These are the marks of an unusually warm heart: largeness of respiration,
quickness and density of pulse, boldness and maniacal ferocity, the
chest is covered with hair, particularly the breast, and usually the
parts of the hypochondriac regions adjoining to it; and the whole body
is hot, unless the liver powerfully antagonise. And capacity of chest
is also a mark of heat, unless the brain in that case antagonise. But
an unusually cold heart has the pulse smaller than moderate, and such
persons are timid and spiritless, more especially if there be no hairs
on the breast. Dryness of the heart renders the pulse hard, and the
passions ungovernable, fierce, and difficult to quell; and, for the most
part, the whole body is drier than usual, unless the parts about the
liver antagonise. These are the marks of a more humid temperament: a soft
pulse, a disposition easily roused to anger, and easily pacified, and
the whole body more humid than common, unless antagonised by the parts
about the liver. When the temperament is both hotter and drier, the pulse
is large, hard, and quick and dense; and the respirations large, quick,
and dense. And of all others such persons have the most hair upon the
breast and præcordia; they are prone to action, given to anger, fierce
and tyrannical in their dispositions; for they are both passionate and
implacable. But, if humidity prevails with heat, such persons are less
covered with hair than the afore-mentioned; they are prompt to action,
their disposition is not fierce, but only prone to anger; their pulse is
large, soft, quick, and dense. But when the temperament is more humid and
cold than common, the pulse is soft, the disposition spiritless, timid
and sluggish; they have no hair on the breast, and neither indulge in
lasting resentment, nor are prone to anger. A cold and dry heart renders
the pulse harder and small. Of all others, such persons are least given
to anger, but when provoked they retain their resentment. They are also
particularly distinguished by having no hair on the breast.
* * * * *
COMMENTARY. In the ancient system of physiology, the heart was considered
as the seat of the Vital powers, its office being the preservation of
the innate heat of the body. The philosopher, Aristotle, had pointed
out the connexion between heat and vitality, and had taught that the
heart, as being the centre of heat, is the prime organ in the animal
frame. Hence, as his commentator, Averrhoes, remarks, it is the _primum
movens et ultimum moriens_. Galen, however, maintained with Hippocrates,
that the animal frame is a circle, having neither beginning nor end,
and that, consequently, it has no prime organ. He taught that the brain
does not, properly speaking, derive its powers from the heart, nor the
heart from the brain; but that these organs are mutually dependent
upon one another, the heart being indebted to the brain for supplying
the parts concerned in respiration with muscular energy, and the brain
being indebted to the heart for its vital heat, without which it could
not continue to be the vehicle of sensibility and motion. (De Placitis
Hippocrat. et Platon. pluries.) We have mentioned in the preceding
Section, that the ancient physiologists looked upon respiration as being
a process similar to combustion. See Galen (de Usu Respirationis),
Alexander Aphrodisiensis (Probl. i, 16.)
The heart, then, was supposed to convey heat to all parts of the body,
by means of the animal spirits incorporated with the blood in the
arteries. Respecting the contents of the arteries, two hypotheses divided
the ancient schools of medicine. The first was that of the celebrated
Erasistratus, who maintained, that the arteries do not contain a fluid,
but merely certain airs or vapours. The other hypothesis was that
of Galen, who keenly attacked this, as he did most of the tenets of
Erasistratus, and endeavoured to prove, by experiment, observation, and
reasoning, that the contents of the arteries is blood, mixed, indeed,
with a certain proportion of heat and airs, but in every respect a fluid,
little different from that contained in the veins. It was also part of
his system, that the right cavity of the heart attracts blood from the
liver, and conveys it to the left, from which it is diffused all over the
body by the arteries. He taught that, at every systole of the arteries,
a certain portion of their contents is discharged at their extremities,
namely, by the exhalents and secretory vessels; and that at every
diastole a corresponding supply is attracted from the heart. He decidedly
inculcates, in opposition to Asclepiades, that it is the expansion or
diastole of the artery which occasions the influx of the blood, and not
the influx of the blood which occasions the expansion of the artery; or,
in other words, that the systole is the function of the heart, and the
diastole its return to its natural state. (De Diff. Puls. iv, 10.) Though
he demonstrated the anastomosis of arteries and veins, he nowhere hints
his belief, that the contents of the former pass into the latter, to be
conveyed back to the heart, and from it to be again diffused over the
body. In a word, his system appears to have been nearly, or altogether,
the same as that which was afterwards taught by the unfortunate Servetus.
It is clear, therefore, that Galen had made a very near approach to
the Harveian theory of the circulation; indeed, Harvey himself candidly
admits this. It will be perceived, from what we have stated, that the
grand point of difference between Galen and Harvey, and that upon which
the theory of the latter mainly rests, is the question whether or not
at every systole of the left ventricle more blood be thrown out than is
expended on exhalation, secretion, and nutrition. Upon this point Galen
held the negative, Harvey, as we all know, the affirmative.
In proof of the opinions which we have attributed to Galen, we refer the
reader to ‘An Natura Sanguinis sit in Arteriis;’ ‘Administ. Anatom.’
(vii, 15); ‘de Usu Partium,’ (vi and vii, 7, 8, 9); ‘de Placitis Hippocr.
et Plat.’ (i, 5.)
See also Averrhoes (Colliget. ii, 8, ii, 9; Collect. i, 9; in Cant. Avic.
i, 1); Avicenna (iii, xi, 1); Actuarius (de Spiritu Animali, i, 6; de
Causis Urinarum, ii, 2); Nemesius (de Natura Hominis, 24.)
With regard to the passages collected by the ingenious M. Dutens
and others, from the works of Hippocrates, Plato, Nemesius, Pollux,
and Theodoret, to prove that the ancients were acquainted with the
circulation of the blood, as taught by Harvey, we shall only remark,
that, after having attentively considered them, we cannot but draw the
conclusion, that some of these authors must have had, at least, an
obscure idea of this doctrine, although, in general, these passages
may be understood to refer merely to the lesser circulation and the
movement of the blood from the centre to the extremities, as maintained
by Galen. See Dutens (Origine des Découvertes attribuées aux Modernes,
p. 157); Drelincurtius (de Lienosis Epimetris); and Littré (Introduction
aux Œuvres d’Hippocrate.) The last of these writers, whose minute
acquaintance with the earlier works on medicine entitles his opinion
to every consideration, after a searching investigation into the state
of anatomical knowledge in the days of Hippocrates and his immediate
successors, comes to the conclusion, that the germ of the theory of the
circulation is, beyond doubt, to be found in the Hippocratic treatises.
(T. i, 223.)