Bryce K.

Peterson, MS4 The Ohio State University College of Medicine 6 March 2010

Introduction Background to Harvey·s story Wm Harvey Other medical discoveries Conclusion

Map of Mars with ´canalsµ discovered by early telescope

Current photograph of Mars

Galen Vesalius Colombo Fabricius

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Galen of Pergamum, 2nd C. A.D.
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Originally studied philosophy Anatomic studies unsurpassed until Vesalius (16th C)
Suggested muscles controlled via nerves after his experiments with nerve ligation

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Endorsed Hippocrates· (5th C. B.C.)ideas of 4 humors
Blood, Phlegm, Yellow Bile, Black Bile However, experimentation led Galen to reject Hippocrates· idea that arteries contained pneuma only Arteries from heart drew air through pores of skin, blood from liver in veins during diastole, combining into ´sooty vaporµ Sooty vapor crossed septum to LV, to be exhaled

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This interpretation lasted until the 15th C.

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Medical Renaissance of the 16th C.
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Return to original Greek writing
Discard Latin/Arabic interpretations of past 12 C.

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Greek Galenic Codex published 1525 (600 titles!) Trained by conservative Galenic physician at Padua Studied anatomy via human dissection De humani corporis fabrica, 1543 Rejected Galen·s assumptions
Explicitly showed ventricular septum was not permeable

Vesalius
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Vesalius·s successor at Padua
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Tried to establish himself through public schism with mentor De re anatomica (1559) ² suggested that Galenic model of Air/Blood mixing in RV was baseless
Logical analysis of components, and their size  RV, pulm. artery, lungs

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Father of Embryology, Padua 1603 - Discovered ´valvesµ in veins
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Assumed to retard flow, allowing symmetric distribution ² regulating volume, not flow

Background Experiments & Conclusions Publish De motu cordis Impact

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Cambridge man (Caius College)
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Aristotelian, ´archaicµ education Famed medical school of Europe

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Padua
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´« know I tread but the steps of other men who have lighted me the way, and (so farre as is fit) I make use of their notions. But in chief, of all the Ancients, I follow Aristotle; and of the later Writers, [Fabricius], Him as my General, and this as my Guide.µ

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´I do not profess either to learn or to teach anatomy from books or from the maxims of philosophers but from dissections and from the fabric of natureµ Harvey repeated Colombo·s experiments
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Same results Different conclusion Argued that venous valves do not prevent pooling  Jugular valves are backwards, if this is the case

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analysis

ƒ Calculation:

Heart rate, heart size  3.5 lbs of blood in 30 minutes
ƒ Inspection:

4 lbs of blood in human body

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Original experiments on vasculature via ligatures
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Blood could not be forced distal to heart past a venous valve Impossible to draw blood at venous valve

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Observed pulse remained, veins distended further in arm when ligated
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Surmised connection b/n arterial/venous systems

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Exercitatio anatomica de motu cordis et sanguinis in animalibus, 1628
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The heart continuously pumps large volumes of blood
Far more than could be explained by conversion from food

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The Vena Cava ´seesµ more blood than the body contains The veins unceasingly return blood to heart

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De motu cordis
Presented the mechanical model of closed circulation with pulmonary and systemic components ƒ Clung to his Aristotlean physiology
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Heart distributed heat throughout the body The heart ´envivifiedµ the blood, allowing it to carry some component to tissue, after which it ´coagulatedµ

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Debated heatedly
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Primrose, Descartes, Bartholin No.
Did not abandon Aristotlean magical physiology

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´New Scientific Methodµ?
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Generally accepted by ~1650 His own clinic suffered
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New ideas frightened off patients

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The major influence of Harvey·s work:

Attack on Galenic physiology

Is ´progressµ always progress?

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Phalacrophobia ² fear of becoming bald Peladophobia ² fear of bald people

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Prophylaxis of Baldness ² JAMA 1903

´If anyone had insisted 25 years ago that tuberculosis was only slightly hereditary, but distinctly communicable, they would have been laughed at. The germ theory has now become a doctrine of ever widening scope, and we realize that many affections are directly communicable and only a few hereditary. . . ´

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Premature baldness is ´practically always associated with the presence of certain bacteria.µ Relative ischemia caused by hatbands likely contributes to condition by decreased immune response

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Clinical prophylaxis: ´Greater care should be taken with regard to brushes and combs, especially in families in which early baldness is the rule.µ ´The hair brush should be dipped in antiseptic«µ

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´These precautions may seem a high price to pay for the prophylaxis of premature baldness, and many will prefer to take the chance of becoming bald, but some have such a horror of the affliction that they will willingly put themselves to such trouble to prevent it.µ

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Described accurately by Brinton, 1857 Etiological scope as broad as a good DDx
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old age privation fatigue mental anxiety intemperance

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ACIDIFICATION
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Due to focal infection

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Lead to many procedures
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Extractions Appendectomies Colectomies Colostomies

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Fell out of favor in 1930s

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Psychological Factors
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´shell shockµ the ´increasing demands of the industrialized worldµ

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Racial factors

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Progress is viewed through a human filter
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Physician vs. Surgeon Current paradigms Ideology

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´to point this out is not in any way to denigrate biomedical science . . . it is merely to remind practitioners that it would be wise to recognize the contingent nature of etiological explanations and therapies.µ

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´I do not profess to learn or to teach anatomy from books or from the maxims of philosophers but from dissections and from the fabric of nature.µ ²Wm Harvey Skepticism vs. Acceptance

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Conrad, Lawrence, Michael Neve, Vivian Nutton, et. al. The Western Medical Tradition. Cambridge, England, Cambridge University Press, 1995. French, Roger. William Harvey's Natural Philosophy. Cambridge, England, Cambridge University Press, 1994. Harvey, William, Gweneth Whitteridge, ed., De Motv Locali Animalivm. Cambridge, England, Cambridge University Press, 1959. Harvey, William, Gweneth Whitteridge, ed., The Movement of the Heart & Blood. Blackwell Scientific Publications, Oxford, England, 1976. Harvey, William, Kenneth Franklin, ed. The Circulation of the Blood and Other Writings. J.M. Dent & Sons, Ltd., London, England, 1979. Magner, Lois. A History of Medicine. New York City, New York, Marcel Dekker, Inc., 1992. Porter, Roy. Cambridge Illustrated History of Medicine. Cambridge University Press, Cambridge, England, 2001. Porter, Roy. The Greatest Benefit of Mankind. Harper Collins Publishers, Ltd., NYC, USA, 1997. Whitteridge, Gweneth. William Harvey and the Circulation of the Blood. MacDonald, London, England, 1971.