Chapter 13 Chapter Eleven Vesalius, Paracelsus, and Harvey:

A revolution in life sciences? The discussion of scientific revolutions tends to focus on physics and exact sciences rather than biology or life sciences; to focus on revolutions closely related to Copernicus, Newton, Galileo, and Kepler rather than Focus on the possibility of Vesalius or Harvey starting a revolution.Historians and scientists agree that all of the major scientific revolutions that preceded the 20th century—all but one—occurred in the field of physics.Darwin was largely responsible for that solitary revolution in biology.This chapter examines the scientific enterprise of three revolutionaries who may have led to a biological or life science revolution in the sixteenth and seventeenth centuries.

Andrea Vesalius: Rebellion or Revolution? Andre Vesalius (1514-1564), the founder of modern anatomy, in 1543, his great book ["On the structure (or structure) of the human body"] was published, which is the same as Copernicus's "celestial bodies "Operational Theory" came out in the same year.When his book was published, Vesalius was in the prime of his youth, full of vigor and vitality; at this time, Copernicus was in his twilight years, in fact, he had not long passed away.The talent of Vesalius was recognized from the very beginning of his career; he received with honors the degree of Doctor of Medicine from the University of Padua on December 5, 1537, and was appointed to the Department of Surgery the next day. A teacher who began teaching surgery and anatomy to medical students when he was only 23 years old.From the outset he showed his assertive character, breaking with tradition and "breaking convention... Do the dissection yourself, rather than leave the work to a surgeon" (O'Malley 1976, 4).A year later, in 1538, Vesalius published two works.One is an anatomy atlas, titled: "Six Anatomy".The other is an "updated" version of the anatomy manual used by former teachers "adapted to Galen's theory", this book is due to Vesalius' own "original anatomical insights" (such as "the contraction of the heart is related to Galen is famous for his apparently contrary opinion that the beating of the arteries was synchronized").According to official records, in 1539, the eminent anatomist and lecturer "had commanded the admiration of all his pupils."

In the same year, the judges of the Criminal Court of Padua handed over to Vesalius the bodies of executed criminals for anatomical study.With ample sources of cadavers available for dissection, Vesalius made major advances in the field of human anatomy and "began to gradually realize that Galen's descriptions of human anatomy were essentially The description of animal anatomy, and with respect to the human body, is often erroneous" (ibid., p. 5).By the end of 1539, he had been able to publicly declare in Padua and also in Bologna (where he was invited by medical students to give anatomy demonstrations) that the only way to learn human anatomy was not to read books by heart, but to directly Engaged in dissection and observation.By contrasting and comparing the articulated human skeleton with that of an ape or monkey, he proved beyond doubt that most of Galen's descriptions of the skeleton were based on apes rather than on man.Moreover, as Vesalius points out in the preface to Tectonics (O'Malizer, 1964, 321), "many incorrect insights . . . appear in Galen's theory, some even in his monkeys." Since Galen at that time was a respected and undisputed authority on every aspect of medical theory and practice, Vesalius' bold challenge must undoubtedly be seen as a rebellious behavior.So, is this the first step in a revolution?

The fact that Vesalius' masterpiece On the Structure of the Human Body is a thick folio with a remarkable number of full-page illustrations shows that the use of art has reached the heights of expressing scientific knowledge.It's also exciting to think about today, because they were achieved some four and a half centuries ago.Vesalius' later role in promoting the development of anatomy itself may have been diminished because, in fact, almost as soon as his book was published, he ended his academic career and gave up his anatomical studies.With "the impulse of youth" (O'Malley 1976, 5), he quit his teaching job and practiced medicine, becoming the "royal" physician to Emperor Charles V.

After Charles V abdicated in 1555, Vesalius remained in Spain and became the physician to Charles' son Philip II. In 1564 he left Spain for a pilgrimage to Palestine, and - apparently - died on the Greek island of Zakynthos on his way home. The purpose of Vesalius is to let doctors and anatomists realize some inappropriate or even fallacious things in Galen's anatomy at that time, so as to start to reform this discipline. At that time, this discipline—— —to use his words—to be in such a state that very little can be taught to the student, and not much more than what a butcher can tell the people in his shop.According to Vesalius, true anatomy, that is, anatomy based on anatomy, is the only solid and reliable foundation for the whole of medicine. C． D．O'Malley—a prominent 20th-century student of Vesalius' life and career—suggests that even "the word structure [in the title of Vesalius's book] can be interpreted as referring not only to the structure of the human body , but also refers to the basic structure or basis of medical art." Vesalius not only tried to correct Galen's error in a illustrated way, but also advocated that every medical student and every doctor himself should describe his own knowledge of the human body. Knowledge is based on performing anatomy.O'Malley sums up Vesalius' justification as: "In addition to surgeons who have done field dissections before, professors or teachers must step off their podiums and do the dissections themselves" (ibid., 7).In one of the most impressive parts of Vesalius's work, he explains how and why the failure of doctors to do their own dissections contributed to the decline of medicine.

In ancient or classical Latin, the closest thing to what we mean by the word revolution today is "novaeres" (literally, "new things").There is no doubt that there is a great deal of newness in Vesalius' Construct, many of which contradict Galen's account or already accepted views.Building anatomical knowledge based on direct human anatomy experience and, for comparison, animal anatomy, and promoting self-dissection work by medical students, anatomists, and physicians, It's all new and unheard of.Vesalius not only illustrates by example that this field dissection has yielded new knowledge; but he also gives the reader clear instructions on how to look at the dissection of the hand in order to justify Vesalius' own description, or " draw some sort of independent conclusion." The revolutionary value of Vesalius' work is considerably enhanced by the exquisitely detailed and artistic anatomical illustrations.Precisely to underscore this revolutionary suggestion of "do it yourself," Vesalius even devotes a full page of illustrations to showcasing the tools necessary to perform the dissections he advises readers to do.

There is no doubt that Vesalius succeeded in initiating a revolution in the discipline of anatomy and in the method of its teaching.According to O'Malley: "By the early seventeenth century, Vesalius' anatomy was winning both academic and public support, except in a few conservative centers such as Paris and certain parts of the Empire"( 1976, 12).O'Malley, however, does not say that Vesalius revolutionized the discipline of anatomy, nor that Vesalius started a revolution, and even begins his authoritative biography by saying: "Now, the great Some scholars do not consider André Vesalius the founder of modern anatomy" (1964).Nor do I find that historians of science—or, for that matter, historians of biology, medicine, and anatomy—have generally referred to a "Vesalian revolution," although unlike the usual Vesalius' tangible achievements and immediate impact in transforming his science seem more worthy of the use of "Vesalian Revolution" than the so-called astronomical reformation denoted in the expression "Copernican Revolution" this appellation.

One possible reason why Vesalius was not regarded as a revolutionary in the evaluation of Vesalius is that he was modest, which can be seen from his actual remarks about Galen: Lun Zun is called the "Prince of Doctors".In his published works, he neither takes a frontal attack on Galen or Galen's theory, nor does he criticize or correct Galen, except in such special cases that "he feels that there are sufficient reasons for taking such an approach." action" (O'Malley 1964, 149).He "never violated this code of his conduct", nor did he ever mock Galen or "publicly admonish him". (See also the discussion of Vesalius' humanism in Supplement 5.2 to Chapter 5 of this book.)

Vesalius did not adopt a revolutionary attitude against Galen.He hesitated for a long time before stating publicly anything that differed from Galen's teaching, and, when he finally did, he criticized Galen's writings on anatomy rather than "in general Galen's System of Medicine" (Walter Pagel and P. Ratanhi 1964, 318).Although Vesalius boldly criticized Galen's followers who never "diverged from him in the slightest" (Vesalius 1543, pref. 4; Trans. Farrington, 1932, 1362), Vesalius immediately He added that he himself did not wish to appear "a complete betrayal of the author's worth, or any disrespect to his authority." After pointing out that Galen "did not notice that the ostium of the vena cava was observed to be three times the size of the ostium of the aorta", Vesalius concludes, "However, I I do not find any pleasure in studying these and many other questions in greater detail" (O'Malizer, 1964, 177).This attitude contrasts perhaps with that of the rebellious Paracelsus (discussed later), who openly burned Avicenna's medical writings, thereby declaring them all worthless.

Vesalius's unrevolutionary attitude is perhaps most clearly reflected in the discussion of micropores in the septum (wall) that is said to separate the left and right ventricles.These micropores or channels were an essential part of Galen's physiology, and they provided the necessary pathway for blood to seep, one drop at a time, from the so-called "arteriovenous" (in our case, the pulmonary artery) into the "venous artery" (the or pulmonary veins).Galen taught (and Galenists believed) that air is transported from the lungs to the heart by the "venous arteries" where it seeps drop by drop through the pores in the diaphragm combined blood to produce arterial blood.We now know that although there are tiny dimples in the septum that separates the left and right ventricles, there is no such thing as a micropore that leads from the left ventricle to the right ventricle (or vice versa).These pits are difficult to discern; "not even a hair can pass through them from one side of the ventricle to the other" (Charles Singer 1956, 14).Yet Charles Singer notes that "some people, blind to rational proofs, continue to believe that such lines of thought do exist." Why? "Galen the Great believes they exist, and that is enough!"

By dissecting the human heart on the spot, Vesalius immediately understood that there was no such passage from one side of the heart to the other.I think that a true revolutionary could well conclude that the whole of Galenic physiology, and even Galenic medicine based on it, must be wrong, and should be discarded immediately, since they are in fact without any basis.But Vesalius didn't do that!On the contrary, in the second edition of his book (Basel, 1555) he showed a "lack of self-confidence", which probably only led him to reform Galen's teachings about the heart and blood (M. 6, Ch. 15) .We are told that he consciously "made his textbooks cater to Galen's theory (dogmata) to a large extent." The reason why Vesalius strictly adhered to Galen's theory of physiology and did not dare to go one step further was not because he sincerely Believing them to be correct, but "because he felt that he was incapable of carrying out the work of reform" (Pecher & Ratanhi, 1964, 318). Vesalius noted in "Construction" that the septum of the heart is "consisting of the very dense matter of the heart," so that—although the septum is "deeply dented on both sides"—"as far as we can perceive, there is no Which pit is constructed to pass from the right ventricle to the left ventricle." In view of this, he can only draw this conclusion: "We have therefore to make the blood flow from the right ventricle through invisible micropores for the Creator. Impressed by the technique [industria] of the left ventricle" (Singerzer, 1956, 27).In the second edition of Tectonics, this passage was slightly revised (ibid): Although these dimples are sometimes quite obvious, none of them perceptibly lead from the right ventricle to the left ventricle... I have not found the most hidden passage through the septum of the ventricles.However, those teachers of anatomy who assert that blood is pumped from the right ventricle to the left ventricle still describe such passages.In any case, I have serious doubts about the function of the heart in this respect. In another of his discussions of this issue, there are signs of his growing independence from Galen (Singerser, 1956, 28): With regard to the structure of the heart and the work of its parts, I have made my statements generally agree with Galen's teachings: not because I think that they are all consistent with the truth, but because, sometimes, I myself am still less confident when it comes to the new uses and efficacy of these parts.Not so long ago, I would have dared not stray a bit from Galen, the doctor-prince... Yet the septum of the heart is as thick and dense as the rest.So I can't imagine...how even the tiniest particle could get from the right ventricle through the septum material to the left ventricle. We seem to agree with Charles Singer's explanation of Vesalius' attitude to the heart (1956, 25): "In his day the whole of physiology was based on Galen's views, which required that one The belief that there are passages through the pores of the septum allowing blood to pass from the right ventricle to the left ventricle also requires the belief that air enters the heart through the venous arteries, known as the pulmonary veins." "Not good for the heart to explain the activities of the human body," Vesalius could hardly "dispute it," and to do so would have to "overthrow all prevailing views in the writings on the human body and change everything"; and this is Vesalius was "unwilling to do it." Thus, "he suggested in his writings that the passage through the septum of the heart did not really exist, but he did not say so outright at the outset" (ibid.). Vesalius was not a full-fledged revolutionary. He did not completely and categorically deny that the human body could possibly function as Galen had taught and Vesalius's contemporaries still believed. Of course, individual contradictory facts are not like T. H．Huxley (1894) said that "a beautiful hypothesis is killed by an ugly fact", can overthrow the theory.Many historians and philosophers of science have pointed out that some theories, although contradicted by individual experimental facts or observational facts, continue to exist until a better theory can replace them.Or, as Max Planck (and Joseph Loughlin put it some 80 years ago), the old theories never die until all those who believe in them die (1949; see margin p. 467).However, the accumulation of such contradictory facts will eventually sound the death knell of a certain theory or a certain scientific system, and lead to T. S．What Kuhn said is that one paradigm supersedes another.The fact is that in the "Construction" (and later in the "Introduction") Vesalius did not adopt the boldly rebellious attitude he had adopted in Padua and Bologna, when Vesalius openly used articulation Linking human skeletons and ape skeletons illustrates that Galen's skeletal anatomy applied to the animals he dissected, not to humans. Vesalius adopted a non-revolutionary attitude, even when arguing for some of Galen's errors; an attitude that undoubtedly had something to do with his personality.But we must also remember that a revolutionary attitude must be fully displayed in the field of science, as we have seen in the writings of Galileo, Descartes, Harvey, and later scientists of the second century. After all, this is still a bit early for the era of 1543.In addition, Vesalius was deeply influenced by the humanist tradition, which was based on the study of classical philosophy and literature.The great admiration of the arts and sciences, and seeks to restore the social norms of ancient Greek culture (see margin page 485 of this book, Supplementary material 5.2 of Chapter 5).Vesalius presumably realized that his task was to be a reformer of Greek anatomy and a restorer of the Greek anatomical tradition, not to be the initiator of an attack on popular ideas about Galenic science.As we shall see, Vesalius was not a revolutionist, whereas William Harvey was, apparently willing to abandon the basis of Galen's physiology and accept any impact it might have on the practice of medicine. rebellious paracelsus Many historians refer to Vesalius' contemporary but slightly older Paracelsus as revolutionary in his ideas.Indeed, the life and career of Paracelsus (1493-1541) bears a trace of rebellion, rebellion, and perhaps revolution.Even his use of the name Paracelsus (an alias he picked up when he was about 36 years old) may be a reference to the fact that he had published "traditional" paradoxical works (Pagel 1974, 304). The word "paradox" comes from the Greek words "beyond" and "opinion", which together mean "contradicting with...opinion", that is, "contradicting an accepted opinion". When Paracelsus was appointed physician and professor at the Municipal Hospital in Basel in 1527, he refused to take the routine oath; And a new system of medicine was proclaimed.Only a few months later (June 24, 1527) he publicly burned a standard textbook of the day: Avicenna's Canon of Medicine. Contrary to the rules and traditions of the academy, Paracelsus lectured not in Latin but in a Germanic dialect, and he even allowed a barber-surgeon into his workshops.He also rejected "organized religion and classical learning."He has been described as having "a parallel to his massive condemnation of conventional science and medicine, to be seen in his rude behavior and reluctant concessions to traditional custom and authority" (Pagel 1974, 306).Unorthodox behavior and polemics characterized his later life, which swung like a pendulum between a well-appointed career and a "roaming worldly agitator dressed as a beggar." "He died in Salzburg in 1541, and "long after his death" his grave became "a holy place of worship for the sick" (p, 305).Bombastus, the Christian name of Paracelsus, has long been considered the source of the word "bombast". As a scientific revolutionist, Paracelsus was influential in two important fields: medicine and chemistry.In his day, and for about two centuries thereafter, nearly all medical theory and practice was governed by the ancient doctrine that disease is caused by four bodily fluids (blood, mucus, bile or yellow) bile, and depressive or black bile) imbalance.It is believed that the diseases resulting from this imbalance are the direct result of excess or deficiency of one or more of these humors in relation to the particular "makeup" of each individual's body.Broadly speaking, this doctrine implies that there are as many different diseases as there are people, and that these diseases are not caused by any particular agent, and that they do not have any particular tissue influence or injury.A true revolutionary, Paracelsus took a very different position, arguing that disease was caused by causes external to the body and that each disease had a "special" site of occurrence.He was convinced that the causes of disease were to be found in the mineral world and in the air, and that disease "is determined by some special agent outside the body, which occupies a part of the body and exerts control over its structure and functions." , thereby posing a threat to life"—this is "the disease view or ontological view of disease caused by parasites, which is essentially the modern view of disease" (Page 1974, 307).The treatment methods of traditional medicine are nothing more than making the patient sweat, have diarrhea, or let people bleed and make people vomit, while the purpose of Paracelsus medicine is to find out special substances for treating each disease. Because of this, the search for medical chemicals is closely linked with Paracelsus' views on chemistry.He believed that there were three "elements" namely: salt, which was related to (or was responsible for) the solid state of any substance; sulfur, which was related to the state of combustibles or excess fat; vapor) or liquid.Although these are chemical elements, they are all implied to have a soul, which is inseparable from the unique alchemical imprint on Paracelsus.Paracelsus made many new compounds (mainly in his quest for potions), and he apparently invented the method of producing concentrated alcohol by removing water, which was borrowed by farmers in the northern United States. method, fermented apple juice can be made into apple brandy without a still.His influence on the development of chemistry may perhaps be seen in the 1618 and subsequent editions of the London Pharmacopoeia, which list the chemicals manufactured by Paracelsus, among them calomel.But his reputation was marred by his "uncompromising negation of tradition" (Pecher 1974, 3if), and his conscious revival and even development of the simple uneducated (or pagan) ) preserved folk medicine, which displeased many would-be disciples. Perhaps his greatest contribution to science was to divert alchemy from the traditional quest to refine base metals into gold or silver. The original purpose was transformed into trying to prolong life indefinitely, and a new goal was set for alchemy: to discover substances that can effectively treat diseases. The previous explanation is to clarify this point: What are the best and most meaningful things in the teaching and practice of Paracelsus that we feel today.Still, as Walter Page (1958, 344) reminds us, part of Paracelsus' chemistry belongs to the "cosmology and philosophy of the mystical domain" of symbols, which are "certainly unscientific" , although his work in the chemical laboratory was logical, he had new ways of formulating mineral compounds and worked on heavy metals. In medicine, although his new theory of disease and the accompanying medical Principles are important, but he objected to the traditional approach of basing theoretical medicine on anatomy and physiology—fields in which he knew little and had little interest.” "germ cell" concept in pathology, but it is "not scientific in general", since it is a collection of "analogies and metaphors based on his microcosm theory", in which system " The part of observation and raw science "perhaps seeps too much of a hodgepodge of speculation" that would strike us as strange" (ibid., 345). In medicine and chemistry, there was a Paracelsus movement that swept across Europe, beginning some 30 years after Paracelsus' death (Alan Debs 1965, 33-37; 1977).Watching the reaction from the opposite side, we can understand how powerful this movement is.For example, in 1569, the Duke of Bavaria ordered all the monasteries in his domain "to insist on teaching the medicine of Hippocrates and Galen, and not to teach the new medicine." Medicine in Paracelsus was "a revolutionary movement." , this famous movement in the 16th and 17th centuries also made its founder famous, and highlighted the characteristics of him "single-handedly" launching this movement (Pecher 1958, 349).Later, however, the movement discredited its initiators, and—because J. B．Van Helmont and others advanced the movement in a more rigorously scientific fashion - resulting in "medical chemistry" rather than Paracelsian chemistry. In Montaigne's Essays, written in the 1570s and 1580s, the term "revolution" does not seem to have been used to refer to radical "revolutionary" changes.The notion of such change appears in a striking form (though without actually using the term "revolution") in the most famous of these essays, "In Defense of Raymond Seppender," which Written about 1576.Speaking of medicine, Montaigne (1958, 429) speaks of "a strange man whom they called Paracelsus," who—they said—"was changing and overturning the ancient system of dogma, "And he insisted that, until now, medicine "has been of no use except to kill." I do not think it wise to put life to the test of his new experience." In another essay entitled "On the Resemblance of Father and Son," he speaks of a condensed history of ancient medicine (ibid., 586), which he calls "the qualitative changes in those ancient medicines," the word qualitative Very similar to the idiom used today when discussing revolutions in science.Montaigne speaks of "innumerable other cases [that is, qualitative changes] up to our time"; these, he says, are "for the most part" "out of the box. Universal qualitative changes, like Par Lacelsus, Leonardo Fioraventi, and Argentarius have brought about the same qualitative changes in our time." Montaigne then shows his understanding of the nature of Paracelsus medicine With full understanding, he notes that Paracelsus "transformed not just one convention, but, so far as I know, the whole subject and order of medicine." As Montaigne so accurately saw As already stated, Paracelsus and his followers had put forward a revolutionary program for the theory and practice of medicine. Obviously, the qualitative change in Paracelsus mentioned by Montaigne has the qualities required to become a revolution. So, has there really been a Paracelsus revolution?According to the classification system I have adopted in this book, Paracelsus was clearly a revolutionary.There is no doubt that the medicine of Paracelsus was a revolution in thought, that is, a "revolution in itself."In a recent article, Allan Debs (1976, 307) argues that there has been a "pharmaceutical revolution" following the revival of Paracelsus—and, he argues, began with " Paracelsus' fantasy of transforming medicine with chemistry." Now that Paracelsus published his insights in published form, and that they were adopted by his followers and used as their guides, I think that , it should be said with justice that the Paracelsus revolution in the treatise also had.However, to the question of whether Paracelsus caused a scientific revolution, many seventeenth-century authors answered no.And it is a sentiment shared by some of our sharpest historians today.Thus, Walter Pagel, the elder among the contemporary Paracelsus scholars, reminds us that in Paracelsus the primacy was "the study and exploration of nature to illustrate his The desire for the correctness of the philosophy of cosmology and philosophy of religion was the driving force for its study" (1958, 350).Pagel sums up his lifelong study of Paracelsus in this way: "Of the series of scholars of nature to whom modern science is owed," Paracelsus Seuss wasn't very good, he wasn't even a good "modern and revolutionary" doctor (ditto John Maxon Stillman (1920, 173) "His methods are not the methods of modern science," said Lacelsus's study. Stillman outlines this rather scholarly work by Max Neuberger, which he himself strongly agrees with. Opinion (ibid., 129): Newberg rightly values ​​the achievements of Paracelsus, but remains skeptical that he, like Vesalius and Ambroise Pare, can be regarded as a reformer of medicine , To be precise, he did not lay any important foundations, and the interpretation of the true value of most of his thoughts awaits the development of modern scientific thought in the future.His aim was to base medicine on the basis of physiology and biology, but the method he chose was not the right one, and his analogical reasoning and whimsical philosophy of the macrocosm and microcosm were neither convincing nor practical. No way.According to Newberg, the dissatisfaction and indignation about the state of medicine expressed by his lobbying activities is hardly a revolution.This revolution came about later through constructive work using a more scientific method. Two centuries earlier, Walter Charlton had said, "The admirers of that whimsical drunken Paracelsus are fools" (1654, 3), largely reflecting Charlton's respect for Paracelsus and his writings were rather dissatisfied. William Harvey and the Revolution in the Life Sciences William Harvey, unlike Paracelsus or Vesalius, was always deferential in his account of Galen, and seemed to suffer when he had to correct Galen.However, in his work on the blood circulation, he boldly and clearly stated that a new foundation for human physiology and animal physiology will be laid ethics theory.Harvey was fully aware of the revolutionary nature of his program, as were his admirers and detractors.He proposed a closed mechanistic system in which the heart pumps blood into arteries and veins; more than that, he developed the idea of ​​a single circulatory system.The single circulatory system of blood was in fact pioneered by Harvey.His work marks a radical shift from imaginary pathways to provable cycles, and from unprovable Galen's conjectures to quantitative biology grounded in empirical facts.The contribution of William Harvey brought the life sciences into the modern realm as a full-fledged participant in the scientific revolution. William Harvey was born in 1578, 35 years after the publication of Vesalius' Construct.From 1593 to 1599 he was a student of Gonville and Caius College, Cambridge University, then went to Padua for further education, and in 1602 he received the degree of Doctor of Medicine.Among Harvey's teachers was the great anatomist and embryologist Girolamo Fabrizi (or Fabrizius), discoverer of the valves of veins.When Harvey was in Padua, the university was a center of scientific development and active thought; the young Galileo was also a professor at the university, and he soon discovered the peaks on the moon, the phases of Venus, and the moons of Jupiter. and many other new celestial phenomena.On his return to England, Harvey practiced medicine and became a Fellow of the Royal College of Physicians (he was lecturer in surgery at Lumley from 1615 to 1656).He was appointed physician to James I and held a similar post under Charles I.He sympathized with the Royalists, and indeed remained Charles I's nurse during the Civil War.Because Charles I was very interested in Harvey's work, Harvey was allowed to use some of the royal family's deer for fertility research. Harvey died in 1657 at the age of 79. 与维萨里不同，哈维制定了一个被说成是"庞大的研究纲领"的计划，它有可能导致一系列以他"心脏运动、呼吸、脑功能和脾功能、动物的运动和生殖、以及比较解剖学和病理解剖学等方面的独创性研究"为基础的种种学科的著作的问世，和有关诸如动物的生殖与动物胚胎学这类课题的著作的出版（拜勒比尔1972，151）。然而他只完成和出版了两部专著，一部是有关血液循环的著作，题为《论心脏的运动》（1628），该书还有一个补充部分《论血液循环》（1649）；另一部是部头大得多的《论动物的生殖》（1651），它记录了当时和更早些时候有关卵生动物和胎生动物的生殖以及胚胎学思想的重大发展。这后一部著作采纳了渐成说的观点，它是以揭示全部可见的发育阶段的详尽分析为依据的。尽管哈维成功地阐述了"自古以来第一个全新的生殖理论，"但他的思想（虽然是"超过他的那些前辈的一项重大进步"）却在很大程度上逐渐被"后来的研究""破坏了"（拜勒比尔1972，159），而他的《论动物的生殖》相对于他的那部伟大著作《论心脏的运动》而言，显得不那么重要了。 哈维的那部论血液循环的著作的全名是：《动物心血运动的解剖研究》。这本书在美因河畔的法兰克福出版，书印得很糟，全书只有72页（加2页），并附有两幅插图。哈维发现血液循环一事是问世纪重大的科学事件之一。有人说，《论心脏的运动》"以简洁的形式包容了比已经出版的任何医学著作都丰富的重要内容"（道尔顿1884，163）。与他同时代的人充分意识到了，他对人类生理学和动物生理学所作的系统的阐述有着头等重要的意义。史学家和科学家们一致认为，他使生物学思想和医学思想发生了革命。总之，哈维的工作通过了鉴别科学革命的所有检验。此外，虽然哈维的著作写得很早，因而没有使用"革命"这个词，但他在说心脏的运动冲的确十分明确地表明，他已经有了很大的创新，即"我有关心脏运动和功能的新概念和血液在身体中循环运动的新概念"（1963，pref．5）。他写道，尽管许多"杰出和博学之士"已经阐明了这一学科的某些方面，"但我这部书是唯一的与传统相对立的著作，而且是唯一的断定血液是沿着它特有的、以前尚不为人所知的循环路线流动的著作"（p．6）。在第八章中（p．57），他简单明了地表明，他的思想"如此新颖，而且迄今为止尚未有人谈到过，以至于讲到它们时，我不仅担心会受到少数存心不良的人的困扰，而且害怕所有的人都会反对我。"哈维记述说，他领悟到血液循环的真谛，便开始在"私下向朋友们"、"在公开场合，在学院找开的解剖学课中"阐述其"有关这一问题"的观点。他的一些同事"要求对这一新生事物有更充分的解释，他们认定，这一问题值得研究，而且它将被证明具有极为重要的实践意义。"（与哈维的名字联系在一起的革命在前面的第5章中讨论过了。） 哈维对生物学和医学的生理学基础的根本性改革包括三个重要方面。其中意义最大的恐怕就是，坚定地把实验和细致的直接观察确定为发展生物学和确立医学知识的方法。对亚里土多德，哈维予以称赞，因为他注重实验；对盖伦，哈维则予以抨击，因为（哈维认为）他的学说实际上不是以实验甚至也不是以直接的观察为依据的。哈维使"新一代解剖学家"受到了鼓舞，"他们都试图仿效他在动物功能的研究中所使用的方法"（拜勒比尔1972，151）。哈维改革生物学的第二个重要方面是，引入了定量推理，并把它作为有关生命过程问题的结论的基础。当然，还有血液循环的发现，它完全"使生理学思想革命化了"（同上）。 我已经说过了，哈维著作中非常新颖的部分之一，就是论证了心脏、动脉和静脉构成了一个循环"系统"。在史学家对这个问题几乎所有的讨论中，哈维系统总是被用来与盖伦"系统"相比较。但事实上并不存在什么盖伦"系统"。盖伦连一部完整的介绍其生理学思想的著作都没有写过：史学家们所介绍的那个系统［正如特姆金（1973）提醒我们注意的那样〕，是用从他的不同著作中抽出来的只言片语拼凑而成的。而且，这些只言片语产生的不只是一个盖伦系统，而是好几个盖伦系统。例如，盖伦把肝脏和静脉看作是与心脏和动脉系统完全不同的系统。而哈维在这部分的革命则是单一系统概念。 要想了解哈维革命怎样完全改变了知识框架，有必要简略地考察一下当时所流行的一些思想观点。盖伦认为，已被消化的食物会以"乳糜"的形式被输送到肝脏，在这里它又转变成血液，随后血液又从这里流出，通过静脉把营养送到身体的各个器官和各个组成部分。血液被假定在肝脏中注满了"天然元气"，据信，这种天然元气是完成生命活动不可或缺的东西。肝脏血虽然也有涨有落（不过不是循环），但大部分都从肝脏中流了出去。按照盖伦系统的观点，有一部分肝脏血通过"动静脉"（即自哈维以来人们所说的肺动脉）流入肺中，在这里，它会把聚积起来的杂质和废物排入周围的空气中。据认为，另一部分肝脏血则流入了心脏的右心室；盖伦假定，这部分血将通过把左心室与右心室分隔开的心脏隔膜或肌肉壁上的狭小通道，流到心脏的左部。据认为，一旦这部分血液流入了左。动室，便会通过"静动脉"（即我们所说的肺静脉）与进入肺部的空气混合在～起，并被注满了"动物元气"——其颜色从深紫色变为鲜红色。这部分衡鲜血液将通过动脉进人身体的各个部分。第三个"系统"出现在脑部，它是"动物元气"的来源，通过空心的神经，"动物元气"从脑中输送出去。 在哈维时代，有些科学家已经意识到，血液通过肺动脉到达肺部，又从肺静脉返回。接替维萨里任帕多瓦大学解剖学教授的吕亚尔都斯·哥伦布就已经认识到了这种有时被称作小循环（或更恰当地说肺部过渡）的现象。哈维本人在帕多瓦的老师阿夸彭登特·阿布·法布里齐乌斯已经发现，在静脉中存在着一些瓣膜，尽管他没有把握住瓣膜对于血液循环的全部意义，但这项发现还是很重要的。哈维充分认识到了法布里齐乌斯发现中的暗示：在静脉中运动着的血液只会流向心脏；哈维进行了一系列不同的实验和检验，以证明在静脉中只有单向的流动。瓣膜会使人联想到泵的活动，正如哈维告诉我们的那样，当他考虑。已胜及其瓣膜系统的结构时，他想到了泵（参见查尔斯·韦伯斯特1965；佩奇尔1976，212-213）。 在被称作收缩和舒张的活动中，心脏挛缩、扩张。当心脏的一个心房挛缩时，其中的血液就会被排出来；当它扩张时，它就会吸入新的血液，这些血液在下次挛缩时又会被排出。由于心脏有瓣膜，所以血液的流动是单向的。正如哈维指出的那样，血液被排出左心室推入主动脉，亦即大动脉，随后又被排出（在每次相继而来的排出后）进入动脉系统。血液通过静脉回到心脏进入右心室。挛缩和扩张推动血液从右心室进人右心耳，然后从右心耳流出，通过肺动脉进入肺脏。血液通过肺静脉流回心脏，进入左心耳。血液从这里被送入左心室，然后又一次流出，进入主动脉和动脉系统。这样就完成了心脏、动脉和静脉——单循环系统的所有部分的一次连续的循环。 从活体解剖、肉眼观察和实验中积累的大量证据，使哈维的新概念得到了证实。他可以自豪地宣布，他已经纠正了"一个持继了两千多年的错误。"他的发现不是以教条为依据，而是以对80多种不同种类的动物所进行的经验研究为基础的，这些动物包括，不同的哺乳动物、蛇、鱼、龙虾船炼、蜥蜴、蛞蝓和昆虫等（肯尼思·基尔1965，130）。他的各种实验和观察资料是无可争辩的。他在其著作的第五章中指出，盖伦说血液可以穿过心脏隔膜上的微孔，然而他错了。这种微孔并不存在；因此，"必须准备和开通一条新的通道。" 哈维充分意识到，他的定量研究（正如他所说的那样）是件"新生的"事物，他担心，他会受到所有读者的攻击（ch．8）。今天看来，转而进行量化的论证似乎是很平常很自然的事。但在哈维那个时代情况决非如此，尽管定量的测量已经进入了药房医学领域。切莫忘记，对当时来讲，用数量的方式表示身体温度和对血压进行定量的测量，为时尚早。纵然事实上哈维并没有发明生物学的定量方法，但他的确使用了量化的推理并取得了显著的效果。奥塞·特姆金（1961）曾经指出，盖伦运用了类似的定量论证，以便证明尿并不完全是"肾中营养物的残余成份"（佩奇尔1967，78）。范·海尔蒙特大约与哈维同时，也在进行定量的生物学实验，尽管这些材料是在很久以后发表的（佩奇尔1967，78），圣托里奥在他自己身上进行了一系列实验，在实验中，他记录下了他对自己的固态食物和液态摄取量、以及液态和固体的排泄物所做的定量的测量，并且确定了排汗量；他的著作《医学统计》描述了他的方法并提供了一些数据资料，该书出版于1614年，即哈维的《论心脏的运动》出版前14年。不过，那时定量方法的使用并未普及，哈维也充分意识到，他的量化推理，无论从方法还是从结果来看，都是很激进的。哈维不仅把量化方法用于生命科学的经验调查研究之中，而且还用于"已经为生物学和医学开辟了一个新时代、并一直使这些学科保持着牢固基础的发现"之上（佩奇尔1967，80）。哈维所要做的就是，根据实际的测量来确定人的心脏及狗和鱼的心脏的容量。然后，他把这一数值与脉搏跳动的次数相乘，计算出从心脏输送到动脉的血的总量——-平均每个人每半小时大约为83磅。哈维说，通过这些定量的测量表明，"心脏的跳动不断地把血液从心脏中排出，而排出量大于摄取的食物所能提供的量或所有静脉血管在任一时刻所包容的全部血液。"他随后指出："倘若，即使通过心脏和肺部的血流量最小时，通过动脉和整个身体的血流量也会比食物的吸收所能提供的血液量多得多——那么，这只有通过循环才能实现"（ch．9佩奇尔泽）。简而言之，哈维觉得他能够"计算出血的总量，并能证明血液的循环运动"（ch．12）。他总结说（Ch．14）： 鉴于计算和视觉证明已经确证了我的所有假说，即血液通过心室的搏动流过肺部和心脏，并被有力地推进身体的各个部分，从那里静静地进入静脉和肌肤的多孔结构，流回各处，通过这些静脉血管从周围流向中心，从小静脉血管进入大静脉血管，最后，进入腔静脉到达心耳；所有这一切，如此大的血流量和如此大规模的潮涨潮落——从心脏流出到达神经末梢区域，再从神经末消区域回到心脏——也是被摄取的营养物无法提供的，而且，其数量也大大超过了满足身体营养所需的量。 所以我只能得出这样的结论，即动物的血液处于周而复始环流不息的运动之中，这是心脏的一种活动或功能，它是借助心脏的搏动来实现的，一言以蔽之，它是心脏搏动的唯一原因。佩奇尔（1967，76ff．）发现，"哈维的直接批评者如约翰·里奥兰和支持者如安德烈亚·阿戈里、琼·马泰特以及约翰·米克雷里都强调定量论证，从而证实了"哈维的计算确实具有重大的历史意义"。拥护者们支持新理论的理由只有一个："有定量的论证"（同上）。 毫无疑问，哈维的发现"使生理学思想革命化了"（拜勒比尔1972，151）。在考虑这一革命时我们务必小心谨慎，切不可以它没有牛顿的世界体系那样的宇宙论意义为理由，或以它没有像哈维去世30年以后出版的牛顿的《原理》那样几乎使整个科学都发生了变化为理由而极度地轻视它。它的确是一场生物学革命。虽然并非每个人都承认这一新的发现，但许许多多的科学家和医生们却都承认它。毕竟，哈维的论证是令人信服的。定量的论证再加上寻找中隔微孔的失败，是对盖伦生理学的致命一击。瓣膜则证明了血液的单向流动。证据中唯一缺少的，是可以证明连接最小的动脉与最小的静脉的毛细血管存在的证据，这些毛细血管最终被M．马尔皮基发现了。 在评价哈维时，我们还必须注意区分生物学思想和方法中的革命与医学的科学基础（即生物学）中的革命和医学实践中的革命之间的区别。按照18世纪的医生和医学史家约翰·弗赖恩德（1750，237）的观点，哈维曾打算写一部有关他的发现在医学中的实际应用的著作，但他一直没有动笔。（参见本章的补充材料11．l有关哈维的发现缺少直接的实践成果的论述。）从17世纪中不难找到证据来证明，哈维已经为科学做出了一项伟大的发现，血液循环的发现是一项伟大的思想成果，但它对于医学实践而言并不具有（或尚未具有）同等的重要意义。有鉴于此，我认为，我们有理由得出这样的结论：在生物学（或生理学中）有过一场哈维革命，尽管在医学实践中不曾有过类似的哈维革命。 最后，把哈维的工作与伽利略的工作加以对照和比较，也许能给人以启示。哈维创造了一个有唯一中心（心脏）的单循环系统，从而取代了盖伦的复合系统。这是一项类似于哥白尼、尤其是开普勒创造的单一的宇宙系统的成就，哥白尼和开普勒创造的系统取代了托勒密的《天文学大成》中由几个独立的系统组合而成的系统。类似的情况还有，哈维证明了盖伦学说的谬误，从而使该学说受到了毁灭性的打击，而伽利略则证明，托勒密的金星体系与实际情况不符，这二位的证明也许可以说是异曲同工的。不过，这里有一个根本性的区别。尽管伽利略指明，金星肯定是在围绕太阳的轨道上运动，而不是在一个其中心围绕地球运动的本轮上运行，但他的结论是模糊的。新的资料不仅适用于哥白尼体系，而且适用于第谷体系甚至还适用于后来的里乔利所发明的宇宙系统。而哈维的论证以及他所做的实验、观察和定量推理，不仅证明了盖伦学说的谬误，而且同时无可争议地证明了一种新的科学——血液循环。这就是为什么我们可以毫不含糊地说在科学中曾有过一场哈维革命的理由。