JMS Pearce
Hull, England

This distinguished physician, the greatest physiologist the world has seen, and the brightest ornament of our College.
—William Munk¹

William Harvey (1578–1657) was born in Folkestone, Kent, and attended King’s School Canterbury before proceeding to Gonville and Caius College, Cambridge. He graduated MD from Padua (1602) and FRCP (1607) and was elected physician to St. Bartholomew’s Hospital in 1607. In 1618, he was appointed Physician Extraordinary to James I, and subsequently to his son, Charles I, to whom he was devoted in the Civil War.

His De Motu Cordis et Sanguinis in Animalibus, Anatomica Exercitatio first accurately described the circulation of the blood. He presented it in the Lumleian lectures to the college, printed in 1628. Its originality and importance established his name amongst the immortals of medical history despite initial dissent from many physicians.²

There was, however, more to Harvey than this groundbreaking discovery. His writings and correspondence show that like many of his generation, he was an accomplished naturalist. By observation and vivisection he recorded the behavior and habits of many animals and speculated about their biological significance and mechanisms. Through such observations, including those in his clinical work, he became a cynosure who counseled physicians “to search and study out the secrets of Nature by way of experiment.” His own researches were not confined to the heart, but also included work on animal reproduction and development and medical anatomy. All were founded on observations of patients, dissections, and reasoning.

Amongst many subjects, he explored the understanding of the nervous system, which was then primitive and inaccurate. Much of this was contained in De motu locali animalium (Fig. 1),³ which comprised Harvey’s notes for a treatise, translated by Dr. Gweneth Whitteridge and remarkably first published in 1958/9. Early translations are considered inaccurate, owing in part to his notoriously bad handwriting.

His ideas of the anatomy and functions of the nervous system can be found in this and in his other works Exercitationes⁴ and Prelectiones.⁵ (Fig. 2)

He distinguished motor from sensory nerves and differentiated irritability from sensibility and contractility—two important contributions. Harvey’s ideas, though not always correct by modern standards, were rooted in the teachings of Aristotle, Galen,* and Vesalius.

Harvey performed many dissections and described the skull vault, venous sinuses, and two layers of meninges (the pia and arachnoid as one). He also observed pulsations that he related to the arteries and Galen’s spiritus animalis (by which he means what we now call the nerve impulse, and not the psyche)⁶ and he was familiar with brain swelling.

He wrote: “Palsies, or the deprivation of motion, occur when the animal spirits are hindered in their passage through the nerves, either by the oppression of the brain or by the affection of the nerves themselves.” In Prelectiones he noted that it is remarkable that a lesion of the right hemisphere should cause paralysis on the left side, and conversely, but failed to explain this. Apoplexy was related to lesions near the ventricles and he describes a case where the lesion appeared like “a little Poridg,” presumably an infarct.

When considering the primary senses, Harvey notes, “consciousness of five principal senses by which we judge external objects. The brain is like a sensitive root to which a variety of fibres tend, one of which sees, another hears, a third touches and a fourth and fifth smell and taste.”

Galen had thought that sensory and motor nerves were both efferent, carrying impulses from the brain. Harvey asked whether a nerve that is sensitive is the same as that which governs motion, “if movements originate in the brain like something that starts from the beginning and returns with sensation back to the beginning again.” Few before him had asked this vital question. Here he separated motor from sensory neurotransmission and gave a glimpse of a reflex circuitry previously unknown but later demonstrated by Marshall Hall in 1833.

Harvey associated epilepsy with an abundance of irritant matter or agitating spirits, but he opposed earlier notions that memory and mental faculties resided within the ventricles; these he correctly located in the substance of the brain.

In De motu locali animalium he stated: “Tremors arise from a certain irritation or agitation of the nervous fibers, where the motion of the animal spirits is disturbed, causing a shaking of the body, often manifesting in the limbs.” Convulsions he observed “when the animal spirits are violently agitated or driven into unnatural motion, either due to an external cause or disease of the brain.” Contractures he said “result from the unopposed and continued action of the muscles, where the spirits of the muscles are continually in a state of tension, preventing relaxation.” He also recorded various palsies, dwarfism, and fasciculations.⁶ His descriptions are generally based in terms of Galenic “spiritus animalis.” But he plainly recognized that both epilepsy and movement disorders might stem from disorders in the brain substance, even though the mechanisms were both unexplored and unknown in his time.

Muscles and movement

Hieronymus Fabricius, his teacher at Padua, attributed muscular contractions to an impulse from the brain traversing the spinal cord and “hollow” nerves. Harvey described the different locomotion of about fifty animal species and speculated on the functions of muscles and nerves. He asked, how is movement initiated? And he noted the complexity and diversity of movement involved in any single action. Though unable to solve these problems, his inquiring mind stimulated their later investigation.⁷

Unlike his contemporaries, he believed that the muscles were concerned with contraction.³ He advanced muscle physiology by separating active from tonic movements (that he called sustained muscular contraction), which he had observed in a kite in flight or while hovering, in spiders, and in a trout while maintaining its position in a torrent of water.

He described convulsions, cramps, twitches, tremors, contractions, and postural arching of the trunk in tetany (i.e. tetanus). He also identified antagonistic, relaxation, and tonic movement. Voluntary movements he deduced were controlled by the brain, but involuntary movements such as occurred in the pulse, defecation, or vomiting, or briefly in a decapitated cock, were “not under our control.” Some thirty years later, Giovanni Alfonso Borelli investigated how muscles move in walking, swimming, and flying, which he reported in De Motu Animalium (1685).

Harvey recognized that power and sensation could be dissociated. Sir Kenelm Digby, cited by Hunter and Macalpine,⁸ told that Harvey had reported to him a servant of the college who was dexterous and “exceeding strong to labour …yet he was so voyde of feeling that he vsed to grind his handes against the walles, and against course lumber… without his feeling of what occasioned it.”

Charleton in 1680 credited Harvey with distinguishing what he “call’d by the name of Tactus Naturalis” or “Natural sense of Touching whereof we are not conscious . . . from the Animal Sense of Touching, whereof we alwayes are conscious.”

He also reported the rudiments of peripheral nerve pressure palsies: after pressure on a nerve at the olecranon, two fingers became numb. Similarly, compressing the nerve at the hip could induce loss of sensation in the leg without motor weakness.

He gave graphic descriptions of several abnormal gaits: “like a crane,” “ambling Turk,” “tripping on the toe, cork shoes,” “stamping on the feet,” but their diagnostic significance is not always obvious.⁶

Hunter and Macalpine commented on several patients in whom Harvey recognized psychological factors determining physical symptoms and mentioned hysteria in an eighteen-year-old maid with loss of sensation of the body but no loss of motion. Thinking it was uterine in origin (hysteria was thought to arise in the uterus), Harvey advised marriage, which “cur’d her of that strange disease.”⁸

In Exercitationes de Generatione Animalium (1651), Harvey studied embryonic development in animals (mainly deer and chickens). He rejected Aristotle’s theory of spontaneous generation, arguing that all life comes from an egg (“ex ovo omnia”). He observed how the embryo develops gradually (epigenesis), rather than suddenly appearing fully formed (preformation).⁹ In a characteristically erudite Harveian oration, Russell Brain said:

Harvey, though he was not an original contributor to our knowledge of neurology, nevertheless had what was, for the times in which he lived, a quite exceptional interest in the functions of the nervous system, and grasp of the problems which neurology presents… Since his vision embraced the whole of life he was a comprehensive man. He was in Sir Thomas Browne’s phrase, the “ocular philosopher,” a great observer, alike of man and of nature, and a thinker…⁶

Of contemporaneous personal accounts, few remain.¹ Geoffrey Keynes provided an admirable picture of Harvey the man.¹⁰ He was said to be of average height with a reserved, dignified, even somewhat commanding presence. He had a calm and composed demeanor.

 Aubrey’s Brief Lives contains selected details:

He was alwayes very contemplative, …His papers, together with his goods, in his lodgings at Whitehall, were plundered at the beginning of the Rebellion, he being for the king, and with him at Oxon; … When Charles I by reason of the tumults left London, he attended him, and was at the fight of Edge-hill with him…

After Oxford was surrendred, which was 24 July 1646, he came to London, and lived with his brother Eliab a rich merchant in London, on a hill, opposite to St. Lawrence (Poultry) church…His brother Eliab bought, about 1654, Cockaine-house, a noble house, where the Doctor was wont to contemplate on the leads [roof] of the house.

He did delight to be in the darke, and told me he could then best contemplate … He had a house at Combe, in Surrey, where he had caves made in the earth, in which in summer time he delighted to meditate.¹¹

William Harvey died, dysphasic after a stroke, on 3 June 1657 at the house of his brother Eliab in Roehampton and was buried in St. Andrew’s Church Hempstead, near Saffron Walden.

End note

* In Harvey’s time, so compelling were Galen’s opinions that the College of Physicians instructed its speakers that teachings to the contrary of Galen may be subject to a fine.

References

1. Royal College of Physicians. Munk’s Roll: Inspiring Physicians 1578-1657. Vol I: 124.
2. Whitteridge G. William Harvey and the Circulation of the Blood. Macdonald & Co., 1971.
3. Harvey W. De motu locail animalium, 1651. Ed., trans., and introduced by Gweneth Whitteridge. Cambridge UP, 1958/9.
4. Harvey W. Exercitationes degeneration animalium. Amsterdam: Elzivir, 1651. Republished London: J&A Churchill, 1686.
5. Harvey W. Anatomical Lectures [Prelectiones anatomia universalis and De musculis]. Trans. G Whitteridge, 1964.
6. Brain WR. William Harvey, Neurologist. In: Doctors Past and Present. London: Pitman, 1964: 8-29.
7. The Works of William Harvey, M.D., translated by Robert Willis. The London: Sydenham Society, 1847.
8. Hunter RA, Macalpine I. Harvey: His Neurological and Psychiatric Observations. Journal of the History of Medicine 1957;12:126-39.
9. Meyer AW. An Analysis of the De Generatione Animalium of William Harvey. Stanford UP, 1936.
10. Keynes G. The Life of William Harvey. Oxford: Clarendon Oxford UP, 1966.
11. Aubrey J. Brief Lives, Chiefly of Contemporaries, Set Down by John Aubrey, Between the Years 1669 & 1696. Ed. Andrew Clark. Oxford: Clarendon Oxford UP, 1898.