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Knowledge, Empiricism, and Authority in the Works of William Harvey

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Knowledge, Empiricism, and Authority in the Works of William Harvey Knowledge, Empiricism, and Authority in the Works of William Harvey Daniel Welch Advisor: Dr. Howard Louthan 1 Table of Contents Introduction 3 Chapter 1: Knowledge and Medicine Before Harvey Galenism and Aristotelianism in Renaissance Medicine 12 Anatomical Discovery Before Harvey in 17 Renaissance Anatomy Chapter 2: Harvey’s Discovery, Methodology, and Epistemology The New Anatomy of De motu cordis 25 Empiricism and Observation in the 31 Methodology of William Harvey Harvey, Aristotle, and the Philosophy of Empiricism 36 Chapter 3: Reaction to Harvey’s New Knowledge Riolan’s Defense of the Old Anatomy 40 Walaeus and Harvey: Debate and Acceptance 47 2 Introduction In December 1623 members of the College of Physicians in London were filled with excitement. The college, housed on land leased from St. Paul’s Cathedral since 1614, was preparing for the annual Lumleian Lecture on all of human anatomy. During the lecture, an expert anatomist would perform a dissection on a human corpse in front of the audience, using the visual demonstration to teach the most up-to-date understanding of anatomy each year. For years, the position of Lumleian Lecturer had been held by the great William Harvey (1578-1657), seventeenth-century England’s most prominent physician and anatomist. Five years earlier, Harvey had used the lecture as an opportunity to propose an incredible new model for the movement of the heart and blood in the human body. This proposal was such a dramatic and comprehensive departure from what was commonly taught of the heart, blood, and vessels that it surely shocked all who were in attendance. This was the circulatory model of blood flow, the foundation of our modern understanding of the circulatory system. Although Harvey would probably never provide excitement quite as strong as that in his 1618 lecture, the college eagerly awaited Harvey’s latest findings. Since accepting the position in 1615, Harvey had decided to perform his dissections over a period of three days, instead of the typical five-day period. One can hardly blame Harvey for desiring to finish as quickly as possible, before the fresh body began to rot. This year, Harvey would be lecturing on the anatomy of the trunk of the body, including the abdominal cavity and its many digestive organs. The topic for that day was digestion in the small intestine and large intestine, or colon. After speaking at length on the small intestine, perhaps unfolding and extracting the tangled mess from the corpse to demonstrate its incredible length, Harvey turned his attention to the colon. The ultimate purpose of the colon, Harvey told the audience, 3 necessitates its “large, thick, fleshy, strong” structure.1 Of course, Harvey added, a diseased colon could become damaged and quite enlarged. It is quite likely that during that lecture he made a passing reference to one of the most intriguing cases he had encountered. Earlier that year he had dissected a body and discovered a colon that had grown to a “huge” size before the patient’s death. Harvey may have noted the fecal blockage that caused such a dramatic enlargement, no doubt the source of the patient’s constipation. This mystery patient just happened to be Harvey’s own father, Thomas.2 This, however, was not the only family member whom Harvey would slice into during his long and active career. Perhaps driven by pure curiosity, Harvey dissected not only his father, but also his own sister. It seems, at least in some respects, that the great William Harvey fit the stereotype of the ever-curious, clinically detached anatomist, willing to cut into his own family members to advance the understanding of human anatomy. This morbid incident is an appropriate way to introduce one of England’s most celebrated physicians and anatomists, for it illustrates the revolutionary approach he brought to his field of study. But before we begin to ask what was different about Harvey’s anatomical methodology that led him to this monumental discovery, we must first ask: who was William Harvey, the great physician and anatomist? William Harvey was born on April 1, 1578, in the coastal town of Folkestone in Kent, England. William was the eldest of seven sons born to Thomas Harvey and his second wife, Joan Halke. Thomas Harvey worked in Folkestone as a merchant, and William was fortunate to be raised in a healthy and nurturing environment. The young William Harvey was characterized by noticeable curiosity and intelligence and perhaps as a result was enrolled in the King’s School in 1 C. D. O’Malley, F. N. L. Poynter, and K. F. Russell, Lectures on the Whole of Anatomy: An Annotated Translation of Prelectiones Anatomiae Universalis (Berkeley: University of California Press, 1961), 75. 2 Ibid., 76. 4 Canterbury at the age of ten. His early years paralleled a time of heightened tension between England and Spain, and Harvey, even as a child, was undoubtedly aware of England’s great triumph over the Spanish Armada in 1588.3 In 1593, Harvey moved on from King’s School to Gonville and Caius College in Cambridge. Interestingly, the college’s namesake, Dr. Keys or Caius, studied medicine in Italy at the University of Padua in 1529, returning in 1544 to become Physician in Ordinary to King Edward VI, a path that Harvey would closely mirror.4 At Cambridge, Harvey studied Aristotelian natural philosophy, although his enrollment in Gonville and Caius College most likely afforded him some exposure to medicine and perhaps influenced his decision to pursue a medical degree. The college had a tradition of medical study influenced by Dr. Caius himself, and the college even enjoyed the “privilege” of receiving the bodies of two felons, hanged in Cambridge, for anatomical dissection each year.5 Harvey’s decision to travel to the University of Padua after receiving his B.A. from Cambridge in 1597 was a natural choice for an English student interested in studying medicine. Not only did he follow in the tradition of Dr. Caius, but Padua had become a prestigious home to many of the great anatomists of past centuries (Vesalius, Colombo, and Fabricius, to name only a few). In addition, Padua was perceived as a welcoming destination for Protestant students in Italy. Historians have attributed the perceived sense of security to its connection with the Republic of Venice and relative freedom from the power of the Roman Catholic Church.6 It is no coincidence, then, that Harvey joined a large number of English students in Padua. Historians can only speculate as to whether or not Harvey had already began considering a circulatory model for the 3 Louis Chauvois, William Harvey: His Life and Times, His Discoveries, His Methods (New York: Philosophical Library, 1957), 45-48. 4 Ibid., 50-51. 5 Ibid., 54-55 and Roger French, William Harvey’s Natural Philosophy (Cambridge: Cambridge University Press, 1994), 53. 6 Chauvois, William Harvey, 56-57. 5 motion of the heart and blood during his education in Italy, but there can be little doubt that Harvey’s teacher at Padua, Hieronymus Fabricius (1537-1619) significantly influenced his future. As we will see, his discovery of the venous valves, the purpose of which remained largely a mystery to Fabricius, eventually provided a critical component of Harvey’s circulatory proposal.7 After completing his studies and graduating from Padua on April 25, 1602, Harvey returned to England in early 1603 to practice medicine and continue his research. Once in England, Harvey quickly rose to prominence as a skilled practitioner and researcher. After gaining admittance to the College of Physicians in October of 1604, Harvey became the head physician of St. Bartholomew’s Hospital in London in 1609.8 Perhaps the greatest sign of the respect Harvey had earned at this time was his appointment as a Lumleian lecturer in 1615, a prestigious position that required a series of annual anatomical lectures.9 As a Lumleian lecturer, Harvey performed anatomical demonstrations, or dissections of humans and animals, in front of an audience of his fellow physicians and students. These demonstrations were a common and significant method of conveying anatomical knowledge in the sixteenth and early seventeenth centuries. The height of Harvey’s prestige as a practicing physician came with his appointment as Physician Extraordinary to King James I on February 3, 1618. Years later, in 1631, Harvey was appointed Physician in Ordinary to his son, Charles I. It was during this same period that Harvey was forming, testing, and perfecting a new theory on the nature of the heart, blood, and vessels of the body. Harvey knew that his new theory was not a routine addition to the understanding of a well-studied anatomical system but a 7 William Harvey, Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, 1628, in The Works of William Harvey, trans. Robert Willis (Philadelphia: University of Pennsylvania Press, 1989), 64. Henceforth cited as De motu cordis. 8 Chauvois, William Harvey, 96-97. 9 Gwenneth Whitteridge, The Anatomical Lectures of William Harvey (London: E. & S. Livingstone, 1964), xxvi. 6 revolutionary break from an ancient model that had persisted for well over a millennium. Indeed, before Harvey’s discovery, the accepted model of the heart and blood in the human body had remained largely unchanged since its description by the ancient Greek physician Galen (129 - c. 200 AD). Galenic ideas formed the basis of Western medical science since his death. To challenge Galen was to challenge the very foundation of medical study. Yet Harvey’s research had led him to reject the Galenic model of blood flow, which relied upon efferent blood flow (away from the heart) in both the arteries and veins and an intrinsic difference in purpose between the arterial and venous blood.
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