8. A public lecture (late 1610s): ‘Nasty (yet recompensed by admirable variety)’

IN 1615 THE College of Physicians appointed the thirty-seven-year-old William Harvey as Lumleian lecturer in anatomy for life. The position brought him considerable cachet as the public and intellectual face of the college; it also offered a very welcome stipend. Officially the anatomical lectures (first instituted in 1582 by Lord Lumley) were to be delivered for ‘three quarters of an hour in Latine, and [one] quarter of an hour in English, wherin that shall be plainlie declared for those that understand not Latine, what was said in Latine’.

In preparation for his lectures, Harvey compiled copious Latin notes. His jottings also contain numerous remarks in English, the language he often employed when offering an illustration of a general statement. In this characteristically vivid and homely quotation, for example, the words in italics were originally written in English, the rest in Latin: ‘Examples of motion … hawke putts over her meate crap turning upon the giserd erecte itself. Likewise a dog: by the fier: cunny in ye sunn.’

Harvey may in fact have departed from the college statutes and given his lectures mostly in the vernacular, using his Latin notes as a guide, summarizing and translating them as he went along, rather than reading from them verbatim. The members of the Barber Surgeons Company, at whom the lectures were principally aimed, were ignorant of Latin, not having been educated at university. Barbers had been the first surgeons in England, originally assisting monks, who were forbidden for religious reasons from performing operations. The Barbers Company had been founded in 1462, the surgeons amalgamating with them a century later. By the turn of the seventeenth century surgeons performed most operations, but barbers still carried out bloodletting – hence the red and white barber’s pole that was the emblem of their trade, the red signifying blood, the white the cloth of the tourniquet.

A page from Harvey’s lecture notes. Fragmentary, cryptic and elliptical, they were compiled, altered and augmented over the period c.1615–1629.

Every year of his lectureship Harvey had to offer a course on ‘the whole art of anatomy’, over a five-day period, ‘dissecting all the body of [a single] man, if the body may so last without annoie’. In a bid to preserve the corpse for as long as possible, dissections took place in winter, yet despite that decomposition was usually so rapid that a number of bodies had to be cut up over the course. Generally, one corpse was dissected during the muscular lecture to show the muscles, another to display the bones in the osteological lecture, with a third for the visceral lecture, during which the abdomen, the thorax and then the head were anatomized in turn. The visceral lecture especially had to be conducted, in Harvey’s phrase, ‘according to the glass’ (i.e. with a close eye on the hourglass): the abdomen came first because it decayed most rapidly, being crammed full of matter that was ‘nasty (yet recompensed by admirable variety)’. Then came the thorax (‘the parlour’ of the body), because it decomposed next, and last of all came the more durable brain.

In his lectures Harvey aimed to show, in the words of his notes, the ‘action, function and purpose of the parts’, to investigate morbid conditions, and to present ‘problems in the authors’ – that is, controversies in the anatomical tradition. He also offered a comprehensive course in ‘the whole art’ of surgery and dissection for the barbers and surgeons, promising to ‘cut up as much as may be, so that the skill [in cutting] may illustrate the narrative’. In addition, he endeavoured to ‘show as much in one observation as can be’, and ‘not to speak of anything which without the carcase may be delivered or read at home’. Although he would introduce some Aristotelian elements into his lectures (using animal carcasses occasionally, in the manner of Fabricius, and perhaps even performing experiments on live animals) Harvey generally adopted the hands-on, human body-centred anatomical style of Vesalius. The style was tailored to his audience, the barbers and surgeons requiring practical instruction, and the physicians, steeped in Galenic anatomy, being exclusively interested in human physiology and pathology.

Harvey lectures were performed at five o’clock sharp at the anatomy theatre in the College of Physicians’ magnificent three-storeyed premises at Amen Corner, to which it had migrated from Knight Ryder Street in 1614. Here, on a winter’s evening in the late 1610s, the entire body of the Barber Surgeons gathered for a lecture, dressed in their black gowns and flat caps. Members of the college were in evidence too, seating themselves towards the front of the audience, attired in wool or silk. Several courtiers sat down with them, along with various gentlemen and law students.¹ The hall’s hearth was fireless, the breath of the audience visible in the nipping air.

The lecturer and the dissection table were hidden from the audience’s view behind a circular curtain. In accordance with the college statutes, a mat had been placed next to the table so that Harvey did not ‘take colde upon his feet’. A sixteen-inch whalebone wand with a silver tip lay on the table so that the lecturer might ‘touche the body when it shall please him’. There was a candle with which he could ‘loke into the bodye’, as well as an assortment of surgical instruments. Next to these lay a number of bowls and sponges. Finally, there was the body of the recently hanged man, which had been washed, shaven and hollowed out at the abdomen, which resembled a pink, bloody cave. Harvey had eviscerated it the previous evening; tonight it was the turn of the thorax.

Sixteenth-century anatomical instruments. For his dissections Harvey used knives, probes, lancets, hooks, drills, razors, scalpels and dilators, some of which can be seen here.

Behind the curtain the stewards dressed Harvey in a white bonnet and a gleaming white apron with detachable sleeves covering ‘the whole arm with tapes for chaunge’. As it was ‘unseemly’ for an anatomist to ‘occupy one aprone and one payr of sleves’ for the whole of the messy and bloody five-day demonstration, the stewards prepared a fresh set each day. An additional apron and pair of sleeves lay beside the dissection table, in case the first set became too soiled during the lecture.

On the stroke of five, the stewards drew back the curtain and the spectators reacquainted themselves with the bruised cadaver. Those in the front rows caught on the air the pungent odour of the decaying flesh. Sometimes the demonstration conformed to the conventional anatomical model, with Harvey reading his lecture while an ostensor-cum-sector (usually a barber) carried out the cutting. On occasion, however, Harvey followed Vesalius in cutting the corpse himself, and we may picture him doing so on this particular evening. A barber, also dressed in white, stood by the table, on hand to assist him.

John Banister giving a lecture on the abdomen to surgeons and barbers in 1581. He is describing the bone structure displayed by the skeleton; an anatomical text rests on the lectern behind him.

Harvey set about opening up the thorax of the corpse with a knife, describing in considerable detail the incisions he made as he went along. ‘Now with a sharp knife, I will set about freeing the clavicle [collarbone] from the sternum [breastbone] dividing the strong ligaments. See how I take care lest the knife be driven too deeply and injure the vessels lying beneath.’ Harvey made the incisions, his assistant hovering around the body with a sponge to wipe away any blood that seeped out of the openings.

‘Forcibly’, he went on, ‘I then raise the freed cartilages and bend the first rib outward from the sternum … the cartilage must be freed from the rib with a razor.’ Harvey bent back the first rib and put his knife down on the table, where it was wiped by the assistant. He then took up a razor, using it to cut the cartilage away from the rib. ‘And now I will do the same with all of the other ribs in turn.’ The task took Harvey and his assistant some time to complete. When all of the ribs had been raised and cleaned, Harvey took up his knife again and divided the intercostal muscles with a continuous incision as far down as the base of the thorax.

Quick, decisive and supremely confident, Harvey’s handiwork excited the admiration of the audience. Although not yet forty, the small, round-shouldered anatomist was already the veteran of numerous public anatomies and countless private autopsies. The authority he displayed during lectures earned him the reputation of a consummate performer. One spectator would praise, in a series of Latin verses, Harvey’s ‘marvellous dissecting’, ‘clever hand’ and ‘dexterity beyond compare’. Brandishing the scalpel as adroitly as Hercules ‘wielded his club’, the Englishman was ‘unrivalled at the table’.

Harvey now required all his strength, as well as all his dexterity, as he attempted to free the man’s breastbone from his ribs. ‘The sternum must be bent somewhat upward and then to the right and left, toward the head’; with these words he removed the breastbone with its vessels from the thorax. Using a hook he ‘pulled away here and there the membrane lining the ribs’, then, with his hands, he separated the membrane from the lung before attempting to break the ribs ‘almost in their middle’. Harvey accomplished this by ‘grasping firmly with the hands and twisting and bending forcibly’, his assistant again coming to his aid.

The work of removal complete, the heart (which would be the focus of this lecture) was now laid bare. With a knife Harvey cleaned away the fat surrounding it. He then held up a lit candle to the exposed thorax, so that the spectators could see the organ clearly. ‘The heart’, he announced, ‘is situated at the fourth and fifth ribs, in the very middle of the body. It is the principal organ because it is in the principal place. In quantity the heart of man is, as you see, fairly large. The substance of the heart’ – here he prodded the man’s heart with the silver tip of the whalebone rod – ‘is dense, thick, hard flesh, compacted like the kidneys. We can say that the temperament of the heart is very hot, since it is very full of blood.’

Harvey indicated the various parts of the heart to the audience. He first pointed out the vena cava, which brought blood from the veins to the right side of the heart. With the rod he traced the transit of the vena cava through the thorax, and its ‘distribution in the root of the neck’. He then grasped the heart in his hands, and, squeezing the organ, indicated the pulmonary artery on the right side near to the vena cava. ‘It is whitish’, he said, and ‘is the highest of the vessels of the heart.’ Its function was to carry blood from the right side of the heart down into the lungs.

Turning to the left side of the heart Harvey pointed out the pulmonary vein, ‘which coveys blood from the lungs to the left side of the heart; it is darker than the pulmonary artery’. Then he turned to the aorta, ‘the great artery’, which ‘carries vivified blood throughout the body. It is near the entrance of the pulmonary vein.’

Harvey made an incision in the right side of the heart with a razor. He then squeezed the right ventricle with his fingers so that the purple blood inside it oozed out, his assistant wiping this away with a sponge. Harvey indicated the inside of the vena cava, opening it up further with a stylus. Inserting a long, thick rod into it, he then showed the audience how it extended down to the lower reaches of the body. Moving on to the pulmonary artery he put his finger into its orifice, located in the higher part of the right side of the heart, his assistant again mopping up the blood that issued out of it. Next he ‘followed the course of the pulmonary artery, into the lungs’ with his rod. Having finished with the right side of the heart, Harvey then cut the left ventricle in the same fashion, and proceeded to display to the audience the interior of the pulmonary vein, and the aorta, with the help of a stylus and a knife.

In his lectures, Harvey generally offered a synopsis of conventional theory. He was reluctant to draw extensively on his own opinions, nor did he ‘disprayse’ other anatomists, but rather expressed the conservative view that all his anatomical predecessors ‘had done well’, those found to be culpable of error being so solely because of chance. Harvey frequently complimented the ‘great’ Galen, explaining away the discrepancies between the Greek’s theories and the dissected body on the table by suggesting that the human body itself had altered since Roman times. It was diplomatic of Harvey to excuse Galen in front of his fellow physicians whose medical therapies and authority were underpinned by Galenic theories. In compiling his lecture notes Harvey had used as a crib Caspar Bauhin’s orthodox anatomical manual, Theatrum anatomicum (1605).

Yet there were times when the Lumleian lecturer’s language became more idiosyncratic, occasions when he introduced a note of doubt into his summaries of received opinion. Scattered throughout his fragmentary lecture notes is a personal shorthand that served as a commentary on the conventional text. The symbol ‘X’ prompted Harvey to offer a concrete illustration of whatever he happened to be discussing; it also served as a cue for him to air disagreement with a particular theory. The letters ‘WH’ (William Harvey) indicated an opportunity to furnish his listeners with an original observation or example.

In describing the movement of blood, within the arteries and veins that carried it throughout the body, Harvey took the traditional line that it ebbed and flowed sluggishly in both directions. In discussing the muscular wall (septum) that divided the ventricles, however, he cast doubt on the validity of Galen’s famous theory. Aware that Vesalius had questioned Galen’s idea of the porous septum, Harvey treated the issue as a ‘problem in the authors’ – that is, as an anatomical controversy.

Pointing with his whalebone rod to the septum in front of him, Harvey declared: ‘Galen believed that blood crosses the heart through the septum, through interstices in the wall; accordingly many hold the view that it is porous.’ The symbol ‘X’ comes after the word ‘porous’ in Harvey’s lecture notes, followed by the name ‘Colombo’.

The Italian anatomist Realdo Colombo (c. 1515–1559) had been a pupil of Vesalius. Determined to surpass the mentor he referred to as a ‘clumsy Belgian peasant’ by any means fair or fowl (including plagiarism), Colombo set about rewriting various aspects of conventional anatomy. In discussing the septum in Book VII of De re Anatomica (On Anatomy) – a book which aimed to ‘contradict all, both ancients and moderns’ – Colombo had extended Vesalius’ criticism of Galen. ‘Between the ventricles of the heart’, he remarked, ‘is the septum, through which nearly everyone thinks that there is a way open for the blood to pass … But those who believe this err by a long way.’ Contradicting Galen in such an emphatic manner would not have been welcomed by the physicians in Harvey’s audience, so the lecturer doubtless trod carefully now as he retraced Colombo’s footsteps. He may have watered down one of Colombo’s bold pronouncements, alluding also perhaps to Vesalius’ comments on the subject, and gently implying his own approval as he did so.

In his description of the vessels of the heart, Harvey had also drawn on Colombo’s ideas, particularly when discussing the structure and role of the pulmonary artery and the pulmonary vein. The lecturer expanded upon his previous comments now. ‘Blood is carried to the lung by the pulmonary vein’, he quoted Colombo, ‘and in the lung it is refined, and then together with the air it is brought through the pulmonary vein to the left ventricle of the heart.’

Colombo had posited this idea after observing, during numerous dissections, that the left side of the heart was always full of red arterial blood. The purple venous blood must, he concluded, travel from the right side of the heart to the lungs and, in doing so, became transformed there into ‘shining’ and ‘beautiful’ arterial blood. Galen had, he said, ‘erroneously’ located this transformation within the heart itself.

Although Harvey was citing an opinion that had not achieved the status of accepted truth, he was on relatively safe ground because Galen had also suggested that blood entered the lungs, albeit in a very small quantity and solely for the purpose of nourishing that organ.

Harvey then addressed the movement of the heart, another issue Colombo had recently made a ‘problem in the authors’. The lecturer first explained to his audience the traditional Galenic view that the heart’s active phase was expansion (known as diastole), the moment in which the organ was said to draw blood into itself from the veins. Some of the liquid then overflowed into the arteries, which also actively sucked blood out of the heart by virtue of a wave expansion (i.e. a pulse). The relaxing heart was then in a state of contraction, or systole. This, Galen maintained, was the passive phase of the heart’s movement, ‘concerned with death, and the internal rest of the heart after its forcible diastole.’

Harvey may have attempted to evoke the movements of the heart through the motion of his hands. He was a fine performer, with a repertoire of vivid gestures and the brio of an amateur actor, so it is easy to imagine him illustrating the pulsating organ. He may also have made other gestures for comic effect – when he described the ‘waddle of a puffin’, and the way ducks in motion ‘sway this way and that’, it is possible that he imitated the movements of these animals. He certainly enlivened his dissections with jokes whenever he could. Discussing callused skin, for instance, he used as an illustration the knees of overzealous Puritans who spent too long kneeling in prayer. Scatological references also abound: he described constipated men as all ‘shite and groan’ at stool.

Having presented Galen’s theory of the movement of the heart, Harvey turned to Colombo’s opposing view. The Italian, Harvey explained, had argued that blood was forcefully ejected from the heart into the arteries when the organ contracted; systole was therefore its active phase, rather than diastole. If this was the case, Harvey continued, then the heart could be regarded as a muscle which moved like any other, in a cycle of contraction, relaxation and rest.

Colombo had arrived at his theory after performing countless vivisections on animals. Harvey probably mentioned these experiments to the audience, adding that he himself had likewise ‘observed the movement of the heart in animals for whole hours at a time’. The announcement excited some surprise among the spectators, for vivisection was not commonly practised by English anatomists, nor was it of immediate relevance to the operations carried out by barbers and surgeons. It was also quite an audacious move for the lecturer to refer to his own experiments alongside those of acknowledged authorities. ‘During those observations’, Harvey went on boldly, ‘I found it arduous and difficult, to discern what is systole and what diastole, for the heart in its running is always in motion. And yet it seems not unlikely to me that Colombo, rather than Galen, may have been closer to the truth about these matters.’

However interesting Harvey’s discourse on the heart was, the barbers and surgeons could only absorb a certain amount of detail in a single sitting. Many became restless as they sat in the cold hall; some were doubtless relieved as Harvey brought the session to a close. The lecture was followed by a series of questions from the audience, during which Harvey was interrogated on his controversial comments regarding the septum, the movement of blood across the lungs and the movement of the heart.

The question and answer session over, the steward approached Harvey, took the whalebone rod from his hand, then turned to address the audience. ‘This Lecture, Gentlemen, shall be continued tomorrow at five o’clock precisely.’ The steward then invited the audience to follow him to the hall parlour, where a dinner had been prepared for them.

Colleagues approached Harvey to continue the discussion of the controversial points he had raised; the more curious students came up to the table to examine the dissected corpse closely, touching the body. Members of the general public also moved forward to look at the anatomized body, typically remarking on its ‘unpleasantness’, and ‘appalling’ smell. They were not alone in being offended by the stench of a carved-up cadaver: Harvey spoke of ‘hands infected with the smell of carrion’ after a dissection, and the overpowering smell of his ‘sleeves during an anatomy’. Around four hours after an anatomy, he said, such smells seem to diminish, only to return again later with a vengeance.

Yet the sight and the smell of rotting flesh did not blunt the edge of the audience’s appetite. The post-lecture dinner was a fine one, during which the king’s health was enthusiastically toasted with beakers of wine. As they ate, the diners dissected the lecture. Sir Simon D’Ewes, a law student, sitting with some companions of his from the Middle Temple, reckoned he had gained ‘much profitable knowledge’. Another spectator, who fancied himself as a poet, composed a verse eulogy to Harvey in which he ‘rankt [him] among perui’. As ‘perui’ refers to the traditional venue for a formal disputation, the implication is that Harvey showed as much dexterity in argument as he did in cutting, being as skilled with ‘knives as with words’.

Before the star performer joined his admirers at the dinner table, he and the stewards carefully examined the butchered corpse in the theatre to decide whether it was too putrid to be used again the following day. If it was rotten and another corpse was available, it could be dispensed with. In that case, the stewards would gather the remains together, place them in a coffin, and inter them at the expense of the college at a nearby church such as St Olave’s, whose burial register contains references to a number of anatomized men and women. Inspection of the cadaver over, Harvey pulled off his robes and put on the clerk’s gown that it was ‘always usual for him to dine in’.

1 In 1662, the ever busy, ever curious Samuel Pepys, clerk of the king’s ships, would find time to attend an anatomy at the Barber Surgeons, performed by one of Harvey’s disciples. Pepys enjoyed a ‘fine good discourse’ on the mysteries of the body, the subject on the occasion being a ‘lusty fellow, a seaman, hanged for robbery’. The civic and legal aspect of the dissection was made explicit, with the audience being informed of the subject’s occupation, crime and punishment.