomist, and a skilful experimenter, he was able to show in what particulars Erasistratus had erred, and to build up a system of thought upon this subject which was not improved upon for fully 1,300 years. I have endeavoured, in Fig. 2, to make clear to you exactly what it was he tried to establish. You will observe that this diagram is practically the same as that given in Fig. 1, only simplified. The same facts may be looked upon by different people from different points of view. Galen looked upon these facts from a very different point of view from that which we ourselves occupy; but, so far as the facts are concerned, they were the same for him as for us. Well then, the first thing that Galen did was to make out experimentally that, during life, the arteries are not full of air, but that they are full of blood. And he describes a great variety of experiments which he made upon living animals with the view of proving this point, which he did prove effectually and for all time; and that you will observe was the only way of settling the matter. Furthermore, he demonstrated that the cavities of the left side of the heart—what we now call the left auricle and the left ventricle—are, like the arteries, full of blood during life, and that that blood was of the scarlet kind—arterialised, or as he called it "pneumatised," blood. It was known before, that the pulmonary artery, the right ventricle, and the

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