the use of the truss, insisted that regular surgeons should not abstain from the treatment of hernia, cataract, and stone, and followed the practice of the old French lithotomists in employing a grooved director; he suggested syphilis as a cause of aneurism and hypertrophy of the prostate as a cause of strangury; he revived version by the feet, advocated prompt evacuation of the uterus in case of hæmorrhage during labor, and knew of the possibility of the Cæsarean operation during the life of the mother; he performed bronchotomy, neurotomy, staphyloplasty, and made use of the figure 8 suture in cases of hare-lip; he removed articular concretions, refrained from the too frequent dressing of ulcers, improved the method of trepanning, and made advances in eye surgery. Like Guy de Chauliac, Paré did not confine his attention to surgery, but wrote on various branches of medical science and insisted on isolation of those suffering from leprosy.

The work of the father of modern surgery was supplemented by his favorite disciple Guillemeau, by Rousset, by Pierre Franco, by Laurent Colot, by the Italian Tagliacozzi, and by the naval and military surgeon William Clowes (1540-1604). With the father of modern anatomy must likewise be mentioned his contemporaries Vidius, Charles Etienne, the great Eustachius (1524-74), his pupils Fallopius and Columbus, his fellow-student Serve

tus, as well as Ingrassias, Aranzi, the brilliant Varolius, Andrea Cesalpino, and Fabricius (1537– 1619), the teacher of Harvey.

REFERENCES

Ball, James Moores: Andreas Vesalius. St. Louis, 1910. 149 pp. Heizmann, Charles L.: "Military Sanitation in the Sixteenth, Seventeenth, and Eighteenth Centuries," Annals of Medical History, pp. 281-300. '

Hopstock, H.: "Leonardo as Anatomist," Studies in the History and Method of Science, pp. 151-91, Clarendon Press, 1921. Leonardo da Vinci: I Manoscritti, edited by Sabacnikoff and Piumati, with French translation, and an introduction by Professor Duval. 2 vols. Paris, Turin, 1898, 1901.

Quaderni d'Anatomia, edited by Vangensten, Hopstock, and Fonahn, with English and German translations. Christiania. 6 vols. 1911-16.

Locy, W. A.: "Anatomical Illustration before Vesalius," Journal of Morphology, Chicago, 1911, pp. 945-87.

McMurrich, J. P.: "Leonardo da Vinci and Vesalius," Medical Library and Historical Journal, 1906, pp. 338-50.

Paget, Stephen: Ambroise Paré and his Times. London, 1897. 304 pp.

Pilcher, L. S.: "The Mondino Myth," Medical Library and Historical Journal, 1906, pp. 311-31.

Roth, M.: Andreas Bruxellensis (in German). Berlin, 1892. 500 pp.

Singer, Charles: "The Figures of the Bristol Guy de Chauliac MS" (circa 1430), Proc. Roy. Soc. Med., 1917, vol. x (Section, History of Medicine), pp. 71–90.

"Thirteenth Century Miniatures illustrating Medieval Practice," Proc. Roy. Soc. Med., 1915, vol. IX (S. H. M.), pp. 29-42.

Welch, W. H.: The Times of Vesalius. Contributions of Vesalius Other than Anatomical. Johns Hopkins Hospital Bulletin, 1915, pp. 118-20.

Vesalius: De Humani Corporis Fabrica Libri Septem, cum indice, etc. Venetiis, 1568. 510 pp.

CHAPTER VI

WILLIAM HARVEY AND THE REVIVAL OF PHYSIOLOGY

WE have seen in an earlier chapter the views of Erasistratus and Galen concerning the structure and function of the heart, the arteries, and the veins. The advance in anatomy led by Vesalius prepared the way for a further advance in physiology. His careful study of the structure of the minute ramifications of the veins and arteries must have brought him to the very threshold of the discovery of the circulation of the blood, and the second edition of the "De Fabrica" (1555) shows that he became very skeptical concerning the passage of blood from the right to the left ventricle through the septum of the heart. His incredulity on this score may have been strengthened by the "Restitutio Christianismi” of his fellow student Michael Servetus, published in 1553. In this book Servetus taught that the blood — or, at least, some of it -passes from the right ventricle to the left, not through the cardiac septum, but "is moved in a long passage through the lungs; by them it is prepared; it is made bright; it is transfused from the arterious vein to the venous artery"; in fact, that what we call arterial blood is "a mix

ture made in the lungs of the inhaled air with the blood which the right ventricle communicates to the left."

Before the death of Vesalius, Eustachius described a large vessel extending downward from the left subclavian vein, provided at its orifice with a semicircular valve, and containing a scanty, watery, fluid. The valves of the veins were known to Charles Etienne, another contemporary of Vesalius, to their master, Jacobus Sylvius, to Cannanus (in 1546), and other anatomists. Fabricius, the pupil of Fallopius and the master of William Harvey, observed the valves of the veins independently in 1574, and published an illustrated treatise on the subject ("De Venarum Ostiolis") the year after Harvey's graduation at Padua. Two other predecessors of Harvey took an honorable part in the discovery of the circulation of the blood. Matheus Realdus Columbus, who had been the assistant and successor of Vesalius at Padua, became in 1545 the first professor of anatomy at the University of Pisa, and in 1548 was called to Rome. In the "De Re Anatomica," which was published after his death in 1559, Columbus states that "the blood is carried by the artery-like vein to the lung and being there made thin is brought back thence together with air by the vein-like artery to the left ventricle of the heart." Harvey indeed acknowledged his indebted

ness to Columbus, "that skilful and learned anatomist," as well as to Galen, for guidance in reference to the pulmonary circulation. Andreas Casalpinus, 1519-1603, approached even more nearly the modern explanation of the circulation of the blood. In his "Quæstiones Peripatetica" (1571) he wrote as follows: "Of the vessels ending in the heart, some send into it the material which they carry, for instance the vena cava into the right ventricle, and the vein-like artery into the left; some on the other hand carry material away from the heart, as for instance the aorta from the left ventricle and the artery-like vein, nourishing the lung, from the right. To each orifice are attached little membranes the function of which is to secure that the orifices leading in do not let out and that those leading out do not let in." Cæsalpinus also knew that the arteries dilate as the heart contracts. Moreover, in his "Quæstiones Medica" (1593) he explains why, in case of ligature for venesection, the veins swell on the side of the ligature away from the heart, and, in general, that “there is a sort of perpetual movement from the vena cava through the heart and lungs into the aorta."

A year before the appearance of the "Medical Questions," Casalpinus left Pisa, where he had been professor of medicine since 1567, for Rome. At the same time Galileo, the father of dynamics, went