"Some when they die, die all; their mouldering clay
Is but an emblem of their memories;
The space quite closes up through which they passed."

Fain would I believe that many of you would make enduring records. Yet each can do his best, and I doubt not each will do it. You have so much to encourage you, so comparatively little to hamper or hold back. Glorious is your work, glorious may be your fulfillment of it. We have lived in a goodly time; you will enjoy one still more goodly. With scientific progress, whose like the world has never known, and with an altruism which makes the world constantly better, you will be able to do things never done by your predecessors.

"'Tis coming up the steeps of time,
And this old world is growing brighter!
We may not see its dawn sublime,
Yet high hopes make the heart throb lighter!
Our dust may slumber underground
When it awakens the world in wonder;
But we have felt it gathering 'round!
We have heard its voice of distant thunder.
'Tis coming! Yes, 'tis coming!
"'Tis coming now, that glorious time
Foretold by seers and sung in story,
For which, when thinking was a crime,
Souls leaped to heaven from scaffolds gory!
They passed. But lo! the work they wrought!
Now the crowned hopes of centuries blossom,
The lightning of their living thought
Is flashing through us, brain and bosom;
'Tis coming! Yes, 'tis coming."

XI
THE EVOLUTION OF THE SURGEON FROM THE BARBER

If one attempt to scan the field of the history of medicine, to take note of all the fallacies and superstitions which have befogged men's minds, and brought about what now seem to be the most absurd and revolting views and practices of times gone by, and if one search deliberately for that which is of curious nature, or calculated to serve as a riddle difficult of solution, he will scarcely in the tomes which he may consult find anything stranger than the close connection, nay, even the identity maintained for centuries, between the trade of the barber and the craft of the surgeon. Even after having studied history and the various laws passed at different times, he will still miss the predominant yet concealed reason for this state of affairs. This will be found to be, in the words of Paget, the "maintenance of vested rights as if they were better than the promotion of knowledge." He will wonder also why women were licensed to practise surgery in the fourteenth century and prevented in the nineteenth, or why specialties were legally recognized in the sixteenth century only to lose their dignity and identity a little later.

In thus attempting to consider the relations which have existed in time past between barbers and surgeons I must ask you to remember that there was a time when bleeding was deemed necessary for the cure of almost all ailments, and that after the Church had condemned the shedding of blood by any of her officials it was most natural to turn for assistance to the barbers, who were supposed to be dexterous with sharp instruments, with basins and with towels. Thus it happened that when the barbers found themselves permitted to perform this sole act they naturally ventured further and practised many parts of minor surgery independently of the ecclesiastics.

Moreover there persist to-day in Europe many relics of the old customs, and the barber surgeon is still a common figure in Germany, and particularly in Russia, where the really educated surgeons are still too few for a vast and widespread population. It must be remembered also that the Church gradually imbued men's minds with a horror of a dead body, and of the profanation which followed having anything to do with it, and surrounded the study of anatomy with every possible obstacle and obloquy; even to such an extent that to be known as having dissected a human body was to be exposed to indignity, assault and even death. It was, therefore only intense yearning for knowledge, on the part of earnest men, which then permitted anatomical instruction to be given or encouraged.

During the middle ages the greatest medical school in the world was situated at Salernum (or Salerno), but a short distance from Naples. This is not the place in which to discuss its history, although it became famous above almost every other institution of learning of any kind, and though, by one of the freaks of history, even the site of the buildings is now lost and no one seems to know just where they stood. In his time, namely, in 1240, the Emperor Frederick II was the great patron of this college; his decrees concerning the regulation of the study and practice of medicine deserve attention to-day. A part of one of his enactments reads as follows: "Since it is possible for a man to understand medical science only if he has previously learned something of logic, we ordain that no one shall be permitted to study medicine until he has given his attention to logic for three years. After these three years he may if he wishes proceed to the study of medicine." And again: "No surgeon shall be allowed to practise until he has submitted certificates in writing, of the teachers of the faculty of medicine, that he has spent at least one year in that part of medical science which gives skill in the practice of surgery, that in the college he has diligently and especially studied the anatomy of the human body, and is also thoroughly experienced in the way in which operations are successfully performed and healing afterwards brought about."

When first we hear of medical men in Great Britain they were commonly spoken of as leeches, as among the Danes and Saxons; later the clergy introduced books from Rome, and almost every Monastery had some brother possessed of more or less knowledge of the medicine of the day. The College of Salernum later gave great impetus to the study of medicine, even before the days of William the Conqueror, which was strengthened by the influence emanating from Naples, and particularly from Montpellier. For centuries the Catholic clergy were almost the only persons with sufficient education to study and practise physic; which profession became in time so lucrative that many of the monks abandoned their monasteries, neglecting their religious duties, and applied themselves to the study of medicine. To such an extent was this true that in 1163 the Council of Tours forbade monks staying out of the monastery for more than two months at a time, or teaching or practising physic. In taking this action the Council only repeated what had been ordained by decree of Henry III in 1216, and by the second Council of Lateran in 1139. No restraint was at first placed upon the secular clergy, and many of the Bishops and other church dignitaries gained both money and honor by acting as physicians to Kings and Princesses.

Next to the clergy the Jews possessed the largest share of learning. Their nomadic life permitted an intercourse with the different nations of the world, which was denied to most others, and there were many who studied medicine and practised, not only among those of their own race but amongst Moors and Christians alike. The priests became extremely jealous of Jewish physicians and of lay surgeons, and endeavored to secure through Rome a formal excommunication of all who committed themselves to the care of a Jew, while by canon law no Jew might give medicine to a Christian. But so celebrated were the Jewish physicians, and so superior to everything else was men's desire for life and strength, that even the power of Rome could not exclude them from practice. Still less could the clergy restrain the lay surgeons from the performance of their craft, and though it would appear that at first, in England, the priests were not disposed to separate surgery from medicine, the Pope became jealous of so much interruption to the duties of the clergy and looked upon the manual part of surgery as detracting from clerical dignity. Accordingly were made numerous attempts to debar priests from the performance of surgical operations. In 1215 the ecclesiastics were prohibited by Pope Innocent III from undertaking any operation involving the shedding of blood, while by Boniface VIII at the close of the thirteenth century, and Clement V, about the beginning of the fourteenth century, surgery was formally separated from physic and the priests positively forbidden to practice it. It is to the Church then that we owe this absolute abandonment of surgery to an illiterate and grasping laity. For some time, however, the priests kept their hold upon surgery by instructing their servants, the barbers, who were employed to shave their own priestly beards, in the performance of minor operations. It was these men, who were in some degree qualified by the instruction of the clergy, who first assumed the title of barber surgeons, and who gradually formed a great fraternity.

In France it was in the reign of Louis XIV that the hairdressers were formally separated from the barber-surgeons, the latter being incorporated as a distinct medical body. In London it was in 1375 that the Company of Barbers were practically divided into two sections, containing respectively those who practiced shaving, and those who practiced surgery. In 1460 the surgeons were finally incorporated by themselves as the Guild of Surgeons and took their place as one of the liveried companies of the city of London. Similar separation occurred in the original great Guild of Weavers, who divided into the Woollen Drapers and Linen Armourers, the latter afterwards becoming the wealthy and powerful Company of Merchant Tailors.

To trace the history of the London Company of Barbers a little more fully, it was first formed in 1308 and incorporated in 1462 by a charter. In one of the statutes of Henry VIII it was enacted that: "No person using any shaving or barbery in London shall occult (i. e. practise) any surgery, letting of blood or other matter except only drawing of teeth." In 1540 Parliament passed an act allowing the United Companies of Barbers and Surgeons each to have yearly the bodies of four criminals for dissection. In 1518 the barbers and surgeons were united in one company; the former being restricted from all operations except tooth drawing, and the latter having to abandon shaving and hair dressing.

It is interesting also to note that in Oxford, for instance, the Barbers, Surgeons, Waferers and Makers of "Singing bread" were all of the same fellowship, from 1348 to 1500; when, at last, the Cappers, or knitters of caps, were united to them, in 1551, the barbers and waferers abrogated their charter and took one in the name of the city, until 1675, when they received a charter from the University.

The London Guild of Surgeons appears to have been first a mere fraternity which had incorporated itself, and to have originated from an association of the military barber surgeons who had been trained in the hundred years war with France, 1337 to 1444. Its membership, however, was select, and when the physicians declined an alliance with it, it amalgamated with the barber companies in 1540. The United Company of Barbers and Surgeons was peculiar in that strangers and those who were not free men were admitted, while the journeymen of the craft formed a subordinate body within the company. In 1745 the surgeons separated from the barbers and formed a surgeon's company which rapidly acquired influence. By a foolish blunder it forfeited its charter in 1796 but was subsequently incorporated by George III, in 1800, as the Royal College of Surgeons in London; a body which has since maintained its identity, grown tremendously in wealth and strength, and having become one of the licensing bodies of England, has acquired the finest collection of books and specimens in the world and has numbered the brightest intellects which the English surgical profession has contained.

In Dublin the Barber Surgeons were incorporated as a guild by charter granted by Henry VI, in 1446. In 1576 they were amalgamated with the independent surgeons, and by Queen Elizabeth with the barber surgeons and wig-makers. This confraternity was dissolved in 1784 and the College of Surgeons founded immediately afterwards. In Edinburgh the barbers and surgeons were united in 1505, to be separated at about the same time as elsewhere in Great Britain.

During the eighteenth and nineteenth centuries on the continent medicine and surgery were abruptly separated, and the latter was almost entirely in the hands of the barbers. For hundreds of years the dissection of corpses and the embalming of those who could afford it, were in the hands of first the butchers and later of the barbers. The greatest contempt was everywhere shown for one who attempted any surgery. If for instance a nobleman while being bled by a barber received the slightest harm the poor barber was heavily fined, while, should the gentleman die, the culprit was given into the hands of the dead man's relatives to be dealt with as they desired. Throughout the monasteries and whenever the influence of the Church was felt it was forbidden to the monks, who had the monopoly of knowledge, to perform any surgical operation since the Church abhorred the shedding of blood.[8]

For hundreds of years the monks were not allowed to wear a beard; this necessitated the employment of tonsors ("tonsorial-artists" they call themselves to-day) to whom was left also the performance of anything that partook of the nature of an operation, such as bleeding, bandaging, etc. This calling, was however, recognized as a most inferior one, and the barbers, like the bathkeeper, the shepherd and the hangman, were not considered of good repute. Consequently, such an one was not eligible for membership in any other guilds or fraternities. In 1406 the Emperor Wenzel was rescued from prison, in Prague, by the daughter of a bathkeeper; in gratitude he made her his mistress, and declared both barbers and bathkeepers to be respectable; but having lost his position his decree had no weight, and not until 1548, in Augsburg, were they really made eligible to the guilds. At this time their most dignified labor was the sharpening of instruments. In 1696 Leopold I. decreed their profession to be an art, and gave it a position above that of the apothecary so that in their most dignified occupation they were elevated to the making of ointments and plasters.

As surgery has for the profession of barber surgery to thank the existence upon man of a beard, so the European continent may thank the Crusaders of the eleventh century for having necessitated the existence of the bathkeeper, because of the leprosy which they brought home from the East. During the Crusades, as is well known, there were founded numerous Orders having for their original purpose the care and protection of pilgrims and injured soldiers. The three most celebrated Orders were the Knights of St. John, the Knights Templar and the Teutonic Order. Were this the place it would be most interesting to go into a history of these religio-medico-military Orders, and show how from most devout purposes and humble origin they grew into despotic and tyrannical associations of great power, which it finally took all the force of Church and State to suppress. As the then humble and enthusiastic members of these Orders returned from the Holy Land they established hospitals for the care of lepers, who became very numerous in Europe. For instance it is stated that in France, in 1225, there were two thousand hospitals for this purpose, while the King Louis the Great founded, in 1260, a special hospital for those made blind by Egyptian ophthalmia. It is well known also that during the middle ages there was the greatest neglect of the ordinary canons of cleanliness both among the upper and lower classes. The number of hospitals and cloisters dedicated to the lepers being insufficient, bath houses were built and bathkeepers were engaged in order, so far as possible, to prevent the spread of leprosy. At this time the bathkeeper was permitted to bathe and cup, later also to bleed, although the bleeding was required to be done in the bathkeepers' own house, since he was not usually permitted to enter a patient's house. As bathing became less necessary for purposes already mentioned the bathkeeper took to imitating the barber, though much later, and not until about 1750 in some countries, were they permitted to do this publicly, and only after having passed the examinations to which the barber was also subjected. In Prussia they were only allowed to treat wounds and chronic diseases, and so it came about that by the beginning of the eighteenth century a really conscientious and efficient barber surgeon was supposed to have served an apprenticeship in large hospitals, to have witnessed the work of noted surgeons and to have served in the Army or Navy. He was also supposed to be something of a linguist and to know a little botany; particularly was he expected to be conversant with anatomy, although there was a sad lack of cadavers—which was atoned for by the use of carcasses of animals, for the main part swine.

Eckardt, writing at this time of the sixteen different virtues of a barber, enumerated, first of all, fear of God; then that he should be careful, prudent, temperate, and ready to use both hands with equal dexterity; he claimed that "Arrogance seems most prevalent among barbers, as a common saying would imply 'barbers are proud animals.'" He expressed his surprise also at the envy and malice between bathkeepers and barbers, and advised them both to consult physicians and other masters.

The customs of the time must be blamed for this lamentable condition of affairs. The boy who was destined to become a barber was apprenticed at a time when he had scarcely learned to write. If he could write legibly and read a little Latin no one dared refuse him. He learned to shave and went from house to house for this purpose, spending the little time remaining in sharpening knives, spreading plasters, picking lint, taking care of children, doing all menial duties, and using the same light as the housemaid because it would have been disrespectful to his master's wife to use any other. After years of this work he was gradually taken to visit patients and then was taught how to bleed, cup, apply leeches, extract teeth and clysters. His master knowing nothing of anatomy could give him no instruction, though by the laws of apprenticeship he was bound to do so. Before concluding this apprenticeship he was supposed to pass an examination, which his master's laziness usually permitted him to escape. He then presented the master with some silver instruments and was dismissed with an injunction to be thankful that such a miserable specimen of God's creatures had ever been taught to shave a beard or spread a plaster. He now became a journeyman, still living at the house of his master, and was not allowed to marry; after a while he received a paltry sum as wages, got his dinners free and began to dabble on his own account. Study was out of the question; these men could not understand what little they did read and served the community mainly as bearers of tales. After some years of activity as journeyman they could become masters by applying to the authorities, presenting certificates, and passing an examination before the physicians of the district.

Prussia was the first country to appreciate the necessity of regulating medical practice, and the barbers and bathkeepers were placed under the control of the Medical College founded, in 1685, by Prince Frederick William. In 1724 this institution attained its greatest activity, having a subordinate school in each province. In 1725 King Frederick William issued a famous edict which did much to regulate medical affairs throughout the kingdom, and directed among other things that barbers and bathkeepers should "lead a religious, temperate, retired and sober life, in order to be at their best whenever their services were required." When their business was not sufficiently good they assumed other cares, as, for instance, one man was surgeon, municipal judge and post-master all at once. They were extremely envious of each other and often dabbled in medicine without permission. It was not until 1779 that the bathkeepers were permitted to rank in Prussia with the barbers, and were allowed to use more than four basins, the bathkeepers' guild being incorporated with that of the barber.

There being no temptation to enter these ranks it is not strange that so late even as 1790 good surgeons were rare in Germany; not one in fifty of the barbers really knowing the first principles of the work they were supposed to perform. It came to such a pass that surgeons were compelled to shave and perform other duties of the hairdresser, for no surgeon, however skilled, was allowed to practice as such, unless he was the proprietor of a head-shaving and bathing establishment, with assistants and apprentices, and belonged to the barbers' guild, or unless he was favored by Royal exemption. It was the general lament in Germany, all through the 18th century, that German surgeons were educated in barber shops. Even by the middle of that century the practice of surgery was not considered an honorable business, and those who practiced it were not permitted to carry a sword, neither was a surgeon admitted into society nor tolerated among physicians; moreover when unsuccessful he was bitterly and relentlessly pursued. Under existing conditions the Reichstag either could or would do nothing to alleviate the distressing condition. The physician boasted of his education and treated the surgeon and his craft with disdain, holding that surgery sustained the same relation to medicine that geometry does to higher mathematics and physics. All this time, however, while the physician contented himself with disdaining surgeons he made no attempt to elevate the craft nor to himself study and adorn it. Even by the beginning of the nineteenth century there were scarcely any physicians in Europe who could diagnose a surgical case, while dentistry they claimed called for no more skill than that sufficient for tooth extraction. It was even claimed that so long as the people generally were neglectful of their teeth the physician, or even the surgeon, should be ashamed to concern himself with dentistry.

Von Siebold, in his day, deplored the position of the surgeon; his large military experience had shown him the difficulties with which he had to contend before he could enter society, while his ambitions and high motives were scorned. Even the peasantry were bitterly opposed to all operations. So intense were their feelings that he repeatedly removed his patients to other towns before performing operations. Nevertheless it was true that there were the best of reasons for lack of confidence in any barber who dropped his razor for the purpose of treating a fracture, a hernia or an obstetric case. The State required a barber surgeon to call in a physician in all complicated surgical cases. In such a case the physician demanded the control of the case and reserved to himself the right to judge of what was required. He would not even consider a surgeon who had obtained the doctorate as his equal. Such consultations resulted in little but quarrels and disagreeable scenes. If a village contained no physician the surgeon treated also internal diseases, though he was not allowed to use strong medicines. Every district had its special surgeon who, alone, had charge of several villages where he had the right to keep journeymen and apprentices and to do shaving and cupping. In the Prussian capital city only twenty German and six French surgeons were allowed to practice in 1725, besides the court and private surgeons.

Until 1808 every German surgeon carried on a medico-legal business which was later separated from his surgery. In 1782 there were three classes of surgeons; from the lower one might be promoted to a higher after an examination. In Austria, in 1805, there were doctors of surgery who were required to show a general knowledge of medicine and who had the same rights as the physicians; there were also medical surgeons who could practice under restrictions, and bathkeepers for minor surgery. After the year 1773 barbers and bathkeepers were both spoken of in Austria as surgeons; this was to break up the disputes between them. According to an official feebill holding good in Prussia in 1815, the highest fee that could be charged for an operation was for lithotomy in adults, the maximum limit being about M. 140 ($35), while the majority of operations ranged from M. 20 to M. 50 ($5.00 to $13.00 expressed in U. S. money). Of course this was at a time when the value of money was much greater than now.

As already made plain, it was the Church which by its decrees brought about the separation of surgery from medicine, a condition not existing during the palmy days of Greece and Rome. Even the University of Paris at one time refused to admit a student who had not foresworn the study of surgery, while the denouncement of anatomy and surgery alike was promulgated by both papal bulls and clerical decrees. While many of the physicians considered surgery too burdensome a study, and many others had a severe prejudice against it, the principal cause operating to keep them apart was probably the fact that for surgeons there was absolutely no social position. In 1774 Mederer was made Professor of Surgery in Freiburg, in Breisgau; he delivered his opening address on the wisdom and necessity of combining medicine and surgery. As a result he was persecuted by the public, insulted by students, abused by surgeons and constantly threatened with personal assault. He maintained his position, however, and fought against the prejudice. Twenty-two years later, when he left Freiburg, he referred in his last lecture to his early experience. By this time public opinion had been so changed that the students serenaded him and humbly apologized for what their predecessors had done. Mederer could then see the success of his efforts in that the constitution of France contained a clause combining medicine and surgery, and the Royal Sanitary Commissioners of Vienna had unanimously resolved in favor of such union.

The movement begun by Mederer was continued by men like Richter, Von Siebold, Loder and others. In 1797, or over a hundred years ago, the Electoral Academy of Erfurt offered a prize for the best essay on the subject "Is it necessary and possible to combine medicine and surgery theoretically as well as practically?" Fourteen papers were submitted, of which twelve were in favor of union. Nevertheless the Academy awarded the prize to the only writer who had opposed such union. His reasons for such opposition were most puerile, as were all the arguments subsequently advanced against it. Nevertheless a great step was taken in advance, when the guilds and fraternities of barbers and bathkeepers were abolished, in which good work Vienna, in 1783, took the lead. It was then declared that shaving was the business of the hair-dresser, and that barber surgeons must attend lectures in surgery and anatomy. Bavaria followed in 1804, and four years later, in Prussia, no one was permitted to practice surgery without having studied medicine. The rules of 1786 regulating the respective positions and duties between physicians and surgeons were annulled in 1808, and by 1811 the barber license was no longer essential for the practice of surgery, the privileges of the barber, as such, being abolished, while for his trade only a common license was needed.


XII
THE STORY OF THE DISCOVERY OF THE CIRCULATION

A Study of the Times and Labors of William Harvey[9]

History in general is but a record of the succession of great events or epochs which have moulded the world's affairs. That which is of the greatest import in the life of the individual may count for little in the lives of his contemporaries, and yet it must be said that in the events of to-day there has occurred a great epoch in the life of each of you, presumably the most important as yet in your personal records. This day is then in your personal histories one of the greatest importance. It is desirable, therefore, that your lives be so moulded and influenced by it that you may long hence look back to it and recall its significance.

I do not know what advice I can give you which will be more fruitful of results, than that among your studies you include that of the lives of the great men who have moulded destiny and made the world's history. Their lives were modified by little things, as have been and will be yours, and yet out of small matters grew for them and for us some of the most far reaching effects. Select the really great men of whom you best happen to know and analyze their characters that you may appreciate how they have become great; while if they have, as all great men have, traits of smallness, study even wherein they are small, and how such faults may be avoided.

History runs as does a fairly steady stream, save that every now and then some event abruptly diverts its course or influences its current. It has been so, for instance, with the history of medicine. For the first sixteen hundred years of the Christian era men engaged in the crude practices of our profession, utterly ignorant of the course of the blood, as well as of its purposes. Then appeared upon the scene a man who did his own thinking, who was willing to free himself from the shackles of the past, to observe nature and to reason therefrom. In this way came suddenly upon the world, as it were, an appreciation of the Circulation of the Blood, than which perhaps no event in medical history has been of greater importance or reflected more credit upon its demonstrator.

It is my purpose, then, to-day to try to tell you, in a semipopular way, how William Harvey came to make this great discovery, as well as to give you some idea of the difficulties under which he worked, and of the men and influences that surrounded him, believing that rather than spend a half hour in humorous platitudes which may provoke a smile, but which are quickly forgotten, it is much better to try to implant something which may linger a while in your memories, and sufficiently impress you with the value of observation and inductive reasoning, since if you become thus fully impressed you will be spared in the future many sad errors of speech and even of thought.

Before telling the story of Harvey's life and work let us study for a few moments the general condition of affairs in Europe, in order that we may better understand the men whose influence surrounded him, as well as the spirit of the times and men's habits of thought.

Among the monarchs reigning in various parts of Europe during Harvey's time there were, for instance, in that part of the Empire of the West which was called Germany, Rudolph II, Matthias and Ferdinand. In Sweden reigned King Sigismund, Charles IX, the great monarch Gustavus Adolphus, and Queen Christine. In Prussia the throne had been occupied by Joachim, George William and Frederick William, as electors, this being before the days of the Prussian kings. In Russia the Czars Boris Godunow, Michael Theodore and Alexis had occupied the throne.

France had but recently passed through the inhuman butchery of the massacre of St. Bartholomew and its accompanying persecution of the Huguenots, under Charles IX, who expressed the hope that not a single Huguenot would be left alive to reproach him with the deed, but who died himself soon after the massacre, which is said to have caused him bitter remorse. Charles had been succeeded by his brother Henry III, a weak, fickle and vicious monarch, whose weakness caused him to be embroiled in civil strife, which was only concluded by his own assassination at the hands of a Dominican friar. Then came Henry IV, he of Navarre, afterwards surnamed The Great, who fought the famous battle of Ivry in 1590, and who reigned for twenty-one years, the greatest and most popular sovereign who ever occupied the throne of France. Notwithstanding his noble qualities he did not succeed in preserving his court from many of the contaminations of the age, and in his reign it is said that no less than 4,000 French gentlemen were killed in duels, chiefly arising out of quarrels about women. He was succeeded by Louis XIII, who was still on the throne when Harvey died.

In Harvey's own country James I was occupying the throne when Harvey appeared upon the scene. He was that royal pedant whom the Duke of Sully pronounced "the wisest fool in Europe." After his death, and when Charles I ascended the throne during his twenty-fifth year, in 1625, Harvey was preparing to publish his great work. It was this Charles I who retained as a favorite the worthless scoundrel Buckingham, whose misconduct in Spain prevented the proposed marriage of the king with the Spanish Infanta and brought about the Civil War. It was because of the cost of this war, and of the king's disputes with Parliament regarding the matter, that England was rent between the conflicts of the Cavaliers and the Roundheads, two of the consequences of this intestine strife being the execution of the Earl of Strafford and of Archbishop Laud. The troubles thus engendered finally cost the life of the king himself, who was beheaded in 1649. Harvey even lived to see the first half of the short tenure of office of Cromwell as the Great Protector, and was perhaps fortunate in dying before began the reign of that odious profligate Charles II.

It is worth while to enquire for a moment what was doing on this side of the ocean at this period which we have now under consideration. In 1607 Virginia was settled by the English, in 1614 New York, by the Dutch, in 1620 Massachusetts and, three years later, New Hampshire, by the English Puritans; in 1624 New Jersey, by the Dutch, in 1627 Delaware by Swedes and Finns, in 1630 Maine, by the English, in 1634 Maryland, by Irish Catholics, in 1635 Connecticut, by English Puritans. Thus it will be seen that the active period of Harvey's life was synchronous with the beginnings of our colonial activities. Very little knowledge of what was going on in the then world of science was brought to this country at this period of its existence, however, and it was many years before in these colonies there were any exhibitions of scientific interest save in extremely scattered and sporadic cases.

Among Harvey's literary associates were a number of celebrated English poets, for example,—Marlowe (1593), Spenser (1598), Beaumont (1615), Shakespeare (1615), Herbert (1635), Ben Jonson (1637), Massinger (1639). Lord Bacon died a year or two after the appearance of Harvey's book, while Baron Napier, the inventor of logarithms, had passed away. His contemporaries in Italy, where he had studied, included Tasso (1595) and Galileo (1645). Rubens had died in 1640, Michael Angelo in 1564 and Titian in 1576. In France, Calvin, the practical murderer of Servetus, had passed away in 1564, Beza died in 1605, Descartes in 1650, Pascal in 1662 and Gassendi in 1655. Portugal had produced but one great figure in the 16th century, namely Camoens, who died in 1579. In Spain, Loyola, the ascetic and fanatic founder of the Jesuits, had joined the great majority in 1556; but Cervantes did not die until 1616, Lope de Vega in 1635, Velasquez in 1660 and Calderon in 1667.

In Germany some great figures had but recently disappeared. Paracelsus died in 1541, Copernicus in 1543, Luther in 1546, Hans Holbein in 1554, and Melancthon in 1560. Mercator, who introduced a new method of cartography, died in 1594, Tycho Brahe in 1601, Keppler in 1631, Van Dyck in 1641, Grotius, the great scholar, in 1645, Rembrandt in 1668 and Spinoza in 1677.

In philosophy, scepticism was the prevailing doctrine in the time of Harvey. It had been founded a hundred years previously by Montaigne, and continued by Charron, the chaplain of Queen Margaret of Navarre, who died in 1603, and who declared all religion to be opposed to human reason;—a remarkable attitude for a chaplain to assume. Opposed to the scepticism of Harvey's day was the mystic, Cabalistic or supernatural philosophy especially represented by Böhme, a peasant shoemaker, uneducated and yet wonderfully gifted. He had been the philosophical colleague of that great Meistersinger, Hans Sachs. Later philosophers and thinkers, yet belonging to Harvey's time, were Pascal, the great Jansenist, who discovered the variations of atmospheric pressure at different levels, and Malebranche, who figures prominently in the history of philosophy.

Descartes, who died in 1650, held the pineal gland to be the seat of the soul. He was the discoverer of the laws of refraction of light and furnished the explanation for the rainbow. He attained greatest eminence in mathematics, physics and philosophy, and was one of the inventors of modern algebra. One of his greatest opponents was that noble Jew, Spinoza, whose colleagues had expelled him from the Sanhedrim to the sound of the trombone.

The Italian Dominican Campanella, who died in 1639, considered the foundation of knowledge to be supernatural revelation and its perception by the senses. In spite of these views he came before The Inquisition on a charge of heresy and of cooperation with the Turks, was tortured by the rack, and imprisoned for thirty years.

The mystic or Cabalistic notions of Harvey's day have just been mentioned. Under them we may recognize many degenerate products and amalgamations of the real doctrines of Paracelsus. The doctrines of the Rosicrucians, as well as of Zoroaster and the Cabala, were revived and made to do strange work. There was, for instance, that Sir Kenelm Digby, who died in 1605, a King's chamberlain, who posed among the English as a so-called Rosicrucian. It was he who suggested the famous "sympathetic powder," which was to be applied to the weapon by which a wound had been inflicted, after which the weapon was anointed and dressed two or three times a day, while the wound itself was carefully bound up with dressings and left alone for a week. This was perhaps much the better course, but it will show what strange notions prevailed in those days.

What it meant to run counter to ecclesiastical policy and theological dogma appears not only in such tragedies as terminated the lives of Bruno and many other martyrs to science, but in such facts as these; for instance, when in 1624, just when Harvey was preparing to publish his work, some young chemists in Paris, seeing the benefit of the experimental method, broke away from Aristotle and the canons of theological reasoning, the faculty of theology appealed to the Parliament of Paris, which latter prohibited all such researches, under the severest penalties.

This was the time too when such exhibitions as the following were altogether too frequent;—One Quaresimo, of Lodi, came out with a ponderous work entitled "A Historical, Theological and Moral Explanation of the Holy Land," in which he devoted great space to the question of The Dead Sea and the salt pillar supposed to represent Lot's wife, dividing a long chapter upon the subject into three parts, dealing with the method and the locality of this transformation and the question of the existence at that time of her saline remains. Thus, with his peculiar powers of reasoning, he was able to decide the exact point where the saline change took place, and finally showed that the statue was still in existence.

Lord Bacon was also an older contemporary of Harvey, having been born in 1561 and dying in 1626, shortly after the appearance of Harvey's great work. His services to analytic science need no description here, but it is worth while to remember that Harvey, like many others, must have come under his influence and have profited by his teachings in logic and analysis.

At about the time when Harvey made known his discovery Bacon was publishing his views of the laws of transmission and reflection of sound. Great man as he was, with a keen foresight into the value of the recent inventions of the compass, gun-powder and printing, he nevertheless was himself so narrow, in some respects, that he placed but little value upon the discovery of Copernicus. He, however, paved the way for one in some respects still greater, namely Isaac Newton, who, however, had scarcely attained man's stature when Harvey died.

How much we owe to the two great Bacons of history one cannot indicate in this short résumé. Roger Bacon (1214-1292) seems to have been the first great thinker along truly scientific lines. He was more than a mere chemist while, as White says, more than three centuries before Francis Bacon advocated the experimental method Roger Bacon had practised it, and in many directions. He did more than anyone else in the middle ages to direct thought into fruitful paths, and only now are we finding out how nearly he reached some of the principal doctrines of modern philosophy and chemistry. Most important of all, his methods were even greater than his results, and this at a time when "theological subtilizing" was the only passport to reputation for scholarship.

It was Avicenna, the Arabian, who perhaps first announced substantially the modern theory of geology, accounting for changes in the earth's surface by suggesting a stone-making force, but the presence of fossils in the rocks had been always a thorn in the sides of the theologians. It was Leonardo da Vinci, that versatile genius in science and art, who, previous to Harvey's generation, suggested true notions as to the origin of fossils, while, in Harvey's time, Bernard Palissy, another artist, vehemently contended for their correctness. Still, even at Harvey's death, neither geology nor paleontology had come anywhere near scientific accuracy.

The Academia dei Lyncei, so-called from its seal, which bore the image of a fox, was founded in Rome in 1603. In France The Academy of Science was not founded until 1665, in Germany The Society of Naturalists and Physicians in 1652, and the British Royal Society in 1665.

In matters of general interest it may be worth while to say that in architecture the general style of The Renaissance was changed for the more substantial Barocco, while the more formal and limited style of church music had given away to musical drama, i. e., opera, albeit in very crude form. The first newspaper had appeared at Antwerp in 1605, the first German paper being published in Frankfort in 1615, and The London Weekly News making its first appearance in 1620. Tobacco, which had been brought over by Raleigh in 1560, had come into quite general use, while coffee, tea and chocolate had gained in public esteem. When coffee was first introduced in England it sold for about $28 a pound. The first coffee house appears to have been established in Constantinople, in the middle of the 16th century, while the first coffee house in London was not opened until a century later.

The barbers still retained their ascendency, and the bath keepers had scarcely lost their position next to the barbers. It was not until Harvey had reached a ripe age that the barbers were required in Germany to pass an examination, in which they had to prove not only their knowledge but the legitimacy of their birth, and the fact that they had studied for three years and had worked for three years more as apprentices.

Anatomy was studied quite generally, sometimes upon human bodies. A dissecting room had been established in Dresden in 1617, in which stuffed bears, at that time a great rarity, were preserved with other curiosities. In 1623 Rolfink, at Jena, arranged for public dissection upon the bodies of all executed malefactors, delegates being present thereat from various other institutions. It is worth while to mention that in Frankfort, for instance, during the expiration of 65 years, but seven dissections were made, and that these were always accompanied by a celebration which lasted several days. Vienna did not possess a skeleton in 1668, and Strassburg did not have one until 1671. Yet it is of interest to remember that the anatomical plates, like those often published to-day, which are meant to be lifted off in layers, existed even at this period. On the other hand, botanical gardens and chemical laboratories existed in several of the universities,—in Strassburg, for instance, in 1619,—in Oxford in 1622.

Fabricius Hildanus, the father of German surgery, or, as he has been sometimes called, the Ambroise Paré, of Germany, was also a contemporary of Harvey's. His real name was Fabry and he was born in Hilden, but he latinized his name into that form usually adopted to-day.

Scultetus was another famous surgeon of the same period.

William Gilbert, 1540-1603, had been the talented physician of Queen Elizabeth, and was among the first to study the experimental method. With the appearance of his book upon the magnet, in 1600, began the science of electricity and magnetism. He was the first to teach the fact that the earth itself was a great magnet and he distinguished between magnetic and electric reactions. Later the great Dutch anatomist, Ruysch, afforded corroboration of Harvey's views by another method, when he invented and practised those beautiful minute injections of the vascular system which made him so famous, and built up that great collection of specimens which Peter the Great bought for Russia at an expense of about $75,000.

Contemporary with Harvey also was Swammerdam, one of the most versatile men of his time, famous as naturalist, savant, physiologist, linguist and poet. It was during the fifteenth century that astronomy began to assume an importance and degree of accuracy never hitherto known. This was due very largely to the independence of thought and the researches of Copernicus, who was born in Cremona in 1477, and who studied medicine in Krakau and astronomy in Vienna. He lived to the age of 70 and was the real father of the heliocentric theory, now known as the Copernician system, which he substituted for the previous Ptolemaic theory, thus reversing the ancient idea that the sun circled about the earth. Copernicus demonstrated the phases of the moon, but his opponents claimed that if this doctrine were true Venus would exhibit the same phenomena; to which he replied that it was true, though he knew not what to say to these objections, but that God was good and would in time furnish answer to them. It was Galileo's crude telescope which, in Harvey's younger day, in 1611, furnished this answer and revealed the phases of Venus. To illustrate how the views of Copernicus were received we might add here that Martin Luther paid his compliments to him by declaring that Copernicus was a fool who wished to stand astronomy upon its head.

Copernicus was succeeded by Galileo, who was born in 1554 in Pisa, and died 1642. He may be called the creator of dynamic astronomy and mechanics, as well as one of the most brilliant exponents of experimental and inductive reasoning. He was of noble birth and was, in fact, the torch bearer of physics at the period of The Renaissance. He gave up speculation and substituted for it the habit of observation, reaping a large harvest of surprising facts, any one of which might have immortalized him. He not only established the movements of the earth on its own axis as well as around the sun, which Copernicus had shown, but he discovered the weight of the atmosphere and first calculated the law of gravity. He and his successors were governed always by that aphorism which is to-day as true as ever: "Experience is deceptive and judgment difficult."

In 1615 when he was before The Inquisition, at Rome, and when its theologians had examined statements extracted from his letters, they solemnly rendered their decision in these words: "The first proposition that the sun is the centre and does not revolve about the earth is foolish, absurd, false in theology and heretical, because expressly contrary to The Holy Scripture. The second proposition that the earth is not the centre, but revolves about the sun, is absurd, false in philosophy and, from a theological point of view, at least, opposed to the true faith." This for a pronunciamento from the infallible Church!

Galileo and Bruno have by some writers both been made to stand in an unpleasant light because of their recantation or shifting position before The Inquisition. Bruno was the greatest philosopher and sceptic of the latter part of the 16th century, and had outlined, withal somewhat vaguely, that which is now known as the nebular hypothesis. He was murdered by The Inquisition in 1600, and the views which he enunciated seem to have been buried with him, not to reappear until long after his sad fate had been consummated. He had, for instance, contended for the truths of the Copernican doctrine, but it was not until ten years after his martyrdom that Galileo proved it with his telescope. That both these great men yielded in some respects to the influences of The Inquisition and renounced some of their scientific "heresies" is largely to be excused by the fact that they were both old, broken in health from the sufferings which they had endured, as well as from their disappointments, and that they had been, under these circumstances, handed over to that Inquisition which knew no mercy. Galileo could well remember the auto da fê in the Piazza dei Fiore, in Rome, the scene of Bruno's martyrdom, as well as the tragic end of many another who had dared to have the courage of his convictions. Let us, then, not judge him harshly, but be grateful even that the enormous power of The Inquisition did not and could not suppress the truth.

Galileo's discovery of the satellites of Jupiter, the rings of Saturn, his experiments with the pendulum, his construction of the telescope, as well as of the thermometer, and many other deeds, have stamped him as one of the great figures in the history of progress and science. It is most interesting to note that this contemporary of Harvey's, like himself, was given to inductions obtained from experimental studies. Another great astronomical light of Harvey's time was Keppler, who was driven from one place to another by religious fanaticism, until he ended his life in 1630. It was he who formulated the great principle which underlies the motions of the planets, and who gave to the world his so-called "laws," which so materially advanced the science of astronomy. It was he who really discovered that comet which was later given Hailey's name, whose periodic return he first foretold.

Such was the spirit of the times in which Harvey lived, and such the influences which surrounded his teachers before him and himself in turn. It makes a long preface to a consideration of what Harvey himself accomplished, but it is not without its interest because men and their deeds must be judged largely by their environment. Now, to speak more particularly of Harvey himself, and what was known of the circulation when he undertook his investigations.

The liver had been considered, from time immemorial, as the principal factor in the production and movement of the blood. The ancients supposed that here the veins took their origin and that through them the blood flowed to all parts of the body, returning to its source by an undulating movement or series of alternate waves. The arteries had been supposed to contain only vital spirits, whose great reservoir was the heart, although Erasistratus had admitted that in certain cases blood might escape into the arterial channels. Later Galen showed that the arteries always contained blood, and he knew that blood was poured into the right side of the heart by the great veins, but believed that only a little of it passed from the right ventricle into the lungs, the greater part of it passing through hypothetical pores in the septum and thus into the left ventricle. This opinion, like Galen's in other respects, remained unchanged until the middle of the 16th century. It was also known that valves existed within the veins, and that if an artery were tied on a living animal blood would cease to flow and pulsation be checked below the ligature, while if a vein were tied it shrunk above the ligature and became distended below.

Three men before Harvey's time came very near to discovering the secret that made him famous; in fact, they made such advances on what was already known that history should accord them a distinguished place. One was Columbus, who was born at Cremona in 1490, and died in 1559. He was first a pupil and prosector and then a friend of Vesalius, the great anatomist. Later he succeeded him at The University of Padua and unfortunately, after gaining his position, ungratefully turned upon his old teacher. He was, however, for his day a good anatomist and especially a good osteologist. It was he who first demonstrated experimentally that blood passes through the lungs into the pulmonary veins and that the latter connect with the left ventricle. He thus practically established the fact of the lesser circulation. He suffered, however, as did Servetus, from the prevailing notion that spirits and blood were mixed together. From Padua Columbus went to Pisa, and then to Rome. He wrote with elegance and correctness of style and even described the vessels which penetrate the bone cells, the ossicles of the ear, the minute anatomy of the teeth, the ventricles of the larynx, as well as those valves which prevent the return of blood from the lungs to the heart. In fact, he narrowly missed the significance of the actual facts of the case, simply failing in his final analysis and assembling of those facts which he had already demonstrated.

Cesalpinus, who lived a little later, came still nearer the mark, having accepted the teachings of Columbus regarding the course of the blood through the lungs. He added that the ultimate arterial branches connect with those of the veins, and he taught that blood and vital spirits, from which the ancients could never separate themselves, passed from the arteries into the veins during sleep, as was demonstrated by the swelling of the veins and the diminution of the pulse at that time.

A little later came Michael Servetus, who figures principally in history as a theologian and a victim of theologians, since he perished a martyr to Calvin's jealousy. He was, in effect, a wisely and widely educated man who did a great deal for science, one of the offences attributed to him being an edition of Ptolemy's geography, in which Judea was described as a barren and inhospitable land instead of one "flowing with milk and honey." This simple statement of a geographical fact was made a tremendous weapon of offence by Calvin, who replied that even if Servetus had only quoted from Ptolemy and, although there were ample geographical proofs, it nevertheless "unnecessarily inculpated Moses and grievously outraged The Holy Ghost." Servetus dared to deny the passage of the blood through the septum of the heart, and contended that that which comes into the right side was distributed to the lung and returned to the left ventricle. He published his views, however, in a religious treatise on Errors concerning The Trinity, a most unfortunate place in which to inject such an important fact, since it gave his enemies a still greater opportunity to vent and ventilate their spleen. Had he been able to leave out that notion of vital spirits, which prevailed with all his predecessors, he might actually have made the great discovery left for Harvey to enunciate. I have not been able to refer to original documents in this matter, but it is claimed by some that his description of the circulation was contained in another religious work concerning the Restitution of Christianity, which was printed in Nuremberg in 1790.

Such was the actual state of knowledge concerning the movements of the blood and the functions of the heart when Harvey published his great work. It behooves us now to proceed with a short account of Harvey's own life and researches.

William Harvey was born at Folkestone on the first of April, 1578. He was the eldest son of a prosperous merchant who raised a large family and who occupied the highest positions of honor in his own town. The son William was born to his second wife, by whom he had seven sons and two daughters. All of these children were helped to remunerative or honorable positions. They became merchants or politicians or secured prominence in some way, but William was the only one to study medicine. He was sent to the King's school at Canterbury, in 1588, and he was admitted at Caius, in Cambridge, in 1593, where he graduated in arts in 1597. The following year he went to Padua, which then had one of the greatest medical schools of the time, and he obtained his medical diploma in 1602, when twenty-four years of age. Returning to England he received a doctor's degree at Cambridge, and shortly afterward married a daughter of a London physician and entered upon the practice of medicine in London.

In the great city his practice as a physician seems to have been from the outset successful, and his knowledge and ability procured him various valuable appointments. He was made a Fellow of The College of Physicians in 1607. This Royal College of Physicians was given a grant of incorporation by Henry VIII in 1518, at the intercession of Chambers, Linacre and Ferdinand Victoria, the King's Physicians, it being under the patronage of Cardinal Wolsey. The first meetings were held at Linacre's house which he bequeathed to the corporation at his death. Until this College was founded practitioners of medicine were licensed to practise by the Bishop of London or by the Dean of St. Paul's.

A few years later Harvey was appointed Physician-Extraordinary to King James I, and later yet, after the publication of his great treatise and its dedication to the King, he was made Physician-in-Ordinary to Charles I, whom he attended during the Civil Wars.

It must have been about 1615 when Harvey first began expounding his views on the circulation of the blood, during lectures which were delivered at The College of Physicians, but it was not until thirteen years later, i. e., in 1628, that his great work DE MOTU CORDIS was published in Latin, as was customary among scholars, and at Frankfort-on-the-Main, since that was then the great center of the book publishing trade.

The treatise was dedicated to King Charles I, in a manner which to us would seem servile, and yet which was according to a custom followed by nearly all of the scholars of the day, who desired to attract not only the attention of royalty, but, in most instances, their benevolent assistance. It is worth while to quote at this point the first sentence or two of his dedication:

"To the
Most Serene and Invincible
CHARLES,
of Great Britain, France and Ireland,
KING: DEFENDER of the FAITH,
Most Serene King,

"The heart of animals is the basis of their life, the principle of the whole, the Sun of their Microcosm, that upon which all movement depends, from which all strength proceeds. The King in like manner is the basis of his Kingdom, the Sun of his World, the heart of the Commonwealth, whence all power derives, all grace appears. What I have here written of the movements of the heart I am the more emboldened to present to your Majesty, according to the Custom of the present age, because nearly all things human are done after human examples and many things in the King are after the pattern of the heart."

The dedication was followed by a Proemium which one may hardly read to-day without emotion. In it he sets forth the mystery that has surrounded the subject of the motion and function of the heart, as well as the attendant difficulties of the subject, speaking of his own early despair that he would ever be able to clear up the subject. He even said that at one time he found the matter so beset with difficulties that he was inclined to agree with Fracastorius "that the movements of the heart and their purpose could be comprehended by God alone." Only later was this despair dispelled by a suggestion when, as he says: "I began to think whether there might not be a movement in a circle" when thus the truth dawned fully upon him.

We shall have to speak later of the opposition provoked by the appearance of this work and its almost general rejection. It is perhaps, however, but just to those who disputed Harvey's discoveries to recall that no complete and actual demonstration of the actual circulation was possible at that time, nor for many years after, and until the introduction of the microscope, the common magnifying glass of that day being the only lens in use. It remained for Malpighi to demonstrate the blood actually in circulation in the lung of a frog some three or four years after Harvey's death, in 1657. But Harvey lived long enough to see his views gain general acceptance, and though at first, and as the result of the opposition provoked by his publication, his practice fell off mightily, he later regained his professional position and rose to the highest eminence, being elected in 1654 to the Presidency of the College of Physicians. To this institution he proved a great benefactor, making considerable additions to the building after its destruction in The Great Fire of 1666 and its subsequent restoration. He also left a certain sum of money as a foundation for an annual oration, to be delivered in commemoration of those who had been great benefactors of the College. This oration is still regularly delivered on St. Luke's Day, i. e., the 18th of October, and is ordinarily known as the Harveian oration. In these orations more or less reference to Harvey's work and influence is always made.

This great man passed away on the 3d of June, 1657, within ten months of his eightieth birthday, thus affording a brilliant exception to the list of men who have rendered great service to the world and not lived long enough to see it appreciated.

As one reads Harvey's own words, the wonder ever grows that it should have remained for him, after the lapse of so many centuries, to not only call attention to what had been said by Galen but apparently forgotten by his successors, namely, that "the arteries contained blood and nothing but blood, and, consequently, neither spirits nor air, as may be readily gathered from experiments and reasonings," which he elsewhere furnishes. He furthermore shows how Galen demonstrated this by applying two ligatures upon an exposed artery at some distance from each other, and then opening the vessel itself in which nothing but blood could be found. He calls attention also to the result of ligation of one of the large vessels of an extremity, the inevitable result being just what we to-day know it must be, and the procedure terminating with gangrene of the limb.

Not long before Harvey's own publication, Fabricius, he of Aquapendente, had published a work on respiration, stating that, as the pulsation of the heart and arteries was insufficient for the ventilation and refrigeration of the blood, therefore were the lungs fashioned to surround the heart. Harvey showed how the arterial pulse and respiration could not serve the same ends, combating the view generally held, that if the arteries were filled with air, a larger quantity of air penetrating when the pulse is large and full, it must come to pass that if one plunge into a bath of water or of oil when the pulse is strong and full it should forthwith become either smaller or much slower, since the surrounding fluid would render it either difficult or impossible for air to penetrate. He also called attention to the inconsistencies between this view and the arrangement of the prenatal circulation; also to the fact that marine animals, living in the depths of the sea, could under no circumstances take in or emit air by the movements of their arteries and beneath the infinite mass of waters, inasmuch as "to say that they absorb the air that is present in the water and emit their fumes into this medium, were to utter something very like a figment;" furthermore "when the windpipe is divided, air enters and returns through the wound by two opposite movements, but when an artery is divided blood escapes in one continuous stream and no air passes."

Discussing further the views which he stigmatized as so incongruous and mutually subversive that every one of them is justly brought under suspicion, he reverts again to the statements of Galen, calling attention to the fact that from a single divided artery the whole of the blood of the body may be withdrawn in the course of half an hour or less, and to the inevitable consequences of such an act; also that when an artery is opened the blood is emptied with force and in jets, and that the impulse corresponds with that of the heart; again that in an aneurism the pulsation is the same as in other arteries, appealing for corroboration in this matter to the recent statements of Riolan, who later became his avowed enemy. Harvey also called attention to the fact that while ordinarily there was a seemingly fixed relation between respiration and pulse-rate, this might vary very much under certain circumstances, showing that respiration and circulation were two totally different processes. Harvey utilized also the results of his researches in comparative anatomy and physiology, for early in his work he called attention to the fact that every animal which is unfurnished with lungs lacks a right ventricle.

In his Proemium he then proceeds to ask certain very pertinent questions which can only be briefly summarized in this place. He asks: First, why, inasmuch as the structure of both ventricles is practically identical, it should be imagined that their uses are different, and why, if tricuspid valves are placed at the entrance into the right ventricle and prove obstacles to the return of blood into vena cava, and if similar valves are situated at the commencement of the pulmonary artery, preventing return of blood into the ventricle, then why, when similar valves are found in connection with the other side of the heart, should we deny that they are there for the same purpose of prevention "here the egress" and "there the regurgitation of the blood?"

Secondly, he asks why, in view of the similarity of these structures, it should be said that things are arranged in the left ventricle for the egress and regress of spirits, and in the right ventricle for those of blood?

Thirdly, he enquires why, when one notes the resemblance between the passages and vessels connected with the opposite sides of the heart, one should regard one side as destined to a private purpose, namely, that of nourishing the lungs, the other to a more public function? Furthermore, he enquires, since the lungs are so near, and in continual movement, and the vessels supplying them of such dimensions, what can be the use of the pulse of the right ventricle, which he had often observed in the course of his experiments? He sums up his inability to accept the explanations previously offered with a phrase which reads rather strangely, even in original Latin: "Deus bone! Quomodo tricuspides impediunt aëris egressum, non sanguinis." i. e., "Good God! how should the mitral valves prevent the regurgitation of air and not of blood?"

He then takes up the views of those who have believed that the blood oozed through the septum of the heart from the right to the left side by certain secret pores, and to them he replied "By Hercules, no such pores can be demonstrated, nor, in fact, do any such exist." Again, "Besides, if the blood could permeate the substance of the septum, or could be emptied from the ventricles, what use were there for the coronary artery and vein, branches of which proceed to the septum itself, to supply it with nourishment?"

Further on in the treatise Harvey sets forth his motives for writing, stating how greatly unsettled had become his mind in that he did not know what he himself should conclude nor what to believe from others. He says: "I was not surprised that Laurentius should have written that the movements of the heart were as perplexing as the flux and reflux of Euripus had appeared to Aristotle." He apologizes for the crime, as some of his friends considered it, that he should dare to depart from the precepts and opinions of all anatomists. He acknowledged that he took the step all the more willingly, seeing that Fabricius, who had accurately and learnedly delineated almost every one of the several parts of animals in a special work, had left the heart entirely untouched.

Passing more directly to the actual work of the heart, he shows that not only are the ventricles contracted by virtue of the muscular structure of their own walls, but further that those fibers or bands, styled "Nerves" by Aristotle, that are so conspicuous in the ventricles of larger animals when they contract simultaneously, by an admirable adjustment, help to draw together all the internal surfaces as if with cords, thus expelling the charge of contained blood with force. Later on he says that if the pulmonary artery be opened, blood will be seen spurting forth from it, just as when any other artery is punctured, and that the same result follows division of the vessel which in fishes leads from the heart. He furnishes a very happy simile to prove that the pulses of the arteries are due to the impulses of the left ventricle by showing how, when one blows into a glove all of its fingers will be found to have become distended at one and the same time. He quotes Aristotle, who made no distinction between veins and arteries, but said that the blood of all animals palpitates within their vessels and by the pulse is sent everywhere simultaneously, all of this depending upon the heart.

It is in Chapter Five of the treatise that he gives, probably for the first time, an accurate published account of just what transpires with one complete cycle of cardiac activity. The passage need not be quoted here, but deserves to be read by everyone interested in the subject, as who should not be? One sentence, however, is worth quotation or, at least, a summary, as follows: "But if the divine Galen will here allow, as in other places he does, that all the arteries of the body arise from the great artery, and that this takes its origin from the heart; that all the vessels naturally contain and carry blood; that the three semilunar valves situated at the orifice of the aorta prevent the return of the blood into the heart, and that they were here for some important purpose,—I do not see how he can deny that the great artery is the very vessel to carry the blood, when it has attained its highest triumph of perfection, from the heart for distribution to all parts of the body."