A History of Science - v.2 (Williams)

History of Science II

171

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

Get any book for free on: www.abika.com

History of Science II

172

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

Get any book for free on: www.abika.com

History of Science II

173

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 the veins was unknown, and nothing like a "circulation" more than vaguely conceived even by Harvey himself. Once it could be shown that the veins were constantly returning blood to the heart, the discovery that the blood in some way passes from the arteries to the veins was only a short step. Harvey, by resorting to vivisections of lower animals and reptiles, soon demonstrated beyond question the fact that the veins do carry the return blood. "But this, in particular, can be shown clearer than daylight," says Harvey. "The vena cava enters the heart at an inferior portion, while the artery passes out above. Now if the vena cava be taken up with forceps or the thumb and finger, and the course of the blood intercepted for some distance below the heart, you will at once see it almost emptied between the fingers and the heart, the blood being exhausted by the heart's pulsation, the heart at the same time becoming much paler even in its dilatation, smaller in size, owing to the deficiency of blood, and at length languid in pulsation, as if about to die. On the other hand, when you release the vein the heart immediately regains its color and dimensions. After that, if you leave the vein free and tie and compress the arteries at some distance from the heart, you will see, on the contrary, their included portion grow excessively turgid, the heart becoming so beyond measure, assuming a dark-red

Get any book for free on: www.abika.com

History of Science II

174

color, even to lividity, and at length so overloaded with blood as to seem in danger of suffocation; but when the obstruction is removed it returns to its normal condition, in size, color, and movement."[4]

This conclusive demonstration that the veins return the blood to the heart must have been most impressive to Harvey, who had been taught to believe that the blood current in the veins pursued an opposite course, and must have tended to shake his faith in all existing doctrines of the day.

His next step was the natural one of demonstrating that the blood passes from the arteries to the veins. He demonstrated conclusively that this did occur, but for once his rejection of the ancient writers and one modern one was a mistake. For Galen had taught, and had attempted to demonstrate, that there are sets of minute vessels connecting the arteries and the veins; and Servetus had shown that there must be such vessels, at least in the lungs.

However, the little flaw in the otherwise complete demonstration of Harvey detracts nothing from the main issue at stake. It was for others who followed to show just how these small vessels acted in effecting the transfer of the blood from artery to vein, and the grand general statement that such a transfer does take place was, after all, the all-important one, and the exact method of how it takes place a detail. Harvey's experiments to demonstrate that the blood passes from the arteries to the veins

Get any book for free on: www.abika.com

History of Science II

175

are so simply and concisely stated that they may best be given in his own words.

"I have here to cite certain experiments," he wrote, "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 by anastomosis from the arteries into the veins, or immediately by the pores of 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 hence thither; from the centre to the extremities, to wit, and from the extreme parts back again to the centre. Finally, upon grounds of circulation, 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.

"Now let any one make an experiment on the arm of a man, either using such a fillet as is employed in blood-letting or grasping the limb tightly 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 large quantities 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

Get any book for free on: www.abika.com

History of Science II

176

the wrist nor anywhere else do the arteries pulsate, that at the same time 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 permanently full. The hand under such circumstances retains its natural color and appearances; 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 some short time in this way, let it be slackened a little, brought to the 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, 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.

"As we have noted, in connection 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, the fillet swell and become dilated, while the arteries shrink; and such is the degree of distention 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.

Get any book for free on: www.abika.com

History of Science II		177
"From these facts it is easy for any careful observer to		learn
that the blood	enters an extremity by the arteries; for when they
are effectively compressed nothing is DRAWN to the member; the
hand preserves	its color; nothing flows into 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 when they do not pulsate, or 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 distention.
But the arteries, in spite of	the 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."[5]

This use of ligatures is very significant, because, as shown, a very tight ligature stops circulation in both arteries and veins, while a loose one, while checking the circulation in the veins, which lie nearer the surface and are not so directly influenced

Get any book for free on: www.abika.com

History of Science II

178

by the force of the heart, does not stop the passage of blood in the arteries, which are usually deeply imbedded in the tissues, and not so easily influenced by pressure from without.

The last step of Harvey's demonstration was to prove that the blood does flow along the veins to the heart, aided by the valves that had been the cause of so much discussion and dispute between the great sixteenth-century anatomists. Harvey not only demonstrated the presence of these valves, but showed conclusively, by simple experiments, what their function was, thus completing his demonstration of the phenomena of the circulation.

The final ocular demonstration of the passage of the blood from the arteries to the veins was not to be made until four years after Harvey's death. This process, which can be observed easily in the web of a frog's foot by the aid of a low-power lens, was first demonstrated by Marcello Malpighi (1628-1694) in 1661. By the aid of a lens he first saw the small "capillary" vessels connecting the veins and arteries in a piece of dried lung. Taking his cue from this, he examined the lung of a turtle, and was able to see in it the passage of the corpuscles through these minute vessels, making their way along these previously unknown channels from the arteries into the veins on their journey back to the heart. Thus the work of Harvey, all but complete, was made absolutely entire by the great Italian. And all this in a single generation.

Get any book for free on: www.abika.com

History of Science II

179

LEEUWENHOEK DISCOVERS BACTERIA

The seventeenth century was not to close, however, without another discovery in science, which, when applied to the causation of disease almost two centuries later, revolutionized therapeutics more completely than any one discovery. This was the discovery of microbes, by Antonius von Leeuwenhoek (1632-1723), in 1683. Von Leeuwenhoek discovered that "in the white matter between his teeth" there were millions of microscopic "animals"--more, in fact, than "there were human beings in the united Netherlands," and all "moving in the most delightful manner." There can be no question that he saw them, for we can recognize in his descriptions of these various forms of little "animals" the four principal forms of microbes--the long and short rods of bacilli and bacteria, the spheres of micrococci, and the corkscrew spirillum.

The presence of these microbes in his mouth greatly annoyed Antonius, and he tried various methods of getting rid of them, such as using vinegar and hot coffee. In doing this he little suspected that he was anticipating modern antiseptic surgery by a century and three-quarters, and to be attempting what antiseptic surgery is now able to accomplish. For the fundamental principle of antisepsis is the use of medicines for ridding wounds of similar microscopic organisms. Von Leenwenhoek was only temporarily successful in his attempts, however, and took occasion to communicate his discovery to the Royal Society of England, hoping that they would be "interested in this novelty."

Get any book for free on: www.abika.com

History of Science II

180

Probably they were, but not sufficiently so for any member to pursue any protracted investigations or reach any satisfactory conclusions, and the whole matter was practically forgotten until the middle of the nineteenth century.

VIII. MEDICINE IN THE SIXTEENTH AND SEVENTEENTH CENTURIES

Of the half-dozen surgeons who were prominent in the sixteenth century, Ambroise Pare (1517-1590), called the father of French surgery, is perhaps the most widely known. He rose from the position of a common barber to that of surgeon to three French monarchs, Henry II., Francis II., and Charles IX. Some of his mottoes are still first principles of the medical man. Among others are: "He who becomes a surgeon for the sake of money, and not for the sake of knowledge, will accomplish nothing"; and "A tried remedy is better than a newly invented." On his statue is his modest estimate of his work in caring for the wounded, "Je le pansay, Dieu le guarit"--I dressed him, God cured him.

It was in this dressing of wounds on the battlefield that he accidentally discovered how useless and harmful was the terribly painful treatment of applying boiling oil to gunshot wounds as advocated by John of Vigo. It happened that after a certain battle, where there was an unusually large number of casualties, Pare found, to his horror, that no more boiling oil was available for the surgeons, and that he should be obliged to dress the

Get any book for free on: www.abika.com