Produced by David Turner, Charles Franks
and the Online Distributed Proofreading Team.
The Harvard Classics Volume 38
Scientific Papers (Physiology, Medicine, Surgery, Geology)
CONTENTS
THE OATH OF HIPPOCRATES
THE LAW OF HIPPOCRATES
JOURNEYS IN DIVERSE PLACES … AMBROISE PARE TRANSLATED BY STEPHEN PAGET
ON THE MOTION OF THE HEART AND BLOOD IN ANIMALS WILLIAM HARVEY. . . TRANSLATED BY ROBERT WILLIS
THE THREE ORIGINAL PUBLICATIONS ON VACCINATION AGAINST SMALLPOX . … .. EDWARD JENNER
THE CONTAGIOUSNESS OF PUERPERAL FEVER O. W. HOLMES
ON THE ANTISEPTIC PRINCIPLE OF THE PRACTICE OF SURGERY LORD LISTER
THE PHYSIOLOGICAL THEORY OF FERMENTATION
LOUIS PASTEUR
TRANSLATED BY F. FAULKNER AND D. C. ROBB (Revised)
THE GERM THEORY AND ITS APPLICATIONS TO MEDICINE AND
SURGERY (Revised) . … .. LOUIS PASTEUR
TRANSLATED BY H. C. ERNST
ON THE EXTENSION OF THE GERM THEORY TO THE ETIOLOGY
OF CERTAIN COMMON DISEASES (Revised) LOUIS PASTEUR
TRANSLATED BY H. C. ERNST
PREJUDICES WHICH HAVE RETARDED THE PROGRESS OF GEOLOGY. … . … .. SIR CHARLES LYELL
UNIFORMITY IN THE SERIES OF PAST CHANGES IN THE ANIMATE AND INANIMATE WORLD SIR CHARLES LYELL
INTRODUCTORY NOTE
Hippocrates, the celebrated Greek physician, was a contemporary of the historian Herodotus. He was born in the island of Cos between 470 and 460 B. C., and belonged to the family that claimed descent from the mythical AEsculapius, son of Apollo. There was already a long medical tradition in Greece before his day, and this he is supposed to have inherited chiefly through his predecessor Herodicus; and he enlarged his education by extensive travel. He is said, though the evidence is unsatisfactory, to have taken part in the efforts to check the great plague which devastated Athens at the beginning of the Peloponnesian war. He died at Larissa between 380 and 360 B. C.
The works attributed to Hippocrates are the earliest extant Greek medical writings, but very many of them are certainly not his. Some five or six, however, are generally granted to be genuine, and among these is the famous "Oath." This interesting document shows that in his time physicians were already organized into a corporation or guild, with regulations for the training of disciples, and with an esprit de corps and a professional ideal which, with slight exceptions, can hardly yet be regarded as out of date.
One saying occurring in the words of Hippocrates has achieved universal currency, though few who quote it to-day are aware that it originally referred to the art of the physician. It is the first of his "Aphorisms": "Life is short, and the Art long; the occasion fleeting; experience fallacious, and judgment difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and externals cooperate."
THE OATH OF HIPPOCRATES
I swear by Apollo the physician and AEsculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation —to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.
THE LAW OF HIPPOCRATES
Medicine is of all the arts the most noble; but, owing to the ignorance of those who practice it, and of those who, inconsiderately, form a judgment of them, it is at present far behind all the other arts. Their mistake appears to me to arise principally from this, that in the cities there is no punishment connected with the practice of medicine (and with it alone) except disgrace, and that does not hurt those who are familiar with it. Such persons are like the figures which are introduced in tragedies, for as they have the shape, and dress, and personal appearance of an actor, but are not actors, so also physicians are many in title but very few in reality.
2. Whoever is to acquire a competent knowledge of medicine, ought to be possessed of the following advantages: a natural disposition; instruction; a favorable position for the study; early tuition; love of labour; leisure. First of all, a natural talent is required; for, when Nature leads the way to what is most excellent, instruction in the art takes place, which the student must try to appropriate to himself by reflection, becoming an early pupil in a place well adapted for instruction. He must also bring to the task a love of labour and perseverance, so that the instruction taking root may bring forth proper and abundant fruits.
3. Instruction in medicine is like the culture of the productions of the earth. For our natural disposition, is, as it were, the soil; the tenets of our teacher are, as it were, the seed; instruction in youth is like the planting of the seed in the ground at the proper season; the place where the instruction is communicated is like the food imparted to vegetables by the atmosphere; diligent study is like the cultivation of the fields; and it is time which imparts strength to all things and brings them to maturity.
4. Having brought all these requisites to the study of medicine, and having acquired a true knowledge of it, we shall thus, in travelling through the cities, be esteemed physicians not only in name but in reality. But inexperience is a bad treasure, and a bad fund to those who possess it, whether in opinion or reality, being devoid of self-reliance and contentedness, and the nurse both of timidity and audacity. For timidity betrays a want of powers, and audacity a lack of skill. They are, indeed, two things, knowledge and opinion, of which the one makes its possessor really to know, the other to be ignorant.
5. Those things which are sacred, are to be imparted only to sacred persons; and it is not lawful to impart them to the profane until they have been initiated in the mysteries of the science.
JOURNEYS IN DIVERSE PLACES
BY AMBROISE PARE
TRANSLATED BY STEPHEN PAGET
Ambroise Pare was born in the village of Bourg-Hersent, near Laval, in Maine, France, about 1510. He was trained as a barber- surgeon at a time when a barber-surgeon was inferior to a surgeon and the professions of surgeon and physician were kept apart by the law of the Church that forbade a physician to shed blood. Under whom he served his apprenticeship is unknown, but by 1533 he was in Paris, where he received an appointment as house surgeon at the Hotel Dieu. After three or four years of valuable experience in this hospital, he set up in private practise in Paris, but for the next thirty years he was there only in the intervals of peace; the rest of the time he followed the army. He became a master barber-surgeon in 1541.
In Pare's time the armies of Europe were not regularly equipped with a medical service. The great nobles were accompanied by their private physicians; the common soldiers doctored themselves, or used the services of barber-surgeons and quacks who accompanied the army as adventurers. "When Pare joined the army" says Paget, "he went simply as a follower of Colonel Montejan, having neither rank, recognition, nor regular payment. His fees make up in romance for their irregularity: a cask of wine, fifty double ducats and a horse, a diamond, a collection of crowns and half-crowns from the ranks, other honorable presents and of great value'; from the King himself, three hundred crowns, and a promise he would never let him be in want; another diamond, this time from the finger of a duchess: and a soldier once offered a bag of gold to him."
When Pare was a man of seventy, the Dean of the Faculty of Medicine in Paris made an attack on him on account of his use of the ligature instead of cauterizing after amputation. In answer, Pare appealed to his successful experience, and narrated the "Journeys in Diverse Places" here printed. This entertaining volume gives a vivid picture, not merely of the condition of surgery in the sixteenth century, but of the military life of the time; and reveals incidentally a personality of remarkable vigor and charm. Pare's own achievements are recorded with modest satisfaction: "I dressed him, and God healed him," is the refrain. Pare died in Paris in December, 1590.
JOURNEYS IN DIVERSE PLACES
[Footnote: The present translation is taken from Mr. Stephen
Paget's "Ambroise Pare and His Times" by arrangement with Messrs.
G. P. Putnam's Sons.]
1537-1569
THE JOURNEY TO TURIN. 1537
I will here shew my readers the towns and places where I found a way to learn the art of surgery: for the better instruction of the young surgeon.
And first, in the year 1536, the great King Francis sent a large army to Turin, to recover the towns and castles that had been taken by the Marquis du Guast, Lieutenant-General of the Emperor. M. the Constable, then Grand Master, was Lieutenant-General of the army, and M. de Montejan was Colonel-General of the infantry, whose surgeon I was at this time. A great part of the army being come to the Pass of Suze, we found the enemy occupying it; and they had made forts and trenches, so that we had to fight to dislodge them and drive them out. And there were many killed and wounded on both sides,—but the enemy were forced to give way and retreat into the castle, which was captured, part of it, by Captain Le Rat, who was posted on a little hill with some of his soldiers, whence they fired straight on the enemy. He received an arquebus-shot in his right ankle, and fell to the ground at once, and then said, "Now they have got the Rat." I dressed him, and God healed him.
We entered pell-mell into the city, and passed over the dead bodies, and some not yet dead, hearing them cry under our horses' feet; and they made my heart ache to hear them. And truly I repented I had left Paris to see such a pitiful spectacle. Being come into the city, I entered into a stable, thinking to lodge my own and my man's horse, and found four dead soldiers, and three propped against the wall, their features all changed, and they neither saw, heard, nor spake, and their clothes were still smouldering where the gunpowder had burned them. As I was looking at them with pity, there came an old soldier who asked me if there were any way to cure them; I said no. And then he went up to them and cut their throats, gently, and without ill will toward them. Seeing this great cruelty, I told him he was a villain: he answered he prayed God, when he should be in such a plight, he might find someone to do the same for him; that he should not linger in misery.
To come back to my story, the enemy were called on to surrender, which they did, and left the city with only their lives saved, and the white stick in their hands; and most of them went off to the Chateau de Villane, where about two hundred Spaniards were stationed. M. the Constable would not leave these behind him, wishing to clear the road for our own men. The castle is seated on a small hill; which gave great confidence to those within, that we could not bring our artillery to bear upon them. They were summoned to surrender, or they would be cut in pieces: they answered that they would not, saying they were as good and faithful servants of the Emperor, as M. the Constable could be of the King his master. Thereupon our men by night hoisted up two great cannons, with the help of the Swiss soldiers and the lansquenets; but as ill luck would have it, when the cannons were in position, a gunner stupidly set fire to a bag full of gunpowder, whereby he was burned, with ten or twelve soldiers; and the flame of the powder discovered our artillery, so that all night long those within the castle fired their arquebuses at the place where they had caught sight of the cannons, and many of our men were killed and wounded. Next day, early in the morning, the attack was begun, and we soon made a breach in their wall. Then they demanded a parley; but it was too late, for meanwhile our French infantry, seeing them taken by surprise, mounted the breach, and cut them all in pieces, save one very fair young girl of Piedmont, whom a great seigneur would have. … The captain and the ensign were taken alive, but soon afterward hanged and strangled on the battlements of the gate of the city, to give example and fear to the Emperor's soldiers, not to be so rash and mad as to wish to hold such places against so great an army.
The soldiers within the castle, seeing our men come on them with great fury, did all they could to defend themselves, and killed and wounded many of our soldiers with pikes, arquebuses, and stones, whereby the surgeons had all their work cut out for them. Now I was at this time a fresh-water soldier; I had not yet seen wounds made by gunshot at the first dressing. It is true I had read in John de Vigo, first book, Of Wounds in General, eighth chapter, that wounds made by firearms partake of venenosity, by reason of the powder; and for their cure he bids you cauterise them with oil of elders scalding hot, mixed with a little treacle. And to make no mistake, before I would use the said oil, knowing this was to bring great pain to the patient, I asked first before I applied it, what the other surgeons did for the first dressing; which was to put the said oil, boiling well, into the wounds, with tents and setons; wherefore I took courage to do as they did. At last my oil ran short, and I was forced instead thereof to apply a digestive made of the yolks of eggs, oil of roses, and turpentine. In the night I could not sleep in quiet, fearing some default in not cauterising, that I should find the wounded to whom I had not used the said oil dead from the poison of their wounds; which made me rise very early to visit them, where beyond my expectation I found that those to whom I had applied my digestive medicament had but little pain, and their wounds without inflammation or swelling, having rested fairly well that night; the others, to whom the boiling oil was used, I found feverish, with great pain and swelling about the edges of their wounds. Then I resolved never more to burn thus cruelly poor men with gunshot wounds.
While I was at Turin, I found a surgeon famed above all others for his treatment of gunshot wounds; into whose favour I found means to insinuate myself, to have the recipe of his balm, as he called it, wherewith he dressed gunshot wounds. And he made me pay my court to him for two years, before I could possibly draw the recipe from him. In the end, thanks to my gifts and presents, he gave it to me; which was to boil, in oil of lilies, young whelps just born, and earth-worms prepared with Venetian turpentine. Then I was joyful, and my heart made glad, that I had understood his remedy, which was like that which I had obtained by chance.
See how I learned to treat gunshot wounds; not by books.
My Lord Marshal Montejan remained Lieutenant-General for the King in Piedmont, having ten or twelve thousand men in garrison in the different cities and castles, who were often fighting among themselves with swords and other weapons, even with arquebuses. And if there were four wounded, I always had three of them; and if there were question of cutting off an arm or a leg, or of trepanning, or of reducing a fracture or a dislocation, I accomplished it all. The Lord Marshal sent me now hire now there to dress the soldiers committed to me who were wounded in other cities beside Turin, so that I was always in the country, one way or the other.
M. the Marshal sent to Milan, to a physician of no less reputation than the late M. le Grand for his success in practice, to treat him for an hepatic flux, whereof in the end he died. This physician was some while at Turin to treat him, and was often called to visit the wounded, where always he found me; and I was used to consult with him, and with some other surgeons; and when we had resolved to do any serious work of surgery, it was Ambroise Pare that put his hand thereto, which I would do promptly and skilfully, and with great assurance, insomuch that the physician wondered at me, to be so ready in the operations of surgery, and I so young. One day, discoursing with the Lord Marshal, he said to him:
"Signor, tu hai un Chirurgico giovane di anni, ma egli e vecchio di sapere e di esperientia: Guardato bene, perche egli ti fara servicio et honore." That is to say, "Thou hast a surgeon young in age, but he is old in knowledge and experience: take good care, of him, for he will do thee service and honour." But the good man did not know I had lived three years at the Hotel Dieu in Paris, with the patients there.
In the end, M. the Marshal died of his hepatic flux. He being dead, the King sent M. the Marshal d'Annebaut to be in his place: who did me the honour to ask me to live with him, and he would treat me as well or better than M. the Marshal de Montejan. Which I would not do, for grief at the loss of my master, who loved me dearly; so I returned to Paris.
THE JOURNEY TO MAROLLE AND LOW BRITTANY. 1543
I went to the Camp of Marolle, with the late M. de Rohan, as surgeon of his company; where was the King himself. M. d'Estampes, Governor of Brittany, had told the King how the English had hoist sail to land in Low Brittany; and had prayed him to send, to help him, MM. de Rohan and de Laval, because they were the seigneurs of that country, and by their help the country people would beat back the enemy, and keep them from landing. Having heard this, the King sent these seigneurs to go in haste to the help of their country; and to each was given as much power as to the Governor, so that they were all three the King's Lieutenants. They willingly took this charge upon them, and went off posting with good speed, and took me with them as far as Landreneau. There we found every one in arms, the tocsin sounding on every side, for a good five or six leagues round the harbours, Brent, Couquet, Crozon, le Fou, Doulac, Laudanec; each well furnished with artillery, as cannons, demi-cannons, culverins, muskets, falcons, arquebuses; in brief, all who came together were well equipped with all sorts and kinds of artillery, and with many soldiers, both Breton and French, to hinder the English from landing as they had resolved at their parting from England.
The enemy's army came right under our cannons: and when we perceived them desiring to land, we saluted them with cannon- shot, and unmasked our forces and our artillery. They fled to sea again. I was right glad to see their ships set sail, which were in good number and good order, and seemed to be a forest moving upon the sea. I saw a thing also whereat I marvelled much, which was, that the balls of the great cannons made long rebounds, and grazed over the water as they do over the earth. Now to make the matter short, our English did us no harm, and returned safe and sound into England. And they leaving us in peace, we stayed in that country in garrison until we were assured that their army was dispersed.
Now our soldiers used often to exercise themselves with running at the ring, or with fencing, so that there was always some one in trouble, and I had always something to employ me. M. d'Estampes, to make pastime and pleasure for the Seigneurs de Rohan and de Laval, and other gentlemen, got a number of village girls to come to the sports, to sing songs in the tongue of Low Brittany: wherein their harmony was like the croaking of frogs when they are in love. Moreover, he made them dance the Brittany triori, without moving feet or hips: he made the gentlemen see and hear many good things.
At other tunes they made the wrestlers of the towns and Villages come, where there was a prize for the best: and the sport was not ended but that one or other had a leg or arm broken, or the shoulder or hip dislocated.
There was a little man of Low Brittany, of a square body and well set, who long held the credit of the field, and by his skill and strength threw five or six to the ground. There came against him a big man, one Dativo, a pedagogue, who was said to be one of the best wrestlers in all Brittany: he entered into the lists, having thrown off his long jacket, in hose and doublet: when he was near the little man, it looked as though the little man had been tied to his girdle. Nevertheless, when they gripped each other round the neck, they were a long time without doing anything, and we thought they would remain equal in force and skill: but the little man suddenly leaped beneath this big Dativo, and took him on his shoulder, and threw him to earth on his back all spread out like a frog; and all the company laughed at the skill and strength of the little fellow. The great Dativo was furious to have been thus thrown to earth by so small a man: he rose again in a rage, and would have his revenge. They took hold again round the neck, and were again a good while at their hold without falling to the ground: but at last the big man let himself fall upon the little, and in falling put his elbow upon the pit of his stomach, and burst his heart, and killed him stark dead. And knowing he had given him his death's blow, took again his long cassock, and went away with his tail between his legs, and eclipsed himself. Seeing the little man came not again to himself, either for wine, vinegar, or any other thing presented to him, I drew near to him and felt his pulse, which did not beat at all: then I said he was dead. Then the Bretons, who were assisting at the wrestling, said aloud in their jargon, "Andraze meuraquet enes rac un bloa so abeuduex henelep e barz an gouremon enel ma hoa engoustun." That is to say, "That is not in the sport." And someone said that this great Dativo was accustomed to do so, and but a year past he had done the same at a wrestling. I must needs open the body to know the cause of this sudden death. I found much blood in the thorax. … I tried to find some internal opening whence it might have come, which I could not, for all the diligence that I could use. … The poor little wrestler was buried. I took leave of MM. de Rohan, de Laval, and d'Estampes. M. de Rohan made me a present of fifty double ducats and a horse, M. de Laval gave me a nag for my man, and M. d'Estampes gave me a diamond worth thirty crowns: and I returned to my house in Paris.
THE JOURNEY TO PERPIGNAN. 1543
Some while after, M. de Rohan took me with him posting to the camp at Perpignan. While we were there, the enemy sallied out, and surrounded three pieces of our artillery before they were beaten back to the gates of the city. Which was not done without many killed and wounded, among the others M. de Brissac, who was then grand master of the artillery, with an arquebus-shot in the shoulder. When he retired to his tent, all the wounded followed him, hoping to be dressed by the surgeons who were to dress him. Being come to his tent and laid on his bed, the bullet was searched for by three or four of the best surgeons in the army, who could not find it, but said it had entered into his body.
At last he called for me, to see if I could be more skilful than they, because he had known me in Piedmont. Then I made him rise from his bed, and told him to put himself in the same posture that he had when he was wounded, which he did, taking a javelin in his hand just as he had held his pike to fight. I put my hand around the wound, and found the bullet. … Having found it, I showed them the place where it was, and it was taken out by M. Nicole Lavernot, surgeon of M. the Dauphin, who was the King's Lieutenant in that army; all the same, the honour of finding it belonged to me.
I saw one very strange thing, which was this: a soldier in my presence gave one of his fellows a blow on the head with a halbard, penetrating to the left ventricle of the brain; yet the man did not fall to the ground. He that struck him said he heard that he had cheated at dice, and he had drawn a large sum of money from him, and was accustomed to cheat. They called me to dress him; which I did, as it were for the last time, knowing that he would die soon. When I had dressed him, he returned all alone to his quarters, which were at the least two hundred paces away. I bade one of his companions send for a priest to dispose the affairs of his soul; he got one for him, who stayed with him to his last breath. The next day, the patient sent for me by his girl, dressed in boy's apparel, to come and dress him; which I would not, fearing he would die under my hands; and to be rid of the matter I told her the dressing must not be removed before the third day. But in truth he was sure to die, though he were never touched again. The third day, he came staggering to find me in my tent, and the girl with him, and prayed me most affectionately to dress him, and showed me a purse wherein might be an hundred or sixscore pieces of gold, and said he would give me my heart's desire; nevertheless, for all that, I put off the removal of the dressing, fearing lest he should die then and there. Certain gentlemen desired me to go and dress him; which I did at their request; but in dressing him he died under my hands in a convulsion. The priest stayed with him till death, and seized his purse, for fear another man should take it, saying he would say masses for his poor soul. Also he took his clothes, and everything else.
I have told this case for the wonder of it, that the soldier, having received this great blow, did not fall down, and kept his reason to the end.
Not long afterward, the camp was broken up from diverse causes: one, because we were told that four companies of Spaniards were entered into Perpignan: the other, that the plague was spreading through the camp. Moreover, the country folk warned us there would soon be a great overflowing of the sea, which might drown us all. And the presage which they had, was a very great wind from sea, which rose so high that there remained not a single tent but was broken and thrown down, for all the care and diligence we could give; and the kitchens being all uncovered, the wind raised the dust and sand, which salted and powdered our meats in such fashion that we could not eat them; and we had to cook them in pots and other covered vessels. Nor was the camp so quickly moved but that many carts and carters, mules and mule drivers, were drowned in the sea, with great loss of baggage.
When the camp was moved I returned to Paris.
THE JOURNEY TO LANDRESY. 1544
The King raised a great army to victual Landresy. Against him the Emperor had no fewer men, but many more, to wit, eighteen thousand Germans, ten thousand Spaniards, six thousand Walloons, ten thousand English, and from thirteen to fourteen thousand horse. I saw the two armies near each other, within cannon-shot; and we thought they could not withdraw without giving battle. There were some foolish gentlemen who must needs approach the enemy's camp; the enemy fired on them with light field pieces; some died then and there, others had their arms or legs carried away. The King having done what he wished, which was to victual Landresy, withdrew his army to Guise, which was the day after All Saints, 1544; and from there I returned to Paris.
A little while after, we went to Boulogne; where the English, seeing our army, left the forts which they were holding, Moulanabert, le petit Paradis, Monplaisir, the fort of Chastillon, le Portet, the fort of Dardelot. One day, as I was going through the camp to dress my wounded men, the enemy who were in the Tour d' Ordre fired a cannon against us, thinking to kill two men-at-arms who had stopped to talk together. It happened that the ball passed quite close to one of them, which threw him to the ground, and it was thought the ball had touched him, which it did not; but only the wind of the ball full against his corselet, with such force that all the outer part of his thigh became livid and black, and he could hardly stand. I dressed him, and made diverse scarifications to let out the bruised blood made by the wind of the ball; and by the rebounds that it made on the ground it killed four soldiers, who remained dead where they fell.
I was not far from this shot, so that I could just feel the moved air, without its doing me any harm save a fright, which made me duck my head low enough; but the ball was already far away. The soldiers laughed at me, to be afraid of a ball which had already passed. Mon petit maistre, I think if you had been there, I should not have been afraid all alone, and you would have had your share of it.
Monseigneur the Due de Guise, Francois de Lorraine, was wounded before Boulogne with a thrust of a lance, which entered above the right eye, toward the nose, and passed out on the other side between the ear and the back of the neck, with so great violence that the head of the lance, with a piece of the wood, was broken and remained fast; so that it could not be drawn but save with extreme force, with smith's pincers. Yet notwithstanding the great violence of the blow, which was not without fracture of bones, nerves, veins, and arteries, and other parts torn and broken, my lord, by the grace of God, was healed. He was used to go into battle always with his vizard raised: that is why the lance passed right out on the other side.
THE JOURNEY TO GERMANY. 1552
I went to Germany, in the year 1552, with M. de Rohan, captain of fifty men-at-arms, where I was surgeon of his company, as I have said before. On this expedition, M. the Constable was general of the army; M. de Chastillon, afterward the Admiral, was chief colonel of the infantry, with four regiments of lansquenets under Captains Recrod and Ringrave, two under each; and every regiment was of ten ensigns, and every ensign of five hundred men. And beside these were Captain Chartel, who led the troops that the Protestant princes had sent to the King (this infantry was very fine, and was accompanied by fifteen hundred men-at-arms, with a following of two archers apiece, which would make four thousand five hundred horse); and two thousand light horse, and as many mounted arquebusiers, of whom M. d'Aumalle was general; and a great number of the nobility, who were come there for their pleasure. Moreover, the King was accompanied by two hundred gentlemen of his household, under the command of the Seigneurs de Boisy and de Canappe, and by many other princes. For his following, to escort him, there were the French and Scotch and Swiss guards, amounting to six hundred foot soldiers; and the companies of MM. the Dauphin, de 'Guise, d'Aumalle, and Marshal Saint Andre, amounting to four hundred lances; which was a marvellous thing, to see such a multitude; and with this equipage the King entered into Toul and Metz.
I must not omit to say that the companies of MM. de Rohan, the Comte de Sancerre, and de Jarnac, which were each of them of fifty horse, went upon the wings of the camp. And God knows how scarce we were of victuals, and I protest before Him that at three diverse times I thought to die of hunger; and it was not for want of money, for I had enough of it; but we could not get victuals save by force, because the country people collected them all into the towns and castles.
One of the servants of the captain-ensign of the company of M. de Rohan went with others to enter a church where the peasants were retreated, thinking to get victuals by love or by forces; but he got the worst of it, as they all did, and came back with seven sword wounds on the head, the least of which penetrated to the inner table of the skull; and he had four other wounds upon the arms, and one on the right shoulder, which cut more than half of the bladebone. He was brought back to his master's lodging, who seeing him so mutilated, and not hoping he could be cured, made him a grave, and would have cast him therein, saying that else the peasants would massacre and kill him: I in pity told him the man might still be cured if he were well dressed. Diverse gentlemen of the company prayed he would take him along with the baggage, since I was willing to dress him; to which he agreed, and after I had got the man ready, he was put in a cart, on a bed well covered and well arranged, drawn by a horse. I did him the office of physician, apothecary, surgeon, and cook. I dressed him to the end of his case, and God healed him; insomuch that all the three companies marvelled at this cure; The men-at-arms of the company of M. de Rohan, the first muster that was made, gave me each a crown, and the archers half a crown,
THE JOURNEY TO DANVILLIERS. 1552
On his return from the expedition against the German camp, King Henry besieged Danvilliers, and those within would not surrender. They got the worst of it, but our powder failed us; so they had a good shot at our men. There was a culverin-shot passed through the tent of H. de Rohan, which hit a gentleman leg who was of his household. I had to finish the cutting off of it, which I did without applying the hot irons.
The King sent for powder to Sedan, and when it came we began the attack mere vigorously than before, so that a breach was made. MM. de Guise and the Constable, being in the King's chamber, told him, and they agreed that next day they would assault the town, and were confident they would enter into it; and it must be kept secret, for fear the enemy should come to hear of it; and each promised not to speak of it to any man. Now there was a groom of the King's chamber, who being laid under the King's camp-bed to sleep, heard they were resolved to attack the town next day. So he told the secret to a certain captain, saying that they would make the attack next day for certain, and he had heard it from the King, and prayed the said captain to speak of it to no man, which he promised; but his promise did not hold, and forthwith he disclosed it to a captain, and this captain to a captain, and the captains to some of the soldiers, saying always, "Say nothing." And it was just so much hid, that next day early in the morning there was seen the greater part of the soldiers with their boots and breeches cut loose at the knee for the better mounting of the breach. The King was told of this rumour that ran through the camp, that the attack was to be made; whereat he was astonished, seeing there were but three in that advice, who had promised each other to tell it to no man. The King sent for M. de Guise, to know if he had spoken of this attack; he swore and affirmed to him he had not told it to anybody; and M. the Constable said the same, and told the King they must know for certain who had declared this secret counsel, seeing they were but three. Inquiry was made from captain to captain. In the end they found the truth; for one said, "It was such an one told me," and another said the same, till it came to the first of all, who declared he had heard it from the groom of the King's chamber, called Guyard, a native of Blois, son of a barber of the late King Francis. The King sent for him into his tent, in the presence of MM. de Guise and the Constable, to hear from him whence he had his knowledge, and who had told him the attack was to be made; and said if he did not speak the truth he would have him hanged. Then he declared he lay down under the King's bed thinking to sleep, and so having heard the plan he revealed it to a captain who was a friend of his, to the end he might prepare himself with his soldiers to be the first at the attack. Then the King knew the truth, and told him he should never serve him again, and that he deserved to be hanged, and forbade him ever to come again to the Court.
The groom of the chamber went away with this to swallow, and slept that night with a surgeon-in-ordinary of the King, Master Louis of Saint Andre; and in the night he gave himself six stabs with a knife, and cut his throat Nor did the surgeon perceive it till the morning, when he found his bed all bloody, and the dead body by him. He marvelled at this sight on his awaking, and feared they would say he was the cause of the murder; but he was soon relieved, seeing the reason, which was despair at the loss of the good friendship of the King.
So Guyard was buried. And those of Danvilliers, when they saw the breach large enough for us to enter, and our soldiers ready to assault them, surrendered themselves to the mercy of the King. Their leaders were taken prisoners, and their Soldiers were sent away without arms.
The camp being dispersed, I returned to Paris with my gentleman whose leg I had cut off; I dressed him, and God healed him. I sent him to his house merry with a wooden leg; and he was content saying he had got off cheap, not to have been miserably burned to stop the blood, as you write in your book, won petit matetre,
THE JOURNEY TO CHATEAU LE COMTE. 1552
Some time after. King Henry raised an army of thirty thousand men, to go and lay waste the country about Hesdin. The King of Navarre, who was then called M. de Vendosme, was chief of the army, and the King's Lieutenant. Being at St. Denis, in France, waiting while the companies passed by, he sent to Paris for me to speak with him. When I came he begged me (and his request was a command) to follow him on this journey; and I, wishing to make my excuses, saying my wife was sick in bed, he made answer there were physicians in Pairs to cure her, and he, too, had left his wife, who was of as good a house as mine, and he said he would use me well, and forthwith ordered I should be attached to his household. Seeing this great desire he had to take me with him, I dared not refuse him.
I went after him to Chateau le Comte, within three or four leagues of Hesdin. The Emperor's soldiers were in garrison there, with a number of peasants from the country road. M. de Vendosme called on them to surrender; they made answer that he should never take them, unless it were piecemeal; let him do his worst, and they would do their best to defend themselves. They trusted in their moats, which were full of water; but in two hours, with plenty of faggots and casks, we made a way for our infantry to pass over, when they had to advance to the assault; and the place was attacked with five cannons, and a breach was made large enough for our men to enter; where those within received the attack very valiantly, and killed and wounded a great number of our men with arquebuses, pikes, and stones. In the end, when they saw themselves overpowered, they set fire to their powder and ammunition, whereby many of our men were burned, and some of their own. And they were almost all put to the sword; but some of our soldiers had taken twenty or thirty, hoping to have ransom for them: and so soon as this was known, orders were given to proclaim by trumpet through the camp, that all soldiers who had Spaniards for prisoners must kill them, on pain of being themselves hanged and strangled: which was done in cold blood.
Thence we went and burned several villages; and the barns were all full of grain, to my very great regret. We came as far as Tournahan, where there was a large tower, whither the enemy withdrew, but we found the place empty: our men sacked it, and blew up the tower with a mine of gunpowder, which turned it upside down. After that, the camp was dispersed, and I returned to Paris. And the day after Chateau le Comte was taken, M. de Vendosme sent a gentleman under orders to the King, to report to him all that had happened, and among other things he told the King I had done very good work dressing the wounded, and had showed him eighteen bullets that I had taken out of their bodies, and there were many more that I had not been able to find or take out; and he spoke more good of me than there was by half. Then the King said he would take me into his service, and commanded M. de Goguier, his first physician, to write me down in the King's service as one of his surgeons-in-ordinary, and I was to meet him at Rheims within ten or twelve days: which I did. And the King did me the honour to command me to live near him, and he would be a good friend to me. Then I thanked him most humbly for the honour he was pleased to do me, in appointing me to serve him.
THE JOURNEY TO METZ. 1552
The Emperor having besieged Metz with more than an hundred and twenty thousand men, and in the hardest time of winter,—it is still fresh in the minds of all—and there were five or six thousand men in the town, and among them seven princes; MM. le Duc de Guise, the King's Lieutenant, d'Enghien, de Conde, de la Montpensier, de la Roche-sur-Yon, de Nemours, and many other gentlemen, with a number of veteran captains and officers: who often sallied out against the enemy (as I shall tell hereafter), not without heavy loss on both sides. Our wounded died almost all, and it was thought the drugs wherewith they were dressed had been poisoned. Wherefore M. de Guise, and MM. the princes, went so far as to beg the King that if it were possible I should be sent to them with a supply of drugs, and they believed their drugs were poisoned, seeing that few of their wounded escaped. My belief is that there was no poison; but the severe cutlass and arquebus wounds, and the extreme cold, were the cause why so many died. The King wrote to M. the Marshal de Saint Andre, who was his Lieutenant at Verdun, to find means to get me into Metz, whatever way was possible. MM. the Marshal de Saint Andre, and the Marshal de Vielleville, won over an Italian captain, who promised to get me into the place, which he did (and for this he had fifteen hundred crowns). The King having heard the promise that the Italian captain had made, sent for me, and commanded me to take of his apothecary, named Daigne, so many and such drugs as I should think necessary for the wounded within the town; which I did, as much as a post-horse could carry. The King gave me messages to M. de Guise, and to the princes and the captains that were in Metz.
When I came to Verdun, some days after, M. the Marshal de Saint Andre got horses for me and for my man, and for the Italian captain, who spoke excellent German, Spanish, and Walloon, beside his own mother-tongue. When we were within eight or ten leagues of Metz, we began to go by night only; and when we came near the enemy's camp I saw, more than a league and a half off, fires lighted all round the town, as if the whole earth were burning; and I believed we could never pass through these fires without being discovered, and therefore hanged and strangled, or cut in pieces, or made to pay a great ransom. To speak truth, I could well and gladly have wished myself back in Paris, for the great danger that I foresaw. God guided our business so well, that we entered into the town at midnight, thanks to a signal the captain had with another captain of the company of M. de Guise; to whom I went, and found him in bed, and he received me with high favour, being right glad at my coming.
I gave him my message as the King had commanded me, and told him I had a little letter for him, and the next day I would not fail to deliver it. Then he ordered me a good lodging, and that I should be well treated, and said I must not fail next morning to be upon the breach, where I should find all the princes and seigneurs, and many captains. Which I did, and they received me with great joy, and did me the honour to embrace me, and tell me I was welcome; adding they would no more be afraid of dying, if they should happen to be wounded.
M. le Prince de la Roche-sur-Yon was the first who entertained me, and inquired what they were saying at the Court concerning the town of Metz. I told him all that I chose to tell. Forthwith he begged me to go and see one of his gentlemen named M. de Magnane, now Chevalier of the Order of the King, and Lieutenant of His Majesty's Guards, who had his leg broken by a cannon-shot. I found him in bed, his leg bent and crooked, without any dressing on it, because a gentleman promised to cure him, having his name and his girdle, with certain words (and the poor patient was weeping and crying out with pain, not sleeping day or night for four days past). Then I laughed at such cheating and false promises; and I reduced and dressed his leg so skilfully that he was without pain, and slept all the night, and afterward, thanks be to God, he was healed, and is still living now, in the King's service. The Prince de la Roche-sur-Yon sent me a cask of wine, bigger than a pipe of Anjou, to my lodging, and told me when it was drunk, he would send me another; that was how he treated me, most generously.
After this, M, de Guise gave me a list of certain captains and seigneurs, and bade me tell them what the King had charged me to say; which I did, and this was to commend him to them, and give them his thanks for the duty they had done and were doing in holding his town of Metz, and that he would remember it. I was more than eight days acquitting myself of this charge, because they were many. First, to all the princes; then to others, as the Duke Horace, the Count de Martigues, and his brother M. de Bauge, the Seigneurs de Montmorency and d'Anville, now Marshal of France, M. de la Chapelle aux Ursins, Bonnivet, Carouge, now Governor of Rouen, the Vidasme de Chartres, the Count de Lude, M. de Biron, now Marshal of France, M. de Randan, la Rochefoucaut, Bordaille, d' Estres the younger, M. de Saint Jehan en pauphine, and many others whom it would take too long to name; and also to many captains, who had all done their duty well for the defence of their lives and of the town. Afterward I asked M. de Guise what it pleased him I should do with the drugs I had brought with me; he bade me distribute them to the surgeons and apothecaries, and principally to the poor wounded soldiers, who were in great numbers in the Hospital. Which I did, and can truly say I could not so much as go and see all the wounded, who kept sending for me to visit and dress them.
All the seigneurs within the town asked me to give special care, above all the rest; to M. de Pienne, who had been wounded, while on the breach, by a stone shot from a cannon, on the temple, with fracture and depression of the bone. They told me that so soon as he received the blow, he fell to the ground as dead, and cast forth blood by the mouth, nose, and ears, with great vomiting, and was fourteen days without being able to speak or reason; also he had tremors of a spasmodic nature, and all his face was swelled and livid, He was trepanned at the side of the temporal muscle, over the frontal bone. I dressed him, with other surgeons, and God healed him; and to-day he is still living, thank God.
The Emperor attacked the town with forty double cannons, and the powder was not spared day or night. So soon as M. de Guise saw the artillery set and pointed to make a breach, he had the nearest houses pulled down and made into ramparts, and the beams and joists were put end to end, and between them faggots, earth, beds, and wool-packs; then they put above them other beams and joists as before. And there was plenty of wood from the houses in the suburbs; which had been razed to the ground, for fear the enemy should get under cover of them, and make use of the wood; it did very well for repairing the breach. Everybody was hard at work carrying earth to repair it, day and night; MM. the princes, the seigneurs, and captains, lieutenants, ensigns, were all carrying the basket, to set an example to the soldiers and citizens to do the like, which they did; even the ladies and girls, and those who had not baskets, made use of cauldrons, panniers, sacks, sheets, and all such things to carry the earth; so that the enemy had no sooner broken down the wall than they found behind it a yet stronger rampart. The wall having fallen, our men cried out at those outside, "Fox, fox, fox," and they vented a thousand insults against one another. M. de Guise forbade any man on pain of death to speak with those outside, for fear there should be some traitor who would betray what was being done within the town. After this order, our men tied live cats to the ends of their pikes, and put them over the wall and cried with the cats, "Miaut, Miaut."
Truly the Imperials were much enraged, having been so long making a breach, at great loss, which was eighty paces wide, that fifty men of their front rank should enter in, only to find a rampart stronger than the wall. They threw themselves upon the poor cats, and shot them with arquebuses as men shoot at the popinjay.
Our men often ran out upon them, by order of M. de Guise; a few days ago, our men had all made haste to enrol themselves in sallying-parties, chiefly the young nobility, led by experienced captains; and indeed it was doing them a great favour to let them issue from the town and run upon the enemy. They went forth always an hundred or six score men, well armed with cutlasses, arquebuses, pistols, pikes, partisans, and halbards; and advanced as far as the trenches, to take the enemy unawares. Then an alarum would be sounded all through the enemy's camp, and their drums would beat plan, plan, ta ti ta, ta ta ti ta, tou touf touf. Likewise their trumpets and clarions rang and sounded, To saddle, to saddle, to saddle, to horse, to horse, to horse, to saddle, to horse, to horse. And all their soldiers cried, "Arm, arm arm! to arms, to arms, to arms! arm, to arms, arm, to arms, arm":—like the hue-and-cry after wolves; and all diverse tongues, according to their nations; and you saw them come out of their tents and little lodgings, as thick as little ants when you uncover the ant-hills, to bring help to their comrades, who were having their throats cut like sheep. Their cavalry also came from all sides at full gallop, patati, patata, patati, patata, pa, ta, ta, patata pata, ta, eager to be in the thick of the fighting, to give and take their share of the blows. And when our men saw themselves hard pressed, they would turn back into the town, fighting all the way; and those pursuing them were driven back with cannon-shots, and the cannons were loaded with flint-stones and with big pieces of iron, square or three-sided. And our men on the wall fired a volley, and rained bullets on them as thick as hail, to send them back to their beds; whereas many remained dead on the field: and our men also did not all come back with whole skins, and there were always some left behind (as it were a tax levied on us) who were joyful to die on the bed of honour. And if there was a horse wounded, it was skinned and eaten by the soldiers, instead of beef and bacon; and if a man was wounded, I must run and dress him. Some days afterward there were other sallies, which infuriated the enemy, that we would not let him sleep a little in safety.
M. de Guise played a trick upon them: he sent a peasant, who was none of the wisest, with two letters to the King, and gave him ten crowns, and promised the King would give him an hundred if he got the letters to him. In the one letter M. de Guise told the King that the enemy shewed no of retreating, and had put forth all their strength made a great breach, which he hoped to defend, even at the cost of his own life and of all who were in the town; and that the enemy had planted their artillery so well in a certain place (which he named) that it was with great difficulty he could keep them from entering the town, seeing it was the weakest place in the town; but soon he hoped to rebuild it well, so that they should not be able to enter. This letter was sewed in the lining of the man's doublet, and he was told to be very careful not to speak of it to any person. And the other letter was given to him, wherein M. de Guise told the King that he and all those besieged with him hoped to guard the town well; and other matters which I leave untold here. He sent out the man at night, and he was taken by the enemy's guard and brought to the Duke of Alva, that the Duke might hear what was doing in the town; and the peasant was asked if he had any letters. He said "Yes," and gave them the one; and they having seen it asked him if he had not another. He said "No." Then he was searched, and they found on him that which was sewed in his doubtlet; and the poor messenger was handed and strangled.
The letters were taken to the Emperor, who called his council, where it was resolved, since they had been unable to do anything at the first breach, the artillery should forthwith be set against the place which they thought weakest, where they put forth all their strength to make a fresh breach; and they sapped and mined the wall, and tried hard to make a way into the Hell Tower, but dared not assault it openly.
The Duke of Alva represented to the Emperor that every day their soldiers were dying, to the number of more than two hundred, and there was so little hope of entering the town, seeing the time of year and the great number of our soldiers who were in it. The Emperor asked what men they were who were dying, and whether they were gentlemen and men of mark; answer was made to him "They were all poor soldiers." Then said he, "It was no great loss if they died," comparing them to caterpillars, grasshoppers, and cockchafers, which eat up the buds and other good things of the earth; and if they were men of any worth they would not be in his camp at six livres the month, and therefore it was no great harm if they died. Moreover, he said he would never depart from the town till he had taken it by force or by famine, though he should lose all his army; because of the great number of princes who were shut up in it, with the greater part of the nobility of France, who he hoped would pay his expenses four times over; and he would go yet again to Paris, to see the Parisians, and to make himself King of all the kingdom of France.
M. de Guise, with the princes, captains, and soldiers, and in general all the citizens of the town, having heard the Emperor's resolve to exterminate us all, forbade the soldiers and citizens, and even the princes and seigneurs, to eat fresh fish or venison, or partridges, woodcocks, larks, francolines, plovers, or other game, for fear these had acquired any pestilential air which could bring infection among us. So they had to content themselves with the fare of the army; biscuit, beef, salt cow-beef, bacon, cervelas, and Mayence hams; also fish, as haddock, salmon, shad, tunny, whale, anchovy, sardines, herrings; also peas, beans, rice, garlic, onions, prunes, cheeses, butter, oil, and salt; pepper, ginger, nutmegs and other spices to put in our pies, mostly of horses, which without the spice had a very bad taste. Many citizens, having gardens in the town, had planted them with fine radishes, turnips, carrots, and leeks, which they kept flourishing and very dear, for the extreme necessity of the famine. Now all these stores were distributed by weight, measure, and justice, according to the quality of the persons, because we knew not how long the siege would last. For after we heard the Emperors words, how he would not depart from before Metz, till he had taken it by force or by famine, the victuals were cut down; and what they used to distribute to three soldiers was given to four; and it was forbidden to them to sell the remains which might be left after their meals; but they might give them to the rabble. And they always rose from table with an appetite, for fear they should be subject to take physick.
And before we surrendered to the mercy of the enemy, we had determined to eat the asses, mules, and horses, dogs, cats, and rats, even our boots and collars, and other skins that we could have softened and stewed. And, in a word, all the besieged were resolved to defend themselves valiantly with all instruments of war; to set the artillery at the entry of the breach, and load with balls, stones, cart-nails, bars and chains of iron; also all sorts and kinds of artificial fires, as barricadoes, grenades, stink-pots, torches, squibs, fire-traps, burning faggots; with boiling water, melted lead, and lime, to put out the enemy's eyes. Also, they were to make holes right through their houses, and put arquebusiers in them, to take the enemy in flank and hasten his going, or else give him stop then and there. Also they were to order the women to pull up the streets, and throw from their windows billets, tables, trestles, benches, and stools, to dash out the enemy's brains. Moreover, a little within the breach, there was a great stronghold full of carts and palisades, tuns and casks; and barricades of earth to serve as gabions, interlaid with falconets, falcons, field-pieces, crooked arquebuses, pistols, arquebuses, and wildfires, to break their legs and thighs, so that they would be taken from above and on the flank and from behind; and if they had carried this stronghold, there were others where the streets crossed, every hundred paces, which would have been as bad friends to them as the first, or worse, and would have made many widows and orphans. And if fortune had been so hard on us that they had stormed and broken up our strongholds, there would yet have been seven great companies, drawn up in square and in triangle, to fight them all at once, each led by one of the princes, for the better encouragement of our men to fight and die all together, even to the last breath of their souls. And all were resolved to bring their treasures, rings, and jewels, and their best and richest and most beautiful household stuffs, and burn them to ashes in the great square, lest the enemy should take them and make trophies of them. Also there were men charged to set fire to all the stores and burn them, and to stave in all the wine-casks; others to set fire to every single house, to burn the enemy and us together. The citizens thus were all of one mind, rather than see the bloody knife at their throats, and their wives and daughters ravished and taken by the cruel savage Spaniards.
Now we had certain prisoners, who had been made secretly to understand our last determination and desperation; these prisoners M. de Guise sent away on parole, who being come to their camp, lost no time in saying what we had told them; which restrained the great and vehement desire of the enemy, so that they were no longer eager to enter the town to cut our throats and enrich themselves with the spoils. The Emperor, having heard the decision of this great warrior, M. de Guise, put water in his wine, and restrained his fury; saying that he could not enter the town save with vast butchery and carnage, and shedding of much blood, both of those defending and of those attacking, and they would be all dead together, and in the end he would get nothing but ashes; and afterward men might say it was a like destruction to that of the town of Jerusalem, made of old time by Titus and Vespasian.
The Emperor thus having heard our last resolve, and seeing how little he had gained by his attack, sappings, and mines, and the great plague that was through all his camp, and the adverse time of the year, and the want of victuals and of money, and how his soldiers were disbanding themselves and going off in great companies, decided at last to raise the siege and go away, with the cavalry of his vanguard, and the greater part of the artillery and engines of war. The Marquis of Brandebourg was the last to budge from his place; he had with him some troops of Spaniards and Bohemians, and his German regiments, and there he stopped for a day and a half, to the great regret of M. de Guise, who brought four pieces of artillery out of the town, which he fired on him this side and that, to hurry him off: and off he went, sure enough, and all his men with him.
When he was a quarter of a league from Metz, he was seized with a panic lest our cavalry should fall upon his tail; so he set fire to his store of powder, and left behind him some pieces of artillery, and a quantity of baggage, which he could not take along with him, because their vanguard and their great cannons had broken and torn tip the roads. Our cavalry were longing with all their hearts to issue from the town and attack him behind; but M. de Guise never let them, saying on the contrary we had better make their way smooth for them, and build them gold and silver bridges to let them go; like the good pastor and shepherd, who will not lose one of his sheep.
That is how our dear and well-beloved Imperials went away from Metz, which was the day after Christmas Day, to the great content of those within the walls, and the praise of the princes, seigneurs, captains, and soldiers, who had endured the travail of this siege for more than two months. Nevertheless, they did not all go: there wanted more than twenty thousand of them, who were dead, from our artillery and the fighting, or from plague, cold, and starvation (and from spite and rage that they could not get into the town to cut our throats and plunder us): and many of their horses also died, the greater part whereof they had eaten instead of beef and bacon. We went where their camp had been, where we found many dead bodies not yet buried, and the earth all worked up, as one sees in the Cemetery of the Holy Innocents during some time of many deaths. In their tents, pavilions, and lodgings were many sick people. Also cannon-shot, weapons, carts, waggons, and other baggage, with a great quantity of soldier's bread, spoiled and rotted by the snows and rains (yet the soldiers had it but by weight and measure). Also they left a good store of wood, all that remained of the houses they had demolished and broken down in the villages for two or three leagues around; also many other pleasure-houses, that had belonged to our citizens, with gardens and fine orchards full of diverse fruit-trees. And without all this, they would have been benumbed and dead of the cold, and forced to raise the siege sooner than they did.
M. de Guise had their dead buried, and their sick people treated. Also the enemy left behind them in the Abbey of Saint Arnoul many of their wounded soldiers, whom they could not possibly take with them. M. de Guise sent them all victuals enough, and ordered me and the other surgeons to go dress and physick them, which we did with good will; and I think they would not have done the like for our men. For the Spaniard is very cruel, treacherous, and inhuman, and so far enemy of all nations: which is proved by Lopez the Spaniard, and Benzo of Milan, and others who have written the history of America and the West Indies: who have had to confess that the cruelty, avarice, blasphemies, and wickedness of the Spaniards have utterly estranged the poor Indians from the religion that these Spaniards professed. And all write that they are of less worth than the idolatrous Indians, for their cruel treatment of these Indians.
And some days later M. de Guise sent a trumpet to Thionville to the enemy, that they could send for their wounded in safety: which they did with carts and waggons, but not enough. M. de Guise gave them carts and carters, to help to take them to Thionville. Our carters, when they returned, told us the roads were all paved with dead bodies, and they never got half the men there, for they died in their carts: and the Spaniards seeing them at the point of death, before they had breathed their last, threw them out of the carts and buried them in the mud and mire, saying they had no orders to bring back dead men. Moreover, our carters said they had found on the roads many carts stuck in the mud, full of baggage, for which the enemy dared not send back, lest we who were within Metz should run out upon them.
I would return to the reason why so many of them died; which was mostly starvation, the plague, and cold. For the snow was more than two feet deep upon the ground, and they were lodged in pits below the ground, covered only with a little thatch. Nevertheless, each soldier had his camp-bed, and a coverlet all strewed with stars, glittering and shining brighter than fine gold, and every day they had white sheets, and lodged at the sign of the Moon, and enjoyed themselves if only they had been able, and paid their host so well over night that in the morning they went off quits, shaking their ears; and they had no need of a comb to get the down and feathers out of their beards and hair, and they always found a white table-cloth, and would have enjoyed good meals but for want of food. Also the greater part of them had neither boots, half-boots, slippers, hose, nor shoes: and most of them would rather have none than any, because they were always in the mire up to mid-leg. And because they went bare- foot, we called them the Emperor's Apostles.
After the camp was wholly dispersed, I distributed my patients into the hands of the surgeons of the town, to finish dressing them: then I took leave of M. de Guise, and returned to the King, who received me with great favour, and asked me how I had been able to make my way into Metz. I told him fully all that I had done. He gave me two hundred crowns, and an hundred which I had when I set out: and said he would never leave me poor. Then I thanked him very humbly for the good and the honour he was pleased to do me.
THE JOURNEY TO HESDIN. 1553
The Emperor Charles laid siege to the town of Therouenne; and M. le Due de Savoie was General of his whole army. It was taken by assault: and there was a great number of our men killed and taken prisoners.
The King, wishing to prevent the enemy from besieging the town and castle of Hesdin also, sent thither MM. le Duc de Bouillon, le Duc Horace, le Marquis de Villars, and a number of captains, and about eighteen hundred soldiers: and during the siege of Therouenne, these Seigneurs fortified the castle of Hesdin, so that it seemed to be impregnable. The King sent me to the Seigneurs, to help them with my art, if they should come to have need of it.
Soon after the capture of Therouenne, we were besieged in Hesdin. There was a clear stream of running water within shot of our cannon, and about it were fourscore or an hundred of the enemy's rabble, drawing water. I was on a rampart watching the enemy pitch their camp; and, seeing the crowd of idlers round the stream, I asked M. du Pont, commissary of the artillery, to send one cannon-shot among this canaille: he gave me a flat refusal, saying that all this sort of people was not worth the powder would be wasted on them. Again I begged him to level the cannon, telling him, "The more dead, the fewer enemies;" which he did for my sake: and the shot killed fifteen or sixteen, and wounded many. Our men made sorties against the enemy, wherein many were killed and wounded on both sides, with gunshot or with fighting hand to hand; and our men often sallied out before their trenches were made; so that I had my work cut out for me, and had no rest either day or night for dressing the wounded.
And here I would note that we had put many of them in a great tower, laying them on a little straw: and their pillows were stones, their coverlets were cloaks, those who had any. When the attack was made, so often as the enemy's cannons were fired, our wounded said they felt pain in their wounds, as if you had struck them with a stick: one was crying out on his head, the other on his arm, and so with the other parts of the body: and many had their wounds bleed again, even more profusely than at the time they were wounded, and then I had to run to staunch them. Mon petit maistre, if you had been there, you would have been much hindered with your hot irons; you would have wanted a lot of charcoal to heat them red, and sure you would have been killed like a calf for your cruelty. Many died of the diabolical storm of the echo of these engines of artillery, and the vehement agitation and severe shock of the air acting on their wounds; others because they got no rest for the shouting and crying that were made day and night, and for want of good food, and other things needful for their treatment. Mon petit maistre, if you had been there, no doubt you could have given them jelly, restoratives, gravies, pressed meats, broth, barley-water, almond-milk, blanc-mange, prunes, plums, and other food proper for the sick; but your diet would have been only on paper, and in fact they had nothing but beef of old shrunk cows, seized round Hesdin for our provision, salted and half-cooked, so that he who would eat it must drag at it with his teeth, as birds of prey tear their food. Nor must I forget the linen for dressing their wounds, which was only washed daily and dried at the fire, till it was as hard as parchment: I leave you to think how their wounds could do well. There were four big fat rascally women who had charge to whiten the linen, and were kept at it with the stick; and yet they had not water enough to do it, much less soap. That is how the poor patients died, for want of food and other necessary things.
One day the enemy feigned a general attack, to draw our soldiers into the breach, that they might see what we were like: every man ran thither. We had made a great store of artificial fires to defend the breach; a priest of M. le Duc de Bouillon took a grenade, thinking to throw it at the enemy, and lighted it before he ought: it burst, and set fire to all our store, which was in a house near the breach. This was a terrible disaster for us, because it burned many poor soldiers; it even caught the house, and we had all been burned, but for help given to put it out; there was only one well in the castle with any water in it, and this was almost dry, and we took beer to put it out instead of water; afterward we were in great want of water, and to drink what was left we must strain it through napkins.
The enemy, seeing the explosion and violence of the fires, which made a wonderful flame and thundering, thought we had lit them on purpose to defend the breach, and that we had many more of them. This made them change their minds, to have us some other way than by attack: they dug mines, and sapped the greater part of our walls, till they came near turning our castle altogether upside down; and when the sappers had finished their work, and their artillery was fired, all the castle shook under our feet like an earthquake, to our great astonishment. Moreover, they had levelled five pieces of artillery, which they had placed on a little hillock, so as to have us from behind when we were gone to defend the breach. M. le Duc Horace had a cannonshot on the elbow, which carried off his arm one way and his body the other, before he could say a single word; his death was a great disaster to us, for the high rank that he held in the town. Also M. de Martigues had a gunshot wound which pierced his lungs: I dressed him, as I shall tell hereafter.
Then we asked leave to speak with the enemy; and a trumpet was sent to the Prince of Piedmont, to know what terms he would give us. He answered that all the leaders, such as gentlemen, captains, lieutenants, and ensigns, would be taken prisoners for ransom, and the soldiers would leave the town without their arms; and if we refused this fair and honest offer, we might rest assured they would take us next day, by attack or otherwise.
A council was held, to which I was called, to know if I would sign the surrender of the town; with many captains, gentlemen, and others. I answered it was not possible to hold the town, and I would sign the surrender with my own blood, for the little hope I had we could resist the enemy's forces, and for the great longing I had to be out of this hell and utter torture; for I slept neither night nor day for the great number of the wounded, who were about two hundred. The dead were advanced in putrefaction, piled one upon the other like faggots, and not covered with earth, because we had none. And if I went into a soldier's lodging, there were soldiers waiting for me at the door when I came out, for me to dress others; it was who should have me, and they carried me like the body of a saint, with my feet off the ground, fighting for me. I could not satisfy this great number of wounded: nor had I got what I wanted for their treatment. For it is not enough that the surgeon do his duty toward his patients, but the patient also must do his; and the assistants, and external things, must work together for him: see Hippocrates, Aphorism the First.
Having heard that we were to surrender the place, I knew our business was not prospering; and for fear of being known, I gave a velvet coat, a satin doublet, and a cloak of fine cloth trimmed with velvet, to a soldier; who gave me a bad doublet all torn and ragged with wear, and a frayed leather collar, and a bad hat, and a short cloak; I dirtied the neck of my shirt with water mixed with a little soot, I rubbed my hose with a stone at the knees and over the heels, as though they had been long worn, I did the same to my shoes, till one would have taken me for a chimney- sweep rather than a King's surgeon. I went in this gear to M. de Martigues, and prayed him to arrange I should stop with him to dress him; which he granted very willingly, and was as glad I should be near him as I was myself.
Soon afterward, the commissioners who were to select the prisoners entered the castle, the seventeenth day of July, 1553. They took prisoners MM. le Due de Bouillon, le Marquis de Villars, de Roze, le Baron de Culan, M. du Pont, commissary of the artillery, and M. de Martigues; and me with him, because he asked them; and all the gentlemen who they knew could pay ransom, and most of the soldiers and the leaders of companies; so many and such prisoners as they wished. And then the Spanish soldiers entered by the breach, unresisted; our men thought they would keep their faith and agreement that all lives should be spared. They entered the town in a fury to kill, plunder, and ravage everything: they took a few men, hoping to have ransom for them. … If they saw they could not get it, they cruelly put them to death in cold blood. … And they killed them all with daggers, and cut their throats. Such was their great cruelty and treachery; let him trust them who will.
To return to my story: when I was taken from the castle into the town, with M. de Martigues, there was one of M. de Savoie's gentlemen, who asked me if M. de Martigues's wound could be cured. I told him no, that it was incurable: and off he went to tell M. le Due de Savoie. I bethought myself they would send physicians and surgeons to dress M. de Martigues; and I argued within myself if I ought to play the simpleton, and not let myself be known for a surgeon, lest they should keep me to dress their wounded, and in the end I should be found to be the King's surgeon, and they would make me pay a big ransom. On the other hand, I feared, if I did not show I was a surgeon and had dressed M. de Martigues skilfully, they would cut my throat. Forthwith I made up my mind to show them he would not die for want of having been well dressed and nursed.
Soon after, sure enough, there came many gentlemen, with the Emperor's physician, and his surgeon, and those belonging to M. de Savoie, and six other surgeons of his army, to see M. de Martigues's wound, and to know of me how I had dressed and treated it. The Emperor's physician bade me declare the essential nature of the wound, and what I had done for it. And all his assistants kept their ears wide open, to know if the wound were or were not mortal. I commenced my discourse to them, how M. Martigues, looking over the wall to mark those who were sapping it, was shot with an arquebus through the body, and I was called of a sudden to dress him. I found blood coming from his mouth and from his wounds. Moreover, he bad a great difficulty of breathing in and out, and air came whistling from the wounds, so that it would have put out a candle; and he said he had a very great stabbing pain where the bullet had entered. … I withdrew some scales of bone, and put in each wound a tent with a large head, fastened with a thread, lest on inspiration it should be drawn into the cavity of the chest; which has happened with surgeons, to the detriment of the poor wounded; for being fallen in, you cannot get them out; and then they beget corruption, being foreign bodies. The tents were anointed with a preparation of yolk of egg, Venice turpentine, and a little oil of roses. … I put over the wounds a great plaster of diachylum, wherewith I had mixed oil of roses, and vinegar, to avoid inflammation. Then I applied great compresses steeped in oxycrate, and bandaged him, not too tight, that he might breathe easily. Next, I drew five basons of blood from his right arm, considering his youth and his sanguine temperament. … Fever took him, soon after he was wounded, with feebleness of the heart. … His diet was barley- water, prunes with sugar, at other times broth: his drink was a ptisane. He could lie only on his back. … What more shall I say? but that my Lord de Martigues never had an hour's rest after he was wounded. … These things considered, Gentlemen, no other prognosis is possible, save that he will die in a few days, to my great grief.
Having finished my discourse, I dressed him as I was accustomed. When I displayed his wounds, the physicians and surgeons, and other assistants present, knew the truth of what I had said. The physicians, having felt his pulse and seen that the vital forces were depressed and spent, agreed with me that in a few days he would die. Then they all went to the Duc de Savoie, and told him M. de Martigues would die in a short time. He answered them, "Possibly, if he had been well dressed, he might have escaped death." Then they all with one voice said he had been very well dressed and cared for altogether, and it could not be better, and it was impossible to cure him, and his wound was of necessity mortal. Then M. de Savoie was very angry with them, and cried, and asked them again if for certain they all held his case hopeless: they answered, yes.
Then a Spanish impostor came forward, who promised on his life to cure him; and if he did not, they should cut him in an hundred pieces; but he would have no physicians, nor surgeons nor apothecaries with him: and M. le Duc de Savoie forthwith bade the physicians and surgeons not go near M. de Martigues; and sent a gentleman to bid me, under pain of death, not so much as to touch him. Which I promised, and was very glad, for now he would not die under my hands; and the impostor was told to dress him, and to have with him no other physicians or surgeons, but only himself. By and bye he came, and said to M. de Martigues, "Senor Cavallero, M. de Savoie has bid me come and dress your wound. I swear to God, before eight days I will set you on horseback, lance in hand, provided none touch you but I alone. You shall eat and drink whatever you like. I will be dieted instead of you; and you may trust me to perform what I promise. I have cured many who had worse wounds than yours." And the Seigneurs answered him, "God give you His grace for it."
He asked for a shirt of M. de Martigues, and tore it in little strips, which he laid cross-wise, muttering and murmuring certain words over the wounds: having done this much for him, he let him eat and drink all he would, saying he himself would be dieted in his stead; which he did, eating but six prunes and six morsels of bread for dinner, and drinking only beer. Nevertheless, two days later, M. de Martigues died: and my friend the Spaniard, seeing him at the point of death, eclipsed himself, and got away without good-bye to any man. And I believe if he had been caught he would have been hanged and strangled, for the false promise he made to M. le Due de Savoie and many other gentlemen. M. de Martigues died about ten o'clock in the morning; and after dinner M. de Savoie sent the physicians and surgeons, and his apothecary, with a store of drugs to embalm him. They came with many gentlemen and captains of his army.
The Emperor's surgeon came to me, and asked me in a very friendly way to make, the embalmment; which I refused, saying that I was not worthy to carry his instrument-box after him. He begged me again to do it to please him, and that he would be very glad of it…Seeing his kindness, and fearing to displease him, I then decided to show them the anatomist that I was, expounding to them many things, which would here be too long to recite… Our discourse finished, I embalmed the body; and it was placed in a coffin. Then the Emperor's surgeon drew me aside, and told me, if I would stop with him, he would treat me well, and give me a new suit of clothes, and set me on horseback. I gave him many thanks, and said I had no wish to serve any country but my own. Then he told me I was a fool, and if he were a prisoner as I was, he would serve a devil to get his freedom. In the end I told him flat I would not stop with him. The Emperor's physician then went back to M. de Savoie, and explained to him the causes of M. de Martigues' death, and that it was impossible for all the men in the world to have cured him; and assured him again I had done all that was to be done, and besought him to take me into his service; saying much more good of me than there was. He having been persuaded to do this, sent to me one of his stewards, M. du Bouchet, to tell me, if I would serve him, he would use me well; I sent back my very humble thanks, and that I had decided not to take service under any foreigner. When he heard my answer he was very angry, and said I ought to be sent to the galleys.
M. de Vaudeville, Governor of Graveline, and colonel of seventeen ensigns of infantry, asked him to send me to him, to dress an old ulcer on his leg, that he had had for six or seven years. M. de Savoie said he was willing, so far as I was concerned; and if I used the cautery to his leg, it would serve him right. M. de Vaudeville answered, if he saw me trying it, he would have my throat cut. Soon after, he sent for me four German halberdiers of his guard; and I was terrified, for I did not know where they were taking me: they spoke no more French than I German. When I was come to his lodging, he bade me welcome, and said, now I belonged to him; and so soon as I had healed him, he would let me go without ransom. I told him I had no means to pay any ransom. He called his physician and his surgeon-in-ordinary, to show me his leg; and when we had examined it, we withdrew into a room, where I began my discourse to them. … Then the physician left me with the surgeon, and went back to M. de Vaudeville, and said he was sure I could cure him, and told him all I had decided to do; which pleased him vastly. He sent for me, and asked if I thought I could cure him; I said yes, if he were obedient to what was necessary. He promised to do only what I wished and ordered; and so soon as he was healed, he would let me go home without ransom. Then I asked him to make better terms with me, saying it was too long to wait for my liberty: in fifteen days I hoped his ulcer would be less than half its present size, and give no pain; then his own surgeon and physician could finish the cure. He granted this to me. Then I took a piece of paper to measure the size of the ulcer, and gave it to him, and kept another by me; I asked him to keep his promise, when I had done my work; he swore by the faith of a gentleman he would. Then I set myself to dress him properly, after the manner of Galen. … He wished to know if it were true, what I said of Galen, and bade his physician look to it, for he would know it for himself; he had the book put on the table, and found that what I said was true; so the physician was ashamed, and I was glad. Within the fifteen days, it was almost all healed; and I began to feel happy about the compact made between us. He had me to eat and drink at his table, when there were no more great persons than he and I only. He gave me a big red scarf which I must wear; which made me feel something like a dog when they give him a clog, to stop him eating the grapes in the vineyards. His physician and surgeon took me through the camp to visit their wounded; and I took care to observe what our enemy was doing. I found they had no more great cannons, but only twenty-five or thirty field-pieces.
M. de Vaudeville held prisoner M. de Bauge, brother of M. de Martigues who died at Hesdin. M. de Bauge was prisoner at Chateau de La Motte au Bois, belonging to the Emperor; he had been captured at Therouenne by two Spanish soldiers; and M. de Vaudeville, when he saw him there, concluded he must be some gentleman of good family: he made him pull off his stockings, and seeing his clean legs and feet, and his fine white stockings, knew he was one to pay a good ransom. He told the soldiers he would give them thirty crowns down for their prisoner: they agreed gladly, for they had no place to keep him, nor food for him, nor did they know his value: so they gave their man into his hands, and he sent him off at once, guarded by four of his own soldiers, to Chateau de La Motte au Bois, with others of our gentlemen who were prisoners.
M. de Bauge would not tell who he was; and endured much hardship, living on bread and water, with a little straw for his bed. When Hesdin was taken, M. de Vaudeville sent the news of it to him and to the other prisoners, and the list of the killed, and among them M. de Martigues: and when M. de Bauge heard with his own ears his brother was dead, he fell to crying, weeping, and lamentation. His guards asked him why he was so miserable: he told them, for love of M. de Martigues, his brother. When he heard this, the captain of the castle sent straight to tell M. de Vaudeville he had a good prisoner: who was delighted at this, and sent me next day with four soldiers, and his own physician, to the castle, to say that if M. de Bauge would pay him fifteen thousand crowns ransom, he would send him home free: and he asked only the security of two Antwerp merchants that he should name. M. de Vaudeville persuaded me I should commend this offer to his prisoner: that is why he sent me to the castle. He told the captain to treat him well and put him in a room with hangings, and strengthen his guard: and from that time onward they made a great deal of him, at the expense of M. de Vaudeville.
M. de Bauge answered that he could not pay his ransom himself: it depended on M. d' Estampes his uncle, and Mlle. de Bressure his aunt: he had no means to pay such a ransom. I went back with my guards, and gave this answer to M. de Vaudeville; who said, "Possibly he will not get away so cheap": which was true, for they knew who he was. Then the Queen of Hungary and M. le Duc de Savoie sent word to M. de Vaudeville that this mouthful was too big for him, and he must send his prisoner to them (which he did), and he had other prisoners enough without him. The ransom paid was forty thousand crowns, without other expenses.
On my way back to M. de Vaudeville, I passed by Saint Omer, where I saw their great cannons, most of which were fouled and broken. Also I passed by Therouenne, where I saw not one stone left on another, save a vestige of the great church: for the Emperor ordered the country people for five or six leagues round to clear and take away the stones; so that now you may drive a cart over the town: and the same at Hesdin, and no trace of castle and fortress. Such is the evil that wars bring with them.
To return to my story; M. de Vaudeville soon got the better of his ulcer, and was nearly healed: so he let me go, and sent me by a trumpet, with passport, as far as Abbeville. I posted from here, and went to find my master, King Henry, at Aufimon, who received me gladly and with good favour. He sent MM. de Guise, the Constable, and d' Estres, to hear from me the capture of Hesdin; and I made them a true report, and assured them I had seen the great cannons they had taken to Saint Omer: and the King was glad, for he had feared the enemy would come further into France. He gave me two hundred crowns to take me home: and I was thankful to be free, out of this great torment and thunder of the diabolical artillery, and away from the soldiers, blasphemers and deniers of God. I must add that after Hesdin was taken, the King was told I was not killed but taken prisoner. He made M. Goguier, his chief physician, write to my wife that I was living, and she was not to be unhappy, and he would pay my ransom.
BATTLE OF SAINT QUENTIN. 1557
After the battle of Saint Quentin, the King sent me to La Fere en Tartenois, to M. le Marechal de Bourdillon, for a passport to M. le Duc de Savoie, that I might go and dress the Constable, who had been badly wounded in the back with a pistol-shot, whereof he was like to die, and remained prisoner in the enemy's hands. But never would M. le Duc de Savoie let me go to him, saying he would not die for want of a surgeon; that he much doubted I would go there only to dress him, and not rather to take some secret information to him; and that he knew I was privy to other things besides surgery, and remembered I had been his prisoner at Hesdin. M. le Marechal told the King of this refusal: who wrote to M. le Marechal, that if Mme. the Constable's Lady would send some quick-witted man of her household I would give him a letter, and had also something to say to him by word of mouth, entrusted to me by the King and by M. le Cardinal de Lorraine. Two days later there came one of the Constable's gentlemen of the bedchamber, with his shirts and other linen, to whom M. le Marechal gave a passport to go to the Constable. I was very glad, and gave him my letter, and instructed him what his master must do now he was prisoner.
I thought, having finished my mission, to return to the King; but M. le Marechal begged me to stop at La Fere with him, to dress a very great number of wounded who had retreated there after the battle, and he would write to the King to explain why I stopped; which I did. Their wounds were very putrid, and full of worms, with gangrene, and corruption; and I had to make free play with the knife to cut off what was corrupt, which was not done without amputation of arms and legs, and also sundry trepannings. They found no store of drugs at La Fere, because the surgeons of the camp had taken them all away; but I found the waggons of the artillery there, and these had not been touched. I asked M. le Marechal to let me have some of the drugs which were in them, which he did; and I was given the half only at one time, and five or six days later I had to take the rest; and yet it was not half enough to dress the great number of wounded. And to correct and stop the corruption, and kill the worms in their wounds, I washed them with Aegyptiacum dissolved in wine and eau-de-vie, and did all I could for them; but in spite of all my care many of them died.
There were at La Fere some gentlemen charged to find the dead body of M. de Bois-Dauphin the elder, who had been killed in the battle; they asked me to go with them to the camp, to pick him out, if we could, among the dead; but it was not possible to recognize him, the bodies being all far gone in corruption, and their faces changed. We saw more than half a league round us the earth all covered with the dead; and hardly stopped there, because of the stench of the dead men and their horses; and so many blue and green flies rose from them, bred of the moisture of the bodies and the heat of the sun, that when they were up in the air they hid the sun. It was wonderful to hear them buzzing; and where they settled, there they infected the air, and brought the plague with them. Mon petit maistre, I wish you had been there with me, to experience the smells, and make report thereof to them that were not there.
I was very weary of the place; I prayed M. le Marechal to let me leave it, and feared I should be ill there; for the wounded men stank past all bearing, and they died nearly all, in spite of everything we did. He got surgeons to finish the treatment of them, and sent me away with his good favour. He wrote to the King of the diligence I had shown toward the poor wounded. Then I returned to Paris, where I found many more gentlemen, who had been wounded and gone thither after the battle.
THE JOURNEY TO THE CAMP AT AMIENS. 1558
The King sent me to Dourlan, under conduct of Captain Gouast; with fifty men-at-arms, for fear I should be taken by the enemy; and seeing we were always in alarms on the way, I made my man let down, and made him the master; for I got on his horse, which carried my valise, and could go well if we had to make our escape, and I took his cloak and hat and gave him my mount, which was a good little mare; he being in front, you would have taken him for the master and me for the servant The garrison inside Dourlan, when they saw us, thought we were the enemy, and fired their cannon at us. Captain Gouast, my conductor, made signs to them with his hat that we were not the enemy; at last they ceased firing, and we entered Dourlan, to our great relief.
Five or six days before this, a sortie had been made from Dourlan; wherein many captains and brave soldiers had been killed or wounded: and among the wounded was Captain Saint Aubin, vaillant comme l' espce, a great friend of M. de Guise: for whose sake chiefly the King had sent me there. Who, being attacked with a quartan fever, yet left his bed to command the greater part of his company. A Spaniard, seeing him in command, perceived he was a captain, and shot him through the neck with an arquebus. Captain Saint Aubin thought himself killed; and by this fright I protest to God he lost his quartan fever, and was forever free of it. I dressed him, with Antoine Portail, surgeon-in-ordinary of the King; and many other soldiers. Some died, others got off with the loss of an arm or a leg or an eye, and said they had got off cheap, to be alive at all. Then, the enemy having broken up their camp, I returned to Paris.
I say nothing here of mon petit maistre, who was more comfortable in his house than I at the wars.
THE JOURNEY TO BOURGES. 1562
The King with his camp was but a short time at Bourges, till those within the walls should surrender; and they came out with their goods saved. I know nothing worth remembering, but that a boy of the King's kitchen, having come near the walls of the town before the agreement had been signed, cried with a loud voice, "Huguenot, Huguenot, shoot here, shoot here," having his arm thrown up and his hand spread out; a soldier shot his hand right through with a bullet. When he was thus shot, he came to find me to dress him. And the Constable seeing the boy in tears, with his hand all bloody, asked who had wounded him: then a gentleman who had seen him shot said it served him right, because he kept calling "Huguenot, hit here, aim here." And then the Constable said, this Huguenot was a good shot and a good fellow, for most likely if he had chosen to fire at the boy's head, he would have hit it even more easily than his hand. I dressed the kitchen boy, who was very ill. He recovered, but with no power in his hand: and from that time his comrades called him "Huguenot": he is still living now.
THE JOURNEY TO ROUEN. 1562
Now, as for the capture of Rouen, they killed many of our men both before and at the attack: and the very next day after we had entered the town, I trepanned eight or nine of our men, who had been wounded with stones as they were on the breach. The air was so malignant, that many died, even of quite small wounds, so that some thought the bullets had been poisoned; and those within the town said the like of us; for though they had within the town all that was needful, yet all the same they died like those outside.
The King of Navarre was wounded, some days before the attack, with a bullet in the shoulder. I visited him, and helped to dress him, with one of his own surgeons, Master Gilbert, one of the chief men of Montpellier, and others. They could not find the bullet. I searched for it very accurately, and found reason to believe it had entered at the top of the arm, by the head of the bone, and had passed into the hollow part of the bone, which was why they could not find it; and most of them said it had entered his body and was lost in it. M. le Prince de La Roche-sur-Yon, who dearly loved the King of Navarre, drew me aside and asked if the wound were mortal. I told him yes, because all wounds of great joints, and especially contused wounds, were mortal, according to all those who have written about them. He asked the others what they thought of it, and chiefly Master Gilbert, who told him he had great hope his Lord the King would recover; which made the Prince very glad.
Four days later, the King, and the Queen-mother, and M. le Cardinal de Bourbon, his brother, and M. le Prince de la Roche- sur-Yon, and M. de Guise, and other great persons, after we had dressed the King of Navarre, wished us to hold a consultation in their presence, all the physicians and surgeons together. Each of them said what he thought, and there was not one but had good hope, they said, that he would recover. I persisted always in the contrary. M. le Prince, who loved me, drew me aside, and said I was alone against the opinion of all the others, and prayed me not to be obstinate against so many good men. I answered, When I shall see good signs of recovery, I will change my mind. Many consultations were held, and I never changed what I said, and the prognosis I had made at the first dressing, and said always the arm would fall into a gangrene: which it did, for all the care they could give to it; and he rendered his spirit to God the eighteenth day after his wound.
M. le Prince, having heard of it, sent to me his surgeon, and his physician, one Lefevre, now physician-in-ordinary to the King and Queen-mother, to say he wished to have the bullet, and we were to look for it, to see where it was. Then I was very glad, and assured them I should quickly find it; which I did in their presence, with many other gentlemen: it was just in the very middle of the bone. M. le Prince took and showed it to the King and to the Queen, who all said that my prognosis had come true. The body was laid to rest at Chateau Gaillard: and I returned to Paris, where I found many patients, who had been wounded on the breach at Rouen, and chiefly Italians, who were very eager I should dress them: which I did willingly. Many of them recovered: the rest died. Mon petit maistre, I think you were called to dress some, for the great number there was of them.
THE BATTLE OF DREUX. 1562
The day after the battle of Dreux, the King bade me go and dress M. le Comte d'Eu, who had been wounded in the right thigh, near the hip-joint, with a pistol-shot: which had smashed and broken the thigh-bone into many pieces: whereon many accidents supervened, and at last death, to my great grief. The day after I came, I would go to the camp where the battle had been, to see the dead bodies. I saw, for a long league round, the earth all covered: they estimated it at twenty-five thousand men or more; and it was all done in less than two hours. I wish, mon petit maistre, for the love I bear you, you had been there, to tell it to your scholars and your children.
Now while I was at Dreux, I visited and dressed a great number of gentlemen, and poor soldiers, and among the rest many of the Swiss captains. I dressed fourteen all in one room, all wounded with pistol-shots and other diabolical firearms, and not one of the fourteen died. M. le Comte d'Eu being dead, I made no long stay at Dreux. Surgeons came from Paris, who fulfilled their duty to the wounded, as Pigray, Cointeret, Hubert, and others; and I returned to Paris, where I found many wounded gentlemen who had retreated thither after the battle, to have their wounds dressed; and I was not there without seeing many of them.
THE JOURNEY TO HAVRE DE GRACE. 1563
And I will not omit to tell of the camp at Havre de Grace. When our artillery came before the walls of the town, the English within the walls killed some of our men, and several pioneers who were making gabions. And seeing they were so wounded that there was no hope of curing them, their comrades stripped them, and put them still living inside the gabions, which served to fill them up. When the English saw that they could not withstand our attack, because they were hard hit by sickness, and especially by the plague, they surrendered. The King gave them ships to return to England, very glad to be out of this plague-stricken place. The greater part of them died, and they took the plague to England, and they have not got rid of it since. Captain Sarlabous, master of the camp, was left in garrison, with six ensigns of infantry, who had no fear of the plague; and they were very glad to get into the town, hoping to enjoy themselves there, Mon petit maistre, if you had been there, you would have done as they did.
THE JOURNEY TO BAYONNE. 1564
I went with the King on that journey to Bayonne, when we were two years and more making the tour of well-nigh all this kingdom. And in many towns and villages I was called in consultation over sundry diseases, with the late M. Chapelain, chief physician to the King, and M. Castellan, chief physician to the Queen-mother; honorable men and very learned in medicine and surgery. During this journey, I always inquired of the surgeons if they had noted anything rare in their practices, so that I might learn something new. While I was at Bayonne, two things happened worthy of remark by young surgeons. The first is, I dressed a Spanish gentleman, who had a great and enormous swelling of the throat. He had lately been touched by the deceased King Charles for the king's evil. I opened his swelling. … I left him in the hands of a surgeon of the town, to finish his cure. M. de Fontaine, Knight of the Order of the King, had a severe continued pestilent fever, accompanied with many inflammatory swellings in sundry parts of the body. He had bleeding at the nose for two days, without ceasing, nor could we staunch it: and after this haemorrhage the fever ceased, with much sweating, and by and bye the swellings suppurated, and he was dressed by me, and healed by the grace of God.
BATTLE OF SAINT DENIS, 1567
As for the battle of Saint Denis, there were many killed on both sides. Our wounded withdrew to Paris to be dressed, with the prisoners they had taken, and I dressed many of them. The King ordered me, at the request of Mme. the Constable's Lady, to go to her house to dress the Constable; who had a pistol-shot in the middle of the spine of his back, whereby at once he lost all feeling and movement in his thighs and legs … because the spinal cord, whence arise the nerves to give feeling and movement to the parts below, was crushed, broken, and torn by the force of the bullet. Also he lost understanding and reason, and in a few days he died. The surgeons of Paris were hard put to it for many days to treat all the wounded. I think, mon petit maistre, you saw some of them. I beseech the great God of victories, that we be never more employed in such misfortune and disaster.
VOYAGE OF THE BATTLE OF MONCONTOUR. 1569
During the battle of Moncontour, King Charles was at Plessis-les- Tours, where he heard the news of the victory. A great number of gentlemen and soldiers retreated into the town and suburbs of Tours, wounded, to be dressed and treated; and the King and the Queen-mother bade me do my duty by them, with other surgeons who were then on duty, as Pigray, du Bois, Portail, and one Siret, a surgeon of Tours, a man well versed in surgery, who was at this time surgeon to the King's brother. And for the multitude of bad cases we had scarce any rest, nor the physicians either.
M. le Comte de Mansfeld, Governor of the Duchy of Luxembourg, Knight of the Order of the King, was severely wounded in the battle, in the left arm, with a pistol-shot which broke a great part of his elbow; and he withdrew to Borgueil near Tours. Then he sent a gentleman to the King, to beg him to send one of his surgeons, to help him of his wound. So they debated which surgeon they should send. M. le Marechal de Montmorency told the King and the Queen that they ought to send him their chief surgeon; and urged that M. de Mansfeld had done much toward the victory.
The King said flat, he would not have me go, and wished me to stop with himself. Then the Queen-mother told him I would but go and come back, and he must remember it was a foreign lord, who had come, at the command of the King of Spain, to help him. then he let me go, provided I came back very soon. So he sent for me, and the Queen-mother with him, and bade me go and find the Lord de Mansfeld, wherever he should be, to do all I could for him to heal his wound. I went to him, with a letter from Their Majesties. When he saw it, he received me with good-will, and forthwith dismissed three or four surgeons who were dressing him; which was to my very great regret, because his wound seemed to me incurable.
Now many gentlemen had retreated to Borgueil, having been wounded: for they knew that M. de Guise was there, who also had been badly wounded with a pistol-shot through the leg, and they were sure that he would have good surgeons to dress him, and would help them, as he is kindly and very generous, and would relieve their wants. This he did with a will, both for their eating and drinking, and for what else they needed: and for my part, they had the comfort and help of my art: some died, others recovered, according to their wounds. M. le Comte Ringrave died, who was shot in the shoulder, like the King of Navarre before Rouen. M. de Bassompierre, colonel of twelve hundred horse, was wounded by a similar shot, in the same place, as M. de Mansfeld: whom I dressed, and God healed. God blessed my work so well, that in three weeks I sent them back to Paris: where I had still to make incisions in M. de Mansfeld's arm, to remove some pieces of the bones, which were badly splintered, broken, and carious. He was healed by the grace of God, and made me a handsome present, so I was well content with him, and he with me; as he has shown me since. He wrote a letter to M. le Duc d' Ascot, how he was healed of his wound, and also M. de Bassompierre of his, and many others whom I had dressed after the battle of Moncontour; and advised him to ask the King of France to let me visit M. le Marquis d' Auret, his brother: which he did.
THE JOURNEY TO FLANDERS. 1569
M. le Duc d' Ascot did not fail to send a gentleman to the King, with a letter humbly asking he would do him so much kindness and honour as to permit and command his chief surgeon to visit M. le Marquis d' Auret, his brother, who had received a gunshot wound near the knee, with fracture of the bone, about seven months ago, and the physicians and surgeons all this time had not been able to heal him. The King sent for me and bade me go and see M. d' Auret, and give him all the help I could, to heal him of his wound. I told him I would employ all the little knowledge it had pleased God to give me.
I went off, escorted by two gentlemen, to the Chateau d' Auret, which is a league and a half from Mons in Hainault, where M. le Marquis was lying. So soon as I had come, I visited him, and told him the King had commanded me to come and see him and dress his wound. He said he was very glad I had come, and was much beholden to the King, who had done him so much honour as to send me to him.
I found him in a high fever, his eyes deep sunken, with a moribund and yellowish face, his tongue dry and parched, and the whole body much wasted and lean, the voice low as of a man very near death: and I found his thigh much inflamed, suppurating, and ulcerated, discharging a greenish and very offensive sanies. I probed it with a silver probe, wherewith I found a large cavity in the middle of the thigh, and others round the knee, sanious and cuniculate: also several scales of bone, some loose, others not. The leg was greatly swelled, and imbued with a pituitous humor … and bent and drawn back. There was a large bedsore; he could rest neither day nor night; and had no appetite to eat, but very thirsty. I was told he often fell into a faintness of the heart, and sometimes as in epilepsy: and often he felt sick, with such trembling he could not carry his hands to his mouth. Seeing and considering all these great complications, and the vital powers thus broken down, truly I was very sorry I had come to him, because it seemed to me there was little hope he would escape death. All the same, to give him courage and good hope, I told him I would soon set him on his legs, by the grace of God, and the help of his physicians and surgeons.
Having seen him, I went a walk in a garden, and prayed God He would show me this grace, that he should recover; and that He would bless our hands and our medicaments, to fight such a complication of diseases. I discussed in my mind the means I must take to do this. They called me to dinner. I came into the kitchen, and there I saw, taken out of a great pot, half a sheep, a quarter of veal, three great pieces of beef, two fowls, and a very big piece of bacon, with abundance of good herbs: then I said to myself that the broth of the pot would be full of juices, and very nourishing.
After dinner, we began our consultation, all the physicians and surgeons together, in the presence of M. le Duc d' Ascot and some gentlemen who were with him. I began to say to the surgeons that I was astonished they had not made incisions in M. le Marquis' thigh, seeing that it was all suppurating, and the thick matter in it very foetid and offensive, showing it had long been pent up there; and that I had found with the probe caries of the bone, and scales of bone, which were already loose. They answered me: "Never would he consent to it"; indeed, it was near two months since they had been able to get leave to put clean sheets on his bed; and one scarce dared touch the coverlet, so great was his pain. Then I said, "To heal him, we must touch something else than the coverlet of his bed." Each said what he thought of the malady of the patient, and in conclusion they all held it hopeless. I told them there was still some hope, because he was young, and God and Nature sometimes do things which seem to physicians and surgeons impossible.
To restore the warmth and nourishment of the body, general frictions must be made with hot cloths, above, below, to right, to left, and around, to draw the blood and the vital spirits from within outward. … For the bedsore, he must be put in a fresh, soft bed, with clean shirt and sheets… Having discoursed of the causes and complications of his malady, I said we must cure them by their contraries; and must first ease the pain, making openings in the thigh to let out the matter. … Secondly, having regard to the great swelling and coldness of the limb, we must apply hot bricks round it, and sprinkle them with a decoction of nerval herbs in wine and vinegar, and wrap them in napkins; and to his feet, an earthenware bottle filled with the decoction, corked, and wrapped in cloths. Then the thigh, and the whole of the leg, must be fomented with a decoction made of sage, rosemary, thyme, lavender, flowers of chamomile and melilot, red roses boiled in white wine, with a drying powder made of oak— ashes and a little vinegar and half a handful of salt. … Thirdly, we must apply to the bedsore a large plaster made of the desiccative red ointment and of Unguentum Comitissoe, equal parts, mixed together, to ease his pain and dry the ulcer; and he must have a little pillow of down, to keep all pressure off it. … And for the strengthening of his heart, we must apply over it a refrigerant of oil of waterlilies, ointment of roses, and a little saffron, dissolved in rose-vinegar and treacle, spread on a piece of red cloth. For the syncope, from exhaustion of the natural forces, troubling the brain, he must have good nourishment full of juices, as raw eggs, plums stewed in wine and sugar, broth of the meat of the great pot, whereof I have already spoken; the white meat of fowls, partridges' wings minced small, and other roast meats easy to digest, as veal, kid, pigeons, partridges, thrushes, and the like, with sauce of orange, verjuice, sorrel, sharp pomegranates; or he may have them boiled with good herbs, as lettuce, purslain, chicory, bugloss, marigold, and the like. At night he can take barley-water, with juice of sorrel and of waterlilies, of each two ounces, with four or five grains of opium, and the four cold seeds crushed, of each half an ounce; which is a good nourishing remedy and will make him sleep. His bread to be farmhouse bread, neither too stale nor too fresh. For the great pain in his head, his hair must be cut, and his head rubbed with rose-vinegar just warm, and a double cloth steeped in it and put there; also a forehead-cloth, of oil of roses and water-lilies and poppies, and a little opium and rose-vinegar, with a little camphor, and changed from time to time. Moreover, we must allow him to smell flowers of henbane and water-lilies, bruised with vinegar and rose-water, with a little camphor, all wrapped in a handkerchief, to be held some time to his nose. … And we must make artificial rain, pouring water from some high place into a cauldron, that he may hear the sound of it; by which means sleep shall be provoked on him. As for the contraction of his leg, there is hope of righting it when we have let out the pus and other humors pent up in the thigh, and have rubbed the whole knee with ointment of mallows, and oil of lilies, and a little eau-de-vie, and wrapped it in black wool with the grease left in it; and if we put under the knee a feather pillow doubled, little by little we shall straighten the leg.
This my discourse was well approved by the physicians and surgeons.
The consultation ended, we went back to the patient, and I made three openings in his thigh. … Two or three hours later, I got a bed made near his old one, with fair white sheets on it; then a strong man put him in it, and he was thankful to be taken out of his foul stinking bed. Soon after, he asked to sleep; which he did for near four hours; and everybody in the house began to feel happy, and especially M. le Duc d' Ascot, his brother.
The following days, I made injections, into the depth and cavities of the ulcers, of Aegyptiacum dissolved sometimes in eau-de-vie, other times in wine, I applied compresses to the bottom of the sinuous tracks, to cleanse and dry the soft spongy flesh, and hollow leaden tents, that the sanies might always have a way out; and above them a large plaster of Diacalcitheos dissolved in wine. And I bandaged him so skilfully that he had no pain; and when the pain was gone, the fever began at once to abate. Then I gave him wine to drink moderately tempered with water, knowing it would restore and quicken the vital forces. And all that we agreed in consultation was done in due time and order; and so soon as his pains and fever ceased, he began steadily to amend. He dismissed two of his surgeons, and one of his physicians, so that we were but three with him.
Now I stopped there about two months, not without seeing many patients, both rich and poor, who came to me from three or four leagues round. He gave food and drink to the needy, and commended them all to me, asking me to help them for his sake. I protest I refused not one, and did for them all I could, to his great pleasure. Then, when I saw him beginning to be well, I told him we must have viols and violins, and a buffoon to make him laugh: which he did. In one month, we got him into a chair, and he had himself carried about in his garden and at the door of his chateau, to see everybody passing by.
The villagers of two or three leagues round, now they could have sight of him, came on holidays to sing and dance, men and women, pell-mell for a frolic, rejoiced at his good convalescence, all glad to see him, not without plenty of laughter and plenty to drink. He always gave them a hogshead of beer; and they all drank merrily to his health. And the citizens of Mons in Hainault, and other gentlemen, his neighbours, came to see him for the wonder of it, as a man come out of the grave; and from the time he was well, he was never without company. When one went out, another came in to visit him; his table was always well covered. He was dearly loved both by the nobility and by the common people; as for his generosity, so for his handsome face and his courtesy: with a kind look and a gracious word for everybody, so that all who saw him had perforce to love him.
The chief citizens of Mons came one Saturday, to beg him let me go to Mons, where they wished to entertain me with a banquet, for their love of him. He told them he would urge me to go, which he did; but I said such great honour was not for me, moreover they could not feast me better than he did. Again he urged me, with much affection, to go there, to please him; and I agreed. The next day, they came to fetch me with two carriages: and when we got to Mons, we found the dinner ready, and the chief men of the town, with their ladies, who attended me with great devotion. We sat down to dinner, and they put me at the top of the table, and all drank to me, and to the health of M. le Marquis d'Auret: saying he was happy, and they with him, to have had me to put him on his legs again; and truly the whole company were full of honour and love for him. After dinner, they brought me back to the Chateau d'Auret, where M. le Marquis was awaiting me; who affectionately welcomed me, and would hear what we had done at our banquet; and I told him all the company had drunk many times to his health.
In six weeks he began to stand a little on crutches, and to put on fat and get a good natural colour. He would go to Beaumont, his brother's place; and was taken there in a carrying-chair, by eight men at a time. And the peasants in the villages through which we passed, knowing it was M. le Marquis, fought who should carry him, and would have us drink with them; but it was only beer. Yet I believe if they had possessed wine, even hippocras, they would have given it to us with a will. And all were right glad to see him, and all prayed God for him. When we came to Beaumont, everybody came out to meet us and pay their respects to him, and prayed God bless him and keep him in good health. We came to the chateau, and found there more than fifty gentlemen whom M. le Duc d'Ascot had invited to come and be happy with his brother; and he kept open house three whole days. After dinner, the gentlemen used to tilt at the ring and play with the foils, and were full of joy at the sight of M. d'Auret, for they had heard he would never leave his bed or be healed of his wound. I was always at the upper end of the table, and everybody drank to him and to me, thinking to make me drunk, which they could not; for I drank only as I always do.
A few days later, we went back; and I took my leave of Mdme. la Duchesse d'Ascot, who drew a diamond from her finger, and gave it me in gratitude for my good care of her brother: and the diamond was worth more than fifty crowns. M. d'Auret was ever getting better, and was walking all alone on crutches round his garden. Many times I asked him to let me go back to Paris, telling him his physician and his surgeon could do all that was now wanted for his wound: and to make a beginning to get away from him, I asked him to let me go and see the town of Antwerp. To this he agreed at once, and told his steward to escort me there, with two pages. We passed through Malines and Brussels, where the chief citizens of the town begged us to let them know of it when we returned; for they too wished, like those of Mons, to have a festival for me. I gave them very humble thanks, saying I did not deserve such honour. I was two days and a half seeing the town of Antwerp, where certain merchants, knowing the steward, prayed he would let them have the honour of giving us a dinner or a supper: it was who should have us, and they were all truly glad to hear how well M. d' Auret was doing, and made more of me than I asked.
On my return, I found M. le Marquis enjoying himself: and five or six days later I asked his leave to go, which he gave, said he, with great regret. And he made me a handsome present of great value, and sent me back, with the steward, and two pages, to my house in Paris.
I forgot to say that the Spaniards have since ruined and demolished his Chateau d' Auret, sacked, pillaged, and burned all the houses and villages belonging to him: because he would not be of their wicked party in their assassinations and ruin of the Netherlands.
I have published this Apologia, that all men may know on what footing I have always gone: and sure there is no man so touchy not to take in good part what I have said. For I have but told the truth; and the purport of my discourse is plain for all men to see, and the facts themselves are my guarantee against all calumnies.
ON THE MOTION OF THE HEART AND BLOOD IN ANIMALS BY WILLIAM HARVEY TRANSLATED BY ROBERT WILLIS AND REVISED BY ALEXANDER BOWIE
INTRODUCTORY NOTE
William Harvey, whose epoch-making treatise announcing and demonstrating the ejaculation of the blood is here printed, was born at Folkestone, Kent, England, April 1, 1578. He was educated at the King's School, Canterbury, and at Gonville and Caius College, Cambridge; and studied medicine on the Continent, receiving the degree of M.D. from the University of Padua. He took the same degree later at both the English universities. After his return to England he became Fellow of the College of Physicians, physician to St. Bartholomew's Hospital, and Lumleian lecturer at the College of Physicians. It was in this last capacity that he delivered, in 1616, the lectures in which he first gave public notice of his theories on the circulation of the blood. The notes of these lectures are still preserved in the British Museum.
In 1618 Harvey was appointed physician extraordinary to James I, and he remained in close professional relations to the royal family until the close of the Civil War, being present at the battle of Edgehill. By mandate of Charles I, he was, for a short time, Warden of Merton College, Oxford (1645-6), and, when he was too infirm to undertake the duties, he was offered the Presidency of the College of Physicians. He died on June 3, 1657.
Harvey's famous "Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus" was published in Latin at Frankfort in 1628. The discovery was received with great interest, and in his own country was accepted at once; on the Continent it won favor more slowly. Before his death, however, the soundness of his views was acknowledged by the medical profession throughout Europe, and "it remains to this day the greatest of the discoveries of physiology, and its whole honor belongs to Harvey."
DEDICATION
TO HIS VERY DEAR FRIEND, DOCTOR ARGENT, THE EXCELLENT AND ACCOMPLISHED PRESIDENT OF THE ROYAL COLLEGE OF PHYSICIANS, AND TO OTHER LEARNED PHYSICIANS, HIS MOST ESTEEMED COLLEAGUES.
I have already and repeatedly presented you, my learned friends, with my new views of the motion and function of the heart, in my anatomical lectures; but having now for more than nine years confirmed these views by multiplied demonstrations in your presence, illustrated them by arguments, and freed them from the objections of the most learned and skilful anatomists, I at length yield to the requests, I might say entreaties, of many, and here present them for general consideration in this treatise.
Were not the work indeed presented through you, my learned friends, I should scarce hope that it could come out scatheless and complete; for you have in general been the faithful witnesses of almost all the instances from which I have either collected the truth or confuted error. You have seen my dissections, and at my demonstrations of all that I maintain to be objects of sense, you have been accustomed to stand by and bear me out with your testimony. And as this book alone declares the blood to course and revolve by a new route, very different from the ancient and beaten pathway trodden for so many ages, and illustrated by such a host of learned and distinguished men, I was greatly afraid lest I might be charged with presumption did I lay my work before the public at home, or send it beyond seas for impression, unless I had first proposed the subject to you, had confirmed its conclusions by ocular demonstrations in your presence, had replied to your doubts and objections, and secured the assent and support of our distinguished President. For I was most intimately persuaded, that if I could make good my proposition before you and our College, illustrious by its numerous body of learned individuals, I had less to fear from others. I even ventured to hope that I should have the comfort of finding all that you granted me in your sheer love of truth, conceded by others who were philosophers like yourselves. True philosophers, who are only eager for truth and knowledge, never regard themselves as already so thoroughly informed, but that they welcome further information from whomsoever and from wheresoever it may come; nor are they so narrow-minded as to imagine any of the arts or sciences transmitted to us by the ancients, in such a state of forwardness or completeness, that nothing is left for the ingenuity and industry of others. On the contrary, very many maintain that all we know is still infinitely less than all that still remains unknown; nor do philosophers pin their faith to others' precepts in such wise that they lose their liberty, and cease to give credence to the conclusions of their proper senses. Neither do they swear such fealty to their mistress Antiquity, that they openly, and in sight of all, deny and desert their friend Truth. But even as they see that the credulous and vain are disposed at the first blush to accept and believe everything that is proposed to them, so do they observe that the dull and unintellectual are indisposed to see what lies before their eyes, and even deny the light of the noonday sun. They teach us in our course of philosophy to sedulously avoid the fables of the poets and the fancies of the vulgar, as the false conclusions of the sceptics. And then the studious and good and true, never suffer their minds to be warped by the passions of hatred and envy, which unfit men duly to weigh the arguments that are advanced in behalf of truth, or to appreciate the proposition that is even fairly demonstrated. Neither do they think it unworthy of them to change their opinion if truth and undoubted demonstration require them to do so. They do not esteem it discreditable to desert error, though sanctioned by the highest antiquity, for they know full well that to err, to be deceived, is human; that many things are discovered by accident and that many may be learned indifferently from any quarter, by an old man from a youth, by a person of understanding from one of inferior capacity.
My dear colleagues, I had no purpose to swell this treatise into a large volume by quoting the names and writings of anatomists, or to make a parade of the strength of my memory, the extent of my reading, and the amount of my pains; because I profess both to learn and to teach anatomy, not from books but from dissections; not from the positions of philosophers but from the fabric of nature; and then because I do not think it right or proper to strive to take from the ancients any honor that is their due, nor yet to dispute with the moderns, and enter into controversy with those who have excelled in anatomy and been my teachers. I would not charge with wilful falsehood any one who was sincerely anxious for truth, nor lay it to any one's door as a crime that he had fallen into error. I avow myself the partisan of truth alone; and I can indeed say that I have used all my endeavours, bestowed all my pains on an attempt to produce something that should be agreeable to the good, profitable to the learned, and useful to letters.
Farewell, most worthy Doctors, And think kindly of your
Anatomist,
WILLIAM HARVEY.
INTRODUCTION
As we are about to discuss the motion, action, and use of the heart and arteries, it is imperative on us first to state what has been thought of these things by others in their writings, and what has been held by the vulgar and by tradition, in order that what is true may be confirmed, and what is false set right by dissection, multiplied experience, and accurate observation.
Almost all anatomists, physicians, and philosophers up to the present time have supposed, with Galen, that the object of the pulse was the same as that of respiration, and only differed in one particular, this being conceived to depend on the animal, the respiration on the vital faculty; the two, in all other respects, whether with reference to purpose or to motion, comporting themselves alike. Whence it is affirmed, as by Hieronymus Fabricius of Aquapendente, in his book on "Respiration," which has lately appeared, that as the pulsation of the heart and arteries does not suffice for the ventilation and refrigeration of the blood, therefore were the lungs fashioned to surround the heart. From this it appears that whatever has hitherto been said upon the systole and diastole, or on the motion of the heart and arteries, has been said with especial reference to the lungs.
But as the structure and movements of the heart differ from those of the lungs, and the motions of the arteries from those of the chest, so it seems likely that other ends and offices will thence arise, and that the pulsations and uses of the heart, likewise of the arteries, will differ in many respects from the heavings and uses of the chest and lungs. For did the arterial pulse and the respiration serve the same ends; did the arteries in their diastole take air into their cavities, as commonly stated, and in their systole emit fuliginous vapours by the same pores of the flesh and skin; and further, did they, in the time intermediate between the diastole and the systole, contain air, and at all times either air or spirits, or fuliginous vapours, what should then be said to Galen, who wrote a book on purpose to show that by nature the arteries contained blood, and nothing but blood, and consequently neither spirits nor air, as may readily be gathered from the experiments and reasonings contained in the same book? Now, if the arteries are filled in the diastole with air then taken into them (a larger quantity of air penetrating when the pulse is large and full), it must come to pass that if you plunge into a bath of water or of oil when the pulse is strong and full, it ought forthwith to become either smaller or much slower, since the circumambient bath will render it either difficult or impossible for the air to penetrate. In like manner, as all the arteries, those that are deep-seated as well as those that are superficial, are dilated at the same instant and with the same rapidity, how is it possible that air should penetrate to the deeper parts as freely and quickly through the skin, flesh, and other structures, as through the cuticle alone? And how should the arteries of the foetus draw air into their cavities through the abdomen of the mother and the body of the womb? And how should seals, whales, dolphins, and other cetaceans, and fishes of every description, living in the depths of the sea, take in and emit air by the diastole and systole of their arteries through the infinite mass of water? For to say that they absorb the air that is present in the water, and emit their fumes into this medium, were to utter something like a figment. And if the arteries in their systole expel fuliginous vapours from their cavities through the pores of the flesh and skin, why not the spirits, which are said to be contained in those vessels, at the same time, since spirits are much more subtile than fuliginous vapours or smoke? And if the arteries take in and cast out air in the systole and diastole, like the lungs in the process of respiration, why do they not do the same thing when a wound is made in one of them, as in the operation of arteriotomy? When the windpipe is divided, it is sufficiently obvious that the air enters and returns through the wound by two opposite movements; but when an artery is divided, it is equally manifest that blood escapes in one continuous stream, and that no air either enters or issues. If the pulsations of the arteries fan and refrigerate the several parts of the body as the lungs do the heart, how comes it, as is commonly said, that the arteries carry the vital blood into the different parts, abundantly charged with vital spirits, which cherish the heat of these parts, sustain them when asleep, and recruit them when exhausted? How should it happen that, if you tie the arteries, immediately the parts not only become torpid, and frigid, and look pale, but at length cease even to be nourished? This, according to Galen, is because they are deprived of the heat which flowed through all parts from the heart, as its source; whence it would appear that the arteries rather carry warmth to the parts than serve for any fanning or refrigeration. Besides, how can their diastole draw spirits from the heart to warm the body and its parts, and means of cooling them from without? Still further, although some affirm that the lungs, arteries, and heart have all the same offices, they yet maintain that the heart is the workshop of the spirits, and that the arteries contain and transmit them; denying, however, in opposition to the opinion of Columbus, that the lungs can either make or contain spirits. They then assert, with Galen, against Erasistratus, that it is the blood, not spirits, which is contained in the arteries.
These opinions are seen to be so incongruous and mutually subversive, that every one of them is justly brought under suspicion. That it is blood and blood alone which is contained in the arteries is made manifest by the experiment of Galen, by arteriotomy, and by wounds; for from a single divided artery, as Galen himself affirms in more than one place, the whole of the blood may be withdrawn in the course of half an hour or less. The experiment of Galen alluded to is this: "If you include a portion of an artery between two ligatures, and slit it open lengthwise you will find nothing but blood"; and thus he proves that the arteries contain only blood. And we too may be permitted to proceed by a like train of reasoning: if we find the same blood in the arteries as in the veins, after having tied them in the same way, as I have myself repeatedly ascertained, both in the dead body and in living animals, we may fairly conclude that the arteries contain the same blood as the veins, and nothing but the same blood. Some, whilst they attempt to lessen the difficulty, affirm that the blood is spirituous and arterious, and virtually concede that the office of the arteries is to carry blood from the heart into the whole of the body, and that they are therefore filled with blood; for spirituous blood is not the less blood on that account. And no one denies the blood as such, even the portion of it which flows in the veins, is imbued with spirits. But if that portion of it which is contained in the arteries be richer in spirits, it is still to be believed that these spirits are inseparable from the blood, like those in the veins; that the blood and spirits constitute one body (like whey and butter in milk, or heat in hot water), with which the arteries are charged, and for the distribution of which from the heart they are provided. This body is nothing else than blood. But if this blood be said to be drawn from the heart into the arteries by the diastole of these vessels, it is then assumed that the arteries by their distension are filled with blood, and not with the surrounding air, as heretofore; for if they be said also to become filled with air from the ambient atmosphere, how and when, I ask, can they receive blood from the heart? If it be answered: during the systole, I take it to be impossible: the arteries would then have to fill while they contracted, to fill, and yet not become distended. But if it be said: during diastole, they would then, and for two opposite purposes, be receiving both blood and air, and heat and cold, which is improbable. Further when it is affirmed that the diastole of the heart and arteries is simultaneous, and the systole of the two is also concurrent, there is another incongruity. For how can two bodies mutually connected, which are simultaneously distended, attract or draw anything from one another? or being simultaneously contracted, receive anything from each other? And then it seems impossible that one body can thus attract another body into itself, so as to become distended, seeing that to be distended is to be passive, unless, in the manner of a sponge, which has been previously compressed by an external force, it is returning to its natural state. But it is difficult to conceive that there can be anything of this kind in the arteries. The arteries dilate, because they are filled like bladders or leathern bottles; they are not filled because they expand like bellows. This I think easy of demonstration, and indeed conceive that I have already proved it. Nevertheless, in that book of Galen headed "Quod Sanguis continetur in Arterus," he quotes an experiment to prove the contrary. An artery having been exposed, is opened longitudinally, and a reed or other pervious tube is inserted into the vessel through the opening, by which the blood is prevented from being lost, and the wound is closed. "So long," he says, "as things are thus arranged, the whole artery will pulsate; but if you now throw a ligature about the vessel and tightly compress its wall over the tube, you will no longer see the artery beating beyond the ligature." I have never performed this experiment of Galen's nor do I think that it could very well be performed in the living body, on account of the profuse flow of blood that would take place from the vessel that was operated on; neither would the tube effectually close the wound in the vessel without a ligature; and I cannot doubt but that the blood would be found to flow out between the tube and the vessel. Still Galen appears by this experiment to prove both that the pulsative property extends from the heart by the walls of the arteries, and that the arteries, whilst they dilate, are filled by that pulsific force, because they expand like bellows, and do not dilate as if they are filled like skins, But the contrary is obvious in arteriotomy and in wounds; for the blood spurting from the arteries escapes with force, now farther, now not so far, alternately, or in jets; and the jet always takes place with the diastole of the artery, never with the systole. By which it clearly appears that the artery is dilated with the impulse of the blood; for of itself it would not throw the blood to such a distance and whilst it was dilating; it ought rather to draw air into its cavity through the wound, were those things true that are commonly stated concerning the uses of the arteries. Do not let the thickness of the arterial tunics impose upon us, and lead us to conclude that the pulsative property proceeds along them from the heart For in several animals the arteries do not apparently differ from the veins; and in extreme parts of the body where the arteries are minutely subdivided, as in the brain, the hand, etc., no one could distinguish the arteries from the veins by the dissimilar characters of their coats: the tunics of both are identical. And then, in the aneurism proceeding from a wounded or eroded artery, the pulsation is precisely the same as in the other arteries, and yet it has no proper arterial covering. To this the learned Riolanus testifies along with me, in his Seventh Book.
Nor let any one imagine that the uses of the pulse and the respiration are the same, because, under the influences of the same causes, such as running, anger, the warm bath, or any other heating thing, as Galen says, they become more frequent and forcible together. For not only is experience in opposition to this idea, though Galen endeavours to explain it away, when we see that with excessive repletion the pulse beats more forcibly, whilst the respiration is diminished in amount;, but in young persons the pulse is quick, whilst respiration is slow. So it is also in alarm, and amidst care, and under anxiety of mind; sometimes, too, in fevers, the pulse is rapid, but the respiration is slower than usual.
These and other objections of the same kind may be urged against the opinions mentioned. Nor are the views that are entertained of the offices and pulse of the heart, perhaps, less bound up with great and most inextricable difficulties. The heart, it is vulgarly said, is the fountain and workshop of the vital spirits, the centre from which life is dispensed to the several parts of the body. Yet it is denied that the right ventricle makes spirits, which is rather held to supply nourishment to the lungs. For these reasons it is maintained that fishes are without any right ventricle (and indeed every animal wants a right ventricle which is unfurnished with lungs), and that the right ventricle is present solely for the sake of the lungs.
1. Why, I ask, when we see that the structure of both ventricles is almost identical, there being the same apparatus of fibres, and braces, and valves, and vessels, and auricles, and both in the same way in our dissections are found to be filled up with blood similarly black in colour, and coagulated—why, I say, should their uses be imagined to be different, when the action, motion, and pulse of both are the same? If the three tricuspid valves placed at the entrance into the right ventricle prove obstacles to the reflux of the blood into the vena cava, and if the three semilunar valves which are situated at the commencement of the pulmonary artery be there, that they may prevent the return of the blood into the ventricle; why, when we find similar structures in connexion with the left ventricle, should we deny that they are there for the same end, of preventing here the egress, there the regurgitation, of the blood?
2. And, when we have these structures, in points of size, form, and situation, almost in every respect the same in the left as in the right ventricle, why should it be said that things are arranged in the former for the egress and regress of spirits, and in the latter or right ventricle, for the blood? The same arrangement cannot be held fitted to favour or impede the motion of the blood and of spirits indifferently.
3. And when we observe that the passages and vessels are severally in relation to one another in point of size, viz., the pulmonary artery to the pulmonary veins; why should the one be destined to a private purpose, that of furnishing the lungs, the other to a public function?
4. And as Realdus Columbus says, is it probable that such a quantity of blood should be required for the nutrition of the lungs; the vessel that leads to them, the vena arteriosa or pulmonary artery being of greater capacity than both the iliac veins?
5. And I ask, as the lungs are so close at hand, and in continual motion, and the vessel that supplies them is of such dimensions, what is the use or meaning of this pulse of the right ventricle? and why was nature reduced to the necessity of adding another ventricle for the sole purpose of nourishing the lungs?
When it is said that the left ventricle draws materials for the formation of spirits, air and blood, from the lungs and right sinuses of the heart, and in like manner sends spirituous blood into the aorta, drawing fuliginous vapours from there, and sending them by the pulmonary vein into the lungs, whence spirits are at the same time obtained for transmission into the aorta, I ask how, and by what means is the separation effected? And how comes it that spirits and fuliginous vapours can pass hither and thither without admixture or confusion? If the mitral cuspidate valves do not prevent the egress of fuliginous vapours to the lungs, how should they oppose the escape of air? And how should the semiluftars hinder the regress of spirits from the aorta upon each supervening diastole of the heart? Above all, how can they say that the spirituous blood is sent from the pulmonary veins by the left ventricle into the lungs without any obstacle to its passage from the mitral valves, when they have previously asserted that the air entered by the same vessel from the lungs into the left ventricle, and have brought forward these same mitral valves as obstacles to its retrogression? Good God! how should the mitral valves prevent the regurgitation of air and not of blood?
Moreover, when they appoint the pulmonary artery, a vessel of great size, with the coverings of an artery, to none but a kind of private and single purpose, that, namely, of nourishing the lungs, why should the pulmonary vein, which is scarcely so large, which has the coats of a vein, and is soft and lax, be presumed to be made for many—three or four different—uses? For they will have it that air passes through this vessel from the lungs into the left ventricle; that fuliginous vapours escape by it from the heart into the lungs; and that a portion of the spirituous blood is distributed to the lungs for their refreshment.
If they will have it that fumes and air—fumes flowing from, air proceeding towards the heart—are transmitted by the same conduit, I reply, that nature is not wont to construct but one vessel, to contrive but one way for such contrary motions and purposes, nor is anything of the kind seen elsewhere.
If fumes or fuliginous vapours and air permeate this vessel, as they do the pulmonary bronchia, wherefore do we find neither air nor fuliginous vapours when we divide the pulmonary vein? Why do we always find this vessel full of sluggish blood, never of air, whilst in the lungs we find abundance of air remaining?
If any one will perform Galen's experiment of dividing the trachea of a living dog, forcibly distending the lungs with a pair of bellows, and then tying the trachea securely, he will find, when he has laid open the thorax, abundance of air in the lungs, even to their extreme investing tunic, but none in either the pulmonary veins or the left ventricle of the heart. But did the heart either attract air from the lungs, or did the lungs transmit any air to the heart, in the living dog, much more ought this to be the case in the experiment just referred to. Who, indeed, doubts that, did he inflate the lungs of a subject in the dissecting—room, he would instantly see the air making its way by this route, were there actually any such passage for it? But this office of the pulmonary veins, namely, the ransference of air from the lungs of the heart, is held of such importance, that Hieronymus Fabricius of Aquapendente, contends that the lungs were made for the sake of this vessel, and that it constitutes the principal element in their structure. But I should like to be informed why, if the pulmonary vein were destined for the conveyance of air, it has the structure of a blood—vessel here. Nature had rather need of annular tubes, such as those of the bronchi in order that they might always remain open, and not be liable to collapse; and that they might continue entirely free from blood, lest the liquid should interfere with the passage of the air, as it so obviously does when the lungs labour from being either greatly oppressed or loaded in a less degree with phlegm, as they are when the breathing is performed with a sibilous or rattling noise.
Still less is that opinion to be tolerated which, as a two-fold material, one aerial, one sanguineous, is required for the composition of vital spirits, supposes the blood to ooze through the septum of the heart from the right to the left ventricle by certain hidden porosities, and the air to be attracted from the lungs through the great vessel, the pulmonary vein; and which, consequently, will have it, that there are numerous porosities in the septum of the heart adapted for the transmission of the blood. But by Hercules! no such pores can be demonstrated, nor in fact do any such exist. For the septum of the heart is of a denser and more compact structure than any portion of the body, except the bones and sinews. But even supposing that there were foramina or pores in this situation, how could one of the ventricles extract anything from the other—the left, e.g., obtain blood from the right, when we see that both ventricles contract and dilate simultaneously? Why should we not rather believe that the right took spirits from the left, than that the left obtained blood from the right ventricle through these foramina? But it is certainly mysterious and incongruous that blood should be supposed to be most commodiously drawn through a set of obscure or invisible ducts, and air through perfectly open passages, at one and the same moment. And why, I ask, is recourse had to secret and invisible porosities, to uncertain and obscure channels, to explain the passage of the blood into the left ventricle, when there is so open a way through the pulmonary veins? I own it has always appeared extraordinary to me that they should have chosen to make, or rather to imagine, a way through the thick, hard, dense, and most compact septum of the heart, rather than take that by the open pulmonary vein, or even through the lax, soft and spongy substance of the lungs at large. Besides, if the blood could permeate the substance of the septum, or could be imbibed from the ventricles, what use were there for the coronary artery and vain, branches of which proceed to the septum itself, to supply it with nourishment? And what is especially worthy of notice is this: if in the foetus, where everything is more lax and soft, nature saw herself reduced to the necessity of bringing the blood from the right to the left side of the heart by the foramen ovale, from the vena cava through the pulmonary vein, how should it be likely that in the adult she should pass it so commodiously, and without an effort through the septum of the ventricles which has now become denser by age?
Andreas Laurentius, [Footnote: Lib. ix, cap. xi, quest. 12.] resting on the authority of Galen [Footnote: De Locis Affectia. lib. vi, cap. 7.] and the experience of Hollerius, asserts and proves that the serum and pus in empyema, absorbed from the cavities of the chest into the pulmonary vein may be expelled and got rid of with the urine and feces through the left ventricle of the heart and arteries. He quotes the case of a certain person affected with melancholia, and who suffered from repeated fainting fits, who was relieved from the paroxysms on passing a quantity of turbid, fetid and acrid urine. But he died at last, worn out by disease; and when the body came to be opened after death, no fluid like that he had micturated was discovered either in the bladder or the kidneys; but in the left ventricle of the heart and cavity of the thorax plenty of it was met with. And then Laurentius boasts that he had predicted the cause of the symptoms. For my own part, however, I cannot but wonder, since he had divined and predicted that heterogeneous matter could be discharged by the course he indicates, why he could not or would not perceive, and inform us that, in the natural state of things, the blood might be commodiously transferred from the lungs to the left ventricle of the heart by the very same route.
Since, therefore, from the foregoing considerations and many others to the same effect, it is plain that what has heretofore been said concerning the motion and function of the heart and arteries must appear obscure, inconsistent, or even impossible to him who carefully considers the entire subject, it would be proper to look more narrowly into the matter to contemplate the motion of the heart and arteries, not only in man, but in all animals that have hearts; and also, by frequent appeals to vivisection, and much ocular inspection, to investigate and discern the truth.
ON THE MOTION OF THE HEART AND BLOOD IN ANIMALS
CHAPTER I
THE AUTHOR'S MOTIVES FOR WRITING
When I first gave my mind to vivisections, as a means of discovering the motions and uses of the heart, and sought to discover these from actual inspection, and not from the writings of others, I found the task so truly arduous, so full of difficulties, that I was almost tempted to think, with Fracastorius, that the motion of the heart was only to be comprehended by God. For I could neither rightly perceive at first when the systole and when the diastole took place, nor when and where dilatation and contraction occurred, by reason of the rapidity of the motion, which in many animals is accomplished in the twinkling of an eye, coming and going like a flash of lightning; so that the systole presented itself to me now from this point, now from that; the diastole the same; and then everything was reversed, the motions occurring, as it seemed, variously and confusedly together. My mind was therefore greatly unsettled nor did I know what I should myself conclude, nor what believe from others. I was not surprised that Andreas Laurentius should have written that the motion of the heart was as perplexing as the flux and reflux of Euripus had appeared to Aristotle.
At length, by using greater and daily diligence and investigation, making frequent inspection of many and various animals, and collating numerous observations, I thought that I had attained to the truth, that I should extricate myself and escape from this labyrinth, and that I had discovered what I so much desired, both the motion and the use of the heart and arteries. From that time I have not hesitated to expose my views upon these subjects, not only in private to my friends, but also in public, in my anatomical lectures, after the manner of the Academy of old.
These views as usual, pleased some more, others less; some chid and calumniated me, and laid it to me as a crime that I had dared to depart from the precepts and opinions of all anatomists; others desired further explanations of the novelties, which they said were both worthy of consideration, and might perchance be found of signal use. At length, yielding to the requests of my friends, that all might be made participators in my labors, and partly moved by the envy of others, who, receiving my views with uncandid minds and understanding them indifferently, have essayed to traduce me publicly, I have moved to commit these things to the press, in order that all may be enabled to form an opinion both of me and my labours. This step I take all the more willingly, seeing that Hieronymus Fabricius of Aquapendente, although he has accurately and learnedly delineated almost every one of the several parts of animals in a special work, has left the heart alone untouched. Finally, if any use or benefit to this department of the republic of letters should accrue from my labours, it will, perhaps, be allowed that I have not lived idly, and as the old man in the comedy says:
For never yet hath any one attained
To such perfection, but that time, and place,
And use, have brought addition to his knowledge;
Or made correction, or admonished him,
That he was ignorant of much which he
Had thought he knew; or led him to reject
What he had once esteemed of highest price.
So will it, perchance, be found with reference to the heart at this time; or others, at least, starting hence, with the way pointed out to them, advancing under the guidance of a happier genius, may make occasion to proceed more fortunately, and to inquire more accurately.
CHAPTER II
ON THE MOTIONS OF THE HEART AS SEEN IN THE DISSECTION OF LIVING ANIMALS
In the first place, then, when the chest of a living animal is laid open and the capsule that immediately surrounds the heart is slit up or removed, the organ is seen now to move, now to be at rest; there is a time when it moves, and a time when it is motionless.
These things are more obvious in the colder animals, such as toads, frogs, serpents, small fishes, crabs, shrimps, snails, and shell-fish. They also become more distinct in warm-blooded animals, such as the dog and hog, if they be attentively noted when the heart begins to flag, to move more slowly, and, as it were, to die: the movements then become slower and rarer, the pauses longer, by which it is made much more easy to perceive and unravel what the motions really are, and how they are performed. In the pause, as in death, the heart is soft, flaccid, exhausted, lying, as it were, at rest.
In the motion, and interval in which this is accomplished, three principal circumstances are to be noted:
1. That the heart is erected, and rises upwards to a point, so that at this time it strikes against the breast and the pulse is felt externally.
2. That it is everywhere contracted, but more especially towards the sides so that it looks narrower, relatively longer, more drawn together. The heart of an eel taken out of the body of the animal and placed upon the table or the hand, shows these particulars; but the same things are manifest in the hearts of all small fishes and of those colder animals where the organ is more conical or elongated.
3. The heart being grasped in the hand, is felt to become harder during its action. Now this hardness proceeds from tension, precisely as when the forearm is grasped, its tendons are perceived to become tense and resilient when the fingers are moved.
4. It may further be observed in fishes, and the colder blooded animals, such as frogs, serpents, etc., that the heart, when it moves, becomes of a paler color, when quiescent of a deeper blood-red color.
From these particulars it appears evident to me that the motion of the heart consists in a certain universal tension—both contraction in the line of its fibres, and constriction in every sense. It becomes erect, hard, and of diminished size during its action; the motion is plainly of the same nature as that of the muscles when they contract in the line of their sinews and fibres; for the muscles, when in action, acquire vigor and tenseness, and from soft become hard, prominent, and thickened: and in the same manner the heart.
We are therefore authorized to conclude that the heart, at the moment of its action, is at once constricted on all sides, rendered thicker in its parietes and smaller in its ventricles, and so made apt to project or expel its charge of blood. This, indeed, is made sufficiently manifest by the preceding fourth observation in which we have seen that the heart, by squeezing out the blood that it contains, becomes paler, and then when it sinks into repose and the ventricle is filled anew with blood, that the deeper crimson colour returns. But no one need remain in doubt of the fact, for if the ventricle be pierced the blood will be seen to be forcibly projected outwards upon each motion or pulsation when the heart is tense.
These things, therefore, happen together or at the same instant: the tension of the heart, the pulse of its apex, which is felt externally by its striking against the chest, the thickening of its parietes, and the forcible expulsion of the blood it contains by the constriction of its ventricles.
Hence the very opposite of the opinions commonly received appears to be true; inasmuch as it is generally believed that when the heart strikes the breast and the pulse is felt without, the heart is dilated in its ventricles and is filled with blood; but the contrary of this is the fact, and the heart, when it contracts (and the impulse of the apex is conveyed through the chest wall), is emptied. Whence the motion which is generally regarded as the diastole of the heart, is in truth its systole. And in like manner the intrinsic motion of the heart is not the diastole but the systole; neither is it in the diastole that the heart grows firm and tense, but in the systole, for then only, when tense, is it moved and made vigorous.
Neither is it by any means to be allowed that the heart only moves in the lines of its straight fibres, although the great Vesalius giving this notion countenance, quotes a bundle of osiers bound in a pyramidal heap in illustration; meaning, that as the apex is approached to the base, so are the sides made to bulge out in the fashion of arches, the cavities to dilate, the ventricles to acquire the form of a cupping-glass and so to suck in the blood. But the true effect of every one of its fibres is to constringe the heart at the same time they render it tense; and this rather with the effect of thickening and amplifying the walls and substance of the organ than enlarging its ventricles. And, again, as the fibres run from the apex to the base, and draw the apex towards the base, they do not tend to make the walls of the heart bulge out in circles, but rather the contrary; inasmuch as every fibre that is circularly disposed, tends to become straight when it contracts; and is distended laterally and thickened, as in the case of muscular fibres in general, when they contract, that is, when they are shortened longitudinally, as we see them in the bellies of the muscles of the body at large. To all this let it be added, that not only are the ventricles contracted in virtue of the direction and condensation of their walls, but farther, that those fibres, or bands, styled nerves by Aristotle, which are so conspicuous in the ventricles of the larger animals, and contain all the straight fibres (the parietes of the heart containing only circular ones), when they contract simultaneously by an admirable adjustment all the internal surfaces are drawn together as if with cords, and so is the charge of blood expelled with force.
Neither is it true, as vulgarly believed, that the heart by any dilatation or motion of its own, has the power of drawing the blood into the ventricles; for when it acts and becomes tense, the blood is expelled; when it relaxes and sinks together it receives the blood in the manner and wise which will by-and-by be explained.
CHAPTER III
OF THE MOTIONS OF THE ARTERIES, AS SEEN IN THE DISSECTION OF LIVING ANIMALS
In connexion with the motions of the heart these things are further to be observed having reference to the motions and pulses of the arteries.
1. At the moment the heart contracts, and when the breast is struck, when in short the organ is in its state of systole, the arteries are dilated, yield a pulse, and are in the state of diastole. In like manner, when the right ventricle contracts and propels its charge of blood, the pulmonary artery is distended at the same time with the other arteries of the body.
2. When the left ventricle ceases to act, to contract, to pulsate, the pulse in the arteries also ceases; further, when this ventricle contracts languidly, the pulse in the arteries is scarcely perceptible. In like manner, the pulse in the right ventricle failing, the pulse in the pulmonary artery ceases also.
3. Further, when an artery is divided or punctured, the blood is seen to be forcibly propelled from the wound the moment the left ventricle contracts; and, again, when the pulmonary artery is wounded, the blood will be seen spouting forth with violence at the instant when the right ventricle contracts.
So also in fishes, if the vessel which leads from the heart to the gills be divided, at the moment when the heart becomes tense and contracted, at the same moment does the blood flow with force from the divided vessel.
In the same way, when we see the blood in arteriotomy projected now to a greater, now to a less distance, and that the greater jet corresponds to the diastole of the artery and to the time when the heart contracts and strikes the ribs, and is in its state of systole, we understand that the blood is expelled by the same movement.
From these facts it is manifest, in opposition to commonly received opinions, that the diastole of the arteries corresponds with the time of the heart's systole; and that the arteries are filled and distended by the blood forced into them by the contraction of the ventricles; the arteries, therefore, are distended, because they are filled like sacs or bladders, and are not filled because they expand like bellows. It is in virtue of one and the same cause, therefore, that all the arteries of the body pulsate, viz., the contraction of the left ventricle; in the same way as the pulmonary artery pulsates by the contraction of the right ventricle.
Finally, that the pulses of the arteries are due to the impulses of the blood from the left ventricle, may be illustrated by blowing into a glove, when the whole of the fingers will be found to become distended at one and the same time, and in their tension to bear some resemblance to the pulse. For in the ratio of the tension is the pulse of the heart, fuller, stronger, and more frequent as that acts more vigorously, still preserving the rhythm and volume, and order of the heart's contractions. Nor is it to be expected that because of the motion of the blood, the time at which the contraction of the heart takes place, and that at which the pulse in an artery (especially a distant one) is felt, shall be otherwise than simultaneous: it is here the same as in blowing up a glove or bladder; for in a plenum (as in a drum, a long piece of timber, etc.) the stroke and the motion occur at both extremities at the same time. Aristotle, [Footnote: De Anim., iii, cap. 9.] too, has said, "the blood of all animals palpitates within their veins (meaning the arteries), and by the pulse is sent everywhere simultaneously." And further, [Footnote: De Respir., cap. 20] "thus do all the veins pulsate together and by successive strokes, because they all depend upon the heart; and, as it is always in motion, so are they likewise always moving together, but by successive movements." It is well to observe with Galen, in this place, that the old philosophers called the arteries veins. I happened upon one occasion to have a particular case under my care, which plainly satisfied me of the truth: A certain person was affected with a large pulsating tumour on the right side of the neck, called an aneurism, just at that part where the artery descends into the axilla, produced by an erosion of the artery itself, and daily increasing in size; this tumour was visibly distended as it received the charge of blood brought to it by the artery, with each stroke of the heart; the connexion of parts was obvious when the body of the patient came to be opened after his death. The pulse in the corresponding arm was small, in consequence of the greater portion of the blood being diverted into the tumour and so intercepted.
Whence it appears that whenever the motion of the blood through the arteries is impeded, whether it be by compression or infarction, or interception, there do the remote divisions of the arteries beat less forcibly, seeing that the pulse of the arteries is nothing more than the impulse or shock of the blood in these vessels.
CHAPTER IV
OF THE MOTION OF THE HEART AND ITS AURICLES, AS SEEN IN THE BODIES OF LIVING ANIMALS
Besides the motions already spoken of, we have still to consider those that appertain to the auricles.
Caspar Bauhin and John Riolan, [Footnote: i Bauhin, lib. ii. cap. II. Riolan. lib. viii, cap. I.] most learned men and skilful anatomists, inform us that from their observations, that if we carefully watch the movements of the heart in the vivisection of an animal, we shall perceive four motions distinct in time and in place, two of which are proper to the auricles, two to the ventricles. With all deference to such authority I say that there are four motions distinct in point of place, but not of time; for the two auricles move together, and so also do the two ventricles, in such wise that though the places be four, the times are only two. And this occurs in the following manner:
There are, as it were, two motions going on together: one of the auricles, another of the ventricles; these by no means taking place simultaneously, but the motion of the auricles preceding, that of the heart following; the motion appearing to begin from the auricles and to extend to the ventricles. When all things are becoming languid, and the heart is dying, as also in fishes and the colder blooded animals there is a short pause between these two motions, so that the heart aroused, as it were, appears to respond to the motion, now more quickly, now more tardily; and at length, when near to death, it ceases to respond by its proper motion, but seems, as it were, to nod the head, and is so slightly moved that it appears rather to give signs of motion to the pulsating auricles than actually to move. The heart, therefore, ceases to pulsate sooner than the auricles, so that the auricles have been said to outlive it, the left ventricle ceasing to pulsate first of all; then its auricle, next the right ventricle; and, finally, all the other parts being at rest and dead, as Galen long since observed, the right auricle still continues to beat; life, therefore, appears to linger longest in the right auricle. Whilst the heart is gradually dying, it is sometimes seen to reply, after two or three contractions of the auricles, roused as it were to action, and making a single pulsation, slowly, unwillingly, and with an effort.
But this especially is to be noted, that after the heart has ceased to beat, the auricles however still contracting, a finger placed upon the ventricles perceives the several pulsations of the auricles, precisely in the same way and for the same reason, as we have said, that the pulses of the ventricles are felt in the arteries, to wit, the distension produced by the jet of blood. And if at this time, the auricles alone pulsating, the point of the heart be cut off with a pair of scissors, you will perceive the blood flowing out upon each contraction of the auricles. Whence it is manifest that the blood enters the ventricles, not by any attraction or dilatation of the heart, but by being thrown into them by the pulses of the auricles.
And here I would observe, that whenever I speak of pulsations as occurring in the auricles or ventricles, I mean contractions: first the auricles contract, and then and subsequently the heart itself contracts. When the auricles contract they are seen to become whiter, especially where they contain but little blood; but they are filled as magazines or reservoirs of the blood, which is tending spontaneously and, by its motion in the veins, under pressure towards the centre; the whiteness indicated is most conspicuous towards the extremities or edges of the auricles at the time of their contractions.
In fishes and frogs, and other animals which have hearts with but a single ventricle, and for an auricle have a kind of bladder much distended with blood, at the base of the organ, you may very plainly perceive this bladder contracting first, and the contraction of the heart or ventricle following afterwards.
But I think it right to describe what I have observed of an opposite character: the heart of an eel, of several fishes, and even of some (of the higher) animals taken out of the body, pulsates without auricles; nay, if it be cut in pieces the several parts may still be seen contracting and relaxing; so that in these creatures the body of the heart may be seen pulsating and palpitating, after the cessation of all motion in the auricle. But is not this perchance peculiar to animals more tenacious of life, whose radical moisture is more glutinous, or fat and sluggish, and less readily soluble? The same faculty indeed appears in the flesh of eels, which even when skinned and embowelled, and cut into pieces, are still seen to move.
Experimenting with a pigeon upon one occasion, after the heart had wholly ceased to pulsate, and the auricles too had become motionless, I kept my finger wetted with saliva and warm for a short time upon the heart, and observed that under the influence of this fomentation it recovered new strength and life, so that both ventricles and auricles pulsated, contracting and relaxing alternately, recalled as it were from death to life.
Besides this, however, I have occasionally observed, after the heart and even its right auricle had ceased pulsating,—when it was in articulo mortis in short,—that an obscure motion, an undulation or palpitation, remained in the blood itself, which was contained in the right auricle, this being apparent so long as it was imbued with heat and spirit. And, indeed, a circumstance of the same kind is extremely manifest in the course of the generation of animals, as may be seen in the course of the first seven days of the incubation of the chick: A drop of blood makes its appearance which palpitates, as Aristotle had already observed; from this, when the growth is further advanced and the chick is fashioned, the auricles of the heart are formed, which pulsating henceforth give constant signs of life. When at length, and after the lapse of a few days, the outline of the body begins to be distinguished, then is the ventricular part of the heart also produced, but it continues for a time white and apparently bloodless, like the rest of the animal; neither does it pulsate or give signs of motion. I have seen a similar condition of the heart in the human foetus about the beginning of the third month, the heart then being whitish and bloodless, although its auricles contained a considerable quantity of purple blood. In the same way in the egg, when the chick was formed and had increased in size, the heart too increased and acquired ventricles, which then began to receive and to transmit blood.
And this leads me to remark that he who inquires very particularly into this matter will not conclude that the heart, as a whole, is the primum vivens, ultimum moriens,—the first part to live, the last to die,—but rather its auricles, or the part which corresponds to the auricles in serpents, fishes, etc., which both lives before the heart and dies after it.
Nay, has not the blood itself or spirit an obscure palpitation inherent in it, which it has even appeared to me to retain after death? and it seems very questionable whether or not we are to say that life begins with the palpitation or beating of the heart. The seminal fluid of all animals—the prolific spirit, as Aristotle observed, leaves their body with a bound and like a living thing; and nature in death, as Aristotle [Footnote: De Motu Animal., cap. 8.] further remarks, retracing her steps, reverts to where she had set out, and returns at the end of her course to the goal whence she had started. As animal generation proceeds from that which is not animal, entity from nonentity, so, by a retrograde course, entity, by corruption, is resolved into nonentity, whence that in animals, which was last created, fails first and that which was first, fails last.
I have also observed that almost all animals have truly a heart, not the larger creatures only, and those that have red blood, but the smaller, and pale-blooded ones also, such as slugs, snails, scallops, shrimps, crabs, crayfish, and many others; nay, even in wasps, hornets, and flies, I have, with the aid of a magnifying glass, and at the upper part of what is called the tail, both seen the heart pulsating myself, and shown it to many others.
But in the pale-blooded tribes the heart pulsates sluggishly and deliberately, contracting slowly as in animals that are moribund, a fact that may readily be seen in the snail, whose heart will be found at the bottom of that orifice in the right side of the body which is seen to be opened and shut in the course of respiration, and whence saliva is discharged, the incision being made in the upper aspect of the body, near the part which corresponds to the liver.
This, however, is to be observed: that in winter and the colder season, exsanguine animals, such as the snail, show no pulsation; they seem rather to live after the manner of vegetables, or of those other productions which are therefore designated plant- animals.
It is also to be noted that all animals which have a heart have also auricles, or something analogous to auricles; and, further, that whenever the heart has a double ventricle, there are always two auricles present, but not otherwise. If you turn to the production of the chick in ovo, however, you will find at first no more a vesicle or auricle, or pulsating drop of blood; it is only by and by, when the development has made some progress, that the heart is fashioned; even so in certain animals not destined to attain to the highest perfection in their organization, such as bees, wasps, snails, shrimps, crayfish, etc., we only find a certain pulsating vesicle, like a sort of red or white palpitating point, as the beginning or principle of their life.
We have a small shrimp in these countries, which is taken in the Thames and in the sea, the whole of whose body is transparent; this creature, placed in a little water, has frequently afforded myself and particular friends an opportunity of observing the motions of the heart with the greatest distinctness, the external parts of the body presenting no obstacle to our view, but the heart being perceived as though it had been seen through a window.
I have also observed the first rudiments of the chick in the course of the fourth or fifth day of the incubation, in the guise of a little cloud, the shell having been removed and the egg immersed in clear tepid water. In the midst of the cloudlet in question there was a bloody point so small that it disappeared during the contraction and escaped the sight, but in the relaxation it reappeared again, red and like the point of a pin; so that betwixt the visible and invisible, betwixt being and not being, as it were, it gave by its pulses a kind of representation of the commencement of life.
CHAPTER V
OF THE MOTION, ACTION AND OFFICE OF THE HEART
From these and other observations of a similar nature, I am persuaded it will be found that the motion of the heart is as follows:
First of all, the auricle contracts, and in the course of its contraction forces the blood (which it contains in ample quantity as the head of the veins, the store—house and cistern of the blood) into the ventricle, which, being filled, the heart raises itself straightway, makes all its fibres tense, contracts the ventricles, and performs a beat, by which beat it immediately sends the blood supplied to it by the auricle into the arteries. The right ventricle sends its charge into the lungs by the vessel which is called vena arteriosa, but which in structure and function, and all other respects, is an artery. The left ventricle sends its charge into the aorta, and through this by the arteries to the body at large.
These two motions, one of the ventricles, the other of the auricles, take place consecutively, but in such a manner that there is a kind of harmony or rhythm preserved between them, the two concurring in such wise that but one motion is apparent, especially in the warmer blooded animals, in which the movements in question are rapid. Nor is this for any other reason than it is in a piece of machinery, in which, though one wheel gives motion to another, yet all the wheels seem to move simultaneously; or in that mechanical contrivance which is adapted to firearms, where, the trigger being touched, down comes the flint, strikes against the steel, elicits a spark, which falling among the powder, ignites it, when the flame extends, enters the barrel, causes the explosion, propels the ball, and the mark is attained—all of which incidents, by reason of the celerity with which they happen, seem to take place in the twinkling of an eye. So also in deglutition: by the elevation of the root of the tongue, and the compression of the mouth, the food or drink is pushed into the fauces, when the larynx is closed by its muscles and by the epiglottis. The pharynx is then raised and opened by its muscles in the same way as a sac that is to be filled is lifted up and its mouth dilated. Upon the mouthful being received, it is forced downwards by the transverse muscles, and then carried farther by the longitudinal ones. Yet all these motions, though executed by different and distinct organs, are performed harmoniously, and in such order that they seem to constitute but a single motion and act, which we call deglutition.
Even so does it come to pass with the motions and action of the heart, which constitute a kind of deglutition, a transfusion of the blood from the veins to the arteries. And if anyone, bearing these things in mind, will carefully watch the motions of the heart in the body of a living animal, he will perceive not only all the particulars I have mentioned, viz., the heart becoming erect, and making one continuous motion with its auricles; but farther, a certain obscure undulation and lateral inclination in the direction of the axis of the right ventricle, as if twisting itself slightly in performing its work. And indeed everyone may see, when a horse drinks, that the water is drawn in and transmitted to the stomach at each movement of the throat, which movement produces a sound and yields a pulse both to the ear and the touch; in the same way it is with each motion of the heart, when there is the delivery of a quantity of blood from the veins to the arteries a pulse takes place, and can be heard within the chest.
The motion of the heart, then, is entirely of this description, and the one action of the heart is the transmission of the blood and its distribution, by means of the arteries, to the very extremities of the body; so that the pulse which we feel in the arteries is nothing more than the impulse of the blood derived from the heart.
Whether or not the heart, besides propelling the blood, giving it motion locally, and distributing it to the body, adds anything else to it—heat, spirit, perfection,—must be inquired into by— and—by, and decided upon other grounds. So much may suffice at this time, when it is shown that by the action of the heart the blood is transfused through the ventricles from the veins to the arteries, and distributed by them to all parts of the body.
The above, indeed, is admitted by all, both from the structure of the heart and the arrangement and action of its valves. But still they are like persons purblind or groping about in the dark, for they give utterance to various, contradictory, and incoherent sentiments, delivering many things upon conjecture, as we have already shown.
The grand cause of doubt and error in this subject appears to me to have been the intimate connexion between the heart and the lungs. When men saw both the pulmonary artery and the pulmonary veins losing themselves in the lungs, of course it became a puzzle to them to know how or by what means the right ventricle should distribute the blood to the body, or the left draw it from the venae cavae. This fact is borne witness to by Galen, whose words, when writing against Erasistratus in regard to the origin and use of the veins and the coction of the blood, are the following [Footnote: De Placitis Hippocratis et Platonis, vi.]: "You will reply," he says, "that the effect is so; that the blood is prepared in the liver, and is thence transferred to the heart to receive its proper form and last perfection; a statement which does not appear devoid of reason; for no great and perfect work is ever accomplished at a single effort, or receives its final polish from one instrument. But if this be actually so, then show us another vessel which draws the absolutely perfect blood from the heart, and distributes it as the arteries do the spirits over the whole body." Here then is a reasonable opinion not allowed, because, forsooth, besides not seeing the true means of transit, he could not discover the vessel which should transmit the blood from the heart to the body at large!
But had anyone been there in behalf of Erasistratus, and of that opinion which we now espouse, and which Galen himself acknowledges in other respects consonant with reason, to have pointed to the aorta as the vessel which distributes the blood from the heart to the rest of the body, I wonder what would have been the answer of that most ingenious and learned man? Had he said that the artery transmits spirits and not blood, he would indeed sufficiently have answered Erasistratus, who imagined that the arteries contained nothing but spirits; but then he would have contradicted himself, and given a foul denial to that for which he had keenly contended in his writings against this very Erasistratus, to wit, that blood in substance is contained in the arteries, and not spirits; a fact which he demonstrated not only by many powerful arguments, but by experiments.
But if the divine Galen will here allow, as in other places he does, "that all the arteries of the body arise from the great artery, and that this takes its origin from the heart; that all these vessels naturally contain and carry blood; that the three semilunar valves situated at the orifice of the aorta prevent the return of the blood into the heart, and that nature never connected them with this, the most noble viscus of the body, unless for some important end"; if, I say, this father of physicians concedes all these things,—and I quote his own words,—I do not see how he can deny that the great artery is the very vessel to carry the blood, when it has attained its highest term for term of perfection, from the heart for distribution to all parts of the body. Or would he perchance still hesitate, like all who have come after him, even to the present hour, because he did not perceive the route by which the blood was transferred from the veins to the arteries, in consequence, as I have already said, of the intimate connexion between the heart and the lungs? And that this difficulty puzzled anatomists not a little, when in their dissections they found the pulmonary artery and left ventricle full of thick, black, and clotted blood, plainly appears, when they felt themselves compelled to affirm that the blood made its way from the right to the left ventricle by transuding through the septum of the heart. But this fancy I have already refuted. A new pathway for the blood must therefore be prepared and thrown open, and being once exposed, no further difficulty will, I believe, be experienced by anyone in admitting what I have already proposed in regard to the pulse of the heart and arteries, viz., the passage of the blood from the veins to the arteries, and its distribution to the whole of the body by means of these vessels.
CHAPTER VI
OF THE COURSE BY WHICH THE BLOOD IS CARRIED FROM THE VENA CAVA INTO THE ARTERIES, OR FROM THE RIGHT INTO THE LEFT VENTRICLE OF THE HEART
Since the intimate connexion of the heart with the lungs, which is apparent in the human subject, has been the probable cause of the errors that have been committed on this point, they plainly do amiss who, pretending to speak of the parts of animals generally, as anatomists for the most part do, confine their researches to the human body alone, and that when it is dead. They obviously do not act otherwise than he who, having studied the forms of a single commonwealth, should set about the composition of a general system of polity; or who, having taken cognizance of the nature of a single field, should imagine that he had mastered the science of agriculture; or who, upon the ground of one particular proposition, should proceed to draw general conclusions.
Had anatomists only been as conversant with the dissection of the lower animals as they are with that of the human body, the matters that have hitherto kept them in a perplexity of doubt would, in my opinion, have met them freed from every kind of difficulty.
And first, in fishes, in which the heart consists of but a single ventricle, being devoid of lungs, the thing is sufficiently manifest. Here the sac, which is situated at the base of the heart, and is the part analogous to the auricle in man, plainly forces the blood into the heart, and the heart, in its turn, conspicuously transmits it by a pipe or artery, or vessel analogous to an artery; these are facts which are confirmed by simple ocular inspection, as well as by a division of the vessel, when the blood is seen to be projected by each pulsation of the heart.
The same thing is also not difficult of demonstration in those animals that have, as it were, no more than a single ventricle to the heart, such as toads, frogs, serpents, and lizards, which have lungs in a certain sense, as they have a voice. I have many observations by me on the admirable structure of the lungs of these animals, and matters appertaining, which, however, I cannot introduce in this place. Their anatomy plainly shows us that the blood is transferred in them from the veins to the arteries in the same manner as in higher animals, viz., by the action of the heart; the way, in fact, is patent, open, manifest; there is no difficulty, no room for doubt about it; for in them the matter stands precisely as it would in man were the septum of his heart perforated or removed, or one ventricle made out of two; and this being the case, I imagine that no one will doubt as to the way by which the blood may pass from the veins into the arteries.
But as there are actually more animals which have no lungs than there are furnished with them, and in like manner a greater number which have only one ventricle than there are with two, it is open to us to conclude, judging from the mass or multitude of living creatures, that for the major part, and generally, there is an open way by which the blood is transmitted from the veins through the sinuses or cavities of the heart into the arteries.
I have, however, cogitating with myself, seen further, that the same thing obtained most obviously in the embryos of those animals that have lungs; for in the foetus the four vessels belonging to the heart, viz., the vena cava, the pulmonary artery, the pulmonary vein, and the great artery or aorta, are all connected otherwise than in the adult, a fact sufficiently known to every anatomist. The first contact and union of the vena cava with the pulmonary veins, which occurs before the cava opens properly into the right ventricle of the heart, or gives off the coronary vein, a little above its escape from the liver, is by a lateral anastomosis; this is an ample foramen, of an oval form, communicating between the cava and the pulmonary vein, so that the blood is free to flow in the greatest abundance by that foramen from the vena cava into the pulmonary vein, and left auricle, and from thence into the left ventricle. Further, in this foramen ovale, from that part which regards the pulmonary vein, there is a thin tough membrane, larger than the opening, extended like an operculum or cover; this membrane in the adult blocking up the foramen, and adhering on all sides, finally closes it up, and almost obliterates every trace of it. In the foetus, however, this membrane is so contrived that falling loosely upon itself, it permits a ready access to the lungs and heart, yielding a passage to the blood which is streaming from the cava, and hindering the tide at the same time from flowing back into that vein. All things, in short, permit us to believe that in the embryo the blood must constantly pass by this foramen from the vena cava into the pulmonary vein, and from thence into the left auricle of the heart; and having once entered there, it can never regurgitate.
Another union is that by the pulmonary artery, and is effected when that vessel divides into two branches after its escape from the right ventricle of the heart. It is as if to the two trunks already mentioned a third were superadded, a kind of arterial canal, carried obliquely from the pulmonary artery, to perforate and terminate in the great artery or aorta. So that in the dissection of the embryo, as it were, two aortas, or two roots of the great artery, appear springing from the heart. This canal shrinks gradually after birth, and after a time becomes withered, and finally almost removed, like the umbilical vessels.
The arterial canal contains no membrane or valve to direct or impede the flow of blood in this or in that direction: for at the root of the pulmonary artery, of which the arterial canal is the continuation in the foetus, there are three semilunar valves, which open from within outwards, and oppose no obstacle to the blood flowing in this direction or from the right ventricle into the pulmonary artery and aorta; but they prevent all regurgitation from the aorta or pulmonic vessels back upon the right ventricle; closing with perfect accuracy, they oppose an effectual obstacle to everything of the kind in the embryo. So that there is also reason to believe that when the heart contracts, the blood is regularly propelled by the canal or passage indicated from the right ventricle into the aorta.
What is commonly said in regard to these two great communications, to wit, that they exist for the nutrition of the lungs, is both improbable and inconsistent; seeing that in the adult they are closed up, abolished, and consolidated, although the lungs, by reason of their heat and motion, must then be presumed to require a larger supply of nourishment. The same may be said in regard to the assertion that the heart in the embryo does not pulsate, that it neither acts nor moves, so that nature was forced to make these communications for the nutrition of the lungs. This is plainly false; for simple inspection of the incubated egg, and of embryos just taken out of the uterus, shows that the heart moves in them precisely as in adults, and that nature feels no such necessity. I have myself repeatedly seen these motions, and Aristotle is likewise witness of their reality. "The pulse," he observes, "inheres in the very constitution of the heart, and appears from the beginning as is learned both from the dissection of living animals and the formation of the chick in the egg." [Footnote: Lib de Spiritu, cap. v.] But we further observe that the passages in question are not only pervious up to the period of birth in man, as well as in other animals, as anatomists in general have described them, but for several months subsequently, in some indeed for several years, not to say for the whole course of life; as, for example, in the goose, snipe, and various birds and many of the smaller animals. And this circumstance it was, perhaps, that imposed upon Botallus, who thought he had discovered a new passage for the blood from the vena cava into the left ventricle of the heart; and I own that when I met with the same arrangement in one of the larger members of the mouse family, in the adult state, I was myself at first led to something of a like conclusion.
From this it will be understood that in the human embryo, and in the embryos of animals in which the communications are not closed, the same thing happens, namely, that the heart by its motion propels the blood by obvious and open passages from the vena cava into the aorta through the cavities of both the ventricles, the right one receiving the blood from the auricle, and propelling it by the pulmonary artery and its continuation, named the ductus arteriosus, into the aorta; the left, in like manner, charged by the contraction of its auricle, which has received its supply through the foramen ovale from the vena cava, contracting, and projecting the blood through the root of the aorta into the trunk of that vessel.
In embryos, consequently, whilst the lungs are yet in a state of inaction, performing no function, subject to no motion any more than if they had not been present, nature uses the two ventricles of the heart as if they formed but one, for the transmission of the blood. The condition of the embryos of those animals which have lungs, whilst these organs are yet in abeyance and not employed, is the same as that of those animals which have no lungs.
So it clearly appears in the case of the foetus that the heart by its action transfers the blood from the vena cava into the aorta, and that by a route as obvious and open, as if in the adult the two ventricles were made to communicate by the removal of their septum. We therefore find that in the greater number of animals— in all, indeed, at a certain period of their existence—the channels for the transmission of the blood through the heart are conspicuous. But we have to inquire why in some creatures—those, namely, that have warm blood, and that have attained to the adult age, man among the number—we should not conclude that the same thing is accomplished through the substance of the lungs, which in the embryo, and at a time when the function of these organs is in abeyance, nature effects by the direct passages described, and which, indeed, she seems compelled to adopt through want of a passage by the lungs; or why it should be better (for nature always does that which is best) that she should close up the various open routes which she had formerly made use of in the embryo and foetus, and still uses in all other animals. Not only does she thereby open up no new apparent channels for the passages of the blood, but she even shuts up those which formerly existed.
And now the discussion is brought to this point, that they who inquire into the ways by which the blood reaches the left ventricle of the heart: and pulmonary veins from the vena cava, will pursue the wisest course if they seek by dissection to discover the causes why in the larger and more perfect animals of mature age nature has rather chosen to make the blood percolate the parenchyma of the lungs, than, as in other instances, chosen a direct and obvious course—for I assume that no other path or mode of transit can be entertained. It must be because the larger and more perfect animals are warmer, and when adult their heat greater—ignited, as I might say, and requiring to be damped or mitigated, that the blood is sent through the lungs, in order that it may be tempered by the air that is inspired, and prevented from boiling up, and so becoming extinguished, or something else of the sort. But to determine these matters, and explain them satisfactorily, were to enter on a speculation in regard to the office of the lungs and the ends for which they exist. Upon such a subject, as well as upon what pertains to respiration, to the necessity and use of the air, etc., as also to the variety and diversity of organs that exist in the bodies of animals in connexion with these matters, although I have made a vast number of observations, I shall not speak till I can more conveniently set them forth in a treatise apart, lest I should be held as wandering too wide of my present purpose, which is the use and motion of the heart, and be charged with speaking of things beside the question, and rather complicating and quitting than illustrating it. And now returning to my immediate subject, I go on with what yet remains for demonstration, viz., that in the more perfect and warmer adult animals, and man, the blood passes from the right ventricle of the heart by the pulmonary artery, into the lungs, and thence by the pulmonary veins into the left auricle, and from there into the left ventricle of the heart. And, first, I shall show that this may be so, and then I shall prove that it is so in fact.
CHAPTER VII
THE BLOOD PASSES THROUGH THE SUBSTANCE OF THE LUNGS FROM THE RIGHT VENTRICLE OF THE HEART INTO THE PULMONARY VEINS AND LEFT VENTRICLE
That this is possible, and that there is nothing to prevent it from being so, appears when we reflect on the way in which water permeating the earth produces springs and rivulets, or when we speculate on the means by which the sweat passes through the skin, or the urine through the substance of the kidneys. It is well known that persons who use the Spa waters or those of La Madonna, in the territories of Padua, or others of an acidulous or vitriolated nature, or who simply swallow drinks by the gallon, pass all off again within an hour or two by the bladder. Such a quantity of liquid must take some short time in the concoction: it must pass through the liver (it is allowed by all that the juices of the food we consume pass twice through this organ in the course of the day); it must flow through the veins, through the tissues of the kidneys, and through the ureters into the bladder.
To those, therefore, whom I hear denying that the blood, aye, the whole mass of the blood, may pass through the substance of the lungs, even as the nutritive juices percolate the liver, asserting such a proposition to be impossible, and by no means to be entertained as credible, I reply, with the poet, that they are of that race of men who, when they will, assent full readily, and when they will not, by no manner of means; who, when their assent is wanted, fear, and when it is not, fear not to give it.
The substance of the liver is extremely dense, so is that of the kidney; the lungs, however, are of a much looser texture, and if compared with the kidneys are absolutely spongy. In the liver there is no forcing, no impelling power; in the lungs the blood is forced on by the pulse of the right ventricle, the necessary effect of whose impulse is the distension of the vessels and the pores of the lungs. And then the lungs, in respiration, are perpetually rising and falling: motions, the effect of which must needs be to open and shut the pores and vessels, precisely as in the case of a sponge, and of parts having a spongy structure, when they are alternately compressed and again are suffered to expand. The liver, on the contrary, remains at rest, and is never seen to be dilated or constricted. Lastly, if no one denies the possibility in man, oxen, and the larger animals generally, of the whole of the ingested juices passing through the liver, in order to reach the vena cava, for this reason, that if nourishment is to go on, these juices must needs get into the veins, and there is no other way but the one indicated, why should not the same arguments be held of avail for the passage of the blood in adults through the lungs? Why not maintain, with Columbus, that skilful and learned anatomist, that it must be so from the capacity and structure of the pulmonary vessels, and from the fact of the pulmonary veins and ventricle corresponding with them, being always found to contain blood, which must needs have come from the veins, and by no other passage save through the lungs? Columbus, and we also, from what precedes, from dissections, and other arguments, conceive the thing to be clear. But as there are some who admit nothing unless upon authority, let them learn that the truth I am contending for can be confirmed from Galen's own words, namely, that not only may the blood be transmitted from the pulmonary artery into the pulmonary veins, then into the left ventricle of the heart, and from thence into the arteries of the body, but that this is effected by the ceaseless pulsation of the heart and the motion of the lungs in breathing.
There are, as everyone knows, three sigmoid or semilunar valves situated at the orifice of the pulmonary artery, which effectually prevent the blood sent into the vessel from returning into the cavity of the heart. Now Galen, explaining the use of these valves, and the necessity for them, employs the following language: [Footnote: De Usu partium, lib. vi, cap. 10] "There is everywhere a mutual anastomosis and inosculation of the arteries with the veins, and they severally transmit both blood and spirit, by certain invisible and undoubtedly very narrow passages. Now if the mouth of the pulmonary artery had stood in like manner continually open, and nature had found no contrivance for closing it when requisite, and opening it again, it would have been impossible that the blood could ever have passed by the invisible and delicate mouths, during the contractions of the thorax, into the arteries; for all things are not alike readily attracted or repelled; but that which is light is more readily drawn in, the instrument being dilated, and forced out again when it is contracted, than that which is heavy; and in like manner is anything drawn more rapidly along an ample conduit, and again driven forth, than it is through a narrow tube. But when the thorax is contracted the pulmonary veins, which are in the lungs, being driven inwardly, and powerfully compressed on every side, immediately force out some of the spirit they contain, and at the same time assume a certain portion of blood by those subtle mouths, a thing that could never come to pass were the blood at liberty to flow back into the heart through the great orifice of the pulmonary artery. But its return through this great opening being prevented, when it is compressed on every side, a certain portion of it distils into the pulmonary veins by the minute orifices mentioned." And shortly afterwards, in the next chapter, he says: "The more the thorax contracts, the more it strives to force out the blood, the more exactly do these membranes (viz., the semilunar valves) close up the mouth of the vessel, and suffer nothing to regurgitate." The same fact he has also alluded to in a preceding part of the tenth chapter: "Were there no valves, a three-fold inconvenience would result, so that the blood would then perform this lengthened course in vain; it would flow inwards during the disastoles of the lungs and fill all their arteries; but in the systoles, in the manner of the tide, it would ever and anon, like the Euripus, flow backwards and forwards by the same way, with a reciprocating motion, which would nowise suit the blood. This, however, may seem a matter of little moment: but if it meantime appear that the function of respiration suffer, then I think it would be looked upon as no trifle, etc." Shortly afterwards he says: "And then a third inconvenience, by no means to be thought lightly of, would follow, were the blood moved backwards during the expirations, had not our Maker instituted those supplementary membranes. "In the eleventh chapter he concludes: "That they (the valves) have all a common use, and that it is to prevent regurgitation or backward motion; each, however, having a proper function, the one set drawing matters from the heart, and preventing their return, the other drawing matters into the heart, and preventing their escape from it. For nature never intended to distress the heart with needless labour, neither to bring aught into the organ which it had been better to have kept away, nor to take from it again aught which it was requisite should be brought. Since, then, there are four orifices in all, two in either ventricle, one of these induces, the other educes." And again he says: "Farther, since there is one vessel, which consists of a simple covering implanted in the heart, and another which is double, extending from it (Galen is here speaking of the right side of the heart, but I extend his observations to the left side also), a kind of reservoir had to be provided, to which both belonging, the blood should be drawn in by one, and sent out by the other."
Galen adduces this argument for the transit of the blood by the right ventricle from the vena cava into the lungs; but we can use it with still greater propriety, merely changing the terms, for the passage of the blood from the veins through the heart into the arteries. From Galen, however, that great man, that father of physicians, it clearly appears that the blood passes through the lungs from the pulmonary artery into the minute branches of the pulmonary veins, urged to this both by the pulses of the heart and by the motions of the lungs and thorax; that the heart, moreover, is incessantly receiving and expelling the blood by and from its ventricles, as from a magazine or cistern, and for this end it is furnished with four sets of valves, two serving for the induction and two for the eduction of the blood, lest, like the Euripus, it should be incommodiously sent hither and thither, or flow back into the cavity which it should have quitted, or quit the part where its presence was required, and so the heart might be oppressed with labour in vain, and the office of the lungs be interfered with. [Footnote: See the Commentary of the learned Hofmann upon the Sixth Book of Galen, "De Usu partium," a work which I first saw after I had written what precedes.] Finally, our position that the blood is continually permeating from the right to the left ventricle, from the vena cava into the aorta, through the porosities of the lungs, plainly appears from this, that since the blood is incessantly sent from the right ventricle into the lungs by the pulmonary artery, and in like manner is incessantly drawn from the lungs into the left ventricle, as appears from what precedes and the position of the valves, it cannot do otherwise than pass through continuously. And then, as the blood is incessantly flowing into the right ventricle of the heart, and is continually passed out from the left, as appears in like manner, and as is obvious, both to sense and reason, it is impossible that the blood can do otherwise than pass continually from the vena cava into the aorta.
Dissection consequently shows distinctly what takes place in the majority of animals, and indeed in all, up to the period of their maturity; and that the same thing occurs in adults is equally certain, both from Galen's words, and what has already been said, only that in the former the transit is effected by open and obvious passages, in the latter by the hidden porosities of the lungs and the minute inosculations of vessels. It therefore appears that, although one ventricle of the heart, the left to wit, would suffice for the distribution of the blood over the body, and its eduction from the vena cava, as indeed is done in those creatures that have no lungs, nature, nevertheless, when she ordained that the same blood should also percolate the lungs, saw herself obliged to add the right ventricle, the pulse of which should force the blood from the vena cava through the lungs into the cavity of the left ventricle. In this way, it may be said, that the right ventricle is made for the sake of the lungs, and for the transmission of the blood through them, not for their nutrition; for it were unreasonable to suppose that the lungs should require so much more copious a supply of nutriment, and that of so much purer and more spirituous a nature as coming immediately from the ventricle of the heart, that either the brain, with its peculiarly pure substance, or the eyes, with their lustrous and truly admirable structure, or the flesh of the heart itself, which is more suitably nourished by the coronary artery.
CHAPTER VIII
OF THE QUANTITY OF BLOOD PASSING THROUGH THE HEART FROM THE VEINS TO THE ARTERIES; AND OF THE CIRCULAR MOTION OF THE BLOOD
Thus far I have spoken of the passage of the blood from the veins into the arteries, and of the manner in which it is transmitted and distributed by the action of the heart; points to which some, moved either by the authority of Galen or Columbus, or the reasonings of others, will give in their adhesion. But what remains to be said upon the quantity and source of the blood which thus passes is of a character so novel and unheard-of that I not only fear injury to myself from the envy of a few, but I tremble lest I have mankind at large for my enemies, so much doth wont and custom become a second nature. Doctrine once sown strikes deep its root, and respect for antiquity influences all men. Still the die is cast, and my trust is in my love of truth and the candour of cultivated minds. And sooth to say, when I surveyed my mass of evidence, whether derived from vivisections, and my various reflections on them, or from the study of the ventricles of the heart and the vessels that enter into and issue from them, the symmetry and size of these conduits,—for nature doing nothing in vain, would never have given them so large a relative size without a purpose,—or from observing the arrangement and intimate structure of the valves in particular, and of the other parts of the heart in general, with many things besides, I frequently and seriously bethought me, and long revolved in my mind, what might be the quantity of blood which was transmitted, in how short a time its passage might be effected, and the like. But not finding it possible that this could be supplied by the juices of the ingested aliment without the veins on the one hand becoming drained, and the arteries on the other getting ruptured through the excessive charge of blood, unless the blood should somehow find its way from the arteries into the veins, and so return to the right side of the heart, I began to think whether there might not be a MOTION, AS IT WERE, IN A CIRCLE. Now, this I afterwards found to be true; and I finally saw that the blood, forced by the action of the left ventricle into the arteries, was distributed to the body at large, and its several parts, in the same manner as it is sent through the lungs, impelled by the right ventricle into the pulmonary artery, and that it: then passed through the veins and along the vena cava, and so round to the left ventricle in the manner already indicated. This motion we may be allowed to call circular, in the same way as Aristotle says that the air and the rain emulate the circular motion of the superior bodies; for the moist earth, warmed by the sun, evaporates; the vapours drawn upwards are condensed, and descending in the form of rain, moisten the earth again. By this arrangement are generations of living things produced; and in like manner are tempests and meteors engendered by the circular motion, and by the approach and recession of the sun.
And similarly does it come to pass in the body, through the motion of the blood, that the various parts are nourished, cherished, quickened by the warmer, more perfect, vaporous, spirituous, and, as I may say, alimentive blood; which, on the other hand, owing to its contact with these parts, becomes cooled, coagulated, and so to speak effete. It then returns to its sovereign, the heart, as if to its source, or to the inmost home of the body, there to recover its state of excellence or perfection. Here it renews its fluidity, natural heat, and becomes powerful, fervid, a kind of treasury of life, and impregnated with spirits, it might be said with balsam. Thence it is again dispersed. All this depends on the motion and action of the heart.
The heart, consequently, is the beginning of life; the sun of the microcosm, even as the sun in his turn might well be designated the heart of the world; for it is the heart by whose virtue and pulse the blood is moved, perfected, and made nutrient, and is preserved from corruption and coagulation; it is the household divinity which, discharging its function, nourishes, cherishes, quickens the whole body, and is indeed the foundation of life, the source of all action. But of these things we shall speak more opportunely when we come to speculate upon the final cause of this motion of the heart.