wm harvey, baldness & ulcers

8/9/2019 Wm Harvey, Baldness & Ulcers

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Bryce K. Peterson, MS4

The Ohio State University

College of Medicine

6 March 2010


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Introduction

Background to Harveys storyWm Harvey

Other medical discoveries

Conclusion


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Map of Mars

with canalsdiscovered by

early telescope

Current

photographof Mars


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Galen

VesaliusColombo

Fabricius


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Galen of Pergamum, 2nd C. A.D.

Originally studied philosophy

Anatomic studies unsurpassed until Vesalius (16th C)

Suggested muscles controlled via nerves after his

experiments with nerve ligation

Endorsed Hippocrates (5th C. B.C.)ideas of 4 humors

Blood, Phlegm, Yellow Bile, Black Bile

However, experimentation led Galen to reject

Hippocrates idea that arteries contained pneuma only Arteries from heart drew air through pores of skin,

blood from liver in veins during diastole, combininginto sooty vapor

Sooty vapor crossed septum to LV, to be exhaled

This interpretation lasted until the 15th C.


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Medical Renaissance of the 16th C.

Return to original Greek writing

Discard Latin/Arabic interpretations

of past 12 C.

Greek Galenic Codex published 1525 (600 titles!)

Vesalius

Trained by conservative Galenic physician at Padua

Studied anatomy via human dissection

De humani corporis fabrica, 1543

Rejected Galens assumptions

Explicitly showed ventricular septum was not permeable


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Vesaliuss successor at Padua

Tried to establish himself through

public schism with mentor De re anatomica (1559) suggested thatGalenic model of Air/Blood mixing in RVwas baseless

Logical analysis of components, and their size RV, pulm. artery, lungs


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Father of Embryology, Padua

1603 - Discovered valves in

veins Assumed to retard flow, allowing

symmetric distribution regulating volume, not flow


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Background

Experiments & Conclusions

Publish

De motu cordis

Impact


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Cambridge man (Caius College) Aristotelian, archaic education

Padua

Famed medical school of Europe

know I tread but the steps of other menwho have lighted me the way, and (so farre as

is fit) I make use of their notions. But in chief,of all the Ancients, I follow Aristotle; and of thelater Writers, [Fabricius], Him as my General,and this as my Guide.


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I do not profess either to learn or to teachanatomy from books or from the maxims of

philosophers but from dissections and fromthe fabric of nature

Harvey repeated Colombos experiments

Same results

Different conclusion

Argued that venous valves do not prevent pooling

Jugular valves are backwards, if this is the case


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Logical analysis

Calculation:

Heart rate, heart size

3.5 lbs of blood in 30 minutes

Inspection:4 lbs of blood in human body


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Original experiments on vasculature vialigatures

Blood could not be forced distal to heart past avenous valve

Impossible to draw blood at venous valve

Observed pulse remained, veins distended

further in arm when ligated Surmised connection b/n arterial/venous

systems


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Exercitatio anatomica de motu cordis etsanguinis in animalibus, 1628

1. The heart continuously pumps largevolumes of blood

Far more than could be explained by conversionfrom food

2.The Vena Cava sees more blood than thebody contains

3. The veins unceasingly return blood to heart


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De motu cordis

Presented the mechanical model of

closed circulation with pulmonary andsystemic components

Clung to his Aristotlean physiology

Heart distributed heat throughout the body

The heart envivified the blood, allowingit to carry some component to tissue, afterwhich it coagulated


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Debated heatedly

Primrose, Descartes, Bartholin

New Scientific Method? No.

Did not abandon Aristotlean magical physiology

Generally accepted by ~1650

His own clinic suffered

New ideas frightened off patients


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The major influence of Harveys work:

Attack on Galenic physiology


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Is progress always progress?


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Phalacrophobia

Peladophobia

fear of becoming bald

fear of bald people


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Prophylaxis of Baldness JAMA1903

If anyone had insisted 25 years ago that

tuberculosis was only slightly hereditary,but distinctly communicable, they wouldhave been laughed at. The germ theoryhas now become a doctrine of ever

widening scope, and we realize thatmany affections aredirectlycommunicable and only a fewhereditary. . .


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Premature baldness is practicallyalways associated with the presence

of certain bacteria.

Relative ischemia caused by

hatbands likely contributes tocondition by decreased immuneresponse


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Clinical prophylaxis:

Greater care should be taken with

regard to brushes and combs, especiallyin families in which early baldness is therule.

The hair brush should be dipped inantiseptic


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These precautions may seem a highprice to pay for the prophylaxis of

premature baldness, and many willprefer to take the chance ofbecoming bald, but some have such

a horror of the affliction that theywill willingly put themselves to suchtrouble to prevent it.


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Described accurately by Brinton, 1857

Etiological scope as broad as a good DDx

old age

privation

fatigue

mental anxiety

intemperance


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ACIDIFICATION

Due to focal infection

Lead to many procedures Extractions

Appendectomies

Colectomies

Colostomies

Fell out of favor in 1930s


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Psychological Factors

shell shock

the increasing demands of the industrialized world

Racial factors


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Progress is viewed through a human filter

Physician vs. Surgeon

Current paradigms

Ideology

to point this out is not in any way to denigratebiomedical science . . . it is merely to remindpractitioners that it would be wise to recognize

the contingent nature of etiologicalexplanations and therapies.


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I do not profess to learn or to teachanatomy from books or from the

maxims of philosophers but fromdissections and from the fabric ofnature. Wm Harvey

Skepticism vs. Acceptance


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1. Conrad, Lawrence, Michael Neve, Vivian Nutton, et. al. The WesternMedical Tradition. Cambridge, England, Cambridge University Press,

1995.2. French, Roger. William Harvey's Natural Philosophy. Cambridge,

England, Cambridge University Press, 1994.

3. Harvey, William, Gweneth Whitteridge, ed., De Motv Locali Animalivm.Cambridge, England, Cambridge University Press, 1959.

4. Harvey, William, Gweneth Whitteridge, ed., The Movement of the Heart

& Blood. Blackwell Scientific Publications, Oxford, England, 1976.5. Harvey, William, Kenneth Franklin, ed. The Circulation of the Blood and

Other Writings. J.M. Dent & Sons, Ltd., London, England, 1979.

6. Magner, Lois. A History of Medicine. New York City, New York, MarcelDekker, Inc., 1992.

7. Porter, Roy. Cambridge Illustrated History of Medicine. Cambridge

University Press, Cambridge, England, 2001.

8. Porter, Roy. The Greatest Benefit of Mankind. Harper Collins Publishers,Ltd., NYC, USA, 1997.

9. Whitteridge, Gweneth. William Harvey and the Circulation of the Blood.MacDonald, London, England, 1971.

wm harvey, baldness & ulcers

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