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 7: “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.
7De Placitis Hippocratis et Platonis, vi.
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