Part 19

Harvey himself and all his contemporaries were well aware of the novelty and importance of his theory. He says in the admirable letter to Dr Argent, president of the College of Physicians, which follows the dedication of his treatise to Charles I., that he should not have ventured to publish "a book which alone asserts that the blood pursues its course and flows back again by a new path, contrary to the received doctrine taught so many ages by innumerable learned and illustrious men," if he had not set forth his theory for more than nine years in his college lectures, gradually brought it to perfection, and convinced his colleagues by actual demonstrations of the truth of what he advanced. He anticipates opposition, and even obloquy or loss, from the novelty of his views. These anticipations, however, the event proved to have been groundless. If we are to credit Aubrey indeed, he found that after the publication of the _De motu_ "he fell mightily in his practice; 'twas believed by the vulgar that he was crackbrained, and all the physicians were against him." But the last assertion is demonstrably untrue; and if apothecaries and patients ever forsook him, they must soon have returned, for Harvey left a handsome fortune. By his own profession the book was received as it deserved. So novel a doctrine was not to be accepted without due inquiry, but his colleagues had heard his lectures and seen his demonstrations for years; they were already convinced of the truth of his theory, urged its publication, continued him in his lectureship, and paid him every honour in their power. In other countries the book was widely read and much canvassed. Few accepted the new theory; but no one dreamt of claiming the honour of it for himself, nor for several years did any one pretend that it could be found in the works of previous authors. The first attack on it was a feeble tract by one James Primerose, a pupil of Jean Riolan (_Exerc. et animadv. in libr. Harvei de motu cord. et sang._, 1630). Five years later Parisanus, an Italian physician, published his _Lapis Lydius de motu cord. et sang_. (Venice, 1635), a still more bulky and futile performance. Primerose's attacks were "imbellia pleraque" and "sine ictu"; that of Parisanus "in quamplurimis turpius," according to the contemporary judgment of Johann Vessling. Their dulness has protected them from further censure. Caspar Hoffmann, professor at Nuremberg, while admitting the truth of the lesser circulation in the full Harveian sense, denied the rest of the new doctrine. To him the English anatomist replied in a short letter, still extant, with great consideration yet with modest dignity, beseeching him to convince himself by actual inspection of the truth of the facts in question. He concludes: "I accept your censure in the candid and friendly spirit in which you say you wrote it; do you also the same to me, now that I have answered you in the same spirit." This letter is dated May 1636, and in that year Harvey passed through Nuremberg with the earl of Arundel, and visited Hoffmann. But he failed to convince him; "nec tamen valuit Harveius vel coram," writes P. M. Schlegel, who, however, afterwards succeeded in persuading the obstinate old Galenist to soften his opposition to the new doctrine, and thinks that his complete conversion might have been effected if he had but lived a little longer--"nec dubito quin concessisset tandem in nostra castra." While in Italy the following year Harvey visited his old university of Padua, and demonstrated his views to Professor Vessling. A few months later this excellent anatomist wrote him a courteous and sensible letter, with certain objections to the new theory. The answer to this has not been preserved, but it convinced his candid opponent, who admitted the truth of the circulation in a second letter (both were published in 1640), and afterwards told a friend, "Harveium nostrum si audis, agnosces coelestem sanguinis et spiritus ingressum ex arteriis per venas in dextrum cordis sinum." Meanwhile a greater convert, R. Descartes, in his _Discours sur la methode_ (1637) had announced his adhesion to the new doctrine, and refers to "the English physician to whom belongs the honour of having first shown that the course of the blood in the body is nothing less than a kind of perpetual movement in a circle." J. Walaeus of Leyden, H. Regius of Utrecht and Schlegel of Hamburg successively adopted the new physiology. Of these professors, Regius was mauled by the pertinacious Primerose and mauled him in return (_Spongia qua eluuntur sordes quae Jac. Primirosius_, &c., and _Antidotum adv. Spongiam venenatam Henr. Regii_). Descartes afterwards repeated Harvey's vivisections, and, more convinced than ever, demolished Professor V. F. Plempius of Louvain, who had written on the other side. George Ent also published an _Apologia pro circulatione sanguinis_ in answer to Parisanus.

At last Jean Riolan ventured to publish his _Enchiridium anatomicum_ (1648), in which he attacks Harvey's theory, and proposes one of his own. Riolan had accompanied the queen dowager of France (Maria de' Medici) on a visit to her daughter at Whitehall, and had there met Harvey and discussed his theory. He was, in the opinion of the judicious Haller, "vir asper et in nuperos suosque coaevos immitis ac nemini parcens, nimis avidus suarum laudum praeco, et se ipso fatente anatomicorum princeps." Harvey replied to the _Enchiridium_ with perfectly courteous language and perfectly conclusive arguments, in two letters _De circulatione sanguinis_, which were published at Cambridge in 1649, and are still well worth reading. He speaks here of the "circuitus sanguinis a me inventus." Riolan was unconvinced, but lived to see another professor of anatomy appointed in his own university who taught Harvey's doctrines. Even in Italy, Trullius, professor of anatomy at Rome, expounded the new doctrine in 1651. But the most illustrious converts were Jean Pecquet of Dieppe, the discoverer of the thoracic duct, and of the true course of the lacteal vessels, and Thomas Bartholinus of Copenhagen, in his _Anatome ex omnium veterum recentiorumque observationibus, imprimis institutionibus beati mei parentis Caspari Bartholini, ad circulationem Harveianam et vasa lymphatica renovata_ (Leiden, 1651). At last Plempius also retracted all his objections; for, as he candidly stated, "having opened the bodies of a few living dogs, I find that all Harvey's statements are perfectly true." Hobbes of Malmesbury could thus say in the preface to his _Elementa philosophiae_ that his friend Harvey, "solus quod sciam, doctrinam novam superata invidia vivens stabilivit."

It has been made a reproach to Harvey that he failed to appreciate the importance of the discoveries of the lacteal and lymphatic vessels by G. Aselli, J. Pecquet and C. Bartholinus. In three letters on the subject, one to Dr R. Morison of Paris (1652) and two to Dr Horst of Darmstadt (1655), a correspondent of Bartholin's, he discusses these observations, and shows himself unconvinced of their accuracy. He writes, however, with great moderation and reasonableness, and excuses himself from investigating the subject further on the score of the infirmities of age; he was then above seventy-four. The following quotation shows the spirit of these letters: "Laudo equidem summopere Pecqueti aliorumque in indaganda veritate industriam singularem, nec dubito quin multa adhuc in Democriti puteo abscondita sint, a venturi saeculi indefatigabili diligentia expromenda." Bartholin, though reasonably disappointed in not having Harvey's concurrence, speaks of him with the utmost respect, and generously says that the glory of discovering the movements of the heart and of the blood was enough for one man.

_Harvey's Work on Generation._--We have seen how Dr. Ent persuaded his friend to publish this book in 1651. It is between five and six times as long as the _Exerc. de motu cord. et sang._, and is followed by excursus _De partu, De uteri membranis, De conceptione_; but, though the fruit of as patient and extensive observations, its value is far inferior. The subject was far more abstruse, and in fact inaccessible to proper investigation without the aid of the microscope. And the field was almost untrodden since the days of Aristotle. Fabricius, Harvey's master, in his work _De formatione ovi et pulli_ (1621), had alone preceded him in modern times. Moreover, the seventy-two chapters which form the book lack the co-ordination so conspicuous in the earlier treatise, and some of them seem almost like detached chapters of a system which was never completed or finally revised.

Aristotle had believed that the male parent furnished the body of the future embryo, while the female only nourished and formed the seed; this is in fact the theory on which, in the _Eumenides_ of Aeschylus, Apollo obtains the acquittal of Orestes. Galen taught almost as erroneously that each parent contributes seeds, the union of which produced the young animal. Harvey, after speaking with due honour of Aristotle and Fabricius, begins rightly "ab ovo"; for, as he remarks, "eggs cost little and are always and everywhere to be had," and moreover "almost all animals, even those which bring forth their young alive, and man himself, are produced from eggs" ("omnia omnino animalia, etiam vivipara, atque hominem adeo ipsum, ex ovo progigni"). This dictum, usually quoted as "omne vivurn ex ovo," would alone stamp this work as worthy of the discoverer of the circulation of the blood, but it was a prevision of genius, and was not proved to be a fact until K. E. von Baer discovered the mammalian ovum in 1827. Harvey proceeds with a careful anatomical description of the ovary and oviduct of the hen, describes the new-laid egg, and then gives an account of the appearance seen on the successive days of incubation, from the 1st to the 6th, the 10th and the 14th, and lastly describes the process of hatching. He then comments upon and corrects the opinions of Aristotle and Fabricius, declares against spontaneous generation (though in one passage he seems to admit the current doctrine of production of worms by putrefaction as an exception), proves that there is no _semen foemineum_, that the chalazae of the hen's eggs are not the _semen galli_, and that both parents contribute to the formation of the egg. He describes accurately the first appearance of the ovarian ova as mere specks, their assumption of yelk and afterwards of albumen. In chapter xlv. he describes two methods of production of the embryo from the ovum: one is _metamorphosis_, or the direct transformation of pre-existing material, as a worm from an egg, or a butterfly from an _aurelia_ (chrysalis); the other is _epigenesis_, or development with addition of parts, the true generation observed in all higher animals. Chapters xlvi.-l. are devoted to the abstruse question of the efficient cause of generation, which, after much discussion of the opinions of Aristotle and of Sennertius, Harvey refers to the action of both parents as the efficient instruments of the first great cause.[4] He then goes on to describe the order in which the several parts appear in the chick. He states that the _punctum saliens_ or foetal heart is the first organ to be seen, and explains that the nutrition of the chick is not only effected by yelk conveyed directly into the midgut, as Aristotle taught, but also by absorption from yelk and white by the umbilical (omphalomeseraic) veins; on the fourth day of incubation appear two masses (which he oddly names _vermiculus_), one of which develops into three vesicles, to form the cerebrum, cerebellum and eyes, the other into the breastbone and thorax; on the sixth or seventh day come the viscera, and lastly, the feathers and other external parts. Harvey points out how nearly this order of development in the chick agrees with what he had observed in mammalian and particularly in human embryos. He notes the bifid apex of the foetal heart in man and the equal thickness of the ventricles, the soft cartilages which represent the future bones, the large amount of liquor amnii and absence of placenta which characterize the foetus in the third month; in the fourth the position of the testes in the abdomen, and the uterus with its Fallopian tubes resembling the uterus bicornis of the sheep; the large thymus; the caecum, small as in the adult, not forming a second stomach as in the pig, the horse and the hare; the lobulated kidneys, like those of the seal ("_vitulo_," sc. _marino_) and porpoise, and the large suprarenal veins, not much smaller than those of the kidneys (li.-lvi). He failed, however, to trace the connexion of the urachus with the bladder. In the following chapters (lxiii.-lxxii.) he describes the process of generation in the fallow deer or the roe. After again insisting that all animals arise from ova, that a "conception" is an internal egg and an egg an extruded conception, he goes on to describe the uterus of the doe, the process of impregnation, and the subsequent development of the foetus and its membranes, the _punctum saliens_, the cotyledons of the placenta, and the "uterine milk," to which Sir William Turner recalled attention in later years. The treatise concludes with detached notes on the placenta, parturition and allied subjects.

_Harvey's other Writings and Medical Practice._--The remaining writings of Harvey which are extant are unimportant. A complete list of them will be found below, together with the titles of those which we know to be lost. Of these the most important were probably that on respiration, and the records of post-mortem examinations. From the following passage (_De partu_, p. 550) it seems that he had a notion of respiration being connected rather with the production of animal heat than, as then generally supposed, with the cooling of the blood. "Haec qui diligenter perpenderit, naturamque aeris diligenter introspexerit, facile opinor fatebitur eundem nec refrigerationis gratia nec in pabulum animalibus concedi. Haec autem obiter duntaxat de respiratione diximus, proprio loco de eadem forsitan copiosius disceptaturi."

Of Harvey as a practising physician we know very little. Aubrey tells us that "he paid his visits on horseback with a foot-cloth, his man following on foot, as the fashion then was." He adds--"Though all of his profession would allow him to be an excellent anatomist, I never heard any that admired his therapeutic way. I knew several practitioners that would not have given threepence for one of his bills" (the apothecaries used to collect physicians' prescriptions and sell or publish them to their own profit), "and that a man could hardly tell by his bill what he did aim at." However this may have been,--and rational therapeutics was impossible when the foundation stone of physiology had only just been laid,--we know that Harvey was an active practitioner, performing such important surgical operations as the removal of a breast, and he turned his obstetric experience to account in his book on generation. Some good practical precepts as to the conduct of labour are quoted by Percivall Willughby (1596-1685). He also took notes of the anatomy of disease; these unfortunately perished with his other manuscripts. Otherwise we might regard him as a forerunner of G. B. Morgagni; for Harvey saw that pathology is but a branch of physiology, and like it must depend first on accurate anatomy. He speaks strongly to this purpose in his first epistle to Riolan: "Sicut enim sanorum et boni habitus corporum dissectio plurimum ad philosophiam et rectam physiologiam facit, ita corporum morbosorum et cachecticorum inspectio potissimum ad pathologiam philosophicam." The only specimen we have of his observations in morbid anatomy is his account of the post-mortem examination made by order of the king on the body of the famous Thomas Parr, who died in 1635, at the reputed age of 152. Harvey insists on the value of physiological truths for their own sake, independently of their immediate utility; but he himself gives us an interesting example of the practical application of his theory of the circulation in the cure of a large tumour by tying the arteries which supplied it with blood (_De generat._ Exerc. xix.).

The following is believed to be a complete list of all the known writings of Harvey, published and unpublished:--

_Exercitatio anatomica de motu cordis et sanguinis_, 4to (Frankfort-on-the-Main, 1628); _Exercitationes duae anatomicae de circulatione sanguinis, ad Johannem Riolanum, filium, Parisiensem_ (Cambridge, 1649); _Exercitationes de generatione animalium, quibus accedunt quaedam de partu, de membranis ac humoribus uteri, et de conceptione_, 4to (London, 1651); _Anatomia Thomae Parr_, first published in the treatise of Dr John Betts, _De ortu et natura sanguinis_, 8vo (London, 1669). Letters: (1) to Caspar Hoffmann of Nuremberg, May 1636; (2) to Schlegel of Hamburg, April 1651; (3) three to Giovanni Nardi of Florence, July 1651, Dec. 1653 and Nov. 1655; (4) two to Dr Morison of Paris, May 1652; (5) two to Dr Horst of Darmstadt, Feb. 1654-1655 and July 1655; (6) to Dr Vlackveld of Haarlem, May 1657. His letters to Hoffmann and Schlegel are on the circulation; those to Morison, Horst and Vlackveld refer to the discovery of the lacteals; the two to Nardi are short letters of friendship. All these letters were published by Sir George Ent in his collected works (Leiden, 1687). Of two MS. letters, one on official business to the secretary Dorchester was printed by Dr Aveling, with a facsimile of the crabbed handwriting (_Memorials of Harvey_, 1875), and the other, about a patient, appears in Dr Robert Willis's _Life of Harvey_ (1878). _Praelectiones anatomiae universalis per me Gul. Harveium medicum Londinensem, anat. et chir. professorem, an. dom._ (1616), _aetat._ 37,--MS. notes of his Lumleian lectures in Latin,--are in the British Museum library; an autotype reproduction was issued by the College of Physicians in 1886. An account of a second MS. in the British Museum, entitled _Gulielmus Harveius de musculis, motu locali_, &c., was published by Sir G. E. Paget (_Notice of an unpublished MS. of Harvey_, London, 1850). The following treatises, or notes towards them, were lost either in the pillaging of Harvey's house, or perhaps in the fire of London, which destroyed the old College of Physicians: _A Treatise on Respiration_, promised and probably at least in part completed (pp. 82, 550, ed. 1766); _Observationes de usu Lienis_; _Observationes de motu locali_, perhaps identical with the above-mentioned manuscript; _Tractatum physiologicum_; _Anatomia medicalis_ (apparently notes of morbid anatomy); _De generatione insectorum_. The fine 4to edition of Harvey's Works, published by the Royal College of Physicians in 1766, was superintended by Dr Mark Akenside; it contains the two treatises, the account of the post-mortem examination of old Parr, and the six letters enumerated above. A translation of this volume by Dr Willis, with Harvey's will, was published by the Sydenham Society, 8vo (London, 1849).

The following are the principal biographies of Harvey: in Aubrey's _Letters of Eminent Persons_, &c., vol. ii. (London, 1813), first published in 1685, the only contemporary account; in Bayle's _Dictionnaire historique et critique_ (1698 and 1720; Eng. ed., 1738); in the _Biographia Britannica_, and in Aitken's _Biographical Memoirs_; the Latin Life by Dr Thomas Lawrence, prefixed to the college edition of Harvey's _Works_ in 1766; memoir in _Lives of British Physicians_ (London, 1830); a Life by Dr Robert Willis, founded on that by Lawrence, and prefixed to his English edition of Harvey in 1847; the much enlarged Life by the same author, published in 1878; the biography by Dr William Munk in the _Roll of the College of Physicians_, vol. i. (2nd ed., 1879).

The literature which has arisen on the great discovery of Harvey, on his methods and his merits, would fill a library. The most important contemporary writings have been mentioned above. The following list gives some of the most remarkable in modern times: the article in Bayle's dictionary quoted above; _Anatomical Lectures_, by Wm. Hunter, M.D. (1784); Sprengell, _Geschichte der Arzneikunde_ (Halle, 1800), vol. iv.; Flourens, _Histoire de la circulation_ (1854); Lewes, _Physiology of Common Life_ (1859), vol. i. pp. 291-345; Ceradini, _La Scoperta della circolazione del sangue_ (Milan, 1876); Tollin, _Die Entdeckung des Blutkreislaufs durch Michael Servet_ (Jena, 1876); Kirchner, _Die Entdeckung des Blutkreislaufs_ (Berlin, 1878); Willis, in his Life of Harvey; Wharton Jones, "Lecture on the Circulation of the Blood," _Lancet_ for Oct. 25 and Nov. 1, 1879; and the various _Harveian Orations_, especially those by Sir E. Sieveking, Dr Guy and Professor George Rolleston. (P. H. P.-S.)

FOOTNOTES:

[1] "Ignoscant mihi niveae animae, si, summarum injuriarum memor, levem gemitum effudero. Doloris mihi haec causa est: cum, inter nuperos nostros tumultus et bella plusquam civilia, serenissimum regem (idque non solum senatus permissione sed et jussu) sequor, rapaces quaedam manus non modo aedium mearum supellectilem omnem expilarunt, sed etiam, quae mihi causa gravior querimoniae, adversaria mea, multorum annorum laboribus parta, e museo meo summoverunt. Quo factum est ut observationes plurimae, praesertim de generatione insectorum, cum republicae literariae (ausim dicere) detrimento, perierint."--_De gen._, Ex. lxviii. To this loss Cowley refers--

"O cursed war! who can forgive thee this? Houses and towns may rise again, And ten times easier 'tis To rebuild Paul's than any work of his."

[2] Indeed the same word, [Greek: periodos haimatos], occurs in the Hippocratic writings, and was held by Van der Linden to prove that to the father of medicine himself, and not to Columbus or Caesalpinus, belonged the laurels of Harvey.

[3] Realdo Columbus (_De re anatomica_, 1559) formally denies the muscularity of the heart, yet correctly teaches that blood and spirits pass from the right to the left ventricle, not through the septum but through the lungs, "quod nemo hactenus aut animadvertit aut scriptum reliquit." The fact that Harvey quotes Columbus and not Servetus is explained by the almost entire destruction of the writings of the latter, which are now among the rarest curiosities. The great anatomist Fabricius, Harvey's teacher at Padua, described the valves of the veins more perfectly than had Sylvius. Carlo Ruini, in his treatise on the _Anatomy and Diseases of the Horse_ (1590), taught that the left ventricle sends blood and vital spirits to all parts of the body except the lungs--the ordinary Galenical doctrine. Yet on the strength of this phrase Professor J. B. Ercolani actually put up a tablet in the veterinary school at Bologna to Ruini as the discoverer of the circulation of the blood! The claims of Caesalpinus, a more plausible claimant to Harvey's laurels, are scarcely better founded. In his _Quaestiones peripateticae_ (1571) he followed Servetus and Columbus in describing what we now know as the pulmonary "circulation" under that name, and this is the only foundation for the assertion (first made in Bayle's dictionary) that Caesalpinus knew "the circulation of the blood." He is even behind Servetus, for he only allows part of the blood of the right ventricle to go round by this "circuit"; some, he conceives, passes through the hypothetical pores in the septum, and the rest by the superior cava to the head and arms, by the inferior to the rest of the body: "Hanc esse venarum utilitatem ut omnes partes corporis sanguinem pro nutrimento deferant. Ex dextro ventr deg. cordis vena cava sanguinem crassiorem, in quo calor intensus est magis, ex altero autern ventr deg., sanguinem temperatissimum ac sincerissimum habente, egreditur aorta." Caesalpinus seems to have had no original views on the subject; all that he writes is copied from Galen or from Servetus except some erroneous observations of his own. His greatest merit was as a botanist; and no claim to the "discovery of the circulation" was made by him or by his contemporaries. When it was made, Haller decided conclusively against it. The fact that an inscription has been placed on the bust of Caesalpinus at Rome, which states that he preceded others in recognizing and demonstrating "the general circulation of the blood," is only a proof of the blindness of misplaced national vanity.