II
THE LACTEALS
Asellius, in his account of his discovery of the lacteal vessels (1622), is of opinion that certain of "the ancients" had seen these vessels, but had not recognised them. He has a great reverence for authority: Hippocrates, Plato, Aristotle, the Stoics, Herophilus, Galen, Pollux, Rhases, and a host of other names, he quotes them all, and all with profound respect; and comes to this conclusion: "It did not escape the ancients, that certain vessels must needs be concerned with containing and carrying the chyle, and certain other vessels with the blood: but the true and very vessels of the chyle, that is, my 'veins,' though they were seen by some of the ancients, yet they were recognised by none of them." He can forgive them all, except Galen, qui videtur nosse omnino debuisse—"but, as for Galen, I know not at all what I am to think. For he, who made more than six hundred sections of living animals, as he boasts himself, and so often opened many animals when they were lately fed, are we to think it possible that these veins never showed themselves to him, that he never had them under his eyes, that he never investigated them—he to whom Erasistratus had given so great cause for searching out the whole matter?" Probably, the milk-white threads had been taken for nerves by those who had seen them: and those who had never seen them, but believed in their existence, rested their belief on a general idea that the chyle must, somehow, have vessels of its own apart from the blood-vessels. What Galen and Erasistratus must have seen, Asellius and Pecquet discovered: and Harvey gives a careful review of the discovery in his letters to Nardi (May 1652) and to Morison (November 1653). He does not accept it; but the point is that he recognises it as a new thing altogether.
A year or two after he had made the discovery, Asellius died; and his work was published in 1627 by two Milanese physicians, and was dedicated by them to the senate of the Academy of Milan, where Asellius had been professor of anatomy. The full title of his book is, De Lactibus sive Lacteis Venis, quarto Vasorum Mesaraicorum genere novo invento, Gasparis Asellii Cremonensis, Anatomici Ticinensis, Dissertatio. Quâ sententiæ anatomicæ multæ vel perperam receptæ convelluntur vel partim perceptæ illustrantur. He gives the following account of the discovery, in the chapter entitled Historia primæ vasorum istorum inventionis cum fide narrata. On 23rd July 1622, demonstrating the movement of the diaphragm in a dog, he observed suddenly, "as it were, many threads, very thin and very white, dispersed through the whole mesentery and through the intestines, with ramifications almost endless"—plurimos, eosque tenuissimos candido-sissimosque ceu funiculos per omne mesenterium et per intestina infinitis propemodum propaginibus dispersos:—
"Thinking at first sight that they were nerves, I did not greatly heed them. But soon I saw that I was wrong, for I bethought me that the nerves, which belong to the intestines, are distinct from these threads, and very different from them, and have a separate course. Wherefore, struck by the newness of the matter, I stopped for a time silent, while one way and another there came to my mind the controversies that occupy anatomists, as to the mesenteric veins and their use; which controversies are as full of quarrels as of words. When I had pulled myself together, to make experiment, taking a very sharp scalpel, I pierce one of the larger threads. Scarcely had I hit it off, when I see a white fluid running out, like milk or cream. At which sight, when I could not hold my joy, turning to those who were there, first to Alexander Tadinus and Senator Septalius, both of them members of the most honourable College of Physicians, and, at the time of this writing, officers of the public health, 'I have found it,' I say like Archimedes; and therewith invite them to the so pleasant sight of a thing so unwonted; they being agitated, like myself, by the newness of it."
He then describes the collapse and disappearance of the vessels at death, and the many experiments which he made for further study of them; and the failure, when he tried to find them in animals not lately fed. He did not trace them beyond the mesentery, and believed that they emptied themselves into the liver. The discovery of their connection with the receptaculum chyli and the thoracic duct was made by Jehan Pecquet of Dieppe, Madame de Sévigné's doctor, her "good little Pecquet." The full title of his book (2nd ed., 1654) is, Expérimenta Nova Anatomica, quibus incognitum hactenus Receptaculum, et ab eo per Thoracem in ramos usque subclavios Vasa Lactea deteguntur. He has not the academical learning of Asellius, nor his obsequious regard for the ancients; and the discovery of the thoracic duct came, as it were by chance, out of an experiment that was of itself wholly useless. He had killed an animal by removing its heart, and then saw a small quantity of milky fluid coming from the cut end of the vena cava—Albicantem subinde Lactei liquoris, nec certe parum fluidi scaturiginem, intra Venæ Cavæ fistulam, circ[=a] dextri sedem Ventriculi, miror effluere—and found that this fluid was identical with the chyle in the lacteals. In another experiment, he succeeded in finding the thoracic duct—"At last, by careful examination deep down along the sides of the dorsal vertebræ, a sort of whiteness, as of a lacteal vessel, catches my eyes. It lay in a sinuous course, close up against the spine. I was in doubt, for all my scrutiny, whether I had to do with a nerve or with a vessel. Therefore, I put a ligature a little below the clavicular veins; and then the flaccidity above the ligature, and the swelling of the distended duct below the ligature, broke down my doubt—Ergo subducto paulo infra Claviculas vinculo, cum a ligaturâ sursum flaccesceret, superstite deorsum turgentis alveoli tumore, dubium meum penitus enervavit.... Laxatis vinculis, lacteus utrinque rivulus in Cavam affatim Chylum profudit."
It is to be noted that Asellius and Pecquet, both of them, made their discoveries as it were by chance. Unless digestion were going on, the lacteals would be empty and invisible; and, on the dead body, lacteals, receptaculum, and thoracic duct would all be empty. For these reasons, it cost a vast number of experiments to prove the existence, and to discover the course, of these vessels. Once found in living animals, they could be injected and dissected in the dead body; but they had been overlooked by Vesalius and the men of his time.
From the discovery of the lacteals came the discovery of the whole lymphatic system. Daremberg, in his Histoire des Sciences Médicales (Paris, 1870), after an account of Pecquet's work, says:—
"Up to this point, we have seen English, Italians, and French working together, with more or less success and genius, to trace the true ways of blood and chyle: there is yet one field of work to open up, the lymphatics of the body. The chief honour here belongs, without doubt, to the Swede Rudbeck, though the Dane Bartholin has disputed it with him, with equal acrimony and injustice."
Rudbeck's work (1651-54) coincides exactly, in point of time, with the first and second editions, 1651 and 1654, of Pecquet's De Lactibus. It may be said, therefore, that the whole doctrine of the lymphatic system was roughed out half-way through the seventeenth century.