Harvey's Views on the Use of the Circulation of the Blood

by John Green Curtis

When Harvey jotted this down he had in mind a Galenic passage which doubtless had become the common property of all physicians in his day; for the removal of eye and legs figures in the first chapter of Galen "On the Use of Respiration."[44] Harvey continues:—

"Hence large animals are much warmer and breathe frequently, because they have need of greater cooling and ventilation inasmuch as they very greatly abound in blood and heat."[45]

In the margin opposite this passage there is written:—

"Why and how air is needed by animals which breathe and also air is necessary to a candle and to fire see W. H."

We may conjecture that this note refers to Harvey's promised treatise on respiration, which was never published.

So far Harvey has simply reiterated the ancient doctrine of cooling and ventilation, as in the passages quoted previously from the treatise of 1628. We shall find it very interesting to see how he deals with the other ancient doctrine that some of the substance of the air joins the blood in respiration. That this is true, gas analysis and the mercurial air-pump have taught us; but in this matter modern demonstration does but confirm, extend, and make precise one of the oldest of physiological beliefs. Regarding this we must now give the floor once again to the ancients, in order to make Harvey comprehensible.

Even in the days of Empedocles and Hippocrates, in the fifth and fourth centuries before Christ, men wrote of something derived from the outer air being present, for the use of the organism, in the vessels which also contain the blood.[46] To express this derivative of the outer air the ancient Greeks employed the word "pneuma" (πνεῦμα), the fundamental meaning of which seems to have been "air in motion." Various meanings were acquired by "pneuma," such as the breath of living things, the wind, or simply the air, or what we mean by the words "gas," "vapor," "steam," "exhalation," "emanation." The Latin word equivalent to "pneuma" is "spiritus," and so the English derivative of this, the word "spirits," came into use to express various meanings of the Greek "pneuma." A Hippocratic writer tells us that "the spirits cannot stand still, but go up and down" in the blood vessels. The word "spirits" here designates a derivative of the outer air crudely mingled with the blood.[47] To this writer the distinction between veins and arteries was unknown.

In the genuine works of Aristotle this Hippocratic doctrine does not reappear, though it is fairly certain that Hippocratic treatises which contain it were written before Aristotle's time. We have seen that the entrance of air into the heart, to cool the same, is an important feature of the Aristotelian physiology. Beyond the Aristotelian heart, however, we cannot trace the air which enters it. Yet we find "pneuma," "spirits," referred to by Aristotle, not seldom obscurely or in very general terms, as doing service, sometimes momentous service, in the physiology of generation and in certain workings within the bodies of full-grown creatures. In disease also spirits may play a very important part. These Aristotelian spirits, however, when their origin can be traced at all, are either innate or appear to be vapor produced within the body itself by heat or by disease. They do not appear to be recruited from the outer air which has penetrated the lungs and heart, that air seeming to complete its function within the lungs or within the heart itself by sustaining the native heat which is the great instrument of the soul, and in which the very soul itself is fired.[48]

Physicians of Aristotle's time, however, revived and handed on the doctrine that not only blood but a derivative of the air is distributed to the body at large through the vessels. After the distinction between veins and arteries had been clearly made and the latter had received their present name, a striking modification of this doctrine of the spirits was adopted and pressed by the Greek physician Erasistratus, about 300 B.C., not many years after the death of Aristotle. This modified doctrine separated the paths taken within the vessels by the blood and the spirits derived from the air, and declared the transmission of the necessary blood to the body at large to be by the veins only, that of the necessary spirits, styled "vital," to be by the arteries only. More than four hundred and fifty years later Galen shattered this doctrine and incorporated the vital spirits in the arteries with the blood, which he proved by epoch-making experiments to be normally present in the arteries, he, however, clearly recognizing differences between the cruder blood in the veins and the spirituous blood in the arteries. The tissues, therefore, still received vital spirits by way of the arteries, according to Galen, but not spirits in their pure gaseous Erasistratean state.[49] Now let Galen tell us more in his own words:—

"The breath from the windpipes, which had been drawn in from without, is worked up in the flesh of the lungs in the first place; in the second place in the heart and arteries, and especially in those of the net-like plexus; and to perfection in the ventricles of the brain, where the spirits become completely animal. But what the use may be of these animal spirits and why we have the temerity to call them so, when we confess that we are still utterly ignorant as to the substance of the anima [i.e., of the soul], this is not the moment to say."[50]