Название | The Works of William Harvey M.D |
---|---|
Автор произведения | William Harvey |
Жанр | Языкознание |
Серия | |
Издательство | Языкознание |
Год выпуска | 0 |
isbn | 4064066134532 |
If they will have it that fumes and air—fumes flowing from, air proceeding towards the heart—are transmitted by the same conduit, I reply, that nature is not wont to institute but one vessel, to contrive but one way for such contrary motions and purposes, nor is anything of the kind seen elsewhere.
If fumes or fuliginous vapours and air permeate this vessel, as they do the pulmonary bronchia, wherefore do we find neither air nor fuliginous vapours when we divide the arteria venosa? why do we always find this vessel full of sluggish blood, never of air? whilst in the lungs we find abundance of air remaining.
If any one will perform Galen’s experiment of dividing the trachea of a living dog, forcibly distending the lungs with a pair of bellows, and then tying the trachea securely, he will find, when he has laid open the thorax, abundance of air in the lungs, even to their extreme investing tunic, but none in either the pulmonary veins, or left ventricle of the heart. But did the heart either attract air from the lungs, or did the lungs transmit any air to the heart, in the living dog, by so much the more ought this to be the case in the experiment just referred to. Who, indeed, doubts that, did he inflate the lungs of a subject in the dissecting-room, he would instantly see the air making its way by this route, were there actually any such passage for it? But this office of the pulmonary veins, namely, the transference of air from the lungs to the heart, is held of such importance, that Hieronymus Fabricius, of Aquapendente, maintains the lungs were made for the sake of this vessel, and that it constitutes the principal element in their structure.
But I should like to be informed wherefore, if the pulmonary vein were destined for the conveyance of air, it has the structure of a blood-vessel here. Nature had rather need of annular tubes, such as those of the bronchia, in order that they might always remain open, not have been liable to collapse; and that they might continue entirely free from blood, lest the liquid should interfere with the passage of the air, as it so obviously does when the lungs labour from being either greatly oppressed or loaded in a less degree with phlegm, as they are when the breathing is performed with a sibilous or rattling noise.
Still less is that opinion to be tolerated which (as a two-fold matter, one aëreal, one sanguineous, is required for the composition of vital spirits,) supposes the blood to ooze through the septum of the heart from the right to the left ventricle by certain secret pores, and the air to be attracted from the lungs through the great vessel, the pulmonary vein; and which will have it, consequently, that there are numerous pores in the septum cordis adapted for the transmission of the blood. But, in faith, no such pores can be demonstrated, neither in fact do any such exist. For the septum of the heart is of a denser and more compact structure than any portion of the body, except the bones and sinews. But even supposing that there were foramina or pores in this situation, how could one of the ventricles extract anything from the other—the left, e.g. obtain blood from the right, when we see that both ventricles contract and dilate simultaneously? Wherefore should we not rather believe that the right took spirits from the left, than that the left obtained blood from the right ventricle, through these foramina? But it is certainly mysterious and incongruous that blood should be supposed to be most commodiously drawn through a set of obscure or invisible pores, and air through perfectly open passages, at one and the same moment. And why, I ask, is recourse had to secret and invisible porosities, to uncertain and obscure channels, to explain the passage of the blood into the left ventricle, when there is so open a way through the pulmonary veins? I own it has always appeared extraordinary to me that they should have chosen to make, or rather to imagine, a way through the thick, hard, and extremely compact substance of the septum cordis, rather than to take that by the open vas venosum or pulmonary vein, or even through the lax, soft and spongy substance of the lungs at large. Besides, if the blood could permeate the substance of the septum, or could be imbibed from the ventricles, what use were there for the coronary artery and vein, branches of which proceed to the septum itself, to supply it with nourishment? And what is especially worthy of notice is this: if in the fœtus, where everything is more lax and soft, nature saw herself reduced to the necessity of bringing the blood from the right into the left side of the heart by the foramen ovale, from the vena cava through the arteria venosa, how should it be likely that in the adult she should pass it so commodiously, and without an effort, through the septum ventriculorum, which has now become denser by age?
Andreas Laurentius,[81] resting on the authority of Galen[82] and the experience of Hollerius, asserts and proves that the serum and pus in empyema, absorbed from the cavities of the chest into the pulmonary vein, may be expelled and got rid of with the urine and fæces through the left ventricle of the heart and arteries. He quotes the case of a certain person affected with melancholia, and who suffered from repeated fainting fits, who was relieved from the paroxysms on passing a quantity of turbid, fetid, and acrid urine; but he died at last, worn out by the disease; and when the body came to be opened after death, no fluid like that he had micturated was discovered either in the bladder or in the kidneys; but in the left ventricle of the heart and cavity of the thorax plenty of it was met with; and then Laurentius boasts that he had predicted the cause of the symptoms. For my own part, however, I cannot but wonder, since he had divined and predicted that heterogeneous matter could be discharged by the course he indicates, why he could not or would not perceive, and inform us that, in the natural state of things, the blood might be commodiously transferred from the lungs to the left ventricle of the heart by the very same route.
Since, therefore, from the foregoing considerations and many others to the same effect, it is plain that what has heretofore been said concerning the motion and function of the heart and arteries must appear obscure, or inconsistent or even impossible to him who carefully considers the entire subject; it will be proper to look more narrowly into the matter; to contemplate the motion of the heart and arteries, not only in man, but in all animals that have hearts; and further, by frequent appeals to vivisection, and constant ocular inspection, to investigate and endeavour to find the truth.
CHAPTER I.
THE AUTHOR’S MOTIVES FOR WRITING.
When I first gave my mind to vivisections, as a means of discovering the motions and uses of the heart, and sought to discover these from actual inspection, and not from the writings of others, I found the task so truly arduous, so full of difficulties, that I was almost tempted to think, with Fracastorius, that the motion 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, nor when and where dilatation and contraction occurred, by reason of the rapidity of the motion, which in many animals is accomplished in the twinkling of an eye, coming and going like a flash of lightning; so that the systole presented itself to me now from this point, now from that; the diastole the same; and then everything was reversed, the motions occurring, as it seemed, variously and confusedly together. My mind was therefore greatly unsettled, nor did I know what I should myself conclude, nor what believe from others; I was not surprised that Andreas Laurentius should have said that the motion of the heart was as perplexing as the flux and reflux of Euripus had appeared to Aristotle.
At length, and by using greater and daily diligence, having frequent recourse to vivisections, employing a variety of animals for the purpose, and collating numerous observations, I thought that I had attained to the truth, that I should extricate myself and escape from this labyrinth, and that I had discovered what I so much desired, both the motion and the use of the heart and arteries; since which time I have not hesitated to expose my views upon these subjects, not only in private to my friends, but also in public, in my anatomical lectures, after the manner of the Academy of old.
These views,