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Book of the Month

June 2007

De motu cordis

  Frankfurt: 1628
Sp Coll Hunterian Y.7.13

William Harvey (1578-1657) has been described as the leading medical scientist of the Seventeenth Century and the founder of modern physiology. He is credited with being the first man to correctly describe the human blood circulation system. This system was first detailed in his Exercitatio anatomica de motu cordis et sanguinis in animalibus (Concerning the motion of the heart and blood), more commonly referred to as De motu cordis. This slim but significant volume is from the collection of William Hunter (1718-83); it has been selected as our Book of the Month for June to celebrate the 200th anniversary of Hunter's collections being gifted to Glasgow University.

title page of "De motu cordis"

The discovery and description of the blood circulation system was a landmark in medical history; it has even been described, by historian K. F. Russell, as the "greatest single contribution to anatomy and medicine in any century". In his short 72 page essay, Harvey attempted to describe the motion of both the heart and the blood, proving his hypothesis scientifically using empirical observations and reasoning. Indeed, the way in which Harvey tested his ideas and accumulated quantitative data to support his findings was arguably just as important to the development of medicine and science as the discovery itself.

section from chapter 14. The Latin text translates as: "It must of necessity be concluded that the blood is driven into a round by a circular motion in living creatures, and that it moves perpetually; and that this is the function of the heart, which by pulsation it performs; and lastly, that the motion and pulsation of the heart is the only cause"

By using simple, clear and easily replicable experiments Harvey described the two phases of the heart's motion: systole (contraction) and diastole (expansion). Subsequently, by estimating the volume of blood in the left ventricle of the heart and measuring the rate at which it flowed into the principal artery, Harvey concluded that existing explanations of blood movement must be incorrect. Contemporary thought posited that blood was created in the liver before passing through the heart and being consumed by the body. Harvey's measurements suggested that the rate at which blood was being pumped out of the heart would necessitate an impossibly large volume of blood to begin with for traditional models to be correct. Observations of the heart's one-way valve system and an appreciation of cycles in nature instilled through his Aristotelian education helped Harvey to conceive of the circulation system.
Ever since De motu cordis was first published in 1628, a number of competing claimants, in opposition to Harvey, have been promoted as the true "discoverers" of circulation.  While most of these figures have been dismissed by commentators and historians, one possibility, Ibn an-Nafis, seems to have merit.  Nafis, an Arabian physician who studied in Damascus and taught in Cairo, apparently described pulmonary circulation in the Thirteenth Century - almost three hundred years before Harvey.  Unfortunately for him, his work seems to have been unknown outside of the eastern Mediterranean: he is therefore not widely acknowledged as the "discoverer" of circulation since his work failed to impact on the development of western medicine.

Nontheless, despite Nafis not directly impacting on Harvey's work, the improved understanding of the circulation system, as with any scientific "discovery", arrived as a result of earlier breakthroughs. A new body of anatomical knowledge began to emerge from the mid Sixteenth Century onwards. Firstly in 1543 Andreas Vesalius (1514-1564), professor of surgery and anatomy at Padua, published De humani corporis fabrica, accurately describing human anatomy for the first time. Matteo Realdo Colombo (1516-1559) and then Girolamo Fabrizi of Aquapendente (Fabricius) (ca. 1533-1619), William Harvey's tutor, added to the body of physiological and anatomical knowledge by deducing that, contrary to received opinion, only one blood circulation system existed rather than the two proposed by Galen (129- ca. 200).


detail from plate 1: Harvey performs a simple experiment - using a ligature to extend the veins in the arm he shows that blood can only be moved along the veins in one direction hence proving the existence of one-way valves in the veins

portrait of Vesalius demonstrating the anatomy of the human arm - from "De humani corporis fabrica libri septem" (Sp Coll Bi6-a.5)

Prior to Vesalius, Galenic orthodoxy had gone unchallenged for centuries. Galen and his adherents were unable to dissect human bodies on religious and ethical grounds, instead having to study other mammals. Consequently, many mistakes and false assumptions crept into anatomical discourse. By the Sixteenth Century, Galenic ideas of anatomy and physiology were taught in universities alongside an Aristotelian natural philosophy that linked all natural structures directly with the function for which they were intended.

Galen proposed a method of study that allied reason and logic with sensory observations. He suggested that both reason and observation served a dual purpose: arriving at the truth - then helping confirm truths once they became established. Despite being wrong in many of his conclusions, the anatomical structures described by Galen fitted perfectly with the function for which he claimed they were intended. Considering that approved methodology advocated investigations to support established "truth" rather than test it, no significant medical breakthroughs were achieved for nearly 1500 years after Galen's death.

detail from plate 2: tourniquets/ligatures were often used to distend the veins of the arm in preparation for blood letting.  Blood letting, or phlebotomy, was an important way of maintaining the humoural equilibrium in the traditional
 Galenic system of medicine


Vesalius corrected many anatomical myths with his 1543 De humani corporis fabrica; however, Galen's theories on physiology were still popular at the start of the Seventeenth Century. Many of these ideas seem strange in our post-Harveian world where the heart is acknowledged as merely a pump for the blood.

Harvey's contemporaries understood the body in the same way that Aristotle and the hippocratics had described it - as a microcosm of the greater cosmos. The four earthly elements of fire, earth, water and air were apparently manifested in the human body in four humours: yellow bile, black bile, blood, and phlegm. Each of these humours had specific character traits: yellow bile - choleric and hot tempered; black bile - melancholic and sad; blood - sanguine and cheery; and phlegm - phlegmatic and unemotional.

As opposed to modern ideas of disease concentrating on external factors, the humoural system associated any health problems with a loss of humoural equilibrium within the body. Personality and behaviour, now associated with mental processes and brain function, were directly related to physiological processes of the heart and the balance of humours. The heart therefore was right at the centre of what it was to be human.

detail from plate 2: a hand gripping a Barber's pole in preparation for blood letting.  Medical practice in the Seventeenth Century was divided between the physicians (diagnosing and treating), barber-surgeons (operating and blood letting) and apothecaries (dispensing medicine) 

figure 4 from plate 2: Harvey's final experiment on the ligated arm shows that blood in the veins flows towards the heart rather than away from it

title page of Francis Bacon's 1620 "Instauratio magna".  This work challenged the Aristotelian method of learning through deductive reasoning and advocated a wholesale reorganisation of the sciences.  Harvey's "De motu cordis" was considered very much in keeping with this new approach to natural philosophy.  The title page of the "Instauratio" seems emblematic of the proposed journey into new territory, picturing a ship passing through the pillars of Hercules out into the "new world". (Sp Coll Bm1-e.15)

Downgrading the role of the heart from a vital organ directly involved in personality, psyche and spirituality to a mere pump had many implications. The investigation into the role of the heart within the body took place during a period where significant political and constitutional debates were taking place. The de-mystification of the heart re-enforced challenges to other received "truths" - such as Charles I's divine right to rule England. Furthermore, Harvey provided ammunition to the new breed of philosophers rejecting Aristotelian ideas. René Descartes (1596-1650) quickly adopted and championed Harvey's idea of circulation seeing it as a neat way of removing the soul from the equation and so creating a purely mechanical explanation of the body.

Perhaps the most lasting influence, however, was brought about due to Harvey's scientific method. De motu cordis was often described as the very epitome of Baconian methodology. While commentators such as Walter Pagel have shown that Harvey was, in fact, very conservative, owing many of his circulatory ideas to traditional Aristotelian thought, De motu cordis quickly became understood as a rejection of traditional methods. It was viewed as challenging the traditional system of deductive reasoning via syllogisms, instead advocating experimentation and sensory experience. The empirical methodology observable in Harvey's work is now the acknowledged scientific method and has been universally adopted across all science and medicine.

figure 1 from Descartes' "De homine", published posthumously in 1664, depicting the human heart.  Descartes, who also rejected traditional Aristotelian ideas of natural philosophy, was instrumental in promoting Harvey's ideas on circulation.  However, in contrast to Harvey, Descartes wrongly claimed that circulation was caused by heat-driven blood expansion rather than by the action of the heart.  For Descartes, Harvey's explanation of the heart pumping the blood did not fit with his strictly dualistic dichotomy of soul (i.e. mind) and body.  According to Descartes' ontology, if the heart was acting of its own free will, not directly controlled by human thought, it must have a conscious soul - for him, an absurd notion. (Sp Coll Ferguson An-c.37)

It is perhaps ironic that an Aristotelian traditionalist and conservative produced a work that challenged all orthodox thinking - a work which became synonymous with modernity and change. William Harvey was born in Folkestone, Kent in 1578; he was schooled at King's School Canterbury then Gonville and Cauius College Cambridge. However, arguably it was his subsequent medical schooling at Padua, and resultant exposure to the anatomical research and methods of his Paduan predecessor Vesalius and his teacher Fabricius, that was most instrumental in his medical development.

The University of Padua was a popular destination for many English medical students at the turn of the Seventeenth Century owing to its esteemed teaching staff and improved opportunity, in comparison with Oxford and Cambridge, for taking part in anatomical dissection. However, not all anatomy instruction at Padua followed the same approach. Vesalius had advocated a very novel empirical model urging students to become involved in dissection and "feel with [their] own hands and trust them". Conversely, Harvey's tutor Fabricius taught anatomy from an Aristotelian natural philosophical standpoint rather than a structural one - so advocated a less "hands-on" approach, discouraging direct participation. Consequently Harvey was educated in an environment where there was a tension between describing anatomy structurally, using an empirical approach, and teaching anatomy from a broader Aristotelian philosophical standpoint, explaining units of anatomy in isolation.


frontispiece from the first English translation of "Exercitationes de generatione animalium", another of Harvey's notable works. The frontispiece depicts a bust of William Harvey. (Sp Coll Hunterian Au.1.4)

title page from Vesalius's 1543, "De human corporis fabrica liborum epitome".  The illustrated title page depicts a busy anatomy theatre with the author, Vesalius, at the centre, conducting his own dissection and trusting his own hands rather than relying on those of the demonstrator. (Sp Coll Ay.2.14)

detail from p. 8 of Harvey's epistle dedicatory to Dr. Argent, President of the Royal College of Physicians.  Harvey provides an example of the reverence he displays towards Galen and Aristotle.  The Latin translates as: "I do not endeavour nor think it fit to defraud any of the Ancients of the honour that is due to him ... nor do I think it seemly to contend and strive with those who have been excellent in anatomy and were my teachers"


Arguably this legacy of two alternative approaches can be seen in De motu cordis. While in practice, Harvey carried out experiments on the heart, taking measurements and "feel[ing] with his own hands" in the Vesalian tradition, he remained very deferential towards the ideas of Galen and particularly Aristotle throughout - even describing his enquiry as philosophical rather than medical.

detail from the title page of Vesalius's "De humani corporis liborum epitome".  This detail from the title page shows animated onlookers straining to see the dissection in progress.  According to Cynthia Klestinec, writing about sixteenth century Paduan anatomy theatres, Vesalius practised anatomy teaching just as he preached it.  She cites the testimony of one of Vesalius's students, Baldassar Heseler, who describes, "mad Italian students pulling the dog [the object of the dissection] back and forth so that nobody could truly feel [the] movements [of the heart]"

detail from p.3 of "De motu cordis", the dedication to King Charles I.  In the dedication Harvey likens the King's role in the state to the heart's role in the body

Harvey's conservatism extended to his political opinions too. In the debates that raged during the Seventeenth Century over religious tolerance and the respective roles of parliament and monarch in running the country, Harvey came down firmly on the side of the king. In addition to his regular job as physician at St. Bartholomew's Hospital, Harvey was employed as physician extraordinary to both King James I and later his son Charles I. During the First Civil War of 1642 Harvey even left London and resided with the Royal court at Oxford.

His loyalty to the crown is evident in the wording of his dedication to Charles I in De motu cordis. In the dedication, Harvey likens the King's role in the state to that of the heart in the body, "the heart of all creatures is the foundation of their life, the Prince of all their parts . that on which all growth depends and from whence all strength and vigour flows. In like manner, the King is the foundation of his kingdom . the heart of his commonwealth, from whom all power flows and all mercy proceeds".

De motu cordis, despite being written by an Englishman and dedicated to the English King, was first published in Frankfurt, Germany, a matter that has often vexed commentators. Harvey was perfectly aware that the reactions to his new discovery might not be favourable, declaring in his prefatory dedication to De motu cordis, addressed to the Royal College of Physicians, "Over many centuries a countless succession of distinguished and learned men had followed and illuminated a particular line of thought.. So I was very much afraid of a charge of over presumptuousness should I have let that book [De motu cordis] . be published . unless I had first put my thesis before you...". It has therefore been suggested that the work may have been published in Germany in order to minimise provocation and outrage at home.


detail of the imprint details on the title page of "De motu cordis".  Harvey's work was first published by William Fitzer, a young English printer based in Frankfurt

details from pp. 5-6, the epistle dedicatory to Dr. Argent, President of the Royal College of Physicians.  In it Harvey acknowledges that the work he is putting forward is breaking from the current, well established thinking on the role of the heart and blood

However, other commentators point out that Frankfurt was a notable centre of learning during the first half of the Seventeenth Century. The decision to publish in Frankfurt rather than London may have made good sense academically: it would have enhanced his reputation and highlighted his discoveries to the European market.

Nonetheless, the Frankfurt based publisher, William Fitzer, being relatively unknown, was a strange choice for Harvey. A young Englishman living in Germany, Fitzer may have been chosen over other publishers after being recommended by Harvey's acquaintance and fellow physician, Robert Fludd (1574-1637). While it remains contested quite why Frankfurt and Fitzer were chosen by Harvey, opinion amongst commentators over the quality of Fitzer's work is of a consensus - poor. Most copies were produced on thin, poor quality paper with many errors in transcription from the manuscript. It has been suggested that the printers had great difficulty in deciphering Harvey's handwriting.  A small number of copies contain an additional two leaf erratum listing 126 corrections to the original proof - probably added to only part of the edition after the earliest copies had been distributed.

detail from page 20 of our featured copy, Sp Coll Hunterian Y.7.13.  It is a rare example of a first edition of "De moto cordis" printed on a high quality paper



We are privileged to hold two copies of De motu cordis in Glasgow University Library, the featured copy (Sp Coll Hunterian Y.7.13) and another copy lacking leaves A1-4 (Sp Coll Hunterian Ac.4.18).  Sadly neither copy contains the rare erratum; however, we are fortunate in that the featured copy is printed on different paper from most of the initial print run - an excellent quality paper with a different water mark.

Both copies of De motu cordis arrived in Glasgow in 1807 as part of the Hunterian Library. Dr Hunter (1718-83) was a famous anatomist and physician, and renowned collector of books, manuscripts, coins, medals, paintings, shells, minerals, and anatomical and natural history specimens. Under the terms of his will, his library and other collections remained in London for several years after his death - for the use of his nephew, Dr Matthew Baillie (1761-1823) - and arrived at the University in 1807.

detail from page 20 of Glasgow University Library's second copy of Harvey's 1628 "De motu cordis", Sp Coll Hunterian Ac.4.18.  It, like the majority of Fitzer's first edition run, is printed on a poor quality paper that has now turned brown and has become friable


The featured copy, Sp Coll Hunterian Y.7.13, can be viewed in the Special Collections display case on Level 12 of the library from mid June until mid September. Other items from William Hunter's library, including works by Andreas Vesalius, can be viewed in the Hunterian Museum from May 23rd as part of the bicentenary celebrations of Hunter's bequest.

All translations are from Gwyneth Whitteridge, 1976 apart from the translation of the epistle dedicatory in which Harvey relates his fear of being considered presumptuous and disrespectful of tradition: this translation is from Franklin, 1963, pp. 5-6.



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Robert MacLean June 2007