medical lecture-Harvey Õs Circulatory System In 1661, Malpighi using a good microscope finally...
Transcript of medical lecture-Harvey Õs Circulatory System In 1661, Malpighi using a good microscope finally...
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University
medical
lecture-
Dresden M.S.
1460
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Mondino de’ Liuzzi
d. 1326
Professor of Practical Medicine in Bologna
Anatomy from 1316- handbook for dissection
Used bodies of criminals
Winter the only good time
Started at bottom and worked up
Imported many errors from Galen
Enamored with numerology and astrology
His writings used into 16th century
Title Page to Mondino
de’ Liuzzi’s Anatomy
from a printed edition
from 1493.
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Jacopo Berengario da Carpi (ca.1460-ca.1530) [anatomist]Reworks Mondino treatise from 14th century for print ed. of 1535.This predates Vesalius’ first significant anatomical publications byabout 3 years and employ relatively detailed woodcut illustrations.
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Leonardo 1452-1519
Vitruvian Man
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Leonardo dissected human
beings and drew his
observations.
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Leonardo was into everything.
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The Tabulae Sex (1538)
By Andreas Vesalius
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Sheet 1 [Broad sheets…
posters, you might say.]
Notice the 5-lobed Galenic
Liver. Vesalius puts an
inset showing a 2-lobed
liver like humans have.
He may be trying to
suggest that he knows the
difference, but shows what
the people expect to see.
This image as well as
sheets 2 and 3 were drawn
by Vesalius himself.
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Sheet 2: The System of Veins
Again, the 5-lobed Liver.
The liver created blood
“charged with natural spirit”
from chyle (food nutrients
from the stomach). The spirit
charged blood was distributed
all over the body via the
venous system shown.
Nutritive Spirit
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Sheet 3: The Arterial System
In the heart venous blood
“sweats” through the
ventricular septum, refining
the spirits it contains and
combining it with air from the
lungs into Vital Spirit. This is
the life spirit. It is carried all
over the body by the arteries.
Vital Spirit
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Sheets
3-6:
Drawn
by
Calcar,
a
student
of
Titian.
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Titian
(ca.
1488-
1576)-
Venice
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Titian himself.
St. Sebastian
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Anatomy Theater in Padua
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Anatomy Theater in Bologna
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Galen
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Vesalius’
DE HUMANI CORPORIS
FABRICA
- 1543
Notice
Vesalius himself
Columbo (old man looking at
the dog)
the dog and monkey
the naked man
the skeleton
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Columbo (old man looking at the dog)
the dog and monkey
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C. G.
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Michelangelo Buonarroti 1475-1564
He also studied anatomy, but more from the outside.
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The Last Judgement by Michelangelo
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Valverde: 1559
Perhaps riffing on
Michelangelo.
… another anatomist of the
period
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Remember,
this is,
roughly
speaking,
how people
imagined
the heart
worked. All
that spiritus
and rete
mirable and
inter-
ventricular
pores.
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Vesalius, in his first edition of De fabrica, 1543.
“The septum is formed from the very densest substance of the heart.
It abounds on both sides with pits. Of these none, so far as the senses
can perceive, penetrate from the right to the left ventricle. We
wonder at the art of the Creator which causes blood to pass from right
to left ventricle through invisible pores.”
In the second edition from 1555, he abandons the interventricular
pores of Galen.
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Lesser Circulation Discovered First
Ibn al-Nafis in 13th c. Persia described it, but it was unknown to the
western world until recently.
Servetus (aka Villanovus) wrote about it in On the Restitution of
Christianity. Written 1546 and published 1553. He fled France due
to the heretical nature of the book (not so much anything having to
do with his theory of circulation) and was spotted in Protestant
Geneva where he had earlier in his career earned the wrath of the
Calvinists. They executed him in 1553. Most copies of his book
were burned. Few people were aware of his theory of lesser
circulation. It’s not clear if he came up with it for
anatomical/physiological reasons.
Realdo Columbo (student of Vesalius) wrote Fifteen Books on
Anatomical Matters (1559) and clearly described lesser circulation.
This fellow is usually given the main credit.
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Lesser
Circulation
Blood is pumped
from right atrium to
right ventricle and
then to the lungs
via the pulmonary
artery, and from the
lungs into the left
atrium via the
pulmonary vein…
etc.
Do the names make
sense?
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Valves…
Fabricius of Aquapendente’s On the Ostiola in the Veins from 1603 is
one of the most complete early accounts of “floodgates” in the veins.
He thought that membranes in veins acted more like capacitors or
floodgates, regulating volume. He didn’t make a point about the
directional issue of these venous membranes. Harvey would….
Vesalius’s student and successor was Realdo Columbo, who was
succeeded by Gabriele Falloppio, who was succeeded by Hieronymus
Fabricius who had a student named…
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William Harvey 1578-1657
Studied with Fabricius (of valve fame).
He claimed later in life that it was the unidirectional flow in veins
that got him thinking about a circuit.
He also wondered why the lungs needed such a huge vessel to
nourish them?
By 1618 Harvey had circulation figured out, but he didn’t have it
all proven or written up.
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1628: Harvey’s
Exercitatio anatomica
de motu cordis et
sanguinis in
animalibus,
…or just De Motu
Cordis for short.
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The finger is
holding up a
tricuspid valve flap.
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Harvey’s theory put
those “membranes”
in the veins to use.
They were one-way
valves so that there
couldn’t be any
backflow. Ta-Da!
Circulation.
All venous blood
flows towards the
heart.
Using probes, Harvey
found the valves to
be quite sturdy.
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Vivisection was very helpful for Harvey’s research. He used
coldblodded animals mostly. Vivisections on warm blooded animals
tended to quickly become dissections of dead warm blooded
animals.
He learned by vivisection that the heart pushed via contraction
(systol) rather than pulling via expansion.
Heart and pulse seemed to be the same rhythm.
His theory is admittedly vague as the blood goes through the lungs.
No chemical theory to help out.
Volume arguments from ventricular volume and pumping
frequency.
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Distribution Arguments
He writes in Chapter XVI, “We sometimes see the wholesystem contaminated, though the part first infected remainssound; … Whence it appears that the contagion impressedupon or deposited in a particular part, is by-and-by carried bythe returning current of blood to the heart, and by that organis sent to contaminate the whole body.”
He also states, “medicines applied externally exert theirinfluence on the body just as if they had been taken internally”and tells how “garlic applied to the soles of the feet assistexpectoration.” and that “an infinite number of examples ofthe same kind might be cited.”
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Quantitative Arguments
Chapter IX, Harvey measures the volume of the interior
cavities of the heart and then calculates that the quantity of
blood pumped in one-half hour exceeds the volume ofblood in the entire body.
If the left ventricle holds about 2 oz. of blood and itbeats about 72 times per minute… in an hour it willhave pumpbe into the aorta about 540 lbs. of blood.Where did this gigantic quantity of blood come from...and where does it go?
Why didn’t anyone mention bleeding out a lamb?
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The Arterial-Venous Connections
Harvey needed “Porosites” or capillary connections(or anastomotic connections) between the venousand arterial systems for his circuit to be complete.
On the surface his “porosities of the flesh” are asinadequately justified as the Galenist’s “porosities inthe septum of the heart.” Both are unobservableeven using the magnification technologies at hisdisposal. But Harvey does a good job making a casefor his “porosites,” considering he did not have apowerful enough microscope.
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Harvey’s
Circulatory
System
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In 1661, Malpighi
using a good
microscope finally
proved the capillary
connections.
This is a drawing
done by another
microscopist in the
early 18th c.
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Arm courtesy of Paul
Sammut’s Room-mate.
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Valves, with a little help from Photoshop.