The Works of William Harvey M.D. William Harvey
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carotid arteries. Neither are the valves present, in order that the blood may be retained in the divarications or smaller trunks and minuter branches, and not be suffered to flow entirely into the more open and capacious channels; for they occur where there are no divarications; although it must be owned that they are most frequent at the points where branches join. Neither do they exist for the purpose of rendering the current of blood more slow from the centre of the body; for it seems likely that the blood would be disposed to flow with sufficient slowness of its own accord, as it would have to pass from larger into continually smaller vessels, being separated from the mass and fountain head, and attaining from warmer into colder places.
But the valves are solely made and instituted lest the blood should pass from the greater into the lesser veins, and either rupture them or cause them to become varicose; lest, instead of advancing from the extreme to the central parts of the body, the blood should rather proceed along the veins from the centre to the extremities; but the delicate valves, while they readily open in the right direction, entirely prevent all such contrary motion, being so situated and arranged, that if anything escapes, or is less perfectly obstructed by the cornua of the one above, the fluid passing, as it were, by the chinks between the cornua, it is immediately received on the convexity of the one beneath, which is placed transversely with reference to the former, and so is effectually hindered from getting any farther.
And this I have frequently experienced in my dissections of the veins: if I attempted to pass a probe from the trunk of the veins into one of the smaller branches, whatever care I took I found it impossible to introduce it far any way, by reason of the valves; whilst, on the contrary, it was most easy to push it along in the opposite direction, from without inwards, or from the branches towards the trunks and roots. In many places two valves are so placed and fitted, that when raised they come exactly together in the middle of the vein, and are there united by the contact of their margins; and so accurate is the adaptation, that neither by the eye nor by any other means of examination can the slightest chink along the line of contact be perceived. But if the probe be now introduced from the extreme towards the more central parts, the valves, like the floodgates of a river, give way, and are most readily pushed aside. The effect of this arrangement plainly is to prevent all motion of the blood from the heart and vena cava, whether it be upwards towards the head, or downwards towards the feet, or to either side towards the arms, not a drop can pass; all motion of the blood, beginning in the larger and tending towards the smaller veins, is opposed and resisted by them; whilst the motion that proceeds from the lesser to end in the larger branches is favoured, or, at all events, a free and open passage is left for it.
But that this truth may be made the more apparent, let an arm be tied up above the elbow as if for phlebotomy (A, A, fig. 1).
At intervals in the course of the veins, especially in labouring people and those whose veins are large, certain knots or elevations (B, C, D, E, F,) will be perceived, and this not only at the places where a branch is received (E, F), but also where none enters (C, D): these knots or risings are all formed by valves, which thus show themselves externally. And now if you press the blood from the space above one of the valves, from H to O, (fig. 2,) and keep the point of a finger upon the vein inferiorly, you will see no influx of blood from above; the portion of the vein between the point of the finger and the valve O will be obliterated; yet will the vessel continue sufficiently distended above that valve (O, G). The blood being thus pressed out, and the vein emptied, if you now apply a finger of the other hand upon the distended part of the vein above the valve O, (fig. 3,) and press downwards, you will find that you cannot force the blood through or beyond the valve; but the greater effort you use, you will only see the portion of vein that is between the finger and the valve become more distended, that portion of the vein which is below the valve remaining all the while empty (H, O, fig. 3).
It would therefore appear that the function of the valves in the veins is the same as that of the three sigmoid valves which we find at the commencement of the aorta and pulmonary artery, viz., to prevent all reflux of the blood that is passing over them.
Farther, the arm being bound as before, and the veins looking full and distended, if you press at one part in the course of a vein with the point of a finger (L, fig. 4), and then with another finger streak the blood upwards beyond the next valve (N), you will perceive that this portion of the vein continues empty (L N), and that the blood cannot retrograde, precisely as we have already seen the case to be in fig. 2; but the finger first applied (H, fig. 2, L, fig. 4), being removed, immediately the vein is filled from below, and the arm becomes as it appears at D C, fig. 1. That the blood in the veins therefore proceeds from inferior or more remote to superior parts, and towards the heart, moving in these vessels in this and not in the contrary direction, appears most obviously. And although in some places the valves, by not acting with such perfect accuracy, or where there is but a single valve, do not seem totally to prevent the passage of the blood from the centre, still the greater number of them plainly do so; and then, where things appear contrived more negligently, this is compensated either by the more frequent occurrence or more perfect action of the succeeding valves or in some other way: the veins, in short, as they are the free and open conduits of the blood returning to the heart, so are they effectually prevented from serving as its channels of distribution from the heart.
But this other circumstance has to be noted: The arm being bound, and the veins made turgid, and the valves prominent, as before, apply the thumb or finger over a vein in the situation of one of the valves in such a way as to compress it, and prevent any blood from passing upwards from the hand; then, with a finger of the other hand, streak the blood in the vein upwards till it has passed the next valve above, (N, fig. 4,) the vessel now remains empty; but the finger at L being removed for an instant, the vein is immediately filled from below; apply the finger again, and having in the same manner streaked the blood upwards, again remove the finger below, and again the vessel becomes distended as before; and this repeat, say a thousand times, in a short space of time. And now compute the quantity of blood which you have thus pressed up beyond the valve, and then multiplying the assumed quantity by one thousand, you will find that so much blood has passed through a certain portion of the vessel; and I do now believe that you will find yourself convinced of the circulation of the blood, and of its rapid motion. But if in this experiment you say that a violence is done to nature, I do not doubt but that, if you proceed in the same way, only taking as great a length of vein as possible, and merely remark with what rapidity the blood flows upwards, and fills the vessel from below, you will come to the same conclusion.
CHAPTER XIV.
CONCLUSION OF THE DEMONSTRATION OF THE CIRCULATION.
And now I may be allowed to give in brief my view of the circulation of the blood, and to propose it for general adoption.
Since all things, both argument and ocular demonstration, show that the blood passes through the