A History of Science, vol 2 - Henry Smith Williams (ebook reader with highlight function .TXT) 📗

unable to find them. etienne had first described these structures, and Vesalius had confirmed his observations. It would seem as if there could be no difficulty in settling the question as to the fact of such valves being present in the vessels, for the demonstration is so simple that it is now made daily by medical students in all physiological laboratories and dissecting-rooms. But many of the great anatomists of the sixteenth century were unable to make this demonstration, even when it had been brought to their attention by such an authority as Vesalius. Fallopius, writing to Vesalius on the subject in 1562, declared that he was unable to find such valves. Others, however, such as Eustachius and Fabricius (1537-1619), were more successful, and found and described these structures. But the purpose served by these valves was entirely misinterpreted. That they act in preventing the backward flow of the blood in the veins on its way to the heart, just as the valves of the heart itself prevent regurgitation, has been known since the time of Harvey; but the best interpretation that could be given at that time, even by such a man as Fabricius, was that they acted in retarding the flow of the blood as it comes from the heart, and thus prevent its too rapid distribution throughout the body. The fact that the blood might have been going towards the heart, instead of coming from it, seems never to have been considered seriously until demonstrated so conclusively by Harvey.

Of this important and remarkable controversy over the valves in veins, Withington has this to say: “This is truly a marvellous story. A great Galenic anatomist is first to give a full and correct description of the valves and their function, but fails to see that any modification of the old view as to the motion of the blood is required. Two able dissectors carefully test their action by experiment, and come to a result. the exact reverse of the truth. Urged by them, the two foremost anatomists of the age make a special search for valves and fail to find them. Finally, passing over lesser peculiarities, an aged and honorable professor, who has lived through all this, calmly asserts that no anatomist, ancient or modern, has ever mentioned valves in veins till he discovered them in 1574!”[2]

Among the anatomists who probably discovered these valves was Michael Servetus (1511-1553); but if this is somewhat in doubt, it is certain that he discovered and described the pulmonary circulation, and had a very clear idea of the process of respiration as carried on in the lungs. The description was contained in a famous document sent to Calvin in 1545—a document which the reformer carefully kept for seven years in order that he might make use of some of the heretical statements it contained to accomplish his desire of bringing its writer to the stake. The awful fate of Servetus, the interesting character of the man, and the fact that he came so near to anticipating the discoveries of Harvey make him one of the most interesting figures in medical history.

In this document which was sent to Calvin, Servetus rejected the doctrine of natural, vital, and animal spirits, as contained in the veins, arteries, and nerves respectively, and made the all-important statement that the fluids contained in veins and arteries are the same. He showed also that the blood is “purged from fume” and purified by respiration in the lungs, and declared that there is a new vessel in the lungs, “formed out of vein and artery.” Even at the present day there is little to add to or change in this description of Servetus’s.

By keeping this document, pregnant with advanced scientific views, from the world, and in the end only using it as a means of destroying its author, the great reformer showed the same jealousy in retarding scientific progress as had his arch-enemies of the Inquisition, at whose dictates Vesalius became a martyr to science, and in whose dungeons etienne perished.

THE COMING OF HARVEY

The time was ripe for the culminating discovery of the circulation of the blood; but as yet no one had determined the all-important fact that there are two currents of blood in the body, one going to the heart, one coming from it. The valves in the veins would seem to show conclusively that the venous current did not come from the heart, and surgeons must have observed thousands of times the everyday phenomenon of congested veins at the distal extremity of a limb around which a ligature or constriction of any kind had been placed, and the simultaneous depletion of the vessels at the proximal points above the ligature. But it should be remembered that inductive science was in its infancy. This was the sixteenth, not the nineteenth century, and few men had learned to put implicit confidence in their observations and convictions when opposed to existing doctrines. The time was at hand, however, when such a man was to make his appearance, and, as in the case of so many revolutionary doctrines in science, this man was an Englishman. It remained for William Harvey (1578-1657) to solve the great mystery which had puzzled the medical world since the beginning of history; not only to solve it, but to prove his case so conclusively and so simply that for all time his little booklet must he handed down as one of the great masterpieces of lucid and almost faultless demonstration.

Harvey, the son of a prosperous Kentish yeoman, was born at Folkestone. His education was begun at the grammar-school of Canterbury, and later he became a pensioner of Caius College, Cambridge. Soon after taking his degree of B.A., at the age of nineteen, he decided upon the profession of medicine, and went to Padua as a pupil of Fabricius and Casserius. Returning to England at the age of twenty-four, he soon after (1609) obtained the reversion of the post of physician to St. Bartholomew’s Hospital, his application being supported by James I. himself. Even at this time he was a popular physician, counting among his patients such men as Francis Bacon. In 1618 he was appointed physician extraordinary to the king, and, a little later, physician in ordinary. He was in attendance upon Charles I. at the battle of Edgehill, in 1642, where, with the young Prince of Wales and the Duke of York, after seeking shelter under a hedge, he drew a book out of his pocket and, forgetful of the battle, became absorbed in study, until finally the cannon-balls from the enemy’s artillery made him seek a more sheltered position.

On the fall of Charles I. he retired from practice, and lived in retirement with his brother. He was then well along in years, but still pursued his scientific researches with the same vigor as before, directing his attention chiefly to the study of embryology. On June 3, 1657, he was attacked by paralysis and died, in his eightieth year. He had lived to see his theory of the circulation accepted, several years before, by all the eminent anatomists of the civilized world.

A keenness in the observation of facts, characteristic of the mind of the man, had led Harvey to doubt the truth of existing doctrines as to the phenomena of the circulation. Galen had taught that “the arteries are filled, like bellows, because they are expanded,” but Harvey thought that the action of spurting blood from a severed vessel disproved this. For the spurting was remittant, “now with greater, now with less impetus,” and its greater force always corresponded to the expansion (diastole), not the contraction (systole) of the vessel. Furthermore, it was evident that contraction of the heart and the arteries was not simultaneous, as was commonly taught, because in that case there would be no marked propulsion of the blood in any direction; and there was no gainsaying the fact that the blood was forcibly propelled in a definite direction, and that direction away from the heart.

Harvey’s investigations led him to doubt also the accepted theory that there was a porosity in the septum of tissue that divides the two ventricles of the heart. It seemed unreasonable to suppose that a thick fluid like the blood could find its way through pores so small that they could not be demonstrated by any means devised by man. In evidence that there could be no such openings he pointed out that, since the two ventricles contract at the same time, this process would impede rather than facilitate such an intra-ventricular passage of blood. But what seemed the most conclusive proof of all was the fact that in the foetus there existed a demonstrable opening between the two ventricles, and yet this is closed in the fully developed heart.

Why should Nature, if she intended that blood should pass between the two cavities, choose to close this opening and substitute microscopic openings in place of it? It would surely seem more reasonable to have the small perforations in the thin, easily permeable membrane of the foetus, and the opening in the adult heart, rather than the reverse. From all this Harvey drew his correct conclusions, declaring earnestly, “By Hercules, there ARE

no such porosities, and they cannot be demonstrated.”

Having convinced himself that no intra-ventricular opening existed, he proceeded to study the action of the heart itself, untrammelled by too much faith in established theories, and, as yet, with no theory of his own. He soon discovered that the commonly accepted theory of the heart striking against the chest-wall during the period of relaxation was entirely wrong, and that its action was exactly the reverse of this, the heart striking the chest-wall during contraction. Having thus disproved the accepted theory concerning the heart’s action, he took up the subject of the action of arteries, and soon was able to demonstrate by vivisection that the contraction of the arteries was not simultaneous with contractions of the heart. His experiments demonstrated that these vessels were simply elastic tubes whose pulsations were “nothing else than the impulse of the blood within them.” The reason that the arterial pulsation was not simultaneous with the heart-beat he found to be because of the time required to carry the impulse along the tube, By a series of further careful examinations and experiments, which are too extended to be given here, he was soon able further to demonstrate the action and course of the blood during the contractions of the heart. His explanations were practically the same as those given to-day—first the contraction of the auricle, sending blood into the ventricle; then ventricular contraction, making the pulse, and sending the blood into the arteries. He had thus demonstrated what had not been generally accepted before, that the heart was an organ for the propulsion of blood. To make such a statement to-day seems not unlike the sober announcement that the earth is round or that the sun does not revolve about it. Before Harvey’s time, however, it was considered as an organ that was “in some mysterious way the source of vitality and warmth, as an animated crucible for the concoction of blood and the generation of vital spirits.”[3]

In watching the rapid and ceaseless contractions of the heart, Harvey was impressed with the fact that, even if a very small amount of blood was sent out at each pulsation, an enormous quantity must pass through the organ in a day, or even in an hour. Estimating the size of the cavities of the heart, and noting that at least a drachm must be sent out with each pulsation, it was evident that the two thousand beats given by a very slow human heart in an hour must send out some forty pounds of blood—more than twice the amount in the entire body. The question was, what became of it all? For it should be remembered that the return of the blood by