Blood and More Blood

Gonville and Caius College in Cambridge is understandably proud of its tradition in medicine. One of its illustrious alumni is William Harvey, who studied there in the 1590’s before going on to publish evidence to demonstrate the circulation of blood. One thing that struck me when reading Thomas Wright’s biography of him, Circulation, is just how recognizable the college remains. The trio of gates that marked his progression as a student are still extant: each student enters through the Gate of Humility and then passes through the Gate of Virtue, but cannot use the Gate of Honour until successfully graduating. That last Gate is still mainly kept shut, but opening as it does onto Senate House Passage it means processing graduands have the shortest distance of those from any college to walk before entering the Senate House for the ceremony. This means they are least likely to get drenched or frozen (for those graduating during the winter months, or even some summers). However, it also means that they are one of the colleges most likely to be surrounded by throngs of tourists.

But, if the college is superficially little changed (leaving aside the addition of the Waterhouse Building, and the fourth ‘gate’ helpfully known as the Gate of Necessity due to its proximity to the lavatories), Harvey’s life – and more particularly his approach to research – are wildly different from today’s researcher. He was clearly a non-conformer in his life, ultimately (if initially timidly) rejecting the orthodox views of his fellow Fellows of the Royal College of Physicians who were committed to following Galen’s  traditions and teachings, which were by then already more than 1000 years old . He was socially ambitious, always aiming higher (he ended up as Physician to Charles I) but came from yeoman stock, and it would seem these relatively humble beginnings and social insecurity were part of what drove him on. And driven he clearly was, determined to get to the bottom of what was going on with the heart and the blood. To a modern reader, his methods are distinctly chilling. This biography spares few details of his dissections, the vivisections of a wide variety of different animals from the humble (and cold-blooded) eel to dogs – and of course the dissection of numerous human corpses, usually those of executed criminals, often over several increasingly malodorous days.

In these days of imaging of the human body in many non-invasive ways, it is all too easy to forget just how difficult it was for Harvey to piece together the jigsaw that enabled him to come up with the idea of ‘Circulation’. Today, the flow of blood through the heart valves and along the arteries, can be precisely quantified by Doppler ultrasound for instance (I know, I’ve watched my own blood flow being monitored as my heart pumped away, and a strange experience it was too, though of course I was really more interested in trying to tell from the operator’s face if my heart was behaving as it should). Back then the vivisections were necessary in order to enable him to  piece everything together and publish, in 1628, Exercitatio anatomica de motu cordis et sanguinis in animalibus (Concerning the motion of the heart and blood), usually just known as De Motu Cordis. It all seems so obvious now that it is hard to realise quite how radical his ideas were – and how they flew in the face of Galenic teaching and therefore, according to the oath he took when Harvey was admitted to the Royal College of Physicians, inadmissible.

Because they were counter to the central tenets of ‘physick’ as it was practiced then, his ideas were rejected for many years. He went to great lengths – with many dissections conducted in front of his peers, in the hope of convincing them – to try to win people around but, as with any startling new theory, it took him a long time to find acceptance. He worked hard at quantifying the amount of blood that the heart expelled, to demonstrate the impossibility of so much constantly having to be regenerated if it wasn’t being recirculated. But the habit of quantitative measurement was not so ingrained then as now. After Harvey had gone to great lengths in one showcased vivisection at the University of Altdorf involving a dog, to measure the amount of blood expelled, he eagerly sought the views of the Professor of Medicine there, a friend from his days as an anatomy student in Padua, Caspar Hoffmann. He hoped for support for his ideas, but instead was given the following put-down (the basis for this quote is not given in the book, which lacks specific references, although general sources are given)

Why do you doff the hat of an anatomist, and suddenly put on the hat of an accountant, relying on calculations of how much blood can be transferred from the heart to the arteries in the space of an hour?

This is illuminating on a couple of fronts: firstly, I would not expect most modern-day accountants to get very far in carrying out that calculation (even leaving aside the vivisection), but secondly it vividly indicates just how different ‘science’ in the early 17^th century was in its attitude towards hard numbers compared with now. Arithmetic was seen as something useful for navigators, or perhaps instrument makers, but not for the higher sciences such as anatomy. That was certainly how Harvey’s own alma mater of Cambridge saw it at the time, and Hoffmann was clearly no different.

Of course, in the end all those doubters were proved wrong and Harvey’s ideas were vindicated. These days, no ethics committee would permit the experiments to be done, so it is as well we are now so well-supplied with alternative ways of studying our inner workings.  I am grateful to the Leeds team who gave me this book as a ‘thank-you’ for talking to them at the Athena Swan event I described a few months back. I certainly enjoyed reading about Harvey and learned a lot from the book about his life and times, and also about the practice of ‘science’ consistent with those times.