PARACELSUS

In the year 1526 there appeared a new lecturer on the platform at the University at Basel—a small, beardless, effeminate-looking person—who had already inflamed all Christendom with his peculiar philosophy, his revolutionary methods of treating diseases, and his unparalleled success in curing them. A man who was to be remembered in after-time by some as the father of modern chemistry and the founder of modern medicine; by others as madman, charlatan, impostor; and by still others as a combination of all these. This soft-cheeked, effeminate, woman-hating man, whose very sex has been questioned, was Theophrastus von Hohenheim, better known as Paracelsus (1493-1541).

To appreciate his work, something must be known of the life of the man. He was born near Maria-Einsiedeln, in Switzerland, the son of a poor physician of the place. He began the study of medicine under the instruction of his father, and later on came under the instruction of several learned churchmen. At the age of sixteen he entered the University of Basel, but, soon becoming disgusted with the philosophical teachings of the time, he quitted the scholarly world of dogmas and theories and went to live among the miners in the Tyrol, in order that he might study nature and men at first hand. Ordinary methods of study were thrown aside, and he devoted his time to personal observation—the only true means of gaining useful knowledge, as he preached and practised ever after. Here he became familiar with the art of mining, learned the physical properties of minerals, ores, and metals, and acquired some knowledge of mineral waters. More important still, he came in contact with such diseases, wounds, and injuries as miners are subject to, and he tried his hand at the practical treatment of these conditions, untrammelled by the traditions of a profession in which his training had been so scant.

Having acquired some empirical skill in treating diseases, Paracelsus set out wandering from place to place all over Europe, gathering practical information as he went, and learning more and more of the medicinal virtues of plants and minerals. His wanderings covered a period of about ten years, at the end of which time he returned to Basel, where he was soon invited to give a course of lectures in the university.

These lectures were revolutionary in two respects—they were given in German instead of time-honored Latin, and they were based upon personal experience rather than upon the works of such writers as Galen and Avicenna. Indeed, the iconoclastic teacher spoke with open disparagement of these revered masters, and openly upbraided his fellow-practitioners for following their tenets. Naturally such teaching raised a storm of opposition among the older physicians, but for a time the unparalleled success of Paracelsus in curing diseases more than offset his unpopularity. Gradually, however, his bitter tongue and his coarse personality rendered him so unpopular, even among his patients, that, finally, his liberty and life being jeopardized, he was obliged to flee from Basel, and became a wanderer. He lived for brief periods in Colmar, Nuremberg, Appenzell, Zurich, Pfeffers, Augsburg, and several other cities, until finally at Salzburg his eventful life came to a close in 1541. His enemies said that he had died in a tavern from the effects of a protracted debauch; his supporters maintained that he had been murdered at the instigation of rival physicians and apothecaries.

But the effects of his teachings had taken firm root, and continued to spread after his death. He had shown the fallibility of many of the teachings of the hitherto standard methods of treating diseases, and had demonstrated the advantages of independent reasoning based on observation. In his Magicum he gives his reasons for breaking with tradition. "I did," he says, "embrace at the beginning these doctrines, as my adversaries (followers of Galen) have done, but since I saw that from their procedures nothing resulted but death, murder, stranglings, anchylosed limbs, paralysis, and so forth, that they held most diseases incurable.... therefore have I quitted this wretched art, and sought for truth in any other direction. I asked myself if there were no such thing as a teacher in medicine, where could I learn this art best? Nowhere better than the open book of nature, written with God's own finger." We shall see, however, that this "book of nature" taught Paracelsus some very strange lessons. Modesty was not one of these. "Now at this time," he declares, "I, Theophrastus Paracelsus, Bombast, Monarch of the Arcana, was endowed by God with special gifts for this end, that every searcher after this supreme philosopher's work may be forced to imitate and to follow me, be he Italian, Pole, Gaul, German, or whatsoever or whosoever he be. Come hither after me, all ye philosophers, astronomers, and spagirists.... I will show and open to you... this corporeal regeneration."(1)

Paracelsus based his medical teachings on four "pillars"—philosophy, astronomy, alchemy, and virtue of the physician—a strange-enough equipment surely, and yet, properly interpreted, not quite so anomalous as it seems at first blush. Philosophy was the "gate of medicine," whereby the physician entered rightly upon the true course of learning; astronomy, the study of the stars, was all-important because "they (the stars) caused disease by their exhalations, as, for instance, the sun by excessive heat"; alchemy, as he interpreted it, meant the improvement of natural substances for man's benefit; while virtue in the physician was necessary since "only the virtuous are permitted to penetrate into the innermost nature of man and the universe."

All his writings aim to promote progress in medicine, and to hold before the physician a grand ideal of his profession. In this his views are wide and far-reaching, based on the relationship which man bears to nature as a whole; but in his sweeping condemnations he not only rejected Galenic therapeutics and Galenic anatomy, but condemned dissections of any kind. He laid the cause of all diseases at the door of the three mystic elements—salt, sulphur, and mercury. In health he supposed these to be mingled in the body so as to be indistinguishable; a slight separation of them produced disease; and death he supposed to be the result of their complete separation. The spiritual agencies of diseases, he said, had nothing to do with either angels or devils, but were the spirits of human beings.

He believed that all food contained poisons, and that the function of digestion was to separate the poisonous from the nutritious. In the stomach was an archaeus, or alchemist, whose duty was to make this separation. In digestive disorders the archaeus failed to do this, and the poisons thus gaining access to the system were "coagulated" and deposited in the joints and various other parts of the body. Thus the deposits in the kidneys and tartar on the teeth were formed; and the stony deposits of gout were particularly familiar examples of this. All this is visionary enough, yet it shows at least a groping after rational explanations of vital phenomena.

Like most others of his time, Paracelsus believed firmly in the doctrine of "signatures"—a belief that every organ and part of the body had a corresponding form in nature, whose function was to heal diseases of the organ it resembled. The vagaries of this peculiar doctrine are too numerous and complicated for lengthy discussion, and varied greatly from generation to generation. In general, however, the theory may be summed up in the words of Paracelsus: "As a woman is known by her shape, so are the medicines." Hence the physicians were constantly searching for some object of corresponding shape to an organ of the body. The most natural application of this doctrine would be the use of the organs of the lower animals for the treatment of the corresponding diseased organs in man. Thus diseases of the heart were to be treated with the hearts of animals, liver disorders with livers, and so on. But this apparently simple form of treatment had endless modifications and restrictions, for not all animals were useful. For example, it was useless to give the stomach of an ox in gastric diseases when the indication in such cases was really for the stomach of a rat. Nor were the organs of animals the only "signatures" in nature. Plants also played a very important role, and the herb-doctors devoted endless labor to searching for such plants. Thus the blood-root, with its red juice, was supposed to be useful in blood diseases, in stopping hemorrhage, or in subduing the redness of an inflammation.

Paracelsus's system of signatures, however, was so complicated by his theories of astronomy and alchemy that it is practically beyond comprehension. It is possible that he himself may have understood it, but it is improbable that any one else did—as shown by the endless discussions that have taken place about it. But with all the vagaries of his theories he was still rational in his applications, and he attacked to good purpose the complicated "shot-gun" prescriptions of his contemporaries, advocating more simple methods of treatment.

The ever-fascinating subject of electricity, or, more specifically, "magnetism," found great favor with him, and with properly adjusted magnets he claimed to be able to cure many diseases. In epilepsy and lockjaw, for example, one had but to fasten magnets to the four extremities of the body, and then, "when the proper medicines were given," the cure would be effected. The easy loop-hole for excusing failure on the ground of improper medicines is obvious, but Paracelsus declares that this one prescription is of more value than "all the humoralists have ever written or taught."

Since Paracelsus condemned the study of anatomy as useless, he quite naturally regarded surgery in the same light. In this he would have done far better to have studied some of his predecessors, such as Galen, Paul of Aegina, and Avicenna. But instead of "cutting men to pieces," he taught that surgeons would gain more by devoting their time to searching for the universal panacea which would cure all diseases, surgical as well as medical. In this we detect a taint of the popular belief in the philosopher's stone and the magic elixir of life, his belief in which have been stoutly denied by some of his followers. He did admit, however, that one operation alone was perhaps permissible—lithotomy, or the "cutting for stone."

His influence upon medicine rests undoubtedly upon his revolutionary attitude, rather than on any great or new discoveries made by him. It is claimed by many that he brought prominently into use opium and mercury, and if this were indisputably proven his services to medicine could hardly be overestimated. Unfortunately, however, there are good grounds for doubting that he was particularly influential in reintroducing these medicines. His chief influence may perhaps be summed up in a single phrase—he overthrew old traditions.

To Paracelsus's endeavors, however, if not to the actual products of his work, is due the credit of setting in motion the chain of thought that developed finally into scientific chemistry. Nor can the ultimate aim of the modern chemist seek a higher object than that of this sixteenth-century alchemist, who taught that "true alchemy has but one aim and object, to extract the quintessence of things, and to prepare arcana, tinctures, and elixirs which may restore to man the health and soundness he has lost."

About the beginning of the sixteenth century, while Paracelsus was scoffing at the study of anatomy as useless, and using his influence against it, there had already come upon the scene the first of the great anatomists whose work was to make the century conspicuous in that branch of medicine.

The young anatomist Charles etienne (1503-1564) made one of the first noteworthy discoveries, pointing out for the first time that the spinal cord contains a canal, continuous throughout its length. He also made other minor discoveries of some importance, but his researches were completely overshadowed and obscured by the work of a young Fleming who came upon the scene a few years later, and who shone with such brilliancy in the medical world that he obscured completely the work of his contemporary until many years later. This young physician, who was destined to lead such an eventful career and meet such an untimely end as a martyr to science, was Andrew Vesalius (1514-1564), who is called the "greatest of anatomists." At the time he came into the field medicine was struggling against the dominating Galenic teachings and the theories of Paracelsus, but perhaps most of all against the superstitions of the time. In France human dissections were attended with such dangers that the young Vesalius transferred his field of labors to Italy, where such investigations were covertly permitted, if not openly countenanced.

From the very start the young Fleming looked askance at the accepted teachings of the day, and began a series of independent investigations based upon his own observations. The results of these investigations he gave in a treatise on the subject which is regarded as the first comprehensive and systematic work on human anatomy. This remarkable work was published in the author's twenty-eighth or twenty-ninth year. Soon after this Vesalius was invited as imperial physician to the court of Emperor Charles V. He continued to act in the same capacity at the court of Philip II., after the abdication of his patron. But in spite of this royal favor there was at work a factor more powerful than the influence of the monarch himself—an instrument that did so much to retard scientific progress, and by which so many lives were brought to a premature close.

Vesalius had received permission from the kinsmen of a certain grandee to perform an autopsy. While making his observations the heart of the outraged body was seen to palpitate—so at least it was reported. This was brought immediately to the attention of the Inquisition, and it was only by the intervention of the king himself that the anatomist escaped the usual fate of those accused by that tribunal. As it was, he was obliged to perform a pilgrimage to the Holy Land. While returning from this he was shipwrecked, and perished from hunger and exposure on the island of Zante.

At the very time when the anatomical writings of Vesalius were startling the medical world, there was living and working contemporaneously another great anatomist, Eustachius (died 1574), whose records of his anatomical investigations were ready for publication only nine years after the publication of the work of Vesalius. Owing to the unfortunate circumstances of the anatomist, however, they were never published during his lifetime—not, in fact, until 1714. When at last they were given to the world as Anatomical Engravings, they showed conclusively that Eustachius was equal, if not superior to Vesalius in his knowledge of anatomy. It has been said of this remarkable collection of engravings that if they had been published when they were made in the sixteenth century, anatomy would have been advanced by at least two centuries. But be this as it may, they certainly show that their author was a most careful dissector and observer.

Eustachius described accurately for the first time certain structures of the middle ear, and rediscovered the tube leading from the ear to the throat that bears his name. He also made careful studies of the teeth and the phenomena of first and second dentition. He was not baffled by the minuteness of structures and where he was unable to study them with the naked eye he used glasses for the purpose, and resorted to macerations and injections for the study of certain complicated structures. But while the fruit of his pen and pencil were lost for more than a century after his death, the effects of his teachings were not; and his two pupils, Fallopius and Columbus, are almost as well known to-day as their illustrious teacher. Columbus (1490-1559) did much in correcting the mistakes made in the anatomy of the bones as described by Vesalius. He also added much to the science by giving correct accounts of the shape and cavities of the heart, and made many other discoveries of minor importance. Fallopius (1523-1562) added considerably to the general knowledge of anatomy, made several discoveries in the anatomy of the ear, and also several organs in the abdominal cavity.

At this time a most vitally important controversy was in progress as to whether or not the veins of the bodies were supplied with valves, many anatomists being unable to find them. Etienne had first described these structures, and Vesalius had confirmed his observations. It would seem as if there could be no difficulty in settling the question as to the fact of such valves being present in the vessels, for the demonstration is so simple that it is now made daily by medical students in all physiological laboratories and dissecting-rooms. But many of the great anatomists of the sixteenth century were unable to make this demonstration, even when it had been brought to their attention by such an authority as Vesalius. Fallopius, writing to Vesalius on the subject in 1562, declared that he was unable to find such valves. Others, however, such as Eustachius and Fabricius (1537-1619), were more successful, and found and described these structures. But the purpose served by these valves was entirely misinterpreted. That they act in preventing the backward flow of the blood in the veins on its way to the heart, just as the valves of the heart itself prevent regurgitation, has been known since the time of Harvey; but the best interpretation that could be given at that time, even by such a man as Fabricius, was that they acted in retarding the flow of the blood as it comes from the heart, and thus prevent its too rapid distribution throughout the body. The fact that the blood might have been going towards the heart, instead of coming from it, seems never to have been considered seriously until demonstrated so conclusively by Harvey.

Of this important and remarkable controversy over the valves in veins, Withington has this to say: "This is truly a marvellous story. A great Galenic anatomist is first to give a full and correct description of the valves and their function, but fails to see that any modification of the old view as to the motion of the blood is required. Two able dissectors carefully test their action by experiment, and come to a result, the exact reverse of the truth. Urged by them, the two foremost anatomists of the age make a special search for valves and fail to find them. Finally, passing over lesser peculiarities, an aged and honorable professor, who has lived through all this, calmly asserts that no anatomist, ancient or modern, has ever mentioned valves in veins till he discovered them in 1574!"(2)

Among the anatomists who probably discovered these valves was Michael Servetus (1511-1553); but if this is somewhat in doubt, it is certain that he discovered and described the pulmonary circulation, and had a very clear idea of the process of respiration as carried on in the lungs. The description was contained in a famous document sent to Calvin in 1545—a document which the reformer carefully kept for seven years in order that he might make use of some of the heretical statements it contained to accomplish his desire of bringing its writer to the stake. The awful fate of Servetus, the interesting character of the man, and the fact that he came so near to anticipating the discoveries of Harvey make him one of the most interesting figures in medical history.

In this document which was sent to Calvin, Servetus rejected the doctrine of natural, vital, and animal spirits, as contained in the veins, arteries, and nerves respectively, and made the all-important statement that the fluids contained in veins and arteries are the same. He showed also that the blood is "purged from fume" and purified by respiration in the lungs, and declared that there is a new vessel in the lungs, "formed out of vein and artery." Even at the present day there is little to add to or change in this description of Servetus's.

By keeping this document, pregnant with advanced scientific views, from the world, and in the end only using it as a means of destroying its author, the great reformer showed the same jealousy in retarding scientific progress as had his arch-enemies of the Inquisition, at whose dictates Vesalius became a martyr to science, and in whose dungeons etienne perished.

The time was ripe for the culminating discovery of the circulation of the blood; but as yet no one had determined the all-important fact that there are two currents of blood in the body, one going to the heart, one coming from it. The valves in the veins would seem to show conclusively that the venous current did not come from the heart, and surgeons must have observed thousands of times the every-day phenomenon of congested veins at the distal extremity of a limb around which a ligature or constriction of any kind had been placed, and the simultaneous depletion of the vessels at the proximal points above the ligature. But it should be remembered that inductive science was in its infancy. This was the sixteenth, not the nineteenth century, and few men had learned to put implicit confidence in their observations and convictions when opposed to existing doctrines. The time was at hand, however, when such a man was to make his appearance, and, as in the case of so many revolutionary doctrines in science, this man was an Englishman. It remained for William Harvey (1578-1657) to solve the great mystery which had puzzled the medical world since the beginning of history; not only to solve it, but to prove his case so conclusively and so simply that for all time his little booklet must he handed down as one of the great masterpieces of lucid and almost faultless demonstration.

Harvey, the son of a prosperous Kentish yeoman, was born at Folkestone. His education was begun at the grammar-school of Canterbury, and later he became a pensioner of Caius College, Cambridge. Soon after taking his degree of B.A., at the age of nineteen, he decided upon the profession of medicine, and went to Padua as a pupil of Fabricius and Casserius. Returning to England at the age of twenty-four, he soon after (1609) obtained the reversion of the post of physician to St. Bartholomew's Hospital, his application being supported by James I. himself. Even at this time he was a popular physician, counting among his patients such men as Francis Bacon. In 1618 he was appointed physician extraordinary to the king, and, a little later, physician in ordinary. He was in attendance upon Charles I. at the battle of Edgehill, in 1642, where, with the young Prince of Wales and the Duke of York, after seeking shelter under a hedge, he drew a book out of his pocket and, forgetful of the battle, became absorbed in study, until finally the cannon-balls from the enemy's artillery made him seek a more sheltered position.

On the fall of Charles I. he retired from practice, and lived in retirement with his brother. He was then well along in years, but still pursued his scientific researches with the same vigor as before, directing his attention chiefly to the study of embryology. On June 3, 1657, he was attacked by paralysis and died, in his eightieth year. He had lived to see his theory of the circulation accepted, several years before, by all the eminent anatomists of the civilized world.

A keenness in the observation of facts, characteristic of the mind of the man, had led Harvey to doubt the truth of existing doctrines as to the phenomena of the circulation. Galen had taught that "the arteries are filled, like bellows, because they are expanded," but Harvey thought that the action of spurting blood from a severed vessel disproved this. For the spurting was remittant, "now with greater, now with less impetus," and its greater force always corresponded to the expansion (diastole), not the contraction (systole) of the vessel. Furthermore, it was evident that contraction of the heart and the arteries was not simultaneous, as was commonly taught, because in that case there would be no marked propulsion of the blood in any direction; and there was no gainsaying the fact that the blood was forcibly propelled in a definite direction, and that direction away from the heart.

Harvey's investigations led him to doubt also the accepted theory that there was a porosity in the septum of tissue that divides the two ventricles of the heart. It seemed unreasonable to suppose that a thick fluid like the blood could find its way through pores so small that they could not be demonstrated by any means devised by man. In evidence that there could be no such openings he pointed out that, since the two ventricles contract at the same time, this process would impede rather than facilitate such an intra-ventricular passage of blood. But what seemed the most conclusive proof of all was the fact that in the foetus there existed a demonstrable opening between the two ventricles, and yet this is closed in the fully developed heart. Why should Nature, if she intended that blood should pass between the two cavities, choose to close this opening and substitute microscopic openings in place of it? It would surely seem more reasonable to have the small perforations in the thin, easily permeable membrane of the foetus, and the opening in the adult heart, rather than the reverse. From all this Harvey drew his correct conclusions, declaring earnestly, "By Hercules, there ARE no such porosities, and they cannot be demonstrated."

Having convinced himself that no intra-ventricular opening existed, he proceeded to study the action of the heart itself, untrammelled by too much faith in established theories, and, as yet, with no theory of his own. He soon discovered that the commonly accepted theory of the heart striking against the chest-wall during the period of relaxation was entirely wrong, and that its action was exactly the reverse of this, the heart striking the chest-wall during contraction. Having thus disproved the accepted theory concerning the heart's action, he took up the subject of the action of arteries, and soon was able to demonstrate by vivisection that the contraction of the arteries was not simultaneous with contractions of the heart. His experiments demonstrated that these vessels were simply elastic tubes whose pulsations were "nothing else than the impulse of the blood within them." The reason that the arterial pulsation was not simultaneous with the heart-beat he found to be because of the time required to carry the impulse along the tube.

By a series of further careful examinations and experiments, which are too extended to be given here, he was soon able further to demonstrate the action and course of the blood during the contractions of the heart. His explanations were practically the same as those given to-day—first the contraction of the auricle, sending blood into the ventricle; then ventricular contraction, making the pulse, and sending the blood into the arteries. He had thus demonstrated what had not been generally accepted before, that the heart was an organ for the propulsion of blood. To make such a statement to-day seems not unlike the sober announcement that the earth is round or that the sun does not revolve about it. Before Harvey's time, however, it was considered as an organ that was "in some mysterious way the source of vitality and warmth, as an animated crucible for the concoction of blood and the generation of vital spirits."(3)

In watching the rapid and ceaseless contractions of the heart, Harvey was impressed with the fact that, even if a very small amount of blood was sent out at each pulsation, an enormous quantity must pass through the organ in a day, or even in an hour. Estimating the size of the cavities of the heart, and noting that at least a drachm must be sent out with each pulsation, it was evident that the two thousand beats given by a very slow human heart in an hour must send out some forty pounds of blood—more than twice the amount in the entire body. The question was, what became of it all? For it should be remembered that the return of the blood by the veins was unknown, and nothing like a "circulation" more than vaguely conceived even by Harvey himself. Once it could be shown that the veins were constantly returning blood to the heart, the discovery that the blood in some way passes from the arteries to the veins was only a short step. Harvey, by resorting to vivisections of lower animals and reptiles, soon demonstrated beyond question the fact that the veins do carry the return blood. "But this, in particular, can be shown clearer than daylight," says Harvey. "The vena cava enters the heart at an inferior portion, while the artery passes out above. Now if the vena cava be taken up with forceps or the thumb and finger, and the course of the blood intercepted for some distance below the heart, you will at once see it almost emptied between the fingers and the heart, the blood being exhausted by the heart's pulsation, the heart at the same time becoming much paler even in its dilatation, smaller in size, owing to the deficiency of blood, and at length languid in pulsation, as if about to die. On the other hand, when you release the vein the heart immediately regains its color and dimensions. After that, if you leave the vein free and tie and compress the arteries at some distance from the heart, you will see, on the contrary, their included portion grow excessively turgid, the heart becoming so beyond measure, assuming a dark-red color, even to lividity, and at length so overloaded with blood as to seem in danger of suffocation; but when the obstruction is removed it returns to its normal condition, in size, color, and movement."(4)

This conclusive demonstration that the veins return the blood to the heart must have been most impressive to Harvey, who had been taught to believe that the blood current in the veins pursued an opposite course, and must have tended to shake his faith in all existing doctrines of the day.

His next step was the natural one of demonstrating that the blood passes from the arteries to the veins. He demonstrated conclusively that this did occur, but for once his rejection of the ancient writers and one modern one was a mistake. For Galen had taught, and had attempted to demonstrate, that there are sets of minute vessels connecting the arteries and the veins; and Servetus had shown that there must be such vessels, at least in the lungs.

However, the little flaw in the otherwise complete demonstration of Harvey detracts nothing from the main issue at stake. It was for others who followed to show just how these small vessels acted in effecting the transfer of the blood from artery to vein, and the grand general statement that such a transfer does take place was, after all, the all-important one, and the exact method of how it takes place a detail. Harvey's experiments to demonstrate that the blood passes from the arteries to the veins are so simply and concisely stated that they may best be given in his own words.

"I have here to cite certain experiments," he wrote, "from which it seems obvious that the blood enters a limb by the arteries, and returns from it by the veins; that the arteries are the vessels carrying the blood from the heart, and the veins the returning channels of the blood to the heart; that in the limbs and extreme parts of the body the blood passes either by anastomosis from the arteries into the veins, or immediately by the pores of the flesh, or in both ways, as has already been said in speaking of the passage of the blood through the lungs; whence it appears manifest that in the circuit the blood moves from thence hither, and hence thither; from the centre to the extremities, to wit, and from the extreme parts back again to the centre. Finally, upon grounds of circulation, with the same elements as before, it will be obvious that the quantity can neither be accounted for by the ingesta, nor yet be held necessary to nutrition.

"Now let any one make an experiment on the arm of a man, either using such a fillet as is employed in blood-letting or grasping the limb tightly with his hand, the best subject for it being one who is lean, and who has large veins, and the best time after exercise, when the body is warm, the pulse is full, and the blood carried in large quantities to the extremities, for all then is more conspicuous; under such circumstances let a ligature be thrown about the extremity and drawn as tightly as can be borne: it will first be perceived that beyond the ligature neither in the wrist nor anywhere else do the arteries pulsate, that at the same time immediately above the ligature the artery begins to rise higher at each diastole, to throb more violently, and to swell in its vicinity with a kind of tide, as if it strove to break through and overcome the obstacle to its current; the artery here, in short, appears as if it were permanently full. The hand under such circumstances retains its natural color and appearances; in the course of time it begins to fall somewhat in temperature, indeed, but nothing is DRAWN into it.

"After the bandage has been kept on some short time in this way, let it be slackened a little, brought to the state or term of middling tightness which is used in bleeding, and it will be seen that the whole hand and arm will instantly become deeply suffused and distended, injected, gorged with blood, DRAWN, as it is said, by this middling ligature, without pain, or heat, or any horror of a vacuum, or any other cause yet indicated.

"As we have noted, in connection with the tight ligature, that the artery above the bandage was distended and pulsated, not below it, so, in the case of the moderately tight bandage, on the contrary, do we find that the veins below, never above, the fillet swell and become dilated, while the arteries shrink; and such is the degree of distention of the veins here that it is only very strong pressure that will force the blood beyond the fillet and cause any of the veins in the upper part of the arm to rise.

"From these facts it is easy for any careful observer to learn that the blood enters an extremity by the arteries; for when they are effectively compressed nothing is DRAWN to the member; the hand preserves its color; nothing flows into it, neither is it distended; but when the pressure is diminished, as it is with the bleeding fillet, it is manifest that the blood is instantly thrown in with force, for then the hand begins to swell; which is as much as to say that when the arteries pulsate the blood is flowing through them, as it is when the moderately tight ligature is applied; but when they do not pulsate, or when a tight ligature is used, they cease from transmitting anything; they are only distended above the part where the ligature is applied. The veins again being compressed, nothing can flow through them; the certain indication of which is that below the ligature they are much more tumid than above it, and than they usually appear when there is no bandage upon the arm.

"It therefore plainly appears that the ligature prevents the return of the blood through the veins to the parts above it, and maintains those beneath it in a state of permanent distention. But the arteries, in spite of the pressure, and under the force and impulse of the heart, send on the blood from the internal parts of the body to the parts beyond the bandage."(5)

This use of ligatures is very significant, because, as shown, a very tight ligature stops circulation in both arteries and veins, while a loose one, while checking the circulation in the veins, which lie nearer the surface and are not so directly influenced by the force of the heart, does not stop the passage of blood in the arteries, which are usually deeply imbedded in the tissues, and not so easily influenced by pressure from without.

The last step of Harvey's demonstration was to prove that the blood does flow along the veins to the heart, aided by the valves that had been the cause of so much discussion and dispute between the great sixteenth-century anatomists. Harvey not only demonstrated the presence of these valves, but showed conclusively, by simple experiments, what their function was, thus completing his demonstration of the phenomena of the circulation.

The final ocular demonstration of the passage of the blood from the arteries to the veins was not to be made until four years after Harvey's death. This process, which can be observed easily in the web of a frog's foot by the aid of a low-power lens, was first demonstrated by Marcello Malpighi (1628-1694) in 1661. By the aid of a lens he first saw the small "capillary" vessels connecting the veins and arteries in a piece of dried lung. Taking his cue from this, he examined the lung of a turtle, and was able to see in it the passage of the corpuscles through these minute vessels, making their way along these previously unknown channels from the arteries into the veins on their journey back to the heart. Thus the work of Harvey, all but complete, was made absolutely entire by the great Italian. And all this in a single generation.

The seventeenth century was not to close, however, without another discovery in science, which, when applied to the causation of disease almost two centuries later, revolutionized therapeutics more completely than any one discovery. This was the discovery of microbes, by Antonius von Leeuwenhoek (1632-1723), in 1683. Von Leeuwenhoek discovered that "in the white matter between his teeth" there were millions of microscopic "animals"—more, in fact, than "there were human beings in the united Netherlands," and all "moving in the most delightful manner." There can be no question that he saw them, for we can recognize in his descriptions of these various forms of little "animals" the four principal forms of microbes—the long and short rods of bacilli and bacteria, the spheres of micrococci, and the corkscrew spirillum.

The presence of these microbes in his mouth greatly annoyed Antonius, and he tried various methods of getting rid of them, such as using vinegar and hot coffee. In doing this he little suspected that he was anticipating modern antiseptic surgery by a century and three-quarters, and to be attempting what antiseptic surgery is now able to accomplish. For the fundamental principle of antisepsis is the use of medicines for ridding wounds of similar microscopic organisms. Von Leenwenhoek was only temporarily successful in his attempts, however, and took occasion to communicate his discovery to the Royal Society of England, hoping that they would be "interested in this novelty." Probably they were, but not sufficiently so for any member to pursue any protracted investigations or reach any satisfactory conclusions, and the whole matter was practically forgotten until the middle of the nineteenth century.

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