| William Harvey | |
|---|---|
) William Harvey | |
| Born | 1 April 1578 Folkestone |
| Died | 3 June 1657 (aged 79) Roehampton |
| Nationality | England |
| Fields | Medicine Physiology |
| Doctoral advisor | Hieronymus Fabricius |
| Known for | Systemic circulation |
William Harvey (1 April 1578 – 3 June 1657) was an English physician who was the first person to describe completely and in detail the systemic circulation and properties of blood being pumped to the body by the heart. After his death "The William Harvey Hospital" was constructed in the town of Ashford, several miles from his birthplace of Folkestone.
Family
Harvey's father Thomas Harvey, was a jurat of Folkestone where he served the office of mayor in 1600. Records and personal descriptions delineate him as an overall calm, diligent and intelligent man whose "sons... revered, consulted and implicitly trusted in him... (they) made their father the treasurer of their wealth when they acquired great estates...(He) kept, employed and improved their gainings to their great advantage."[1] Thomas Harvey's portrait can still be seen in the central panel of a wall of the dining-room at Rolls Park, Chigwell, in Essex.
Life
Early life and the University of Padua
Harvey's initial education was carried out in Folkestone, where he learned Latin. He then entered the King's School (Canterbury). Harvey remained at the King's School for five years, after which he joined Caius College in Cambridge.
Harvey graduated as a Bachelor of Arts from Caius College in 1597.[2] He then traveled through France and Germany to Italy, where he entered the University of Padua,in 1599.
During Harvey's years of study there, he developed a relationship with Fabricius and read Fabricius' De Venarum Ostiolis.
Harvey graduated as a Doctor of Medicine at the age of 24 from the University of Padua on 25 April 1602. It reports that Harvey had
"conducted himself so wonderfully well in the examination and had shown such skill, memory and learning that he had far surpassed even the great hopes which his examiners had formed of him."[3]
The College of Physicians, Marriage and Saint Bartholomew's Hospital
After graduating from Padua, Harvey immediately returned to England where he obtained the degree of Doctor of Medicine from the University of Cambridge that same year. Following this, Harvey established himself in London, joining the College of Physicians on 5 October 1604.
A few weeks after his admission, Harvey married Elizabeth Browne, "daughter of Lancelot Browne, (himself) Dr. Physic".[4] They had no children.
Elected a Fellow of the College of Physicians on 5 June 1607, Harvey accepted a position at St. Bartholomew's Hospital that he was to occupy for almost all the rest of his life. Succeeding a Dr Wilkinson on 14 October 1609, he became the Physician in charge at St. Bartholomew's Hospital, which enjoined him, "in God's most holy name" to "endeavor yourself to do the best of your knowledge in the profession of physic to the poor then present, or any other of the poor at any time of the week which shall be sent home unto you by the Hospitaller... You shall not, for favor, lucre or gain, appoint or write anything for the poor but such good and wholesome things as you shall think with your best advice will do the poor good, without any affection or respect to be had to the apothecary. And you shall take no gift or reward... for your counsel... This you will promise to do as you shall answer before God... "[5]
Harvey earned around thirty-three pounds a year and lived in a small house in Ludgate, although two houses in West Smithfield were attached as fringe benefits to the post of Physician. At this point, the physician's function consisted of a simple but thorough analysis of patients who were brought to the hospital once a week and the consequent writing of prescriptions.
Lumleian Lecturer
The next important phase of Harvey's life began with his appointment to the office of Lumleian lecturer on 4 August 1615. The Lumleian lectureship, founded by a Lord Lumley and a Dr. Caldwell in 1583, consisted in pronouncing lectures for a period of seven years, with the purpose of "spreading light" and increasing the general knowledge of anatomy throughout England.
Harvey began his lectures in April 1616. At this time, at the age of thirty-seven, he was described as "a man of lowest stature, round faced; his eyes small, round, very black and full of spirit; his hair as black as a raven and curling".[6] The notes which he used at the time are preserved in the British Museum.
At the beginning of his lectures, Harvey laid down the canons for his guidance:
- "To show as much as may be at a glance, the whole belly for instance, and afterwards to subdivide the parts according to their positions and relations.
- To point out what is peculiar to the actual body which is being dissected.
- To supply only by speech what cannot be shown on your own credit and by authority.
- To cut up as much as may be in the sight of the audience.
- To enforce the right opinion by remarks drawn far and near, and to illustrate man by the structure of animals.
- Not to praise or dispraise other anatomists, for all did well, and there was some excuse even for those who are in error.
- Not to dispute with others, or attempt to confute them, except by the most obvious retort.
- To state things briefly and plainly, yet not letting anything pass unmentioned which can be seen.
- Not to speak of anything which can be as well explained without the body or can be read at home.
- Not to enter into too much detail, or in too minute dissection, for the time does not permit.
- To allot a definite time to each part of the body (i.e. first day's lectures dedicated to the abdomen, the second to the thorax, the third to the brain and so on."[7]
Physician to James I
Harvey continued to participate in the Lumleain lectures while also taking care of his patients at St. Bartholomew's Hospital; he thus soon attained an important and fairly lucrative practice, which climaxed with his appointment as 'Physician Extraordinary' to King James I on 3 February 1618. He seems to have similarly served various aristocrats, including Lord Chancellor Bacon).
In 1628 he published in Frankfort-on-the-Main his completed treatise on the circulation of the blood, the De Motu Cordis. As a result of negative comments by other physicians Harvey "fell mightily in his practice",[8] but continued advancing his career. He was re-elected 'Censor' of the College of Physicians in 1629, having been elected for the first time in 1613 and the second time in 1625. Eventually, Harvey was also elected Treasurer of the College.
Excursions abroad, election as physician to Charles I and the English Civil War
At the age of fifty-two, Harvey received commands by the king to accompany the Duke of Lennox during his trip abroad. This voyage - the first after his return from Padua - lasted three years, taking Harvey through the countries of France and Spain during the Mantuan War and Plague. During this journey he wrote to Viscount Dorchester:
"I can complain that by the way we could scarce see a dog, crow, kite, raven or any other bird, or anything to anatomize, only some few miserable people, the relics of the war and the plague where famine had made anatomies before I came. It is scarce credible in so rich, populous, and plentiful countries as these were that so much misery and desolation, poverty and famine should in so short a time be, as we have seen. I interpret it well that it will be a great motive for all here to have and procure assurance of settled peace. It is time to leave fighting when there is nothing to eat, nothing to be keep, and nothing to be gotten".[9]
Having returned to England in 1632, Harvey accompanied King Charles I wherever he went as 'Physician in Ordinary.' In particular, Charles' hunting expeditions gave Harvey access to many deer carcasses; it was upon them that Harvey made many observations and consequent theories.
During the English Civil War a mob of citizen-soldiers against the King entered Harvey's lodgings, stole his goods, and scattered his papers. The papers consisted of the records of a large number of dissections... of diseased bodies, with this observations on the development on insects, and a series of notes on comparative anatomy."[10] During this period, Harvey maintained his position, helped the wounded on several occasions and protected the King's children.
The conflicts of the Civil War soon led King Charles to Oxford, with Harvey attending, where the physician was made 'Doctor of Physic' in 1642 and later Warden of Merton College in 1645. "In Oxford he (Harvey) very soon settled down to his accustomed pursuits, unmindful of the clatter of arms and of the constant marching and countermarching around him, for the city remained the base of operations until its surrender... "[11]
Harvey's later years, death and burial
The surrender of Oxford in 1645 marks the beginning of Harvey's gradual retirement from public life and duties. Now sixty-eight years old and childless, Harvey had lost three brothers and wife at this time. He thus decided to return to London and live with his brothers Eliab and Daniel separately and in different periods of time. Having retired from St Bartholomew's Hospital and his various other aforementioned positions, he passed most of this time reading general literature. Several attempts to bring Harvey back into the 'working world' were made, however; here is an excerpt of one of Harvey's answers:
"Would you be the man who should recommend me to quit the peaceful haven where I now pass my life and launch again upon the faithless sea? You know full well what a storm my former lucubrations raised. Much better is it oftentimes to grow wise at home and in private, than by publishing what you have amassed with infinite labour, to stir up tempests that may rob you of peace and quiet for the rest of your days."[12]
Harvey died at Roehampton in the house of this brother Eliab on 3 June 1657. Descriptions of the event seem to show that he died of a cerebral hemorrhage from vessels long injured by gout: it is highly probable that the left Sylvian artery malfunctioned, leading to a gradual accumulation of blood to the brain which eventually overwhelmed it. There exists a fairly detailed account of what happened on that day; according to the information at hand, Harvey:
"went to speak and found that he had the dead palsy in his tongue; then he saw what was to become of him. He knew there were then no hopes of his recovery, so presently he sends for his young nephews to come up to him. He then made signs (for seized with the dead palsy in his tongue he could not speak) to let him blood his tongue, which did him little or no good, and so ended his days, dying in the evening of the day on which he was stricken, the palsy giving him an easy passport."[13]
His will distributed his material goods and wealth throughout his extended family also left a substantial amount of money to the College of Physicians.
Harvey was buried in Hempstead, Essex. The funeral procession started on the 26 June 1657 leading Harvey to be placed in the 'Harvey Chapel' built by Eliab. The conditions of Harvey's burial are also known: "Harvey was laid in the chapel between the bodies of his two nieces, and like them he was lept in lead, coffin less "[14]. On St.Luke's Day, October 18, 1883, Harvey's remains were reinterred, the leaden case carried from the vault by eight Fellows of the College of Physicians, and deposited in a sarcophagus containing his works and an inscription:
"The body of William Harvey lapt in lead, simply soldered, was laid without shell or enclosure of any kind in the Harvey vault of this Church of Hempstead, Essex, in June, 1657. In the course of time the lead enclosing the remains was, from expose and natural decay, so seriously damaged as to endanger its preservation, rendering some repair of it the duty of those interested in the memory of the illustrious discoverer of the circulation of the Blood. The Royal College of Physicians, of which corporate body Harvey was a munificent Benefactor did in the years 1882-1883, by permission of the Representatives of the Harvey family, undertake this duty. In accordance with this determination the leaden mortuary chest containing the remains of Harvey was repaired, and was, as far as possible, restored to its original state... "[15]
"De Motu Cordis" (otherwise known as "On the Motion of the Heart and Blood")
Published in 1628 in the city of Frankfurt (host to an annual book fair that Harvey knew would allow immediate dispersion of his work), this 72 page book contains the matured account of the circulation of the blood. Opening with a simple but clear dedication to King Charles I, the quarto has 17 chapters which give a perfectly clear and connected account of the action of the heart and the consequent movement of the blood around the body in a circuit. Having only a mere lens at his disposal, Harvey was not able to reach the adequate images that were attained through such microscopes used by Leeuwenhoek; thus he had to resort to theory – and not practical evidence – in certain parts of his book. After the first chapter, which simply outlines past ideas and accepted rules regarding the heart and lungs, Harvey moves on to a fundamental premise to his treatise, stating that it was extremely important to study the heart when it was active in order to truly comprehend its true movement; a task which even he found of great difficulty, as he says:
"...I found the task so truly arduous... that I was almost tempted to think... that the movement of the heart was only to be comprehended by God. For I could neither rightly perceive at first when the systole and when the diastole took place by reason of the rapidity of the movement..."[16]
This initial thought led Harvey's ambition and assiduousness to a detailed analysis of the overall structure of the heart (studied with less hindrances in cold-blooded animals.) After this, Harvey goes on to an analysis of the arteries, showing how their pulsation depends upon the contraction of the left ventricle, while the contraction of the right ventricle propels its charge of blood into the pulmonary artery. Whilst doing this, the physician reiterates the fact that these two ventricles move together almost simultaneously and not independently like had been thought previously by his predecessors. This discovery was made while observing the heart of such animals as the eel and several other types of fish; indeed, the general study of countless animals was of utmost importance to the physician: among the ones already cited, one can add the study of the snail, the invisible shrimp, the chick before its hatching and even the pigeon. A digression to an experiment can be made to this note: using the inactive heart of a dead pigeon and placing upon it a finger wet with saliva, Harvey was able to witness a transitory and yet incontrovertible pulsation. He had just witnessed the heart's ability to recover from fatigue.
As early as the 17th century, William Harvey had already discerned the existence of the Ductus Arteriosus and explained its relative function. Here he says, "...in embryos, whilst the lungs are in a state of inaction, performing no function, subject to no movement any more than if they had not been present, Nature uses the two ventricles of the heart as if they formed but one for the transmission of the blood."[17] However, the apex of Harvey's work is probably the eighth chapter, in which he deals with the actual quantity of blood passing through the heart from the veins to the arteries. Coming into conflict with Galen's accepted view of the liver as the origin of venous blood, Harvey estimated the capacity of the heart, how much blood is expelled through each pump of the heart, and the amount of times the heart beats in a half an hour. All of these estimates were purposefully low, so that people could see the vast amount of blood Galen's theory required the liver to produce. He estimated that the capacity of the heart was 1.5 ounces, and that every time the heart pumps, 1/8 of that blood is expelled. This led to Harvey's estimate that about 1/6 of an ounce of blood went through the heart every time it pumped. The next estimate he used was that the heart beats 1000 times every half an hour, which gave 10 pounds 6 ounces of blood in a half an hour, and when this number was multiplied by 48 half hours in a day he realized that the liver would have to produce 540 pounds of blood in a day.
Having this simple but essential mathematical proportion at hand - which proved the overall impossible aforementioned role of the liver - Harvey went on to prove how the blood circulated in a circle by means of countless experiments initially done on serpents and fish: tying their veins and arteries in separate periods of time, Harvey noticed the modifications which occurred; indeed, as he tied the veins, the heart would become empty, while as he did the same to the arteries, the organ would swell up.
_Venenbild.jpg'))
This process was later performed on the human body (in the image on the right): the physician tied a tight ligature onto the upper arm of a person. This would cut off blood flow from the arteries and the veins. When this was done, the arm below the ligature was cool and pale, while above the ligature it was warm and swollen. The ligature was loosened slightly, which allowed blood from the arteries to come into the arm, since arteries are deeper in the flesh than the veins. When this was done, the opposite effect was seen in the lower arm. It was now warm and swollen. The veins were also more visible, since now they were full of blood. Harvey then noticed little bumps in the veins, which he realized were the valves of the veins, discovered by his teacher, Hieronymus Fabricius. Harvey tried to push blood in the vein down the arm, but to no avail. When he tried to push it up the arm, it moved quite easily. The same effect was seen in other veins of the body, except the veins in the neck. Those veins were different from the others - they did not allow blood to flow up, but only down. This led Harvey to believe that the veins allowed blood to flow to the heart, and the valves maintained the one way flow.
It is also important to state how Harvey had theorized the existence of capillaries: however, unable to discern them due to the aforementioned scarcity of instruments at this disposal, he was never truly capable of understanding how blood passed from the arterioles into the venules.
The circulation of blood before William Harvey
Theory regarding the role of the heart and circulation of the blood has been reviewed by many physiologists and scientists over many centuries. Contributions of Galen and Harvey are examples of core encyclopedic reference to this knowledge. Galen incompletely perceived the function of the heart, believing it a "productor of heat", while the function of its affluents, the arteries, was that of cooling the blood as the lungs "...fanned and cooled the heart itself"[18]. In more precise terms, it was thought that during dilation the arteries sucked in air, while during their contraction they discharged vapours through pores in the flesh and skin. This theory was founded upon an historically understandable but incorrect apprehension of the nature of the function of the heart. Harvey further stated: "We are too much in habit of worshiping names to the neglect of things. The word 'Blood' has nothing of grandiloquence about it, for it signifies a substance which we have before our eyes and can touch..."[19] Up until the 17th century, two closed systems were thought of existing in our circulation: (1) The natural system, containing venous blood which had its origin in the liver. (2) The vital system, containing arterial blood and the 'spirits' which flowed from the heart, distributing heat and life to all parts. Like bellows, the lungs fanned and cooled this vital blood. It is also important to cite how several men before Harvey ventured close in their own methods to the discovery of the circulation of Blood, including Ibn al-Nafis, Renaldus Columbus, Michael Servetus and Andrea Cesalpino. Historically, one could say that this discovery was only a matter of time. All of these men theorized the circulation of blood; William Harvey first and most accurately described the systemic circulation through experimental method. At the time of Harvey's publication, Galen had been an influential medical authority for several centuries; his works were widely taught and accepted within Eastern and Western Medical circles. Harvey's discoveries inevitably and famously came into conflict with Galen's teachings and the publication of his treatise incited considerable controversy. Some doctors affirmed they would "rather err with Galen than proclaim the truth with Harvey."[20][21]
More facts on Harvey
In terms of his personality, information shows that William Harvey was seen as a "...humorous but extremely precise man..."[22], how he was often so immersed in his own thoughts that he would often suffer from insomnia (cured with a simple walk through the house), and how he was always ready for an open and direct conversation. He also loved the darkness, for it is said that it was there where "...he could best contemplate", thus sometimes hiding out in caves. A heavy drinker of coffee, Harvey would walk out combing his hair every morning full of energy and enthusiastic spirit through the fields. We have also come to understand Harvey's somewhat unorthodox method of dealing with his gout, here cited completely: "...his (Harvey's) cure was thus: he would sit with his legs bare...put them into a pail of water till he was almost dead with cold, then betake himself to his stove, and so 'twas gone"[23]. Apart from the already mentioned love of literature, Harvey was also an intense and dedicated observer of birds during his free time: several long and detailed passages of citations could be written delineating his observations in such places as the "Pile of Boulders" (a small island in Lancashire), 'Bass Rock' (island of the East Coast of Scotland) and "The Bass" (another Scottish island).
A final allusion to the rules established and followed by the physician throughout his life can be made: general canons which are still followed in hospitals today, they embody a final representation of the man that was, William Harvey.
- "That none be taken into the Hospital but such as be curable, or but a certain number of such as are curable.
- That none lurk here for relief only or for slight causes.
- That the Chirurgions, in all difficult cases or where inward physic may be necessary, shall consult with the Doctor, at the times he sitteth once in the week and then the Surgeon himself relate to the Doctor what he conceiveth of the cure and what he hath done therein.
- That no Chirurgion or his man do trepan the head, pierce the body, dismember, or do any great operation on the body of any but with the approbation and the direction of the Doctor..."[24]
.jpg')) William Harvey | ) Color Portrait | ) William Harvey, after a painting by Cornelius Jansen | ) William Harvey |
Pulitzer Prize-winning historian Arthur Schlesinger Jr. included William Harvey in a list of "The Ten Most Influential People of the Second Millennium" in the World Almanac & Book of Facts.
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