ELIZABETHAN CONCEPTIONS OF THE PHYSIOLOGY OF THE CIRCULATION

By IRVING I. EDGAR, M.D.

DETROIT, MICH.

Part ii (Conclusion) *

Here again, these commentators have Humane Passions” (1621), Thomas misinterpreted a movement of blood Wright’s “The Passions of the Minde in towards the heart as signifying a circu­ General” (1601), Burton’s “Anatomy lation; and they have placed upon the of Melancholy,” La Primaudaye’s “The word, “labouring,” the significance of French Academy” (1594), Charron’s regular heart-pump action. Nothing “Of Wisdom” (1601), and others—all can be farther from the truth. These crit­ these readily explain all the passages in ics, apparently unfamiliar with six­ question upon a Renaissance basis much teenth century physiology-psychology, more satisfactorily than the medical crit­ have simply superimposed modern con­ ics do from the modern standpoint. ceptions upon Renaissance doctrines. Thus according to these works, the heart Why, upon the same basis of reasoning, is the center of all the affections and what shall we say of the words of Shake­ emotions—joy, hope, anger, hate, fear, speare’s contemporary, Philip Mas­ sorrow, despair, etc. Joy expands the singer? heart enabling it “to concoct a goodly See, see how her blood drives to her heart store of spirits and to disperse them and straight throughout the body.”80 Should this joy, Vaults to her cheek again.79 however, be too strong it may destroy Presto! Take the crown of Harvey and the heart. Grief, sorrow and fear, all of place it not upon the brow of Shake­ which are present in “a timely parted speare but upon that of Massinger! For ghost” at death, cause blood, spirits and in Massinger’s lines the blood not only the melancholy humour to descend and “drives to” the heart but also “vaults” “muster” to the heart from the periph­ away from the heart to the cheek! It is eral parts of the body.78 As a result, the much easier to place an interpretation heart labors and languishes, the melan­ of this type upon these lines than upon choly humor quenching the natural those of Shakespeare. The truth, how­ heat81 and extinguishing the spirits to ever, is this: neither Shakespeare nor produce death. This mustering of the Massinger, nor any other dramatist of blood to the heart under the emotion of the period knew anything of the circu­ fear is aptly expressed by Davies: lation of the blood. The physiological- As spiders touched seek their webs’ inmost psychological treatises popular in part, Shakespeare’s day, especially the “Mi­ As bees in storms into their hives return As blood in danger gathers to the heart.82 crocosmos” of Sir John Davies of Here­ ford. Nicholas Coeffeteau’s “A Table of La Primaudaye sets forth more clearly * Part 1 appeared in the July, 1936 number of Annals of Medical History, p. 359. the psychology-physiology involved Or if that surly spirit, melancholy here. He is discussing the effect of the Hath bak’d thy blood and made it heavy passions upon the heart, particularly thick.86 that of fear: Dry sorrow drinks our blood. . . ,87 . . first of all it draweth in and shut- In these passages Shakespeare is enun­ teth up the heart, and so weakeneth the ciating the commonly accepted Eliza­ same. Whereupon nature being desirous bethan theory that the humor, melan­ to relieve and succour it, sendeth heate choly, heats and thickens the blood in a unto it from upper parts: and if that be not sufficient, she draweth away that heate literal sense, as a result of the very phys­ also which is in the neather parts. By ical nature of this humor. La Primau- which doing she suddenly calleth backe daye, describing the humours in the the bloud and spirits unto the heart, and blood, says: “For the muddy dregs, then followeth a generall palenesse and tvhich commonly thicken and settle in colde in all the outward parts and chiefly the bottom of it” (“like to the lees of in the face, with a shivering throughout wine in a vessel”) “are of the nature of the whole body . . . whereupon it fol­ the earth and are called Melancholy.” loweth, that by reason of the great beating He goes on to say what Shakespeare here and panting of the heart, the tongue fal- tereth and the voice is interrupted. Yea, says, that this humor thickens the it commeth to pass sometimes that present blood.88 Batman expounds the same death followeth a great and sudden feare, ideas.89 And Christopher Marlowe says because all the bloud retiring to the heart exactly the same thing when he puts choaketh it, and utterly extinguished nat- into the mouth of Faust: “My blood con­ urale heate and spirits, so that death geals, and I can write no more.”90 musts needs ensue thereof.83 Sorrow concealed, like an oven stopp’d It is obvious that all this de­ Doth bum the heart to cinders where it is.91 scending, gathering, retiring of the blood to the heart referred to by Shake­ The tackle of my heart is crack’d and bum’d And all the shrouds wherewith my life should speare has no significance whatsoever as sail far as the circulation of the blood is con­ Are turned to one thread one little hair cerned as the medical commentators My heart hath one poor string to stay it by, would have us believe. Shakespeare Which holds but till thy news is uttered.92 talked but the language of his day, in the thought-patterns of his age. . . . but his flawed heart, Alack, too weak the conflict to support! From this standpoint, the following ’Twixt two extremes of passion, joy and grief, passages become simple of explanation: Burst smilingly.93 I have a faint cold fear thrills through my Nor. He is vexed at something. veins, Sur. I would twere something that would fret That almost freezes up the heat of life.84 the string, f Reference here is to the “generall pale­ The master-cord on’s heart.94 nesse and colde in all the outward parts” as a result of the rush of “bloud and My heart for anger burns; I cannot brook it.95 spirits unto the heart” under the emo­ My tongue will tell the anger of my heart tion of fear. Or else my heart concealing it will break.96 Seeing too much sadness hath congealed your But break my heart for I must hold my blood.85 tongue.97 . . . throw my heart And grief’s a natural sickness of the blood.104 Against the flint and hardness of my fault; Which being dried with grief, will break to Shakespeare has many more refer­ powder.98 ences to the psychological-physiological effects of the emotions on the heart: Here again our great poet is express­ ing the actual physical effects of The broken rancour of your high-swoln emotion. In the Elizabethen physio­ hearts, logical-psychological systems, the heart But lately splintered, knit, and join’d to­ gether.105 expanded and contracted, drawing air from the lungs to cool and fresh itself The execution of my big-swoln heart and expelling “smoking excrements” Upon that Clifford, that cruel child-killer.106 through the same channels, “for the Some devil whisper curses in mine ear heart hath his filaments or small threads And prompt me, that my tongue may utter apt and convenient for that purpose.”99 forth These “filaments” or chordae tendinae The venomous malice of my swelling heart.107 of the heart were believed to “crack” The king, thy sovereign, is not quite exempt, under strong emotion. The psychologist From envious malice of thy swelling heart.108 and contemporary of Shakespeare, Sir Measureless liar, thou hast made my heart John Davies of Hereford, expresses this Too great for what contains it.109 when he says: These passages represent the heart as swelling with the emotion of hate and Worke on my Hart, sterne Griefe, and do thy worst: anger. This is also in accordance with Draw it together till his strings do crack.100 Elizabethan psychology, for as La Pri­ maudaye teaches,37 the heart swells and James Shirley expresses a similar notion, puffs up when it is enraged and there is only here the emotion is not grief but a a great milling and boiling about it. Re­ mighty joy: lief for the heart, however, may be ob­ My heart that call’d my blood and spirits to tained by sighing, sobbing, groaning, Defend it from invasion of my fears etc., even though these consume the Must keep a guard about it still lest this blood. Witness the following: Strange and too mighty joy crush it to noth­ ing.101 Might liquid tears or heart-offending groans Or blood-consuming sighs recall his life, Christopher Marlowe, similarly, voices I would be blind with weeping, sick with the physical effects of anger upon the groans heart: Look pale as primrose with blood-drinking sighs.110 May never spirit, vein or artier, feed The cursed substance of that cruel heart When my heart, as wedged with a sigh would But wanting moisture and remorseful blood, rive in twain.111 Dry up with anger, and consume with heat!102 Dekker expresses the effects of grief: And stop the rising of blood-sucking sighs.112 It will so overcharge her heart with grief And let my liver rather heat with wine That like a cannon when her sighs go off Than my heart cool with mortifying groans.113 She in her duty either will recoil Or break in pieces and so die.103 Here also, we have an expression of Elizabethan physiological-psychological Chapman does likewise in the follow­ reactions. Actually, sighing, groaning, ing line: weeping, sobbing were considered by physiologists of Shakespeare’s day as af­ with his contemporaries in his concep­ fording relief from the effects of passion tions about the physiology of the heart on the heart. and knew no more than they did. For howsoever griefe shutteth up the As Ruth L. Anderson concludes from heart . . . yet by groaning, sighing and her study of Elizabethan psychology: weeping the heart doth in some sort open All these passages from Shakespeare pos­ it selfe, as if it would come forth to sess a literal quality which we have not breathe, least being wholly shut up with often attributed to them, for in the works sorrow it should be stifled.114 of writers whose interests lie definitely in the field of psychology there is an abun­ Timothy Bright says: dant reference to the power of passion to Sighing hath no other cause of moving overcome the actual substance of the then to coole and refresh the heart, with heart.102 fresh breath and pure ayre which is the Shakespeare has done nothing more nourishment and food of the vitall spirits, than put into poetic language the com­ besides the cooling which the heart itselfe received thereby.115 monly accepted tenets of Elizabethan psychology. And all these passages take Thomas Lodge expresses this as follows: their proper place in interpretation as The horrors, burning sighs by cares procured directly and literally referring to Ren­ Which forth I send whilst weeping eye com­ aissance doctrines and not to modern plained facts of science. To cool and heat the heart contained.116 II Should the sighing and groaning, how­ ever, be vehement it might react But the passages in Shakespeare’s dra­ unfavorably to make these “blood-con­ mas upon which most of the medical suming,” “blood-sucking,” “heart-of­ commentators have based their conten­ tion that the great dramatist knew the fending,” as these quoted passes from true circulation of the blood are the fol­ Shakespeare indicate and as the follow­ lowing: ing passages from Shakespeare’s contem­ poraries similarly suggest. Christopher You are my true and honourable wife, As dear to me as are the ruddy drops Marlowe writes: That visit my sad heart.120 Witness this heart, that sighing for thee Note me this, good fellow: breaks.117 Your most grave belly was deliberate Chapman says: Not rash like his accusers, and thus answer’d: “True it is, my incorporate friends,” quoth ... I will . . . kiss he, Spirit into thy blood, or breathe out mine “That I receive the general food at first In sighs and kisses and sad tunes to thine.118 Which you do live upon and fit is, Dekker speaks of: Because I am the storehouse and the shop Of the whole body; But if you do remember . . . such heart swol’n big I send it through the rivers of your blood, With sighs and tears.119 Even to the court, the heart, to the seat of the brain; And Middleton writes: And through the cranks and offices of man, His sighs drink life-blood in this time of feast­ The smallest nerves and the small inferior ing.120 veins From me receive the natural competency Thus Shakespeare was very much at one Whereby they live.”121 Thus, such a recent commentator as and these as merely visiting the heart Dr. S. M. Dodek considers these passages and nothing more. Can any one today as “indeed in anticipation of Harvey” who has ever seen the heart in action and as giving “added confirmation of and who understands the circulation of Shakespeare’s knowledge of the circula­ the blood—can such a one speak of the tion of the blood.”9 Even Dr. W. Bristow constant regular torrential flow of blood who definitely states that “Shakespeare through the heart and its valves as of did not have any superior knowledge “drops that visit . . . [the] sad heart”? along this line” distinctly considers Could Shakespeare, having a true Har- these passages “the strongest evidence veian conception of that swirling, eddy­ that Shakespeare really understood ing, milling circulation, speak of drops something about physiology”122 Dr. visiting the heart? Any true knowledge David Cerna in referring to the first of of the circulation is incompatible with the above passages makes the following metaphorical language of this type. Fur­ statement: “We may take for granted thermore, why should Shakespeare that the ruddy drops spoken of here rep­ speak of these particular “ruddy drops” resent the blood itself, and even admit as especially “dear”? Again, why should that their visiting the heart implies a he speak of the “belly” as sending food sort of going around and around, an en­ throughout the entire body, even to the circling phenomena.”6 heart? Why even to the heart? That Those that have taken upon them­ word has significance here. Had Shake­ selves the task of refuting these medical speare had the least conception of the commentators on this issue have failed true circulation he would have known completely for they have been lacking that anything entering the “rivers” of in a true appreciation of Shakespeare’s the blood would reach the heart almost background. They have not taken into immediately and completely. He would consideration the extent of knowledge not have placed special emphasis on the current in this period and most likely fact that drops of blood reach even to to affect Shakespeare. Hence their argu­ the heart. ments are specious, inadequate and un­ All these questions can readily be an­ convincing. swered by reference to the Elizabethan In referring to the first quoted pas­ theories of physiology, theories un­ sage, Dr. D. Fraser-Harris simply waves doubtedly held by Shakespeare. Only aside all argument as to “. . . the ruddy upon such a basis can we arrive at a true drops that visit my sad heart” by saying interpretation of the passages in Shake­ that “all that this asserts could be known speare dealing with the circulation. from observing slaughtered animals, It will be remembered, that accord­ namely, that blood is in the heart.”123 ing to Renaissance theories, the greatest Had Dr. Fraser-Harris been more portion of the blood remained in the cognizant of the significance of Eliza­ venous system which included the right bethan doctrines as to the circulation side of the heart. From the right ven­ and had he examined Shakespeare’s ut­ tricle, however, a very small portion of terances in the light of these doctrines the blood passed through the supposed he would have been more successful in perforations in the septum into the left his arguments. ventricle where it became refined and In the first place, we note that Shake­ incorporated with the vital spirits gen­ speare speaks only of “ruddy drops,” erated in this ventricle to form the frothy blood, carrying “the nimble spir­ But even the very middle of my heart its in the arteries.” “But the passage of Is warm’d by the rest, and takes it thank­ the blood through these communica­ fully.126 tions was not a current; it was a transu­ From the modern Harveian stand­ dation or distillation, drop by drop.”124 point how shall we interpret the words, From this standpoint we can now un­ “the very middle of my heart”? Nobody derstand what Shakespeare meant. The knowing the true circulation of the “ruddy drops” of blood that are so heart can speak of a “middle” of this “dear” are actually drops of blood and organ. And did Shakespeare know of the of a better, finer, dearer quality than true circulation he could not have the rest. And they but visit “even to the spoken in such terms. However, Shake­ court, the heart.” That Shakespeare lik­ speare was perfectly innocent of any ens the heart to a “court” is further evi­ true conception of the circulation. In dence that the poet thought only in the use of these terms he was merely re­ terms of the Elizabethan physiological- ferring to a theory taught and accepted psychological system, for the likening of in all the scientific centers of Europe. the heart to a “court,” a “counsellor,” a This theory considered the septum of “king” is based on actual Elizabethan the heart containing the perforations as conceptions as to its functions. The taught by Galen, as a middle ventricle. heart was the seat of the affections, the Mundinus, whose book “De omnibus passions, the emotions. All action was humani corporis intercoribus membris supposed to depend upon the judgment anathomia” was a widely used textbook of the heart. Ruth Leila Anderson sums in Europe in Shakespeare’s day “and the up this Elizabethan conception as fol­ standard guide to anatomy for two hun­ lows:125 dred and more years after it was writ­ ten,”127 actually describes a “middle When the imagination has judged an ventricle” in the cardiac septum where impression from the external senses or venous blood is refined into arterial from memory, animal spirits flock through blood.128 Thus does Shakespeare speak certain “secret channels” from the brain of a “middle of the heart,” having in to the heart, where they “pitch at the mind here, as everywhere else where he dore” and make known whether the object mentions the circulation, the Renais­ is good or bad. Immediately the sensitive sance doctrines of his times and not appetite strives to effect the soul’s desire modern facts of science. and through contracting or expanding the And so we are brought down now to heart either calls in or disperses the hu­ mours or spirits ... if the heart is agree­ the last-quoted passage in Shakespeare ably disposed it responds readily. . . . about which controversy has arisen as regards the circulation of the blood. In In this fashion did Shakespeare con­ reality this concerns but the one line, sider the heart a court, all of which is in general accordance with the rest of his I send it through the rivers of your blood. beliefs as to the functions of the heart in Because Shakespeare uses the words, the circulatory system. “rivers of . . . blood” some of the com­ But furthermore: that Shakespeare mentators have assumed that this signi­ held the current ideas as to the heart and fied a continuous current propelled by not the Harveian conceptions of it is a “central motive power” in one direc­ evidenced by the following passage: tion. Thus Dr. Knott writes as follows: Accordingly, the latter [the veins] are of their knowledge. Why even such an in precise metaphorical language the erudite scholar as G. C. Greenwood has rivers of the blood. And accordingly, too, failed utterly in his purpose and al­ if Shakespeare had used . . . the term lowed himself but to become involved veins, as I represented him, he would have in the wrangle of that puerile, superflu­ displayed an “approximate conception” of the knowledge of the present day on ous Greenwood-Knott controversy.130 the subject. But if his application of the Greenwood merely cites the fact that word rivers can be received with exact­ the source of this controversial passage ness, he knew that the central motive Shakespeare found in North’s “Plu­ power of the circulation propelled the tarch” or in Camden’s story “The Belly blood in a definite direction through the and the Members” printed in his “Re­ veins (the true rivers') properly so-called; mains” (1605) and that the poet simply and his knowledge of the general circula­ paraphrased this in poetic language; tion of the blood was complete—there hence Shakespeare could not have was nothing left for Harvey’s discovery known the true circulation of the blood, to teach him on that head.129 for he concludes: “. . . it seems quite He concludes: clear that no peculiar knowledge be­ yond that of his contemporaries—no If this passage does not indicate a dis­ tribution of pabulum by the circulatory prophetic ‘foreshadowing’ or anticipa­ fluid to the various tissues of the body— tion of Harvey’s great discovery—can be distinctly foreshadowing the outline of claimed for the poet on the strength of what is known at the present day—I can­ this quotation.”131 All this is very true, not suggest any other interpretation.3 but such speciousness of argument re­ mains inconclusive for North’s “Plu­ And again: “Shakespeare’s ideas of the tarch” does not speak of “rivers of course of the vital fluid appear to be de­ blood” and Dr. Knott rightfully takes cidedly in advance of those of most of the better of the controversy. But there even his medical contemporaries.”3 is ready proof at hand to show that when Such a level-headed commentator as Shakespeare wrote of “rivers of blood” Dr. Fraser-Harris, even though he defi­ he was not referring to the veins as part nitely states that Shakespeare “held the views which had been taught in the of the circulatory system. He was merely medical schools of Europe for 1400 years using metaphorical language, language —the views of Claudius Galen” never­ common to the day, and quite suited to theless conceded that this passage indi­ the thought-patterns of Renaissance cates some knowledge of the true circu­ England. lation, for he remarks, “If we had none If Shakespeare is to be invested with other than this passage to go upon, we the royal toga of knowledge belonging might admit that Shakespeare had be­ to Harvey then we must do the same for Beaumont and Fletcher, for these also fore him the Harveian notion of a flow only in one direction.”123 Nothing can liken the veins to rivers: be farther from the truth as we shall see. Is it not strange, among so many a score And this seems only to show how such Of lusty bloods I should pick out these things, able investigators as Dr. Fraser-Harris Whose veins, like a dull river far from Springs, Is still the same slow, heavy and unfit and others of his kind have failed to For stream or motion, though the strong bring to their task the full weight of winds hit their capabilities and the broad extent With their continual power upon his sides?132 We must honor Thomas Dekker sim­ It permeated all the processes of his ilarly for he writes: thinking and pervaded all the complexi­ That pair of stars that gave her body light, ties of his psychological system. And con­ Darkened and dim forever; all those rivers sistently, quite consistently, in all the That fed her veins with warm and crimson descriptions of man in this relationship streams —man, this “universe in one small vol­ Frozen and dried: if these be signs of death, ume,”137 this “world’s abridgement”138 Then she is dead.133 —I say in all these descriptions, the veins Likewise, on the same grounds, the are always likened to rivers. anatomical physiologist Cesalpinus de­ Sir Walter Raleigh has this to say serves recognition, for he speaks of “riv­ about man as a microcosm: ulets” in relation to veins: “As, there­ Man thus compounded, became a fore, rivulets derive their water from a Model of the Universe, having a Rational fountain, so do the veins and the arteries Soul, with ability fit for the Government from the heart.”134 of the World, an Intellectual Soul, com­ And also Fabricius, for this great an­ mon with Angels and Sensitive with atomist in describing the valves of the Beasts; thus he became a little World in veins says that they are “so constructed, the Great, in whom all Natures were in order that they may in some measure bound up together; our Flesh is heavy retard the blood and prevent its running like Earth, our Bones hard as stones, our Veins as the Rivers, Breath as the air. pell-mell, like a river, into the feet, 139 hands or fingers and being impacted there.”135 And again: The fact is this: With what the aver­ His blood which disperseth itself by the age Elizabethan knew of anatomy and branches of veins through all the body, physiology, with what he observed with may be resembled to those waters which his own eyes in the stream of blood flow­ are carried by brooks and rivers over all ing from a wound, the flushing and pal­ the earth.140 ing of the countenance, etc., the most Rabelais (1550) writes: natural thing in the world for an ordi­ . . . the Messaraick Veins suck out what nary intelligence to have done, would is good and fit . . . thereafter it is car­ have been to liken the veins to “rivers ried to the Liver . . . becomes Blood of blood.” But even more than this, far . . . What Joy conjecture you, will then more important than this, is the fact that be founded amongst those officers, when the doctrine of the microcosm was ac­ they see this rivulet of Gold . . . through cepted as completely by the Elizabethan the veins is sent to all the parts.141 as we accept the doctrine of evolution today. And: David Person in his “Varieties” (1635) also carries out the idea of the To the literary artist of the Renaissance microcosm. He compares the body of the doctrine of the microcosm, with its man to the earth: intricate series of relationships between the world of man and the universe, was . . . the rocks and stones whereof are his peculiarly attractive. It became the basis bones, the brookes and rivers serpenting of such poems as John Davies of Here­ through it, the veynes and sinews convey­ ford’s “Microcosmos” and Phineas Fletch­ ing moistnesse from their fountaines unto er’s “The Purple Island.”136 all the members; the hollow of our bowells and of the trunke of our bodies contention that Shakespeare knew the to the vast and spacious cavernes and caves true circulation of the blood. within the body of this earth.142 We are led to but one conclusion: One could probably go on and on that Shakespeare’s ideas on the physiol­ quoting references of this character. Is ogy of the human body, especially that it any wonder that Shakespeare used the of the circulation of the blood, were but terms “rivers of . . . blood”? Can there in strict accordance with Renaissance be any question as to what he meant? conceptions of it and not with any mod­ Why, it was one of the commonest si­ ern scientific facts on the subject. In the militudes of Shakespeare’s England, as proving of this point, perhaps, we have clear in its Renaissance implications to applied more effort than the subject the audiences as to the poet himself. merited. At any rate, there is the satis­ And yet this is the type of evidence upon faction that the last stronghold of Shake­ which idolatrous commentators, dis­ spearean idolatry has finally been de­ torted in vision by hero-worship, obtuse molished. No more shall there arise in reason by lack of knowledge, it is those who would place upon Shake­ upon such evidence that they base their speare the crown of William Harvey.

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