The Works of William Harvey M.D. William Harvey
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to the office of the lungs and the ends for which they exist; and upon such a subject, as well as upon what pertains to eventilation, to the necessity and use of the air, &c., as also to the variety and diversity of organs that exist in the bodies of animals in connexion with these matters, although I have made a vast number of observations, still, lest I should be held as wandering too wide of my present purpose, which is the use and motion of the heart, and be charged with speaking of things beside the question, and rather complicating and quitting than illustrating it, I shall leave such topics till I can more conveniently set them forth in a treatise apart. And now, returning to my immediate subject, I go on with what yet remains for demonstration, viz., that in the more perfect and warmer adult animals, and man, the blood passes from the right ventricle of the heart by the vena arteriosa, or pulmonary artery, into the lungs, and thence by the arteriæ venosæ, or pulmonary veins, into the left auricle, and thence into the left ventricle of the heart. And, first, I shall show that this may be so, and then I shall prove that it is so in fact.
CHAPTER VII.
THE BLOOD PERCOLATES THE SUBSTANCE OF THE LUNGS FROM THE RIGHT VENTRICLE OF THE HEART INTO THE PULMONARY VEINS AND LEFT VENTRICLE.
That this is possible, and that there is nothing to prevent it from being so, appears when we reflect on the way in which water percolating the earth produces springs and rivulets, or when we speculate on the means by which the sweat passes through the skin, or the urine through the parenchyma of the kidneys. It is well known that persons who use the Spa waters, or those of La Madonna, in the territories of Padua, or others of an acidulous or vitriolated nature, or who simply swallow drinks by the gallon, pass all off again within an hour or two by urine. Such a quantity of liquid must take some short time in the concoction: it must pass through the liver; (it is allowed by all that the juices of the food we consume pass twice through this organ in the course of the day;) it must flow through the veins, through the parenchyma of the kidneys, and through the ureters into the bladder.
To those, therefore, whom I hear denying that the blood, aye the whole mass of the blood may pass through the substance of the lungs, even as the nutritive juices percolate the liver, asserting such a proposition to be impossible, and by no means to be entertained as credible, I reply, with the poet, that they are of that race of men who, when they will, assent full readily, and when they will not, by no manner of means; who, when their assent is wanted, fear, and when it is not, fear not to give it.
The parenchyma of the liver is extremely dense, so is that of the kidney; the lungs, again, are of a much looser texture, and if compared with the kidneys are absolutely spongy. In the liver there is no forcing, no impelling power; in the lungs the blood is forced on by the pulse of the right ventricle, the necessary effect of whose impulse is the distension of the vessels and pores of the lungs. And then the lungs, in respiration, are perpetually rising and falling; motions, the effect of which must needs be to open and shut the pores and vessels, precisely as in the case of a sponge, and of parts having a spongy structure, when they are alternately compressed and again are suffered to expand. The liver, on the contrary, remains at rest, and is never seen to be dilated and constricted. Lastly, if no one denies the possibility of the whole of the ingested juices passing through the liver, in man, oxen, and the larger animals generally, in order to reach the vena cava, and for this reason, that if nourishment is to go on, these juices must needs get into the veins, and there is no other way but the one indicated, why should not the same arguments be held of avail for the passage of the blood in adults through the lungs? Why not, with Columbus, that skilful and learned anatomist, maintain and believe the like, from the capacity and structure of the pulmonary vessels; from the fact of the pulmonary veins and ventricle corresponding with them, being always found to contain blood, which must needs have come from the veins, and by no other passage save through the lungs? Columbus, and we also, from what precedes, from dissections, and other arguments, conceive the thing to be clear. But as there are some who admit nothing unless upon authority, let them learn that the truth I am contending for can be confirmed from Galen’s own words, namely, that not only may the blood be transmitted from the pulmonary artery into the pulmonary veins, then into the left ventricle of the heart, and from thence into the arteries of the body, but that this is effected by the ceaseless pulsation of the heart and the motion of the lungs in breathing.
There are, as every one knows, three sigmoid or semilunar valves situated at the orifice of the pulmonary artery, which effectually prevent the blood sent into the vessel from returning into the cavity of the heart. Now Galen, explaining the uses of these valves, and the necessity for them, employs the following language:[92] “There is everywhere a mutual anastomosis and inosculation of the arteries with the veins, and they severally transmit both blood and spirit, by certain invisible and undoubtedly very narrow passages. Now if the mouth of the vena arteriosa, or pulmonary artery, had stood in like manner continually open, and nature had found no contrivance for closing it when requisite, and opening it again, it would have been impossible that the blood could ever have passed by the invisible and delicate mouths, during the contractions of the thorax, into the arteries; for all things are not alike readily attracted, or repelled; but that which is light is more readily drawn in, the instrument being dilated, and forced out again when it is contracted, than that which is heavy; and in like manner is anything drawn more rapidly along an ample conduit, and again driven forth, than it is through a narrow tube. But when the thorax is contracted, the pulmonary veins, which are in the lungs, being driven inwardly, and powerfully compressed on every side, immediately force out some of the spirit they contain, and at the same time assume a certain portion of blood by those subtile mouths; a thing that could never come to pass were the blood at liberty to flow back into the heart through the great orifice of the pulmonary artery. But its return through this great opening being prevented, when it is compressed on every side, a certain portion of it distils into the pulmonary veins by the minute orifices mentioned.” And shortly afterwards, in the very next chapter, he says: “The more the thorax contracts, the more it strives to force out the blood, the more exactly do these membranes (viz., the sigmoid valves) close up the mouth of the vessel, and suffer nothing to regurgitate.” The same fact he has also alluded to in a preceding part of the tenth chapter: “Were there no valves, a three-fold inconvenience would result, so that the blood would then perform this lengthened course in vain; it would flow inwards during the diastoles of the lungs, and fill all their arteries; but in the systoles, in the manner of the tide, it would ever and anon, like the Euripus, flow backwards and forwards by the same way, with a reciprocating motion, which would nowise suit the blood. This, however, may seem a matter of little moment; but if it meantime appear that the function of respiration suffer, then I think it would be looked upon as no trifle, &c.” And again, and shortly afterwards: “And then a third inconvenience, by no means to be thought lightly of, would follow, were the blood moved backwards during the expirations, had not our Maker instituted those supplementary membranes [the sigmoid valves].” Whence, in the eleventh chapter, he concludes: “ That they have all a common use, (to wit, the valves,) and that it is to prevent regurgitation or backward motion; each, however, having a proper function, the one set drawing matters from the heart, and preventing their return, the other drawing matters into the heart, and preventing their escape from it. For nature never intended to distress the heart with needless labour, neither to bring aught into the organ which it had been better to have kept away, nor to take from it again aught which it was requisite should be brought. Since, then, there are four orifices in all, two in either ventricle, one of these induces, the other educes.” And again he says: “Farther, since there is one vessel, consisting of a simple tunic, implanted in the heart, and another, having a double tunic, extending from it, (Galen is here speaking of the right side of the heart, but I extend his observations to the left side also,) a kind of reservoir had to be provided, to which both belonging, the blood should be drawn in by the one, and sent out by the other.”
This argument Galen adduces for the transit of the blood by the right ventricle from the vena cava into the lungs; but we can use it with still greater propriety, merely changing the terms, for the passage of the blood from the veins through the heart into the arteries. From Galen, however, that great man, that father of physicians, it clearly