Harvey
CHAPTER
VIII OF
THE QUANTITY OF BLOOD PASSING THROUGH THE HEART FROM THE VEINS TO THE
ARTERIES, AND OF THE CIRCULAR MOTION OF THE BLOOD. Thus far I have spoken
of the blood from the veins into the arteries, and of the manner in which
it is transmitted and distributes by the action of the heart; points to
which some, moved either by the authority of Galen or Columbus, or the
reasonings of others, will give in their adhesion. But what remains to be
said upon the quantity and source of the blood which thus passes, is of a
character so novel and unheard-of that I not only fear injury to myself
from the envy of a few, but I tremble lest I have mankind at large for my
enemies, so much doth wont and custom become a second nature. Doctrine
once sown strikes deep its root, and respect for antiquity influences all
men. Still the die is cast, and my trust is in the love of truth, and the
candour of cultivated minds. And sooth to say, when I surveyed my mass of
evidence, whether derived from vivisections, and my various reflections on
them, or from the study of the ventricles of the heart and the vessels
that enter into and issue from them, the symmetry and size of these
conduits,— for nature doing nothing in vain, would never have given them
so large a relative size without a purpose,—or from observing the
arrangement and intricate structure of the valves in particular, and of
the other parts of the heart in general, with many things besides, I
frequently and seriously bethought me, and long revolved in my mind, what
might be the quantity of blood which was transmitted, in how short a time
its passage might be effected, and the like. But not finding it possible
that this could be supplied by the juices of the ingested aliment without
the veins on the one hand becoming drained, and the arteries on the other
getting ruptured through the excessive charge of blood, unless the blood
should somehow find its way from the arteries into the veins, and so
return to the right side of the heart; I began to think whether there
might not be a motion, as it were,
in a circle. Now this I afterwards found to be true; and I finally
saw that the blood, forced by the action of the left ventricle into the
arteries, was distributed to the body at large, and its several parts, in
the same manner as it is sent through the lungs, impelled by the right
ventricle into the pulmonary artery, and that it then passed through the
veins and along the vena cava, and so round to the left ventricle in the
manner already indicated. This motion we may be allowed to call circular,
in the same way as Aristotle says that the air and the rain emulate the
circular motion of the superior bodies; for the moist earth, warmed by the
sun, evaporates; the vapours drawn upwards are condensed, and descending
in the form of rain, moisten the earth again. By this arrangement are
generations of living things produced; and in like manner are tempests and
meteors engendered by the circular motion, and by the approach and
recession of the sun. And
similarly does it come to pass in the body, through the motion of the
blood, that the various parts are nourished, cherished, quickened by the
warmer, more perfect, vaporous, spirituous, and, as I may say, alimentive
blood; which, on the other hand, owing to its contact with these parts,
becomes cooled, coagulated, and, so to speak, effete. It then returns to
its sovereign the heart, as if to its source, or to the inmost home of the
body, there to recover its state of excellence or perfection. Here it
renews its fluidity, natural heat, and becomes powerful, fervid, a kind of
treasury of life, and impregnated with spirits, it might be said with
balsam. Thence it is again dispersed. All this depends on the motion and
action of the heart. The
heart, consequently, is the beginning of life; the sun of the microcosm,
even as the sun in his turn might well be designated the heart of the
world; for it is the heart by whose virtue and pulse the blood is moved,
perfected, and made nutrient, and is preserved from corruption and
coagulation; it is the household divinity which, discharging its function,
nourishes, cherishes, quickens the whole body, and is indeed the
foundation of life, the source of all action. But of these things we shall
speak more opportunely when we come to speculate upon the final cause of
this motion of the heart. As
the blood-vessels, therefore, are the canals and agents that transport the
blood, they are of two kinds, the cava and the aorta; and this not by
reason of there being two sides of the body, as Aristotle has it, but
because of the difference of office, not, as is commonly said, in
consequence of any diversity of structure, for in many animals, as I have
said, the vein does not differ from the artery in the thickness of its
walls, but solely in virtue of their distinct functions and uses. A vein
and an artery, both styled veins by the ancients, and that not without
reason, as Galen has remarked, for the artery is the vessel which carries
the blood from the heart to the body at large, the vein of the present day
bringing it back from the general system to the heart; the former is the
conduit from, the latter the channel to, the heart; the latter contains
the cruder, effete blood, rendered unfit for nutrition; the former
transmits the digested, perfect, peculiarly nutritive fluid. CHAPTER
IX THAT
THERE IS A CIRCULATION OF THE BLOOD But lest anyone should
say that we give them words only, and make mere specious assertions
without any foundation, and desire to innovate without sufficient cause,
three points present themselves for confirmation, which being stated, I
conceive that the truth I contend for will follow necessarily, and appear
as a thing obvious to all. First,-the blood is incessantly transmitted by
the action of the heart from the vena cava to the arteries in such
quantity that it cannot be supplied from the ingesta, and in such a manner
that the whole must very quickly pass through the organ; Second, the blood
under the influence of the arterial pulse enters and is impelled in a
continuous, equable, and incessant stream through every part and member of
the body, in much larger quantity than were sufficient for nutrition, or
than the whole mass of fluids could supply; Third,—the veins in like
manner return this blood incessantly to the heart from parts and members
of the body. These points proved, I conceive it will be manifest that the
blood circulates, revolves, propelled and then returning, from the heart
to the extremities, from the extremities to the heart, and thus that it
performs a kind of circular motion. Let
us assume either arbitrarily or from experiment, the quantity of blood
which the left ventricle of the heart will contain when distended, to be,
say two ounces, three ounces, or one ounce and a half-ill the dead body I
have found it to hold upwards of two ounces. Let us assume further, how
much less the heart will hold in the contracted than in the dilated state;
and how much blood it will project into the aorta upon each
contraction;-and all the world allows that with the systole something is
always projected, a necessary consequence demonstrated in the third
chapter, CHAPTER
IX THAT
THERE IS A CIRCULATION OF THE BLOOD But lest anyone should
say that we give them words only, and make mere specious assertions
without any foundation, and desire to innovate without sufficient cause,
three points present themselves for confirmation, which being stated, I
conceive that the truth I contend for will follow necessarily, and appear
as a thing obvious to all. First,-the blood is incessantly transmitted by
the action of the heart from the vena cava to the arteries in such
quantity that it cannot be supplied from the ingesta, and in such a manner
that the whole must very quickly pass through the organ; Second, the blood
under the influence of the arterial pulse enters and is impelled in a
continuous, equable, and incessant stream through every part and member of
the body, in much larger quantity than were sufficient for nutrition, or
than the whole mass of fluids could supply; Third,—the veins in like
manner return this blood incessantly to the heart from parts and members
of the body. These points proved, I conceive it will be manifest that the
blood circulates, revolves, propelled and then returning, from the heart
to the extremities, from the extremities to the heart, and thus that it
performs a kind of circular motion. Let
us assume either arbitrarily or from experiment, the quantity of blood
which the left ventricle of the heart will contain when distended, to be,
say two ounces, three ounces, or one ounce and a half, in the dead body I
have found it to hold upwards of two ounces. Let us assume further, how
much less the heart will hold in the contracted than in the dilated state;
and how much blood it will project into the aorta upon each
contraction;-and all the world allows that with the systole something is
always projected, a necessary consequence demonstrated in the third
chapter, and obvious from the structure of the valves; and let us suppose
as approaching the truth that the fourth, or fifth, or sixth, or even but
the eighth part of its charge is thrown into the artery at each
contraction; this would give either half an ounce, or three drachms, or
one drachm of blood as propelled by the heart at each pulse into the
aorta; which quantity, by reason of the valves at the root of the vessel,
can by no means return into the ventricle. Now in the course of half an
hour, the heart will have made more than one thousand beats, in some as
many as two, three, and even four thousand. Multiplying the number of
drachms propelled by the number of pulses, we shall have either one
thousand half ounces, or one thousand times three drachms, or a like
proportional quantity of blood, according to the amount which we assume as
propelled with each stroke of the heart, sent from this organ into the
artery; a larger quantity in every case than is contained in the whole
body! In the same way, in the sheep or dog, say that but a single scruple
of blood passes with each stroke of the heart, in one half hour we should
have one thousand scruples, or about three pounds and a half of blood
injected into the aorta; but the body of neither animal contains above
four pounds of blood, a fact which I have myself ascertained in the case
of the sheep. Upon
this supposition, therefore, assumed merely as a ground for reasoning, we
see the whole mass of blood passing through the heart, from the veins to
the arteries, and in like manner through the lungs. But
let it be said that this does not take place in half an hour, but in an
hour, or even in a day; any way it is still manifest that more blood
passes through the heart in consequence of its action, than can either be
supplied by the whole of the ingesta, or than can be contained in the
veins at the same moment. Nor
can it be allowed that the heart in contracting sometimes propels and
sometimes does not propel, or at most propels but very little, a mere
nothing, or an imaginary something: all this, indeed, has already been
refuted, and is, besides, contrary both to sense and reason. For if it be
a necessary effect of the dilatation of the heart that its ventricles
become filled with blood, it is equally so that, contracting, these
cavities should expel their contents; and this not in any trifling
measure. For neither are the conduits small, nor the contractions few in
number, but frequent, and always in some certain proportion, whether it be
a third or a sixth, or an eighth, to the total capacity of the ventricles,
so that a like proportion of blood must be expelled, and a like proportion
received with each stroke of the heart, the capacity of the ventricle
contracted always bearing a certain relation to the capacity of the
ventricle when dilated. And since in dilating, the ventricles cannot be
supposed to get filled with nothing, or with an imaginary something, so in
contracting they never expel nothing or aught imaginary, but always a
certain something, viz., blood, in proportion to the amount of the
contraction. Whence it is to be concluded, that if at one stroke the heart
in man, the ox or the sheep, ejects but a single drachm of blood, and
there are one thousand strokes in half an hour, in this interval there
will have been ten pounds five ounces expelled: if with each stroke two
drachms are expelled, the quantity would of course amount to twenty pounds
and ten ounces; if half an ounce, the quantity would come to forty-one
pounds and eight ounces; and were there one ounce it would be as much as
eighty-three pounds and four ounces; the whole of which, in the course of
one half hour, would have been transfused from the veins to the arteries.
The actual quantity of blood expelled at each stroke of the heart, and the
circumstances under which it is either greater or less than ordinary, I
leave for particular determination afterwards, from numerous observations
which I have made on the subject. Meantime
this much I know, and would here proclaim to all, that the blood is
transfused at one time in larger, at another in smaller quantity; and that
the circuit of the blood is accomplished now more rapidly, now more
slowly, according to the temperament, age, etc., of the individual, to
external and internal circumstances, to naturals and nonnaturals,—sleep,
rest, food, exercise, affections of the mind, and the like. But, supposing
even the smallest quantity of blood to be passed through the heart and the
lungs with each pulsation, a vastly greater amount would still be thrown
into the arteries and whole body, than could by any possibility be
supplied by the food consumed. It could be furnished in no other way than
by making a circuit and returning. This
truth, indeed, presents itself obviously before us when we consider what
happens in the dissection of living animals; the great artery need not be
divided, but a very small branch only, (as Galen even proves in regard to
man), to have the whole of the blood in the body, as well that of the
veins as of the arteries, drained away in the course of no long time some
half hour or less. Butchers are well aware of the fact and can bear
witness to it; for, cutting the throat of an ox and so dividing the
vessels of the neck, in less than a quarter of an hour they have all the
vessels bloodless—the whole mass of blood has escaped. The same thing
also occasionally occurs with great rapidity in performing amputations and
removing tumours in the human subject. Nor
would this argument lose any of its force, did any one say that in killing
animals in the shambles, and performing amputations, the blood escaped in
equal, if not perchance in larger quantity by the veins than by the
arteries. The contrary of this statement, indeed, is certainly the truth;
the veins, in fact, collapsing, and being without any propelling power,
and further, because of the impediment of the valves, as I shall show
immediately, pour out but very little blood; whilst the arteries spout it
forth with force abundantly, impetuously, and as if it were propelled by a
syringe. And then the experiment is easily tried of leaving the vein
untouched, and only dividing the artery in the neck of a sheep or dog,
when it will be seen with what force, in what abundance, and how quickly
the whole blood in the body, of the veins as well as of the arteries, is
emptied. But the arteries receive blood from the veins in no other way
than by transmission through the heart, as we have already seen; so that
if the aorta be tied at the base of the heart, and the carotid or any
other artery be opened, no one will now be surprised to find it empty, and
the veins only replete with blood. And
now the cause is manifest, why in our dissections we usually find so large
a quantity of blood in the veins, so little in the arteries; why there is
much in the right ventricle, little in the left, which probably led the
ancients to believe that the arteries (as their name implies) contained
nothing but spirits during the life of an animal. The true cause of the
difference is perhaps this, that as there is no passage to the arteries,
save through the lungs and heart, when an animal has ceased to breathe and
the lungs to move, the blood in the pulmonary artery is prevented from
passing into the pulmonary veins, and from thence into the left ventricle
of the heart; just as we have already seen the same transit prevented in
the embryo, by the want of movement in the lungs and the alternate opening
and shutting of their hidden and invisible porosities and apertures. But
the heart not ceasing to act at the same precise moment as the lungs, but
surviving them and continuing to pulsate for a time, the left ventricle
and arteries go on distributing their blood to the body at large and
sending it into the veins; receiving none from the lungs, however, they
are soon exhausted, and left, as it were, empty. But even this fact
confirms our views, in no trifling manner, seeing that it can be ascribed
to no other than the cause we have just assumed. Moreover
it appears from this that the more frequently or forcibly the arteries
pulsate, the more speedily will the body be exhausted of its blood during
hemorrhage. Hence, also, it happens, that in fainting fits and in states
of alarm, when the heart beats more languidly and less forcibly,
hemorrhages are diminished and arrested. Still
further, it is from this, that after death, when the heart has ceased to
beat, it is impossible by dividing either the jugular or femoral veins and
arteries, by any effort to force out more than one half of the whole mass
of the blood. Neither could the butcher ever bleed the carcass effectually
did he neglect to cut the throat of the ox which he has knocked on the
head and stunned, before the heart had ceased beating. Finally,
we are now in a condition to suspect wherefore it is that no one has yet
said anything to the purpose upon the anastomosis of the veins and
arteries, either as to where or how it is effected, or for what purpose. I
now enter upon the investigation of the subject. CHAPTER
X THE
FIRST POSITION: OF THE QUANTITY So far our first
position is confirmed, whether the thing be referred to calculation or to
experiment and dissection, viz., that the blood is incessantly poured into
the arteries in larger quantities than it can be supplied by the food; so
that the whole passing over in a short space of time, it is matter of
necessity that the blood perform a circuit, that it return to whence it
set out. But
if anyone shall here object that a large quantity may pass through and yet
no necessity be found for a circulation, that all may come from the meat
and drink consumed, and quote as an illustration the abundant supply of
milk in the mammae—for a cow will give three, four, and even seven
gallons and more in a day, and a woman two or three pints whilst nursing a
child or twins, which must manifestly be derived from the food consumed;
it may be answered, that the heart by computation does as much and more in
the course of an hour or two. And
if not yet convinced, he shall still insist, that when an artery is
divided, a preternatural route is, as it were, opened, and that so the
blood escapes in torrents, but that the same thing does not happen in the
healthy and uninjured body when no outlet is made; and that in arteries
filled, or in their natural state, so large a quantity of blood cannot
pass in so short a space of time as to make any return necessary;—to all
this it may be answered, that from the calculation already made, and the
reasons assigned, it appears, that by so much as the heart in its dilated
state contains in addition to its contents in the state of constriction,
so much in a general way must it emit upon each pulsation, and in such
quantity must the blood pass, the body being entire and naturally
constituted. But
in serpents, and several fishes, by tying the veins some way below the
heart, you will perceive a space between the ligature and the heart
speedily to become empty; so that, unless you would deny the evidence of
your senses, you must needs admit the return of the blood to the heart.
The same thing will also plainly appear when we come to discuss our second
position. Let
us here conclude with a single example, confirming all that has been said,
and from which everyone may obtain conviction through the testimony of his
own eyes. If
a live snake be laid open, the heart will be seen pulsating quietly,
distinctly, for more than an hour, moving like a worm, contracting in its
longitudinal dimensions, (for it is of an oblong shape,) and propelling
its contents. It becomes of a paler colour in the systole, of a deeper
tint in the diastole; and almost all things else are seen by which I have
already said that the truth I contend for is established, only that here
everything takes place more slowly, and is more distinct. This point in
particular may be observed more clearly than the noon-day sun: the vena
cava enters the heart at its lower part, the artery quits it at the
superior part; the vein being now seized either with forceps or between
the finger and thumb, and the course of the blood for some space below the
heart interrupted, you will perceive the part that intervenes between the
fingers and the heart almost immediately to become empty, the blood being
exhausted by the action of the heart; at the same time the heart will be
come of a much paler colour, even in its state of dilatation, than it was
before; it is also smaller than at first, from wanting blood; and then it
begins to beat more slowly, so that it seems at length as if it were about
to die. But the impediment to the flow of blood being removed, instantly
the colour and the size of the heart are restored. If,
on the contrary, the artery instead of the vein be compressed or tied, you
will observe the part between the obstacle and the heart, and the heart
itself, to become inordinately distended, to assume a deep purple or even
livid colour, and at length to be so much oppressed with blood that you
will believe it about to be choked; but the obstacle removed, all things
immediately return to their natural state in colour, size, and impulse. Here
then we have evidence of two kinds of death: extinction from deficiency,
and suffocation from excess. Examples of both have now been set before
you, and you have had opportunity of viewing the truth contended for with
your own eyes in the heart. CHAPTER
XI THE
SECOND POSITION IS DEMONSTRATED That this may the more
clearly appear to every one, I have here to cite certain experiments, 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 immediately by anastomosis from the arteries into the
veins, or mediately by the porosities 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
that place to this place, and from that point to this one; from the centre
to the extremities, to wit; and from the extreme parts back again to the
centre. Finally, upon grounds of calculation, 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. The
same thing will also appear in regard to ligatures, and wherefore they are
said to draw; though this is
neither from the heat, nor the pain, nor the vacuum they occasion, nor
indeed from any other cause yet thought of; it will also explain the uses
and advantages to be derived from ligatures in medicine, the principle
upon which they either suppress or occasion hemorrhage; how they induce
sloughing and more extensive mortification in extremities; and how they
act in the castration of animals and the removal of warts and fleshy
tumours. But it has come to pass, from no one having duly weighed and
understood the causes, and rationale of these various effects, that though
almost all, upon the faith of the old writers, recommend ligatures in the
treatment of disease, yet very few comprehend their proper employment, or
derive any real assistance from them in effecting cures. Ligatures
are either very tight or of medium tightness. A ligature I designate as
tight or perfect when it so constricts an extremity that no vessel can be
felt pulsating beyond it. Such a ligature we use in amputations to control
the flow of blood; and such also are employed in the castration of animals
and the ablation of tumours. In the latter instances, all afflux of
nutriment and heat being prevented by the ligature, we see the testes and
large fleshy tumours dwindle, die, and finally fall off. Ligatures
of medium tightness I regard as those which compress a limb firmly all
round, but short of pain, and in such a way as still suffers a certain
degree of pulsation to be felt in the artery beyond them. Such a ligature
is in use in blood-letting, an operation which the fillet applied above
the elbow is not drawn so tight but that the arteries at the wrist may
still be felt beating under the finger. Now
let anyone make an experiment upon the arm of a man, either using such a
fillet as is employed in bloodletting, or grasping the limb lightly 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 larger quantity 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 the wrist nor
anywhere else, do the arteries pulsate, at the same time that 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 preternaturally full. The
hand under such circumstances retains its natural colour and appearance;
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 for some short time in this way, let it be
slackened a little, brought to that state or term of medium tightness
which is used in bleeding, and it will be seen that the whole hand and arm
will instantly become deeply coloured and distended, and the veins show
themselves tumid and knotted; after ten or twelve pulses of the artery,
the hand will be perceived excessively distended, injected, gorged with
blood, drawn, as it is said, by this medium ligature, without pain, or
heat, or any horror of a vacuum, or any other cause yet indicated. If
the finger be applied over the artery as it is pulsating by the edge of
the fillet, at the moment of slackening it, the blood will be felt to
glide through, as it were, underneath the finger; and he, too, upon whose
arm the experiment is made, when the ligature is slackened, is distinctly
conscious of a sensation of warmth, and of something, viz., a stream of
blood suddenly making its way along the course of the vessels and
diffusing itself through the hand, which at the same time begins to feel
hot, and becomes distended. As
we had 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, whilst the
arteries shrink; and such is the degree of distension 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. From
these facts it is easy for every careful observer to learn that the blood
enters an extremity by the arteries; for when they are effectually
compressed nothing is drawn to the member; the hand preserves its colour;
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 where they do not pulsate, as, 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 distension. But the arteries, in spite of its
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 ligature. And
herein consists the difference between the tight and the medium ligature,
that the former not only prevents the passage of the blood in the veins,
but in the arteries also; the latter, however, whilst it does not prevent
the force of the pulse from extending beyond it, and so propelling the
blood to the extremities of the body, compresses the veins, and greatly or
altogether impedes the return of blood through them. Seeing,
therefore, that the moderately tight ligature renders the veins turgid and
distended, and the whole hand full of blood, I ask, whence is this? Does
the blood accumulate below the ligature coming through the veins, or
through the arteries, or passing by certain hidden porosities? Through the
veins it cannot come; still less can it come through invisible channels;
it must needs, then, arrive by the arteries, in conformity with all that
has been already said. That it cannot flow in by the veins appears plainly
enough from the fact that the blood cannot be forced towards the heart
unless the ligature be removed; when this is done suddenly all the veins
collapse, and disgorge themselves of their contents into the superior
parts, the hand at the same time resumes its natural pale colour, the
tumefaction and the stagnating blood having disappeared. Moreover,
he whose arm or wrist has thus been bound for some little time with the
medium bandage, so that it has not only got swollen and livid but cold,
when the fillet is undone is aware of something cold making its way
upwards along with the returning blood, and reaching the elbow or the
axilla. And I have myself been inclined to think that this cold blood
rising upwards to the heart was the cause of the fainting that often
occurs after bloodletting: fainting frequently supervenes even in robust
subjects, and mostly at the moment of undoing the fillet, as the vulgar
say, from the turning of the blood. Farther,
when we see the veins below the ligature instantly swell up and become
gorged, when from extreme tightness it is somewhat relaxed, the arteries
meantime continuing unaffected, this is an obvious indication that the
blood passes from the arteries into the veins, and not from the veins into
the arteries, and that there is either an anastomosis of the two orders of
vessels, or porosities in the flesh and solid parts generally that are
permeable to the blood. It is farther an indication that the veins have
frequent communications with one another, because they all become turgid
together, whilst under the medium ligature applied above the elbow; and if
any single small vein pricked with a lancet, they all speedily shrink, and
disburthening themselves into this they subside almost simultaneously. These
considerations will enable anyone to understand the nature of the
attraction that is exerted by ligatures,; and perchance of fluxes
generally; how, for example, when the veins are compressed by a bandage of
medium tightness applied above the elbow, the blood cannot escaped whilst
it still continues to be driven in, by the forcing power of the heart, by
which the parts are of necessity filled, gorged with blood. And now should
it be otherwise? Heat and pain and a vacuum draw, indeed; but in such wise
only that parts are filled, not preternaturally distended or gorged, and
not so suddenly and violently overwhelmed with the charge of blood forced
in upon them, that the flesh is lacerated and the vessels ruptured.
Nothing of the kind as an effect of heat, or pain, or the vacuum force, is
either credible or demonstrable. Besides,
the ligature is competent to occasion the afflux in question without
either pain, or heat, or a vacuum. Were pain in any way the cause, how
should it happen that, with the arm bound above the elbow, the hand and
fingers should swell below the bandage, and their veins become distended?
The pressure of the bandage certainly prevents the blood from getting
there by the veins. And then, wherefore is there neither swelling nor
repletion of the veins, nor any sign or symptom of attraction or afflux,
above the ligature’? But this is the obvious cause of the preternatural
attraction and swelling below the bandage, and in the hand and fingers,
that the blood is entering abundantly, and with force, but cannot pass out
again. Now
is not this the cause of all tumefaction, as indeed Avicenna has it, and
of all oppressive redundancy in parts, that the access to them is open,
but the egress from them is closed? Whence it comes that they are gorged
and tumefied. And may not the same thing happen in local inflammations,
where, so long as the swelling is on the increase, and has not reached its
extreme term, a full pulse is felt in the part, especially when the
disease is of the more acute kind, and the swelling usually takes place
most rapidly. But these are matters for after discussion. Or does this,
which occurred in my own case, happen from the same cause. Thrown from a
carriage upon one occasion, I struck my forehead a blow upon the place
where a twig of the artery advances from the temple, and immediately,
within the time in which twenty beats could have been made, I felt a
tumour the size of an egg developed, without either heat or any great
pain: the near vicinity of the artery had caused the blood to be effused
into the bruised part with unusual force and velocity. And
now, too, we understand why in phlebotomy we apply our ligature above the
part that is punctured, not below it; did the flow come from above, not
from below, the constriction in this case would not only be of no service,
but would prove a positive hinderance; it would have to be applied below
the orifice, in order to have the flow more free, did the blood descend by
the veins from superior to inferior parts; but as it is elsewhere forced
through the extreme arteries into the extreme veins, and the return in
these last is opposed by the ligature, so do they fill and swell, and
being thus filled and distended, they are made capable of projecting their
charge with force, and to a distance, when any one of them is suddenly
punctured; but the ligature being slacked, and the returning channels thus
left open, the blood forthwith no longer escapes, save by drops; and, as
all the world knows, if in performing phlebotomy the bandage be either
slackened too much or the limb be bound too tightly, the blood escapes
without force, because in the one case the returning channels are not
adequately obstructed; in the other the channels of influx, the arteries,
are impeded. CHAPTER
XII THAT
THERE IS A CIRCULATION OF THE BLOOD If these things be so,
another point which I have already referred to, viz., the continual
passage of blood through the heart will also be confirmed. We have seen,
that the blood passes from the arteries into the veins, not from the veins
into the arteries; we have seen, farther, that almost the whole of the
blood may be withdrawn from a puncture made in one of the cutaneous veins
of the arm if a bandage properly applied be used; we have seen, still
farther, that the blood flows so freely and rapidly that not only is the
whole quantity which was contained in the arm beyond the ligature, and
before the puncture was made, discharged, but the whole which is contained
in the body, both that of the arteries and that of the veins. Whence
we must admit, first, that the blood is sent along with an impulse, and
that it is urged with force below the ligature; for it escapes with force,
which force it receives from the pulse and power of the heart; for the
force and motion of the blood are derived from the heart alone. Second,
that the afflux proceeds from the heart, and through the heart by a course
from the great veins; for it gets into the parts below the ligature
through the arteries, not through the veins; and the arteries nowhere
receive blood from the veins, nowhere receive blood save and except from
the left ventricle of the heart. Nor could so large a quantity of blood be
drawn from one vein (a ligature having been duly applied), nor with such
impetuosity, such readiness, such celerity, unless through the medium of
the impelling power of the heart. But
if all things be as they are now represented, we shall feel ourselves at
liberty to calculate the quantity of the blood, and to reason on its
circular motion. Should anyone, for instance, in performing phlebotomy,
suffer the blood to flow in the manner it usually does, with force and
freely, for some half hour or so, no question but that the greatest part
of the blood being abstracted, faintings and syncopes would ensue, and
that not only would the arteries but the great veins also be nearly
emptied of their contents. It is only consonant with reason to conclude
that in the course of the half hour hinted at, so much as has escaped has
also passed from the great veins through the heart into the aorta. And
further, if we calculate how many ounces flow through one arm, or how many
pass in twenty or thirty pulsations under the medium ligature, we shall
have some grounds for estimating how much passes through the other arm in
the same space of time: how much through both lower extremities, how much
through the neck on either side, and through all the other arteries and
veins of the body, all of which have been supplied with fresh blood, and
as this blood must have passed through the lungs and ventricles of the
heart, and must have come from the great veins,—we shall perceive that a
circulation is absolutely necessary, seeing that the quantities hinted at
cannot be supplied immediately from the ingesta, and are vastly more than
can be requisite for the mere nutrition of the parts. It
is still further to be observed, that in practicing phlebotomy the truths
contended for are sometimes confirmed in another way; for having tied up
the arm properly, and made the puncture duly, still, if from alarm or any
other causes, a state of faintness supervenes, in which the heart always
pulsates more languidly, the blood does not flow freely, but distills by
drops only. The reason is, that with the somewhat greater than usual
resistance offered to the transit of the blood by the bandage, coupled
with the weaker action of the heart, and its diminished impelling power,
the stream cannot make its way under the ligature; and farther, owing to
the weak and languishing state of the heart, the blood is not transferred
in such quantity as wont from the veins to the arteries through the
sinuses of that organ. So also, and for the same reasons, are the
menstrual fluxes of women, and indeed hemorrhages of every kind,
controlled. And now, a contrary state of things occurring, the patient
getting rid of his fear and recovering his courage, the pulse strength is
increased, the arteries begin again to beat with greater force, and to
drive the blood even into the part that is bound; so that the blood now
springs from the puncture in the vein, and flows in a continuous stream. CHAPTER
XIII THE
THIRD POSITION IS CONFIRMED: Thus far we have spoken
of the quantity of blood passing through the heart and the lungs in the
centre of the body, and in like manner from the arteries into the veins in
the peripheral parts and the body at large. We have yet to explain,
however, in what manner the blood finds its way back to the heart from the
extremities by the veins, and how and in what way these are the only
vessels that convey the blood from the external to the central parts;
which done, I conceive that the three fundamental propositions laid down
for the circulation of the blood will be so plain, so well established, so
obviously true, that they may claim general credence. Now the remaining
position will be made sufficiently clear from the valves which are found
in the cavities of the veins themselves, from the uses of these, and from
experiments cognizable by the senses. The
celebrated Hieronymus Fabricius of Aquapendente, a most skillful
anatomist, and venerable old man, or, as the learned Riolan will have it,
Jacobus Silvius, first gave representations of the valves in the veins,
which consist of raised or loose portions of the inner membranes of these
vessels, of extreme delicacy, and a sigmoid or semilunar shape. They are
situated at different distances from one another, and diversely in
different individuals; they are connate at the sides of the veins; they
are directed upwards or towards the trunks of the veins; the two—for
there are for the most part two together—regard each other, mutually
touch, and are so ready to come into contact by their edges, that if
anything attempt to pass from the trunks into the branches of the veins,
or from the greater vessels into the less, they completely prevent it;
they are farther so arranged, that the horns of those that succeed are
opposite the middle of the convexity of those that precede, and so on
alternately. The
discoverer of these valves did not rightly understand their use, nor have
succeeding anatomists added anything to our knowledge: for their office is
by no means explained when we are told that it is to hinder the blood, by
its weight, from all flowing into inferior parts; for the edges of the
valves in the jugular veins hang downwards, and are so contrived that they
prevent the blood from rising upwards; the valves, in a word, do not
invariably look upwards, but always towards the trunks of the veins,
invariably towards the seat of the heart. I, and indeed others, have
sometimes found valves in the emulgent veins, and in those of the
mesentery, the edges of which were directed towards the vena cava and vena
portae. Let it be added that there are no valves in the arteries, and that
dogs, oxen, etc., have invariably valves at the divisions of their crural
veins, in the veins that meet towards the top of the os sacrum, and in
those branches which come from the haunches, in which no such effect of
gravity from the erect position was to be apprehended. Neither are there
valves in the jugular veins for the purpose of guarding against apoplexy,
as some have said; because in sleep the head is more apt to be influenced
by the contents of the carotid arteries. Neither are the valves present in
order that the blood may be retained in the divarications or smaller
trunks and minuter branches, and not be suffered to flow entirely into the
more open and capacious channels; for they occur where there are no
divarications; although it must be owned that they are most frequent at
the points where branches join. Neither do they exist for the purpose of
rendering the current of blood more slow from the centre of the body; for
it seems likely that the blood would be disposed to flow with sufficient
slowness of its own accord, as it would have to pass from larger into
continually smaller vessels, being separated from the mass and fountain
head, and attaining from warmer into colder places. But
the valves are solely made and instituted lest the blood should pass from
the greater into the lesser veins, and either rupture them or cause them
to become varicose; lest, instead of advancing from the extreme to the
central parts of the body, the blood should rather proceed along the veins
from the centre to the extremities; but the delicate valves, while they
readily open in the right direction, entirely prevent all such contrary
motion, being so situated and arranged, that if anything escapes, or is
less perfectly obstructed by the cornua of the one above, the fluid
passing, as it were, by the chinks between the cornua, it is immediately
received on the convexity of the one beneath, which is placed transversely
with reference to the former, and so is effectually hindered from getting
any farther. And
this I have frequently experienced in my dissections of the veins: if I
attempted to pass a probe from the trunk of the veins into one of the
smaller branches, whatever care I took I found it impossible to introduce
it far any way, by reason of the valves; whilst, on the contrary, it was
most easy to push it along in the opposite direction, from without
inwards, or from the branches towards the trunks and roots. In many places
two valves are so placed and fitted, that when raised they come exactly
together in the middle of the vein, and are there united by the contact of
their margins; and so accurate is the adaptation, that neither by the eye
nor by any other means of examination, can the slightest chink along the
line of contact be perceived. But if the probe be now introduced from the
extreme towards the more central parts, the valves, like the floodgates of
a river, give way, and are most readily pushed aside. The effect of this
arrangement plainly is to prevent all motion of the blood from the heart
and vena cava, whether it be upwards towards the head, or downwards
towards the feet, or to either side towards the arms, not a drop can pass;
all motion of the blood, beginning in the larger and tending towards the
smaller veins, is opposed and resisted by them; whilst the motion that
proceeds from the lesser to end in the larger branches is favoured, or, at
all events, a free and open passage is left for it. But
that this truth may be made the more apparent, let an arm be tied up above
the elbow as if for phlebotomy (A, A, fig. 1). At intervals in the course
of the veins, especially in labouring people and those whose veins are
large, certain knots or elevations (B, C, D, E, F,) will be perceived, and
this not only at the places where a branch is received (E, F), but also
where none enters ( C, D): these knots or risings are all formed by
valves, which thus show themselves externally. And now if you press the
blood from the space above one of the valves, from H to O, (fig. 2,) and
keep the point of a finger upon the vein inferiorly, you will see no
influx of blood from above; the portion of the vein between the point of
the finger and the valve O will be obliterated; yet will the vessel
continue sufficiently distended above the valve (O, G). The blood being
thus pressed out, and the vein emptied, if you now apply a finger of the
other hand upon the distended part of the vein above the valve O, (fig.
3,) and press downwards, you will find that you cannot force the blood
through or beyond the valve; but the greater effort you use, you will only
see the portion of vein that is between the finger and the valve become
more distended, that portion of the vein which is below the valve
remaining all the while empty (H, O, fig. 3).
It
would therefore appear that the function of the valves in the veins is the
same as that of the three sigmoid valves which we find at the commencement
of the aorta and pulmonary artery, viz., to prevent all reflux of the
blood that is passing over them. Farther,
the arm being bound as before, and the veins looking full and distended,
if you press at one part in the course of a vein with the point of a
finger L, fig. 4), and then with another finger streak the blood upwards
beyond the next valve (N), you will perceive that this portion of the vein
continues empty (L N), and that the blood cannot retrograde, precisely as
we have already seen the case to be in fig. 2; but the finger first
applied (H, fig. 2, L, fig. 4), being removed, immediately the vein is
filled from below, and the arm becomes as it appears at D C, fig. l. That
the blood in the veins therefore proceeds from inferior or more remote to
superior parts, and towards the heart, moving in these vessels in this and
not in the contrary direction, appears most obviously. And although in
some places the valves, by not acting with such perfect accuracy, or where
there is but a single valve, do not seem totally to prevent the passage of
the blood from the centre, still the greater number of them plainly do so;
and then, where things appear contrived more negligently, this is
compensated either by the more frequent occurrence or more perfect action
of the succeeding valves, or in some other way: the veins, in short, as
they are the free and open conduits of the blood returning to the heart,
so are they effectually prevented from serving as its channels of
distribution from the heart. But
this other circumstance has to be noted: The arm being bound, and the
veins made turgid, and the valves prominent, as before, apply the thumb or
finger over a vein in the situation of one of the valves in such a way as
to compress it, and prevent any blood from passing upwards from the hand;
then, with a finger of the other hand, streak the blood in the vein
upwards till it has passed the next valve above (N, fig. 4,) the vessel
now remains empty; but the finger at L being removed for an instant, the
vein is immediately filled from below; apply the finger again, and having
in the same manner streaked the blood upwards, again remove the finger
below, and again the vessel becomes distended as before; and this repeat,
say a thousand times, in a short space of time. And now compute the
quantity of blood which you have thus pressed up beyond the valve, and
then multiplying the assumed quantity by one thousand, you will find that
so much blood has passed through a certain portion of the vessel; and I do
now believe that you will find yourself convinced of the circulation of
the blood, and of its rapid motion. But if in this experiment you say that
a violence is done to nature, I do not doubt but that, if you proceed in
the same way, only taking as great a length of vein as possible, and
merely remark with what rapidity the blood flows upwards, and fills the
vessel from below, you will come to the same conclusion. CHAPTER
XIV CONCLUSION
OF THE DEMONSTRATION And now I may be
allowed to give in brief my view of the circulation of the blood, and to
propose it for general adoption . Since
all things, both argument and ocular demonstration, show that the blood
passes through the lungs and heart by the force of the ventricles, and is
sent for distribution to all parts of the body, where it makes its way
into the veins and porosities of the flesh, and then flows by the veins
from the circumference on every side to the centre, from the lesser to the
greater veins, and is by them finally discharged into the vena cava and
right auricle of the heart, and this in such a quantity or in such a flux
and reflux thither by the arteries, hither by the veins, as cannot
possibly be supplied by the ingesta, and is much greater than can be
required for mere purposes of nutrition; it is absolutely necessary to
conclude that the blood in the animal body is impelled in a circle, and is
in a state of ceaseless motion; that this is the act or function which the
heart performs by means of its pulse; and that it is the sole and only end
of the motion and contraction of the heart. CHAPTER
XV THE
CIRCULATION OF THE BLOOD It will not be foreign
to the subject if I here show further, from certain familiar reasonings,
that the circulation is matter both of convenience and necessity. In the
first place, since death is a corruption which takes place through
deficiency of heat, and since all living things are warm, all dying things
cold, there must be a particular seat and fountain, a kind of home and
hearth, where the cherisher of nature, the original of the native fire, is stored and
preserved; from which heat and life are dispensed to all parts as from a
fountain head; from which sustenance may be derived; and upon which
concoction and nutrition, and all vegetative energy may depend. Now, that
the heart is this place, that the heart is the principle of life, and that
all passes in the manner just mentioned, I trust no one will deny. The
blood, therefore, required to have motion, and indeed such a motion that
it should return again to the heart; for sent to the external parts of the
body far from its fountain, as Aristotle says, and without motion, it
would become congealed. For we see motion generating and keeping up heat
and spirits under all circumstances, and rest allowing them to escape and
be dissipated. The blood, therefore, becoming thick or congealed by the
cold of the extreme and outward parts, and robbed of its spirits, just as
it is in the dead, it was imperative that from its fount and origin, it
should again receive heat and spirits, and all else requisite to its
preservation-that, by returning, it should be renovated and restored. We
frequently see how the extremities are chilled by the external cold, how
the nose and cheeks and hands look blue, and how the blood, stagnating in
them as in the pendent or lower parts of a corpse, becomes of a dusky hue;
the limbs at the same time getting torpid, so that they can scarcely be
moved, and seem almost to have lost their vitality. Now they can by no
means be so effectually, and especially so speedily restored to heat and
colour and life, as by a new efflux and contact of heat from its source.
But how can parts attract in which the heat and life are almost extinct?
Or how should they whose passages are filled with condensed and frigid
blood, admit fresh aliment—renovated blood—unless they had first got
rid of their old contents? Unless the heart were truly that fountain where
life and heat are restored to the refrigerated fluid, and whence new
blood, warm, imbued with spirits, being sent out by the arteries, that
which has become cooled and effete is forced on, and all the particles
recover their heat which was failing, and their vital stimulus well-nigh
exhausted. Hence
it is that if the heart be unaffected, life and health may be restored to
almost all the other parts of the body; but if the heart be chilled, or
smitten with any serious disease, it seems matter of necessity that the
whole animal fabric should suffer and fall into decay. When the source is
corrupted, there is nothing, as Aristotle says, which can be of service
either to it or aught that depends on it. And hence, by the way, it may
perchance be why grief, and love, and envy, and anxiety, and all
affections of the mind of a similar kind are accompanied with emaciation
and decay, or with disordered fluids and crudity, which engender all
manner of diseases and consume the body of man. For every affection of the
mind that is attended with either pain or pleasure, hope or fear, is the
cause of an agitation whose influence extends to the heart, and there
induces change from the natural constitution, in the temperature, the
pulse and the rest, which impairing all nutrition in its source and
abating the powers at large, it is no wonder that various forms of
incurable disease in the extremities and in the trunk are the consequence,
inasmuch as in such circumstances the whole body labours under the effects
of vitiated nutrition and a want of native heat. Moreover,
when we see that all animals live through food digested in their interior,
it is imperative that the digestion and distribution be perfect; and, as a
consequence, that there be a place and receptacle where the aliment is
perfected and whence it is distributed to the several members. Now this
place is the heart, for it is the only organ in the body which contains
blood for the general use; all the others receive it merely for their
peculiar or private advantage just as the heart also has a supply for its
own especial behoof in its coronary veins and arteries. But it is of the
store which the heart contains in its auricles and ventricles that I here
speak. Then the heart is the only organ which is so situated and
constituted that it can distribute the blood in due proportion to the
several parts of the body, the quantity sent to each being according to
the dimensions of the artery which supplies it, the heart serving as a
magazine or fountain ready to meet its demands. Further,
a certain impulse or force, as well as an impeller or forcer, such as the
heart, was required to effect this distribution and motion of the blood;
both because the blood is disposed from slight causes, such as cold,
alarm, horror, and the like, to collect in its source, to concentrate like
parts to a whole, or the drops of water spilt upon a table to the mass of
liquid; and because it is forced from the capillary veins into the smaller
ramifications, and from these into the larger trunks by the motion of the
extremities and the compression of the muscles generally. The blood is
thus more disposed to move from the circumference to the centre than in
the opposite direction, even were there no valves to oppose its motion;
wherefore, that it may leave its source and enter more confined and colder
channels, and flow against the direction to which it spontaneously
inclines, the blood requires both force and an impelling power. Now such
is the heart and the heart alone, and that in the way and manner already
explained. CHAPTER
XI THE
CIRCULATION OF THE BLOOD There are still certain
problems, which, taken as consequences of this truth assumed as proven,
are not without their use in exciting belief, as it were, a
posteriore; and which, although they may seem to be involved in much
doubt and obscurity, nevertheless readily adrnit of having reasons and
causes assigned for them. Of such a nature are those that present
themselves in connection with contagions, poisoned wounds, the bites of
serpents and rabid animals, lues venerea and the like. We sometimes see
the whole system contaminated, thougll the part first infected remains
sound; the lues venerea has occasionally made its attack with pains in the
shoulders and head, and other symptoms, the genital organs being all the
while unaffected; and then we know that the wound made by a rabid dog
having healed, fever and a train of disastrous symptoms may nevertheless
supervene. Whence it appears that the contagion impressed upon or
deposited in a particular part, is by-and-by carried by the returning
current of blood to the heart, and by that organ is sent to contaminate
the whole body. In
tertian fever, the morbific cause seeking the heart in the first instance,
and hanging about the heart and lungs, renders the patient shortwillded,
disposed to sighing, and indisposed to exertion, because the vital
principle is oppressed and the blood forced into the lungs and rendered
thick. It does not pass through them, (as I have myself seen in opening
the bodies of those who had died in the beginning of the attack,) when the
pulse is always frequent, small, and occasionally irregular; but the heat
increasing, the matter becoming attenuated, the passages forced, and the
transit made, the whole body begins to rise in temperature, and the pulse
becomes fuller and stronger. The febrile paroxysm is fully formed, whilst
the preternatural heat kindled in the heart is thence diffused by the
arteries through the whole body along with the morbific matter, which is
in this way overcome and dissolved by nature. When
we perceive, further, that medicines applied externally exert their
influence on the body just as if they had been taken internally, the truth
we are contending for is confirmed. Colocynth and aloes in this way move
the belly, cantharides excites the urine, garlic applied to the soles of
the feet assists expectoration, cordials strengthen, and an infinite
number of examples of the same kind might be cited. Perhaps it will not,
therefore, be found unreasonable, if we say that the veins, by means of
their orifices, absorb some of the things that are applied externally and
carry this inwards with the blood, not otherwise, it may be, than those of
the mesentery imbibe the chyle from the intestines and carry it mixed with
the blood to the liver. For the blood entering the mesentery by the celiac
artery, and the superior and inferior mesenteries, proceeds to the
intestines, from which, along with the chyle that has been attracted into
the veins, it retums by their numerous ramifications into the vena portae
of the liver, and from this into the vena cava, and in such wise that the
blood in these veins has the same colour and consistency as in other
veins, in opposition to what many believe to be the fact. Nor indeed can
we imagine two contrary motions in any capillary system—the chyle
upwards, the blood downwards. This could scarcely take place, and must be
held as altogether improbable. But is not the thing rather arranged as it
is by the consumunate providence of nature? For were the chyle mingled
with the blood, the crude with the digested, in equal proportions, the
result would not be concoction, transmutation, and sanguification, but
rather, and because they are severally active and passive, a mixture or
combination, or medium compound of the two, precisely as happens when wine
is mixed with water and syrup. But when a very minute quantity of chyle is
mingled with a very large quantity of circulating blood, a quantity of
chyle that bears no kind of proportion to the mass of blood, the effect is
the same as Aristotle says, as when a drop of water is added to a cask of
wine, or the contrary; the mass does not then present itself as a mixture,
but is still sensibly either wine or water. So in the mesenteric veins of
an animal we do not find either chyme or chyle and blood, blended together
or distinct, but only blood, the same in colour, consistency, and other
sensible properties, as it appears in the veins generally. Still as there
is a certain though small and inappreciable proportion of chyle or
incompletely digested matter mingled with this blood, nature has
interposed the liver, in whose meandering channels it suffers delay and
undergoes additional change, lest arriving prematurely and crude at the
heart, it should oppress the vital principle. Hence in the embryo, there
is almost no use for the liver, but the umbilical vein passes directly
through, a foramen or anastomosis existing from the vena portae. The blood
returns from the intestines of the foetus, not through the liver, but into
the umbilical vein mentioned, and flows at once into the heart, mingled
with the natural blood which is returning from the placenta; whence also
it is that in the development of the foetus the liver is one of the organs
that is last formed. I have observed all the members perfectly marked out
in the human foetus, even the genital organs, whilst there was yet
scarcely any trace of the liver. And indeed at the period when all the
parts, like the heart itself in the beginning, are still white, and except
in the veins there is no appearance of redness, you shall see nothing in
the seat of the liver but a shapeless collection, as it were, of
extravasated blood, which you might take for the effects of a contusion or
ruptured vein. But
in the incubated egg there are, as it were, two umbilical vessels, one
from the albumen passing entire through the liver, and going straight to
the heart; another from the yelk, ending in the vena portae; for it
appears that the chick, in the first instance, is entirely formed and
nourished by the white; but by the yelk after it has come to perfection
and is excluded from the shell; for this part may still be found in the
abdomen of the chick; many days after its exclusion, and is a substitute
for the milk to other animals. But
these matters will be better spoken of in my observations on the
fortnation of the foetus, where many propositions, the following among the
number, will be discussed: Wherefore is this part formed or perfected
first, that last, and of the several members, what part is the cause of
another? And there are many points having special reference to the heart,
such as wherefore does it first acquire consistency, and appear to possess
life, motion, sense, before any other part of the body is perfected, as
Aristotle says in his third book, “De partibus Animalium”? And so also
of the blood, wherefore does it precede all the rest? And in what way does
it possess the vital and animal principle, and show a tendency to motion,
and to be impelled hither and thither, the end for which the heart appears
to be made? In the same way, in considering the pulse, why should one kind
of pulse indicate death, another recovery? And so of all the other kinds
of pulse what may be the cause and indication of each? Likewise we must
consider the reason of crises and natural critical discharges; of
nutrition, and especially the distribution of the nutriment; and of
defluxions of every description. Finally, reflecting on every part of
medicine, physiology, pathology, semeiotics, and therapeutics, when I sec
how mally questions can bc answered, how many doubts resolved, how much
obscurity illustrated by the truth we have declared, the light we have
made to shine, I see a field of such vast extent in which I might proceed
so far, and expatiate so widely, that this my tractate would not only
spell out into a volume, which was beyond my purpose, but my whole life,
perchance would not suffice for its completion. In
this place, therefore, and that indeed in a single chapter, I shall only
endeavour to refer the various particulars that present themselves in the
dissection of the heart and arteries to their several uses and causes; for
so I shall meet with many things which receive light from the truth I have
been contending for, and which, in their turn, render it more obvious. And
indeed I would have it confirmed and illustrated by anatomical arguments
above all others. There
is but a single point which indeed would be more correctly placed among
our observations on the use of the spleen, but which it will not be
altogether impertinent to notice in this place incidelltally. From the
splenetic branc which
passes into the pancreas, and from the upper part, arise the posterior
coronary, gastric, and gastroepiploic veins, all of which are distributed
UpOII the stomach in numerous branches and twigs, just as the mesenteric
vessels are upon the intestines. In a similar way, from the inferior part
of the same splenic branch, and alone the back of the colon and rectum
proceed the hemor rhoidal veins. The blood returning by these veins, and
bringing the cruder juices along with it, on the one halld from the
stomach, where they are thin, watery, and not yet perfectly chylified; on
the other thick and more earthy, as derived from the feces, but all poured
into this splenic branch, are duly tempered by the admixture of
contraries; and nature mingling together these two kinds of juices,
difficult of coction by reason of most opposite defects, and then diluting
them with a large quantity of warm blood, (for we see that the quantity
returned from the spleen must be very large when we contemplate the size
of its they are brought to the porta of the state of higher preparation.
The defects extreme are supplied and compensated by this arrangement of
the veins. |