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poraries. Amatus Lusitanus observes (i. 52): "If you put a tube in the upper part of the vena cava and blow downwards, both the vena cava and the azygos will be inflated; but if you blow into the lower part of the vena azygos the air will not pass into the cava because of a valve and operculum which exists at their junction. And there is not the least doubt of this for I have proved it a thousand times. For in 1547 at Ferrara I caused twelve bodies of men and animals to be dissected, and both I and a great company of learned spectators saw that all happened as described. As also was observed by that admirable anatomist, J. B. Canani." Fallopius, writing to Vesalius, 1562, says that he could find no such valves. "Nor is Canani such a fool (neque ita ineptus est Cannanus) that he could not easily have seen the large and patent opening between the vena azygos and vena cava," and he concludes that either Amatus made a strange error, or that Canani was having a joke at his expense. To this Vesalius replies: "Whether you think Canani was amusing himself at my expense, as well as that of Amatus, I know not. For when I met him in consultation at Ratisbon on the case of Francis of Este, he told me he had seen valves in the vena azygos, in the renal veins, and at the bifurcation of the vena cava near the promontory of the sacrum, resembling in shape those of the aorta, and pulmonary artery, and serving to hinder reflux of blood." Vesalius determined to verify this on the first opportunity, but failed to find them “Has namque non reperi, but there is a certain thickness and swelling (extuberantiam) at the orifices of the veins, which, I suppose, they have mistaken for valves." As a matter of fact there usually are valves in this position, but they are rarely effective. When they are effective, they act in a way exactly the reverse of that concluded by Amatus from his "thousand experiments". Vesalius was at Ratisbon in 1546.

In 1565 Eustachius described and figured the valve at the end of the coronary vein of the heart. Columbus, 1559, declared that there are valves in the mesenteric veins per

mitting fluid to enter from the intestine, but preventing its regurgitation. Had he discovered the valves of the lacteals? Posthius, a pupil of Rondelet, commenting upon this in 1592, says there are no valves in the mesenteric veins, but very large and distinct ones in the femoral. Finally Fabricius published his treatise De Venarum Ostiolis in 1603, with beautiful illustrations of the valves, which he declares serve, like the locks and weirs on a river, to prevent the too rapid flow of the nutritive fluid, and to ensure its equable distribution.

This is a truly marvellous story. A great Galenic anatomist is the first to give a full and correct description of the valves and their function, but fails to see that any modification of the old view as to the motion of the blood is required. Two able dissectors carefully test their action by experiment, and come to a result the exact reverse of the truth. Urged by them the two foremost anatomists of the age make a special search for valves and fail to find them. Finally, passing over lesser peculiarities, an aged and honourable professor, who has lived through all this, calmly asserts that no anatomist, ancient or modern, had ever mentioned valves in the veins till he discovered them in 1574!

It is interesting to note that the three most distinguished pupils of the great orthodox anatomist were accused of heresy in religion as well as science. Vesalius was persecuted by the theologians, Etienne perished in the dungeons of the Inquisition, while Servetus, as all know, met a yet more terrible fate at the hands of Calvin. But the man who nearly anticipated Harvey deserves more than a mere mention. Medical history first meets with Michael Servetus, M.A., M.B., Paris, on a February afternoon, 1538, in the anatomy theatre of that university, where he has just finished dissecting a human subject, and is disputing with the dean of the medical faculty about some astrological lectures he had been giving. A few days later he sends "certain Italian friends" to apologise to the dean.

It

may have been in dissecting this subject, a rare thing at that time, that he noticed the solidity of the cardiac septum and large size of the pulmonary artery, which led him to the discovery of the so-called lesser circulation, and the "Italian friends" may have taken some hint of the new theory to Columbus at Padua. At any rate the first description of the pulmonary circulation was published by Servetus in his Restitution of Christianity, 1553, and the same theory was contained in the MS. copy of the work which he sent to Calvin at the end of 1545 or beginning of 1546. The reformer refused to return the manuscript, and lay in wait for seven years to slay its author, but a partial copy exists at Paris and contains the famous passage on the "vital spirits". Servetus begins by rejecting the doctrine of three spirits-natural, vital and animal-residing in the veins, arteries, and nerves respectively, and declares that the natural and vital spirits are not distinct, and that the fluids in the veins and arteries are of the same nature, thus removing one of the greatest hindrances in the way of Harvey's discovery. The vital spirit (i.e., arterial blood) is formed from "a mixture made in the lungs of the inbreathed air with the blood which the right ventricle communicates to the left. takes place, not through the cardiac septum, as generally believed, but by consummate art the subtle blood of the right ventricle is moved in a long passage through the lungs; by them it is prepared; it is made bright; it is transfused from the pulmonary artery to the pulmonary vein . . . it is purged from fume by expiration." He confirms this by the arguments noticed above, compares the connection between the artery and vein in the lungs with that between the portal and hepatic veins in the liver, and says that in the transition from artery to vein “there is a new kind of vessels in the lung formed out of vein and artery". It would be difficult to add much to this even at the present day, and Servetus might well claim to have discovered something unknown to Galen or to the greatest philosophers.

This

The early anatomists incurred risks of many kinds, as may be illustrated by the following story from Alexander Benedictus, professor at Padua at the beginning of the century. At the close of the anatomy course at Padua, a medical student left the university, taking with him some bones which he kept in a box with sweet herbs. Arriving at Venice in the evening, he left his luggage at an inn, and went out to enjoy himself. It got very late and he did not return, so "the impudent family of the publican" took possession of his baggage, and opened it in presence of the police. There they found the bones, and recognising an odour of sanctity, proceeded to adore them with bared heads. and bended knees. Then they took them to the magistrate and accused the unfortunate student of rifling the shrine of some saint, in order to study the profane science of anatomy on his bones. In another age or place he might have been tortured till he confessed the name of the saint, and burnt for sacrilege afterwards; but the Venetian secular arm was then strongly in favour of anatomists, and he was rescued by Franciscus Sanutus, consiliarius, vir summae virtutis," his accusers getting nothing but ridicule. Benedict tells the story so vividly that it seems not unlikely that he was himself the hero of it.

It is very interesting to read the original descriptions of various parts of our anatomy as given by their discoverers, but considerations of space confine us to the following account of the ponsor bridge of the brain, by Constantine Varolius: "I observe another large process of the cerebellum which I have not found noticed by any, though the following description will show its great importance. There arises from either side of the cerebellum a process which passes downwards and forwards embracing the spinal cord somewhat in the same way as the broad transverse muscles of the larynx, forming the third pair of common muscles (inferior pharyngeals) embrace the top of the gullet. Any one may see the position of this process in the skull where is a well marked transverse depression just in front of the

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foramen for the spinal cord. The modern opponents of Galen accuse him wrongfully when they say that he was mistaken in attributing the origin of some nerves to the cerebellum, for the auditory nerves, and I believe some others also, arise from this process. May I give a name to my discovery? When I saw the spinal cord passing under this transverse process like a canal under some bridge, I, for the sake of clearness, called it the bridge of the cerebellum, and have long been accustomed to use the term" (Ep. ad Mercurialem).

NOTES.

Carpi, Commentaria Super Anatomiam Mundini, Bologna, 1521. Vesalius, De Corporis Humani Fabricâ, Basel, 1543. A very full account of his biography, and of the great anatomists generally, may be found in Roth, Andreas Vesalius Bruxellensis, Berlin, 1892.

For the University of Padua during the sixteenth century see Papadopoli, Historia Gymnasii Patavini, Venice, 1727. Yriarte, La Vie d'un Patricien de Venise au xvi. Siécle, cap. ix.

Vicary's anatomy has been recently published by the Early English Text Society.

Sylvius named the cystic, gastric, intercostal, popliteal, and other arteries, and many muscles, including the obturators. It is not he, but his younger namesake, Sylvius of Leyden, who is recorded in the fissure and aqueduct of the brain. Here is his description of the valves: "Membranæ quoque epiphysis est in ore venæ azygi, vasorumque aliorum magnorum sæpe, ut jugularum, brachialium, cruralium, truncocavæ ex hepate prosilientis, usus ejusdem cum membranis ora vasorum cordis claudentibus” (Isagoge, i. 4).

For Servetus see Willis, Servėtus and Calvin, the review of this work in the Theological Review, 1878, and especially the numerous papers by Pastor Tollin in Rohlfs' Archiv and other periodicals.

A. Benedictus, Singulis Corporum Morbis Remedia, etc., Basel, 1508, v. 23 (story of the student). In book xxii. cap. 48 there is distinct mention of lithotrity: "Aliqui intus sine plagâ lapidem conterunt ferreis instrumentis, quod equidem tutum non invenimus".

XLIX. THE REFORM OF SURGERY.

THE progress of anatomy not only paved the way for Harvey, but brought with it a new surgery, founded no