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Harvey is a very interesting figure because he lived at a time when
religion was still the active norm and science was yet young and fresh.
Eulogies can be a very fine thing in any field: "our greatest physician,
William Harvey, author of De Motu Cordis (1628). Harvey was present at the
Battle of Edgehill (1642), the first battle of the English civil war,"
[1], but one wonders how these two events might be subtly connected.
"...Francis Bacon proposed...that the pursuit of knowledge depended
on "the fresh examination of particulars," advice that underlaid the
systematic observation of nature that complemented the active
experimentation advocated by his contemporary William Harvey, " [2].
Above all else we might say that 'systematic observation' and 'active
experimentation' are the twin probes with which science has unpicked many
a mystery of the world since Harvey's day, but still he had to fight hard
against dogma:
"I have heard him say, that after his Book of the Circulation of the
Blood came out, that he fell mightily in his Practize, and that 'twas
beleeved by the vulgar that he was crack-brained; and all the physitians
were against his Opinion, and envyed him; many wrote against him. John
Aubrey (1626-97), Brief Lives, on William Harvey (1578-1657)," [3].
"Perhaps few realise that Harvey's classic treatise on the
circulation of the blood was banned by the censors in Britain and had to
be published in Germany, which reflects the depth of hostility that he
faced from the medical establishment in London. He expected trouble even
before he wrote his book and had to fight doggedly against the "Galenic
brigade" for 20 years. At least he avoided the fate of some continental
medical pioneers of the same era, who were burned at the stake," [4].
But if Galen is to be "blamed for the tyranny his ideas exercised for
over one thousand years he might as well be praised for the cosmopolitan
character of scholastic medicine," [5]
However, this eulogising tendency can have a downside, for we might
then giddily begin to see in the writings of old figures chimeras,
phantasms, imagined things, that were not really there, or things that
merely foreshadowed ideas that later rose to greatness, but which cannot
sensibly have figured greatly to them in their time, even though we today
may wish to exaggerate their powers of discernment and elevate them to
'hero status'. And thereby in our giddy excitement, we might accidentally
and simplistically confer upon them greater foresight and wisdom than they
ever in fact possessed.
In the case of Harvey, modern physicians should cautiously examine
his views in a wider frame, for they may then find in him, views they
might not wish to be associated with today or to eulogise. Better to
attempt to see figures of the past more soberly and in the true time-frame
and belief-frame they dwelled in, and thus avoid a very strong temptation
to make dangerous and wildly inaccurate assumptions about what these
eminent medical predecessors could actually have thought and believed.
We need an "obligation to appreciate in full the complexity of the
universe...we must be on the alert against the simple and all too
reasonable account; against the easy and facile solution...it is a
cardinal fault to extend the application of our knowledge of the part, and
to hold it valid for the whole...true knowledge of the whole is not gained
by a simple summation of our knowledge of the parts," [6].
Similarly, old books "yield their meaning only if read in the context
of their time. And the context of the time would primarily mean the
picture of man, health, and disease which that time possessed," [7]. Or,
as Claude Bernard once said, "'that which we know impedes the way to
further knowledge,'..." [8]. Concepts can blind or illuminate our
observation, and in some sense, they always do a bit of both. The lamp of
reason illuminates, but also obscures those factors that are more subtle,
which its harsh light can send scurrying into the shadows.
As most doctors know, "in 1628 Harvey had published his discovery of
the circulation of the blood," [9] which unfortunately led to "a vigorous
exaggeration of the new point of view: every function was regarded as
mechanical; and thus arose the 'iatro-mechanical school'..." [10]. This in
turn led physicians to "conceive of disease as an embarrassment of the
machine in some portion of its working parts," [10]; "the spirit of the
age...was crudely mechanistic," [10]. But the vitalists still hewed to
their own line: "even though they might not be able to furnish lucid
alternatives, the animists denied that machines were accurate models of
the living organism...the conflict between animism and mechanism is a
major aspect in the development of eighteenth century medical thought,"
[11].
It is perhaps a surprise to find that Harvey was also a vitalist, who
maintained that the blood was alive and moving in the embryo, before the
heart was even formed! His religious views found nothing but confirmation
in his embryological studies: "the blood that circulates or semen that
fertilizes...in this...lies the astral pre-eminence of vital heat. In
Neoplatonic terms, Harvey envisages the blood as life and soul," [12]. For
Harvey the blood "is formed, moved and endowed with vital spirit before
any blood-forming or blood-moving organs are in existence...motion is
intrinsic to the substance of the blood and not communicated to it from
outside by any other part or organ," [12]. So things in 'the past' are not
always what they seem to us today, and we should always be careful in
historical studies to purge ourselves of all modern concepts before
travelling to former times.
Although historians 'study the past', what the past actually is and
how to study it are by no means fixed or universally agreed-upon. Each is
redefined and redesigned by each generation and coloured according to
their own needs and inclinations. Study of the past also changes with time
and any construct we might make of it changes too. The past is not
therefore a 'fixed thing' as we imagine it to be, but an evolving and
fluid conception of ours about which new things can always be discovered.
Historical causes might be better sought in "the social and cultural
conditions of those past centuries," [13]; "understanding
[something]...against its own background and not merely in the light of
present day concepts," [13]. And in this process we might need to "tread
lightly...[and] have to penetrate into metaphysical depths which most of
us avoid," [14], so as not to reach a point of view "based upon the
present status, aspirations and functions of medicine," [15]. History must
"enter into the spirit of each century and of each author, report
faithfully the thoughts of all, leave to everybody what is his," [16].
The danger with eulogy is that it often lapses into myth-making. Just
because Harvey discovered the circulation of the blood, so we are apt to
confer upon him other modern scientific views entirely without
justification. The truth probably lies elsewhere. Like many other great
creators of science - Newton, Descartes, Boyle and Sydenham, he was
basically a religious man who saw the pursuit of science as they did -
"for economic utility and the glorification of God," [17].
Perhaps the funniest thing about Harvey has never been stated before.
His work might even be seen as an omen of the Civil War and the King's
demise. In the microcosmic realm of science, Harvey discovered the
circulation in the 1620s and published his work in 1628, while in the
macrocosmic realm of state, things were getting bad in England, and in
1649 King Charles I was finally tried and beheaded, for refusing to deny
his Divine Right as a King. No doubt in those superstitious times, and
certainly a century earlier, such parallels and patterns would have been
raked over, pulverised and examined to a hair's-breadth.
Though Paracelsus "for the medical orthodoxy of the 16th and 17th
centuries and the following period of Enlightenment...personified all that
was bad and ridiculous in hermetic medicine," [18], yet he would certainly
have been delighted to point out that in medieval cosmology 'the heart'
and 'Kings' were both ruled over by the zodiacal sign of Leo. As if the
penetration of one mystery was then followed only 21 years later by the
demise of another. As if the discovery of the flow of our life blood was
soon followed by much blood being shed, not just in a Civil War, but
gushing ingloriously from the severed arteries of a King. Such a
metaphysical 'joke', would of course have to go begging in these less
subtle times.
[4] BMJ 2001;323:519 (1 September), Reviews, Book, Great Feuds in
Medicine: Ten of the Liveliest Disputes Ever, Hal Hellman, reviewed by
Bernard Knight http://www.bmj.com/cgi/content/full/323/7311/519/a
[5] Owsei Temkin, 1946, An Essay On The Usefulness Of Medical History
To Medicine, Bull. Hist. Med., 19.1, 16
[6] Iago Galdston, 1942, The Concept of the Specific in Medicine,
Trans. Coll. Phys. of Philadelphia, IX, 1941-2, 30-31
[7] Owsei Temkin, 1956, On The Interrelationship Of The History And
The Philosophy Of Medicine, Bull. Hist. Med., 30.3, 250
[8] Galdston, 32-33
[9] Walter Pagel, 1967, Harvey and Glisson on Irritability, with a
Note on van Helmont, Bull. Hist. Med., XLI, Nov-Dec. 1967, 497
[10] Galdston, 28-29
[11] Lester Snow King, 1963, Some Problems of Causality in 18th
Century Medicine, Bull. Hist. Med., XXXVII, 18
[12] Pagel, 504-5
[13] Temkin, 1946, 32
[14] Temkin, 1956, 250
[15] Temkin, 1956, 249
[16] Daniel Le Clerq quoted in Temkin, 1946, 33
[17] Robert K Merton, 1973, Sociology of Science, Univ Chicago Press,
268
[18] Temkin, 1946, 18
Competing interests:
No competing interests
09 September 2001
Peter Morrell
Writer and researcher in history and philosophy of medicine
William Harvey - lest eulogy should slip into myth-making
Sir,
Harvey is a very interesting figure because he lived at a time when
religion was still the active norm and science was yet young and fresh.
Eulogies can be a very fine thing in any field: "our greatest physician,
William Harvey, author of De Motu Cordis (1628). Harvey was present at the
Battle of Edgehill (1642), the first battle of the English civil war,"
[1], but one wonders how these two events might be subtly connected.
"...Francis Bacon proposed...that the pursuit of knowledge depended
on "the fresh examination of particulars," advice that underlaid the
systematic observation of nature that complemented the active
experimentation advocated by his contemporary William Harvey, " [2].
Above all else we might say that 'systematic observation' and 'active
experimentation' are the twin probes with which science has unpicked many
a mystery of the world since Harvey's day, but still he had to fight hard
against dogma:
"I have heard him say, that after his Book of the Circulation of the
Blood came out, that he fell mightily in his Practize, and that 'twas
beleeved by the vulgar that he was crack-brained; and all the physitians
were against his Opinion, and envyed him; many wrote against him. John
Aubrey (1626-97), Brief Lives, on William Harvey (1578-1657)," [3].
"Perhaps few realise that Harvey's classic treatise on the
circulation of the blood was banned by the censors in Britain and had to
be published in Germany, which reflects the depth of hostility that he
faced from the medical establishment in London. He expected trouble even
before he wrote his book and had to fight doggedly against the "Galenic
brigade" for 20 years. At least he avoided the fate of some continental
medical pioneers of the same era, who were burned at the stake," [4].
But if Galen is to be "blamed for the tyranny his ideas exercised for
over one thousand years he might as well be praised for the cosmopolitan
character of scholastic medicine," [5]
However, this eulogising tendency can have a downside, for we might
then giddily begin to see in the writings of old figures chimeras,
phantasms, imagined things, that were not really there, or things that
merely foreshadowed ideas that later rose to greatness, but which cannot
sensibly have figured greatly to them in their time, even though we today
may wish to exaggerate their powers of discernment and elevate them to
'hero status'. And thereby in our giddy excitement, we might accidentally
and simplistically confer upon them greater foresight and wisdom than they
ever in fact possessed.
In the case of Harvey, modern physicians should cautiously examine
his views in a wider frame, for they may then find in him, views they
might not wish to be associated with today or to eulogise. Better to
attempt to see figures of the past more soberly and in the true time-frame
and belief-frame they dwelled in, and thus avoid a very strong temptation
to make dangerous and wildly inaccurate assumptions about what these
eminent medical predecessors could actually have thought and believed.
We need an "obligation to appreciate in full the complexity of the
universe...we must be on the alert against the simple and all too
reasonable account; against the easy and facile solution...it is a
cardinal fault to extend the application of our knowledge of the part, and
to hold it valid for the whole...true knowledge of the whole is not gained
by a simple summation of our knowledge of the parts," [6].
Similarly, old books "yield their meaning only if read in the context
of their time. And the context of the time would primarily mean the
picture of man, health, and disease which that time possessed," [7]. Or,
as Claude Bernard once said, "'that which we know impedes the way to
further knowledge,'..." [8]. Concepts can blind or illuminate our
observation, and in some sense, they always do a bit of both. The lamp of
reason illuminates, but also obscures those factors that are more subtle,
which its harsh light can send scurrying into the shadows.
As most doctors know, "in 1628 Harvey had published his discovery of
the circulation of the blood," [9] which unfortunately led to "a vigorous
exaggeration of the new point of view: every function was regarded as
mechanical; and thus arose the 'iatro-mechanical school'..." [10]. This in
turn led physicians to "conceive of disease as an embarrassment of the
machine in some portion of its working parts," [10]; "the spirit of the
age...was crudely mechanistic," [10]. But the vitalists still hewed to
their own line: "even though they might not be able to furnish lucid
alternatives, the animists denied that machines were accurate models of
the living organism...the conflict between animism and mechanism is a
major aspect in the development of eighteenth century medical thought,"
[11].
It is perhaps a surprise to find that Harvey was also a vitalist, who
maintained that the blood was alive and moving in the embryo, before the
heart was even formed! His religious views found nothing but confirmation
in his embryological studies: "the blood that circulates or semen that
fertilizes...in this...lies the astral pre-eminence of vital heat. In
Neoplatonic terms, Harvey envisages the blood as life and soul," [12]. For
Harvey the blood "is formed, moved and endowed with vital spirit before
any blood-forming or blood-moving organs are in existence...motion is
intrinsic to the substance of the blood and not communicated to it from
outside by any other part or organ," [12]. So things in 'the past' are not
always what they seem to us today, and we should always be careful in
historical studies to purge ourselves of all modern concepts before
travelling to former times.
Although historians 'study the past', what the past actually is and
how to study it are by no means fixed or universally agreed-upon. Each is
redefined and redesigned by each generation and coloured according to
their own needs and inclinations. Study of the past also changes with time
and any construct we might make of it changes too. The past is not
therefore a 'fixed thing' as we imagine it to be, but an evolving and
fluid conception of ours about which new things can always be discovered.
Historical causes might be better sought in "the social and cultural
conditions of those past centuries," [13]; "understanding
[something]...against its own background and not merely in the light of
present day concepts," [13]. And in this process we might need to "tread
lightly...[and] have to penetrate into metaphysical depths which most of
us avoid," [14], so as not to reach a point of view "based upon the
present status, aspirations and functions of medicine," [15]. History must
"enter into the spirit of each century and of each author, report
faithfully the thoughts of all, leave to everybody what is his," [16].
The danger with eulogy is that it often lapses into myth-making. Just
because Harvey discovered the circulation of the blood, so we are apt to
confer upon him other modern scientific views entirely without
justification. The truth probably lies elsewhere. Like many other great
creators of science - Newton, Descartes, Boyle and Sydenham, he was
basically a religious man who saw the pursuit of science as they did -
"for economic utility and the glorification of God," [17].
Perhaps the funniest thing about Harvey has never been stated before.
His work might even be seen as an omen of the Civil War and the King's
demise. In the microcosmic realm of science, Harvey discovered the
circulation in the 1620s and published his work in 1628, while in the
macrocosmic realm of state, things were getting bad in England, and in
1649 King Charles I was finally tried and beheaded, for refusing to deny
his Divine Right as a King. No doubt in those superstitious times, and
certainly a century earlier, such parallels and patterns would have been
raked over, pulverised and examined to a hair's-breadth.
Though Paracelsus "for the medical orthodoxy of the 16th and 17th
centuries and the following period of Enlightenment...personified all that
was bad and ridiculous in hermetic medicine," [18], yet he would certainly
have been delighted to point out that in medieval cosmology 'the heart'
and 'Kings' were both ruled over by the zodiacal sign of Leo. As if the
penetration of one mystery was then followed only 21 years later by the
demise of another. As if the discovery of the flow of our life blood was
soon followed by much blood being shed, not just in a Civil War, but
gushing ingloriously from the severed arteries of a King. Such a
metaphysical 'joke', would of course have to go begging in these less
subtle times.
Sources
[1] BMJ 1999;319:1561 (11 December), Filler, William Harvey,
hypothermia, and battle injuries, M J Harbinson.
http://www.bmj.com/cgi/content/full/319/7224/1561
[2] BMJ 1997;315:1075-1077 (25 October), Education and debate,
Geriatric medicine: a brief history, John Grimley Evans
http://www.bmj.com/cgi/content/full/315/7115/1075
[3] BMJ 1997;315 (25 October), Endpiece, Scientific distinction
hampers private practice?
http://www.bmj.com/cgi/content/full/315/7115/0/h
[4] BMJ 2001;323:519 (1 September), Reviews, Book, Great Feuds in
Medicine: Ten of the Liveliest Disputes Ever, Hal Hellman, reviewed by
Bernard Knight
http://www.bmj.com/cgi/content/full/323/7311/519/a
[5] Owsei Temkin, 1946, An Essay On The Usefulness Of Medical History
To Medicine, Bull. Hist. Med., 19.1, 16
[6] Iago Galdston, 1942, The Concept of the Specific in Medicine,
Trans. Coll. Phys. of Philadelphia, IX, 1941-2, 30-31
[7] Owsei Temkin, 1956, On The Interrelationship Of The History And
The Philosophy Of Medicine, Bull. Hist. Med., 30.3, 250
[8] Galdston, 32-33
[9] Walter Pagel, 1967, Harvey and Glisson on Irritability, with a
Note on van Helmont, Bull. Hist. Med., XLI, Nov-Dec. 1967, 497
[10] Galdston, 28-29
[11] Lester Snow King, 1963, Some Problems of Causality in 18th
Century Medicine, Bull. Hist. Med., XXXVII, 18
[12] Pagel, 504-5
[13] Temkin, 1946, 32
[14] Temkin, 1956, 250
[15] Temkin, 1956, 249
[16] Daniel Le Clerq quoted in Temkin, 1946, 33
[17] Robert K Merton, 1973, Sociology of Science, Univ Chicago Press,
268
[18] Temkin, 1946, 18
Competing interests: No competing interests