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Francis Jameson Rowbotham

William Harvey

T HE Little anatomical theatre in the University of Padua, with its wainscoting of curiously carved oak, and its carved desks rising almost perpendicularly one above the other, was filled with students who were listening to the lecture then in progress. The faces of the students—some eager, some indifferent—were only dimly visible in the feeble light of the candles placed upon the table below; they were of every nationality, for Padua, three hundred years ago, was the most famous school of medicine in Europe, and young men flocked thither to attend the lecture of the great anatomist, Hieronymus Fabricius of Aquapendente. As the demonstration proceeded attention was concentrated upon the one bright spot in the dimly lighted room where the lecturer with unerring finger was tracing out the structures of the body stretched upon the table.

From among the shadows one pair of eyes was following the words and action of the anatomist with a keenness and intelligence that betokened the depth of interest taken by their owner in the subject. The student in question was of short stature, with a rounded face, and eyes of a blackness that matched in intensity of colour the raven locks clustering about his broad forehead. There was no mistaking the fire and spirit which burnt in those eyes. Fabricus himself (who had already observed with satisfaction the rapid progress of his clever pupil) may have caught the intelligent glance which shot from those black eyes when, in describing the structure of the blood-vessels, he pointed proudly to the valves in the veins as his own discovery and descanted upon their probably use. That his explanations failed to satisfy one at least of his hearers, he did not know then, any more than he could have guessed how this one fact would stimulate the young student in his determination to find out the true meaning of the various structures connected with the movements of the blood that were puzzling his brain at this moment.

William Harvey, as the student was named, was an Englishman and a native of Folkestone, in which town he was born on April 1, 1558. Of his father, Thomas Harvey, we know nothing beyond the fact that he was a Kentish yeoman of good standing and reputation in the town. The character of his mother, Joane Harvey, may be read in the epitaph in the old parish church of St. Nicholas, which records that she was: 'A Godly harmles Woman: A chaste loveing Wife: A careful tederharted Mother.' Joane Harvey died in 1605; her husband survived her eighteen years, dying in 1623. William was the eldest of seven sons.

Of William's early years nothing, unfortunately, has been recorded, and we are left to imagine him as a child rambling with his brothers on the shore, watching the fishermen unloading their boats or mending their nets at their cottage doors, as we may see them at the present day in the old fisher quarter of the town which abuts upon the harbour. At the age of ten he was sent to the grammar school at Canterbury, where he remained till he was fifteen. Then, having meanwhile 'laid a proper foundation of classical learning', he went to Cambridge, and was admitted as a pensioner to Gonville and Caius College on may 31, 1593. He gained his B.A. degree in 1597, and having resolved to take up the study of medicine he left Cambridge and travelled through France and Germany to Padua.

At the end of five years Harvey received his degree as doctor of medicine, and the diploma expressed the warm satisfaction of the professors of Anatomy, Surgery, and Medicine at the manner in which he had prosecuted his studies and with the abilities he had displayed. He now returned to England, and having graduated M.D. at Cambridge, settled down to practise in London. In 1604 he became a member of the College of Physicians, and three years later was elected a fellow. Among his patients at this time, it is interesting to note, was Bacon—then recently appointed to the Solicitor-Generalship, and famous as the author of the Essays.

On February 25, 1609, Harvey applied to the governors of St. Bartholomew's Hospital in Smithfield for the reversion of the office of physician, bringing in support of his application a recommendation from the King and testimonials from the President and several of the senior doctors of the College of Physicians. Here is the extract relating to his appearance before the governors, taken from the journals of the hospital: —

'Curia cent Subti xxv die Februarii A° Dni 1608/9. In presence of Sr John Spencer, Knight, Psydent. . . .[and others].

'Mr Dr Harvey.

'This day Mr Willyam Harvey Doctor of Phisycke made sute for the re'con of the office of the Physicon of this howse when the same shalbe nexte voyd, and brought the Kinge's Ma his Ires [letters] directed to the Gov'nors of this howse in his behalfe, and showed forthe a Testimony of his sufficiency for the same place under the hande of Mr Doctr Adkynson presydent of the Colledge of ye phisytions and div'se others doctors of the auncientest of the said Colledge It is graunted at the contemplacon of his Ma l'res that the said Mr Harvey shall have the said office nexte after the decease or other dep'ture of Mr Doctor Wilkenson whoe nowe holdeth the same wth the y'ly ffee & dewtyes thereunto belonginge, Soe that he be not founde to be otherwise imployed, that may lett & hynder the chardge of the same office, which belongeth thereunto.'

Dr. Wilkinson died in the summer, and Harvey, not being 'otherwyse imployed' to the detriment of his discharge of the duties 'toward the poore of this hospitall', was admitted to the office of physician on October 14, 1609, and the charge was read to him. In this he was solemnly enjoined to attend at the hospital 'one day in the weeke at the leaste thorough the yeare, or oftner as neede shall requyer', to give to the poor 'the beste of his knowledge in the profession of phisicke'; to prescribe only such medicines as should 'doe the poore good, without any affeccon or respecte to be had to the apothecary'; to take 'noe gifte or reward of any of the poore of the house for his counsell'; and to render account for any negligence on his part.

The hall in which Harvey received his patients was a spacious room (pulled down about 1728) with a huge fireplace, to the fire of which Henry III had granted a supply of wood from Windsor forest. Harvey sat at a table, and the patients brought to him sat upon a settle beside it, the apothecary, the steward, and the matron standing by. Those patients who could not walk he visited in the wards. For his services Harvey received a stipend of twenty-five pounds a year, but in 1626, in lieu of residence, this was increased to thirty-three pounds six shillings and eightpence.

In 1615 we reach a most important period of Harvey's life. In August of that year he was appointed Lecturer in Anatomy to the College of Physicians, and in the following April he delivered his first course of lectures at the college, in which he made the first public announcement of his views regarding the circulation of blood. Ever since the time when he had witnessed Fabricus's demonstrations on the valves in the veins he had set himself to discover the true meaning of these structures, and more especially the action of the heart in relation to the movements of the blood. He would not trust to books or to other men's eyes, but went direct to nature for his information. He dissected the human body, and the bodies of every species of animal which he thought might assist his purpose (and these were days when human subjects were very difficult to obtain); he performed endless experiments and wrote careful accounts of his observations—in the true spirit of scientific inquiry taking nothing for granted, but questioning and comparing each particular structure and every observable action in the living and the dead form, to find the true answer to this great problem. And now he was prepared to lay the results of his labours—the firstfruits of these years of study and experiment—before his pupils and any others who chose to attend his lectures, inviting all to test the truth of his conclusions by the witness of their own eyes.

For over ten years the lectures and demonstrations were continued, but nothing so far had been printed. At length, at the end of 1627, yielding to the entreaties of his most distinguished friends and colleagues, Harvey consented to publish his discovery to the world. In 1628 there issued from a printing-house at Frankfort-on-Main a slender book, of quarto size, containing seventy-two pages and two plates of diagrams, under the title of Exercilatio Anatomica de Motu Cordis et Sanguinis in Animalibus.

Harvey's discovery may be stated in a few words. He demonstrated that there was a continuous flow of blood through the entire body. The centre and origin of this movement was the heart, the muscular contraction of which impelled the blood into the arteries; thence it passed into the veins and was eventually returned to the heart. This was the 'circulation' of the blood, in its complete sense. But the circulation was in reality of a double nature: one circle being traced from the right side of the heart through the lungs to the left side (the Pulmonary, or Lesser, Circulation, as it was called); the other going from the left side of the heart through the rest of the body to the right side (called the Systemic, or Greater, Circulation).

Several famous anatomists before Harvey had, it is true, come very near to forestalling him, in some points at least of his discovery. Servetus, more especially, and, after him, Columbus and Cæsalpinus, had had some glimmerings of the truth; but their conclusions were incomplete, or imperfect, and for the most part merely conjectural. It is quite certain that none of these observers had any clear idea of the Systemic Circulation, nor, what is far more important, 'any conception of the muscular contraction of the heart as the mechanical force that impelled the blood.' The views held with regard to the action of the heart as the organ principally concerned in the movement of the blood, were both erroneous and highly fantastic. A student of Harvey's university days would have been taught that the heart was the source of the heat of the body and the workshop for the manufacture of the vital spirits that were necessary for its support; that the arteries contained spirituous blood, or blood and air mixed together, or in some cases only air, while the veins were used for conveying nutriment; that the arteries expelled 'fuliginous vapours' (impure gases) in their contraction, through the pores of the skin, and in their swelling absorbed air through the same medium; that the pulse and the respiration had the same end, viz. to 'fan and refrigerate' the blood; and, finally, that the swelling of the heart (by which it attracted blood from the vessels) was caused by the effervescence of the spirits contained in it, while its collapse was due to the withdrawal of nutriment into the veins. As regards the movement of the blood, it was believed that such movement partook of the nature of the tides, the blood rising and falling in the vessels as it surged backwards and forwards between the heart and the extremities.

It would take too long to tell how Harvey in his book confutes these errors, one by one; how he demonstrates that the force which impels the blood is exerted by the heart in its contraction, the swelling of the heart representing the period of rest—thus exactly reversing the meaning attached to these movements by previous anatomists; how he shows that the arteries are the conveyors of the bright blood which has previously passed through the lungs, to every part of the body (Systemic Circulation), while the veins are employed in conveying the dark, impure blood back to the heart, to be passed thence to the lungs (Pulmonary Circulation); how the true use of the valves in the veins is to prevent the return of the venous blood into the general circulation; and, finally, how the septum dividing the heart into its two principal chambers, instead of being riddled with holes like a sieve to enable the blood to pass from one side to the other, as was believed, is complete and impervious, as required for the twofold nature of the circulation. His book should be read by all who desire to know more about a subject which, in its important bearing upon the scientific knowledge of the human body and its functions, and consequently upon the treatment of the body in sickness and disease, is to be reckoned amongst the most glorious achievements of mankind. 'To medical practice,' says Sir John Simon, 'it stands much in the same relation as the discovery of the mariner's compass to navigaton; without it, the medical practitioner would be all adrift, and his efforts to benefit mankind would be made in ignorance and at random…. The discovery is incomparably the most important ever made in physiological science, bearing and destined to bear fruit for the benefit of all succeeding ages.'

To the medical world generally, Harvey's conclusions came as a complete surprise, and for some time they were regarded as the idle dreams of a fanciful innovator. Many members of his profession, while envying him his discovery, considered themselves far too respectable to be associated with such new-fangled theories. John Aubrey, the writer, who knew Harvey, says: 'I have heard him say that after his booke of the Circulation of the Blood came out he fell mightily in his practice, and 'twas believed by the vulgar that he was crack-brained, and all the physitians were against him; with much adoe at last in about 20 or 30 years time it was received in all the universities in the world.'

It is an interesting fact with respect to Harvey's discovery that in one essential point it was incomplete. Though he was convinced that the course of the blood was from the heart to the arteries and back to the heart by the veins, he was unable to demonstrate the actual passage of the blood from the arteries to the veins. As Dr. Robert Willis, the translator of Harvey's works, points out, Harvey did not see, and possessed no means of seeing, the transition, by continuity of their canals, from arteries to veins, and so he erroneously concludes that no such transition exists. His idea seems to have been that the arteries ended in the tissues which they supplied, and that the veins, arising in the same manner, drank up the blood, having done its office, that had been shed for the nutrition and vital endowment of the parts. A microscope of even moderate power would have revealed to Harvey the true mode of communication between the two kinds of vessels. The lung of the frog, or the web of its foot, the tail of the newt, or the bat's wing, would have shown him his discovery in actual operation—the blood coursing through the network of fine tubes called capillaries, which serve to connect the arteries with the veins. But Harvey had no such means at hand, and it was not until 1661—four years after Harvey's death—that the improvement of the microscope enabled the Italian anatomist, Malpighi, to observe the precise mode of the circulation in the lung of the frog.

The King, Charles I, was both patron and friend to Harvey, appointing him his body physician and showing a deep interest in his discovery. To assist Harvey in his researches the King supplied him with deer from Hampton Park. In 1630 Harvey was ordered to accompany the young Duke of Lennox on his travels on the Continent, and in a letter to Lord Dorchester of his time he requests that his place of physician at the Court shall be kept vacant during his absence, and describes how the countries he passed through were so wretched 'that by the way we could scarcely see a dogg, crow, kite, raven, or any bird or anything to anatomise, only sum few miserable people, the reliques of the war and the plague, where famine had made anatomies before I came.'

In May, 1633, Harvey accompanied the King on a visit to Scotland, and seized the opportunity of visiting the Bass Rock in the Firth of Forth. His description of the gannets inhabiting the famous rock has been preserved, and shows how closely he observed nature out of doors. About this time the governors of St. Bartholomew's Hospital appointed an assistant physician in order to give Harvey more liberty, but they continued to pay Harvey his salary as before, out of regard for his merit and the services he had rendered to the hospital.

When the Civil War broke out, Harvey retained his position as physician to the King, not only with the consent, but by the desire of the Parliament. He attended the King when the royal family left London, and while the forces of Charles were assembling he visited his friend Percival Willughby at Derby, and discussed the treatment of diseases. He was also present at the battle of Edgehill, and Aubry says had charge of the Prince of Wales and the Duke of York during the fight. 'He told me that he withdrew with them under a hedge, and tooke out of his pocket a booke and read. But he had not read very long before a bullet of a great gun grazed on the ground near him, which made him remove his station.'

During the King's residence at Oxford Harvey remained in attendance, pursuing his studies, and seizing every opportunity that offered itself for making dissections. His great lament at this time was that his lodgings at Whitehall had been plundered at the outbreak of the war, and that his observations upon the structure and generation of numerous animals and insects which he had dissected had disappeared. It is related that whilst at Oxford he used to visit a medical friend at Trinity College who kept a hen to hatch eggs in his chambers, and that the eggs were daily opened to watch the progress and way of generation. In this way he was collecting materials for his second book, though he had then no intention of publishing his observations. In 1645 he was made by royal mandate warden of Merton College, but he only held the post for a year; for in 1646, on the surrender of Oxford, he gave up the wardenship and returned to London. As he was now nearly seventy, he retired from his position of physician to the King (he had resigned his connection with St. Bartholomew's Hospital in 1643), and went to live with his brothers, who were wealthy merchants in the City. For the sake of pure air and a pleasant prospect he established a summer residence at Coombe, in Surrey, where he spent much of his time in retirement. It is said that, 'to indulge a whim he had of delighting in being in the dark, he caused caves to be made in the earth, in which, in summer time, he was pleased to meditate.'

At Coombe he was visited by his friend Dr. George Ent, in 1651, by whom he was persuaded to allow the manuscript of his treatise on The Generation of Animals  to be published. In this book, which comprises seventy exercises, Harvey discusses the origin and development of animal life, basing his conclusions on the example of the hen's egg. Its chief interest, however, lies in the fact that it enunciates the great generalization omne vivum ex ovo  (all life proceeds from the egg) — a generalization which has since been abundantly verified. In another respect the book is remarkable as an instance of prophetic vision, though this latter point is hardly to be expressed in simple language. It is this: that Harvey here brings forward the doctrine that the new organism is formed from the uniform substance of the germ, not by a sudden transformation of the substance into a miniature of the whole organism (as was then believed), but by the successive separation of the parts. In other words, that all parts are not formed at once and together, but in succession one after the other. This, in brief, was the result of his observation, but the microscope was needed to confirm and make clear much of what Harvey only saw imperfectly. It is with reference to passages in the book dealing with this subject that Professor Huxley wrote: 'In these words, by the divination of genius, Harvey in the seventeenth century summarized the outcome of the work of all those who, with appliances he could not dream of, are continuing his labours in the nineteenth century.'

The remaining years of this useful and active life show Harvey in the light of a munificent patron of the science and the profession he had served so ably and so long. In 1651 he offered to the College of Physicians, through its President, Dr. Prujean, to find the means for building a Library and Convocation Hall. The offer was gratefully accepted, and on the fact of Harvey being the donor becoming known the College voted the erection of his statue. On February 2, 1654, the buildings were complete, and Harvey formally handed them over to the College, together with the books, surgical instruments, and anatomical preparations with which he had furnished them. In September of the same year Dr. Prujean resigned the presidency, and Harvey was elected to succeed him; but while sensible of the honour thus conferred upon him by his colleagues, he felt compelled to decline it on account of his age and infirmities. For two years, however, he continued to serve on the council, and then resigning the anatomical lectureship he gave his paternal estate at Burwash, in Sussex, to the College and took leave of the Fellows. In making the donation Harvey stipulated that a certain sum should be employed each year in the delivery of an Oration in commemoration of the benefactors of the College, and of those who had contributed to the knowledge of medicine during the year. This provision has been faithfully carried out ever since, and under the title of the Harveian Oration the memory of Harvey and the inestimable services he rendered to science have been preserved.

Harvey had had many attacks of gout, and he used to check it by putting his feet into a pail of cold water, 'till he was almost dead with cold, and betake himself to his stove, and so 'twas gone,' as Aubrey relates. In old age the attacks became more frequent, and he died on June 3, 1657. His body was followed by the Fellows of the College of Physicians far beyond the limits of the city on its way to Hempstead, in Essex, where it was deposited, 'lapt in lead,' in a vault belonging to his brother Eliab. On his breast (there being no coffin) was inscribed the words: 'Docter William Harvey. Decesed the 3 of June 1657. Aged 79 years.' On St. Luke's Day, October 18, 1883, the remains were translated, in the presence of the President (Sir William Jenner) and several Fellows of the College, to a white marble sarcophagus provided by the College in the Harvey Chapel erected in Hempstead Church.