Kristin Hussey - Secrets in the Blood： William Harvey

Well, thank you, Ian, and thank you again to everyone for coming out this afternoon, risking life and limb. If I was trying to think of, you know, what physician from history would it be worth braving a Siberian snowstorm to hear more about, I'm not surprised that it's William Harvey. So, as Ian said, my name is Kristen, I'm curator at the Royal College of Physicians of London, as is our full proper name, and I feel very honoured to be speaking to you this afternoon on the subject of our newest public exhibition, which we opened only last month, which is called Ceaseless Motion, William Harvey and His Experiments in Circulation. Actually, last week, I was lucky enough to get to show the Queen around the exhibition, which was really fun. We had originally planned to call the exhibition Secrets in the Blood, hence the title of my talk this afternoon, but we later found out that it's already the name of a series of young adult novels about vampires. So if you're trying to name an exhibition that's about blood or the heart, there's a lot of other things that have already been produced in the sort of mills and boon vein, made it a bit challenging. So now, it's just helpful for me to ask this question, you know, how many people here have heard of William Harvey before? I thought so, he's really a man that needs no introduction, why else would you have brave the snow to be here? I was actually told by an auctioneer recently that Harvey is one of the most recognizable brands of medical history, although I'm not quite sure what Harvey would have made of that. Harvey, of course, famously discovered the role of the heart in circulating blood around your body. That is, of course, his essential contribution to science, and we'll be talking a bit more about that later on. I have to start out by admitting, though, that I am a Victorianist myself, and before embarking on the exhibition at the Royal College of Physicians, I knew very little about the man. Here's our exhibition currently on in London. So my area of focus as a historian is the Victorians and Empire, and specifically how late 19th century medicine must be understood in its global context. And nevertheless, as a museum curator, it means you can never really stay in your comfort zone, and you always end up working with objects and eras which are new and really diverse. So it meant I was ripped away from the world of steam power, hospitals and parasites, to the dark streets of 17th century London and Padua, to a world of witchcraft, dissection, professional rivalry, and war. And it certainly was eye-opening. Although I must admit I have managed to fit some Victorians into my talk this afternoon. You've already heard a little bit about my museum background, but it is quite varied. I worked a lot with the Georgians as well while I was assistant curator at the Hunterian Museum at the Royal College of Surgeons. But when I joined the Royal College of Physicians in March 2017, the Harvey exhibition was already in full swing, and it was the centerpiece of our 500th anniversary celebration. In 1518, the Royal College of Physicians of London was founded by King Henry VIII at the behest of his royal physician Thomas Lineker. But because I was new to the project, and I was new to the college, I had a chance to sort of stop and think. Why Harvey? What can an exhibition about William Harvey tell us about the history of medicine and of physicianship? And with a subject that's arguably so well-trodden, what new could I possibly say about Harvey, his life, his work, and his legacy? But also for me personally, I was interested in why it was that Harvey is a figure so frequently returned to by the College of Physicians in their important celebrations. And finally, how might the idea of Harvey differ from Harvey as a historical individual, from Harvey as the man as he was alive? And this actually is a really fascinating portrait. It's known as the Rose Park Harvey for the house that it was found in. One of the very few portraits of Harvey painted from life. It's in the National Portrait Gallery's collection. It did used to be at the College of Physicians in London, and it somehow ended up at an auctioneer's hands and eventually went to America. Anyway, we got it back, and it's now in the exhibition painted of him at the height of his fame in 1628. So before I delve into some of those more profound questions though, I think it's important to highlight that Harvey is absolutely someone who completely revolutionized medicine, physiology, and the way that we understand our bodies. As Oscar Wilde reflected here during his Oxford days in the 1870s, and he says, we want more ideas and fewer facts. The magnificent generalizations of Newton and Harvey could never have been completed in this modern age when eyes are turned to earth in particulars. So he's not saying that he thinks Harvey is wrong or lying about anything. He just means that Harvey fundamentally changed the way that we see the world around us, and for him that was a huge sweeping change that just wasn't being achieved in the world around him. Then I've also included this slightly more recent quote from Harvey's biographer Thomas Wright, and he says, the impact of Harvey's discovery on what we would now call the history of science and on general culture was as great as Darwin's theory of evolution as Newton's theory of gravity. So it's not my intention in asking maybe some more critical questions this afternoon to move away from Harvey's importance or his influence, but I hope we can understand together a little bit more about Harvey in his lifetime, in his context, how he understood his own work, as well as the way in which Harvey has been reused, the way he's been rhetorically useful for later generations of physicians, and which is something that the exhibition deals with as well. So the great American historian of medicine Charles Rosenberg has written this sort of classic summary of history of medicine and practice. The field of the history of medicine was populated quite a few years ago now, almost entirely by scholars trained in medical schools, the great majority of whom were themselves physicians, and they were fascinated with the past or some aspect of it, especially a past that could be seen as progressing upward toward an enlightened and ethical present, and the intellectual significance of events and individuals were seen in terms of the development of our contemporary understanding of the body. And Rosenberg, after this passage, then goes on very much to point the figure at William Harvey specifically, and he says Harvey is thought of as a founder of modern experimental physiology, but not as a man of the 17th century, as a royalist, as an Aristotelian. And this is a point that's been returned to by a number of historians of medicine recently, including Andrew Cunningham and Lyudmila Jordan-Nova, who worked with us actually on our Harvey exhibition. And I think there really is a danger for these scholars of seeing Harvey as part of a march in progress, and as he's often remembered. But Andrew Cunningham actually characterizes him as a reluctant revolutionary, someone who had absolutely no intention of shaking the foundations of medical practice, someone who was really anxious about losing his private practice, about his patients, and critically about his place in court. He was completely against the idea that the body was mechanical, that our heart was simply a pump powering blood around our body. And yet, that's very much the way that he's remembered a great genius, a revolutionary, and an innovator. And personally, I'm quite interested in how this is actually a Victorian construct of Harvey, and I'll come back to that a little bit later on. I've actually illustrated this slide with a terracotta image, which is exactly the same as the terracotta you see in front of you. We have one at the College of Physicians in London. I imagine they're probably copies that we bought at the same time, and which is hardly surprising considering the proliferation of images of Harvey in the 19th century. You'll notice several in the room around you. I might test you at the end, see how many Harveys you can spot here today. So like many participants in this lecture series, I'd qualify myself as a social historian of medicine, which means to say I'm interested in the how, where, and why of history. How economic, social, technological, and cultural factors come together to affect the human experience. But when I stepped to the doors of the Royal College of Physicians, I was asked by a group of doctors to celebrate their hero, William Harvey, and I very much felt that weight of 500 years of history upon me in curating this exhibition. Here's their grant of arms from the 16th century, and of course, this is what the College of Physicians in London looks like if you've never had a chance to be there. So this afternoon, then, I'm going to speak to you about the great Harvey, the man, the myth, the legend, if I can, and the world of 17th century medicine in London. These subjects are undoubtedly fascinating. Many of you will know a lot of the facts that I'm saying. I hope I might be able to speak to a few things perhaps you haven't heard about before. But crucially, I hope that together we can sort of understand Harvey and why it is he's such a valued currency for physicians now, and why it is that he's returned to as the RSP celebrates our 500th birthday. So before sort of delving into Harvey, I think we undoubtedly must start here with medical practice in the 16th century, or certainly that's where I needed to start when I was curating the exhibition. And one of the reasons why I'm personally so fascinated by the Victorians is that they're so very modern. You can find the foundations of medicine as we know it today in their hospitals and their museums, and their concerns were very much like ours about health, about the effects of technology, about air pollution. So their world is not dissimilar to our own. However, this is absolutely not the case for people of Harvey's era. Born in 1578, Harvey grew up in Folkestone near Kent, and at 15 he went to grammar school in Canterbury. In 1593 he went to Gonville and Caius College in Cambridge. But what was the understanding of the body of health and disease which Harvey would have had growing up, and which would have been taught to him at Cambridge? Medicine in this period was of course dominated by the teachings of the Roman physician Claudius Galen, who died in 210 AD. And while undoubtedly medical research and thinking continued in the intervening years, particularly in the Islamic world, it's fair to say that medicine in Western Europe actually changed very little in the 1500 year period between Galen's death and Harvey arriving at Cambridge. The body was understood to be composed of the four humors, blood, black bile, yellow bile, and phlegm, and your body was understood to really be a little universe within itself, a microcosm which was fundamentally isolated from the world around it. So at a time before an understanding of germs, there wasn't the same conception of, as I could say, porousness, the idea that you could be affected by sort of sneezes or touches or the bodily excretions of those around you. If you became ill, it was because there was an imbalance of one of those vital humors, and then remedies would be prescribed to restore balance. So we see here on the screen examples of some really classic sort of 16th century medical interventions. One is the antimony cup, which is absolutely one of my favorite items in our collection. Antimony, of course, is a very poisonous heavy metal, and this would have been prescribed. A physician would have poured wine into the glass. It would have been allowed to stand overnight, so the wine soaks up the essence of the antimony. It would have then been administered, and the patient would have violently purged themselves as their body reacted to that poison. It's very much a kind cure philosophy from the physicians at the time. You also then, of course, have bleeding. Here, this gorgeous leech jar from our Simons collection, and on the far side you can see some pewter leech cages, if you only need an individual leech on your journey. And on the other side, slightly more difficult to see, singular glass leech holders. But of course, there were other remedies that would have been allowed to keep you fit and healthy, so things like diet, exercise, and the use of herbal medicines. But also not forgetting in this period is not the same separation between the religious and the scientific, and so illness could very well be caused by sin, whether that's on your part or in the community, which is very much a framework that was revived in the plague outbreak not long after Harvey's death in 1665. And I would point out as well, this is very much what would have been prescribed standard practice by doctors at the Royal College of Physicians in Harvey's lifetime. Indeed, Galen was very much the law of land when it came to the college. So while within that Galenic tradition, it's important to think then, where does the blood sit specifically? Because this is really where Harvey is going to make his contribution. And for me, there was really no better illustration of the heart and the blood and where that lies in the landscape than this gorgeous image of a German wooden anatomical figure that's actually in the exhibition. We have a loan from the Science Museum, which shows a popular anatomy in the 16th, 17th century. And you can look at it and see the amazing vital organs. If you took the guts out of place, you would see a uterus with a baby inside, as they like to do. But what you won't see anywhere is the heart. And that's simply because it just wasn't that important. In the center of the body, however, you will find the liver. So this is where we start, really, with the understanding of medicine. Blood, or nutritional blood, as they called it, was cooked or concocted in your liver. You would imbibe food. It was then transported to the liver and turned into this nutritional blood. And your organs would then draw them towards themselves as they needed it, consume it, use it. And that's the end of that. So that's one blood system. There's another blood system, however, which would be spiritus blood. So in dissections, they knew you had a darker blood and a lighter blood. There's arterial and venous blood. And so this is how they're explaining it. So that lighter blood is spiritus blood. And what happens is you inhale spirit from the air around us. Not quite sure what it is, but they do know if you stop breathing, you will die. So there must be something inherently life-giving in the air around us. And this is then inhaled by the lungs. The heart is really seen as an organ of respiration. It's almost attached to the lungs. And its job is to bring spiritus blood into the system. Now how it circulates starts to get a bit funny. There's some kind of pores, maybe, in the heart that lets it move around. The heart, there's confusion about how it works. Is it like a bellows? Is it a pump? They don't really know. So there's a lot of sort of misunderstanding that comes from the fact that Galen was really, of course, dissecting animals and not people. So when you look back at his text, a lot of confusion around the heart, the blood, and their various purposes. So while Harvey had a medical scholarship to Cambridge, and the curriculum there as an undergrad was not very dissimilar to what we would think of as liberal arts education today. So he would have studied rhetoric, ethics, logic, maths, astronomy, geometry, and politics, of course, all in Latin. But if you wanted to become an accomplished doctor in this period, you had to complete your medical training in Europe, which is exactly what Harvey did. And in 1599, he headed to the University of Padua. Now without a doubt, Padua was the place for medical learning in Europe, and particularly for the learning of anatomy. In 1594, so just a few years before Harvey arrived, they constructed the first permanent anatomical theater in Europe, and you can see a picture of it there. And it was actually still being used in that same format into the 19th century, which I think is incredible. So it's an incredibly cosmopolitan university, and it's functioning in Padua under the protection of the Republic of Venice, the most serene republic, which means it's protected crucially from the Vatican, and it therefore becomes a place of anatomical learning, a place of human dissection, perhaps most famously associated with the Flemish anatomist Andreas Mesalius, who at the age of about 28 or 29 published his Fabrica, his seven books on the fabric of animals. You might be familiar with some of the pictures that come from this book, these very famous flayed bodies in a landscape, sort of tied to trees and things, and very beautiful. It does make me feel a bit bad about myself that he achieved this at the age of 29, but there you go, he's a virtuoso. So Mesalius was working on the basis that he wanted to go back to the Greeks, back to that ancient anatomical learning, and sort of understand where they were coming from, back to basics. That idea of renaissance very much comes from the idea of going backwards. And so Mesalius is working in this tradition, as is those who come after him. So importantly, Harvey was taught at Padua not by Mesalius, but by Fabricius, who's an anatomist who was interested in going back to Aristotle specifically. And Harvey later described his two inspirations. He said, Aristotle is my general, Fabricius is my guide. So those two people are very inspiring to him. It's important to point out Harvey's not working in a vacuum here. This comes out of a very particular anatomical tradition. And if the illustration here on the far side looks vaguely familiar to you, it's because Harvey copied it pretty much exactly for his own publication. Not the same kind of copyright laws at the time. So Fabricius is Harvey's teacher, and he is a superstar in the field of anatomy. He's looking across the whole animal kingdom and trying to understand all of the various organ systems, why they are the way they are, why they're different, what they do. And he's particularly credited with understanding and discovering the valves in the veins, or as he called them, the little doors in the veins. But this is something he never quite got to the bottom of. He knew they were there, but not what they were for. So really we come then to what really is most revolutionary about Harvey is Harvey's question. He's asking a different sort of question. So if your organs are drawing blood towards themselves, and blood is constantly ebbing and flowing through your body as it's needed, why would you need valves to ensure that the blood only goes one way? So he's left with these really revolutionary questions. What is the purpose of the veins? What are pores in your septum? What is that about? And really, what do the lungs have to do with circulation, and how does the heart play a part? So these are the mysteries that he's left with from his teacher Fabricius, and he then returns to London. So in 1603, Harvey comes back, and he's qualified at Padua, and he's keen to set up his practice. He's got his diploma. So he applies almost immediately to be licensed by the Royal College of Physicians of London, of course, at this time. This is the college's headquarters at Amen Corner. And if you wanted to be a doctor in London or seven miles around, you needed a license from the college. So he arrived. They were quite pleased with him. He answered his questions well. It took them a little while to actually license him officially, but overall he got on quite well in the college. And crucially, he does a really important thing when he gets back, very clever of Harvey. He marries the daughter of an extremely prominent physician, who also happened to be a fellow of the college, and oddly quickly is appointed physician to Bart's Hospital, and eventually a fellow of the Royal College of Physicians itself. Nepotism works. Of course, Harvey was also very talented, but it's certainly typical of physicians at this time, this idea of patronage. And of course, when Harvey was examined to be licensed by the college, it would be noted that it was required for him to not just know and understand Galen, he has to repeat Galen by rote. That is how core it is to the functioning of the college at the time. So upon his return to England, Harvey's not only keen to practice medicine, but he wants to practice anatomy in the way that he's learned in Italy. And he does this in two locations. The first is at the College of Physicians, where from 1615 he was appointed the Lumleyan Lecturer. So this is a role that had been founded in 1582, when Elizabeth I granted the college the corpses of four hung criminals a year for anatomical demonstrations. And who better to carry these out, of course, than the Italian educated Harvey. Actually, in many of the previous years, they couldn't find a doctor that was good enough at anatomy to be the Lumleyan Lecturers, that post sat vacant for a long time. And these dissections were carried out at the college for the benefit of physicians when they would have been done in Latin, but also for the benefit of the barber surgeons, in that case in English, a really important differentiation there, Latin was very much an important part of the physician's prestige. But Harvey was also dissecting at his London home, likely on his kitchen table. So we can imagine he has a very incredibly patient wife. Now Harvey dissected animals at home, in particular eels and fish, which were abundant in supply from the nearby Thames, but they were also cold-blooded, which meant that they had a slower beating heart, which is perfect for his research. Human bodies for dissection were, of course, limited to the college, and we have no reason to believe that Harvey dissected humans really at home or did any body snatching. But this doesn't mean to say he didn't get his hands on bodies when they became available, whether that was in the form of autopsies on his patients or even on his family members. He immortalized his father. Here are the words, in my father, a huge colon, and also in his sister, a very large spleen. Yeah, it's quite an interesting removal from the subjects. So interested was he in anatomy. So if you don't mind, I'm just going to play you a very short clip from our exhibition film. It's only about a minute long, but I just think Andrew Cunningham explains what I'm about to talk about next in an amazingly simple way. He dissected dead humans to teach students of surgery. He did that in his role at the College of Physicians, but he also dissected and re-dissected lots and lots of animals of all kinds. The lectures Harvey gave to the students of the barber surgeons were quite conventional. He had at his disposal the body of a criminal, a male almost always, who had just been hung to death. Now, the lecture would start at five o'clock in the afternoon in the winter, and the winter because you don't have refrigeration and the body decomposes more slowly than in the summer, and he would point out the parts he was talking about either by finger or with a rod. We don't know exactly when Harvey realized he had discovered the circulation of the blood. We do know he was very surprised and taken aback by this because it contradicted all the teaching about medicine and about the functioning of the body for 2,000 years. I just love to show this film because making this film was so much fun. Hiring our actor William Harvey and my colleague Matthew there on the table pretending to be a corpse, but also because Andrew Cunningham has an amazing voice. So as Andrew was sort of beginning to suggest there in the film, we don't actually know exactly when it is that Harvey made his discovery. We do know in the eventual publication of his seminal book in 1628, he says he's been working on this discovery for at least nine if not ten years. So really that puts us in 1618. So isn't it really the 400th anniversary of this discovery, which is the line I'm sticking to in my exhibition. Now that's quite an interesting informative fact that he waited almost a decade before he announced his discovery. And the reason why he waited is because what he's prepared to announce is essentially heresy, not just to medical practice in the way that it had always been performed, but to the college itself, which is an institution that he absolutely loved so much and which existed to enforce the teachings of Galen quite forcibly at times. And yet he cannot doubt his own eyes. That is what they taught him to do at Padua. So he writes here in that eventual publication. The remaining matters, he's about to turn to his discovery of the circulation, are so novel and hitherto unmentioned that in speaking of them, I'm in fear I may suffer ill will from a few but dread lest all men turn against me. So if you're sort of interested in anxiety in medicine, you could get a lot of really interesting examples from Harvey. And this is not someone who's excited about what he's discovered. Since Harvey spent those intervening 10 years making certain assurances for himself, he was a clever man. So he brought people to his home, he brought people to the college, and he showed them what he'd seen. He needed witnesses, he needed support. And actually, interestingly, the word autopsy, the Latin autopsia, comes from the word ocular demonstration. So Harvey spends 10 years carrying out these ocular demonstrations, particularly on influential people at the college. And he's particularly adamant that college president John Argent be one of these people. And he indeed was one of Harvey's great proponents. And but much like at university, the physicians offered challenges and criticisms, and which ultimately helped Harvey prepare his publication. But ultimately, he failed to convince his audience, but he decided to go ahead with his publication anyway. So eventually, in 1628, he comes out with the 70 page book, De Morte Cordis. It has a much longer Latin name, but I'm not a Latin speaker. So I'm going to just stick to this. And now if you've ever seen an original copy of De Morte Cordis, there's a copy here in the college. And actually, if you go to the exhibition that's on the heart at the Surgeon's Hall, which I was going to this morning, it was excellent. They have a copy out as well. But you'll notice that it's very small, it's only 70 pages long. And often it's it's not a very good nick because it was really cheaply printed. The cost of publishing it in England was considered too high, particularly because the book was not going to be a success. Harvey knew that it was not going to be popular. So he sent it out to Germany and had this small, cheap book printed. And in its dedication, Harvey, again, does a really clever thing. And he attempts to cover himself with his two greatest allies, the crown and the college, the two C's, perhaps we can call them. And the initial dedication is to Charles I, for whom he serves as a personal physician. He dedicates it to his most serene king, and he prays his goodwill and his accustomed graciousness on this new account of the heart. And this is what he says to the king. And then here you can see he follows it up by dedicating it to his colleagues at the college. And he says, this book's appearance is under your aegis, excellent doctors, makes me more hopeful for the possibility of an unmarred and unscathed outcome from it. Very dramatic language. And from your number, I can name very reliable witnesses. So again, this sort of refrain to witnessing his discovery. So it's got a lot of build up now, I feel like we'll probably have to talk about what is it that Harvey actually discovered that was causing so much trouble. And in short, for the first time, Harvey accurately describes the human circulatory system. And he looks back at Galen and says, you know, actually, what's written here is incredibly contradictory. And it doesn't make any sense. And it doesn't stack up to what I'm seeing in my dissections. And he also thinks it's important to note that the discoveries are drawn exclusively from dead bodies. And this also makes Harvey different. Harvey is vivisecting animals. So he's able to see the living heart in motion. And it's a very important part of his research. And so he then goes on to investigate the heart and its function in all animals, including humans. And so for in his initial experiments, watching the heart of vivisected animals, he wonders about the speed of the heart, the amount of blood that seems to be passing through it much more than the heart as an organ itself could possibly have need of. And he starts to wonder whether there isn't in fact two systems of blood, but actually one. What if the blood comes through the veins into the heart where it's pumped out again at a high speed through the arteries and round around the body? And this is, I mean, Harvey really says it best himself. He says at the conclusion of his experiment, it's absolutely necessary to conclude that the blood in the animal body is impelled in a circle. It is in a state of ceaseless motion. And that the act or function by which the heart performs them is by means of the pulse and that it is the only end of the motion and contraction of the heart. And so he demonstrates that the blood is expelled from the heart in systole and its contraction, its active state and refilled during diastole. The blood is brought to the lungs to be oxygenated and returned to the heart, passing through the ventricles without any need for these mysterious pores, which don't exist. That wasn't a real thing. And most importantly, Harvey shows that you actually have a finite amount of blood in your body and it's going round and round in a circular motion. He also discovers the various purposes of the valves and that's the one-way flow around the body. So he goes back to Fabritius. He's not entirely there. He doesn't explain the entire circulatory system, partially because he doesn't actually have a microscope. So he can't see your capillaries. He doesn't quite understand the interchange there between the veins and the arteries. But really the foundation of Harvey's theory is very much how we understand the human circulatory system today. So what is the response to this discovery? You can imagine, people actually reacted about as negatively as Harvey had feared. Despite his very careful desire to get the college on side, the official response of the College of Physicians is that they were of the opposite opinion to Harvey when it came to the circulation of the blood. And one commentator, this quote there at the bottom, believed that he was crack brained and he did actually lose most of his private patients as a result of this. Interestingly, it seems to not have affected his relationship with the king. So maybe that very clever dedication paid off. And Harvey spends a lot of the intervening years and he doesn't have very many patients at the king's side. This isn't to say he didn't have some fans. There were a lot of anatomists particularly who thought the discovery was simple and harmonious in line with nature. And Robert Flood, a very prominent physician at the time as well, is very in support into Harvey, calls him revolutionary, deeply understands the mysteries of nature. But that certainly wasn't everyone and certainly not all the prominent physicians. Here's a German physician, Caspar Hoffman, who writes, what reason can you give me for the circulation of the blood? You would accuse nature of superfluity and stupidity. So a lot of people are very angry about it. But I think what's interesting is it's actually a divergence in the way that science is argued. So traditionally science was done by a disputation, a verbal argument. It had to make sense rhetorically. But Harvey is putting the onus on what you can see before you, the observable, the demonstrable. So he's kind of changing the name of the game, as it were, in terms of medical science. And one of the many critiques that's leveled against Harvey particularly is the fact that his observations are made mostly from vivisected animals. How could one, the argument goes, understand what a living human heart might do in comparison to a dying animal one? And this quote comes from a critic of Harvey who says frogs and serpents and gnats and other beasts brought upon the stage of Harvey's books. So how can you dissect a gnat and say that's the same as me, in us, a perfect human? And then even Caspar Hoffman, who Harvey goes to Germany, he shows in his demonstration, he does these vivisections, and he says basically that heart is beating far too fast in a dying animal for me to ever be able to differentiate between systole, diastole, and you can't really come to this conclusion safely. But I think it's important to remember that Harvey is making this discovery without the benefit of a microscope, as I've said already, let alone something like a CT scanner. So you don't actually get the sort of modern imaging technology to be able to see the heart in motion until the 20th century. So technically, it's not until the last hundred years that we've been able to officially confirm what it is that Harvey discovered in the 17th century. Interestingly, Harvey's frustrations were actually shared by Angela Palmer, who's a contemporary artist we commissioned for our exhibition, and this is the the piece she made, which is called Cannulated Heart. It's etched glass and ink, and she works mainly with CT scans, translating them into glass sculpture, and she found, of course, the heart beats too quickly in a CT scan to get a sort of accurate glass impression, and she ended up going back to a human heart, a dead human heart, to make this work. So she's actually going back to those 17th century basics, which I thought was just a really lovely parallel. But of course, over time, Harvey's discovery came to be accepted, and by the end of his lifetime, Harvey was widely renowned and celebrated at the college, and having him evidently made up with everyone there who didn't agree with him initially, he founded a museum at the college, and he donated a large piece of land in Kent, the proceeds of which went on to found a lecture in his name, the Harveyan Oration, which I'm going to come back to shortly. In 1654, he was actually offered the presidency, but turned it down. He thought he was too old, and he actually died about three years later. So he's, as John Aubrey, one of his students, says here, it's quite special to be someone who sees that revolutionary idea accepted in his own lifetime, so he could die knowing that he wasn't universally hated in the way that he was concerned about. I just want to do sort of a quick aside, because a question I get asked a lot about this, is if Harvey's discovery is that we have a circulatory system in which the blood is always in motion, you only have five liters of it at any time, why on earth do they keep bleeding people? It doesn't make any sense. If you don't have excess blood in sort of the Galenic framework, why would you keep bleeding? But it is a practice that continues into the mid-19th century, and arguably much later. I'm actually just reading a book about the 1918 influenza outbreak, and in certain cases, bleeding was prescribed for Spanish flu. Interesting. But I think it really comes back to, I mean, a few things. One, medical practice and medical science are quite different. I think universally it takes a while for discoveries made in medical science to translate themselves into medical practice, but also in the past, physicians are wanting to earn their fee, if I can use that phrase. If your patient wants to be bled, then really you're going to bleed them, because you want that money from them, and indeed Harvey went on bleeding his patients, and part of the reason why he lost many patients is they thought, oh no, he's not going to bleed me anymore, and that's desperately what I needed. Harvey actually, as he was going through his final illness, he had a series of strokes at the end of his life, and called him to be bled himself. So it's a very deeply ingrained practice, despite Harvey's discovery. So running concurrently to these debates about the circulatory system, Harvey's career of course continued, and much broader than just this piece of research, and particularly his role as royal physician. So in 1618, he'd been appointed physician to James I, and in 1628 to his son Charles I, and he actually looks after Charles's sons at the Battle of Edge Hill during the Civil War. It might be a bit of a stretch to say he took fire looking after the boys, but there certainly was firing around him. Harvey, it interrupted him reading a book, and he had to relocate himself and the boys, and after Charles's death, he was banished from London. He was officially labeled a delinquent by the government, and in 1642 the parliamentarians ransacked his house and burned all of his research notes and papers. So it's actually why we have very little left of Harvey in terms of his handwriting. We have a few examples in the exhibition, but there's not much, and also very little about his work as a physician. We don't have his case notes of his patients anymore, but we do know that he was a very deeply felt sense of loyalty to Charles, and after Charles's death and also the ransacking of his papers, we do know that he at least threatened suicide, if not actually tried to carry out suicide. It's a bit confusing in the records, but I feel in my abstract that I promised witches, so here we go. Harvey's going on with the royal court. I kind of tend to be discussed a lot less by historians than his anatomical discovery, which makes sense. It of course changed how we understand our bodies, but certainly Harvey in the court is full of a lot of super interesting anecdotes about the 17th century, and the story of Harvey and the Pendle witches is definitely worth mention. So in this period, as much as Galen's teachings were universally accepted, so too was the existence of witches. Indeed, King James I published his famous Demonology in 1603, so essentially to deny the existence of witches was akin to heresy. But Harvey was someone, as we've seen, that was committed to understanding what could be seen by the eye, by ocular demonstration, by autopsy, and thank goodness for that. In 1632, a boy living near Pendle reported having seen two greyhounds in a field, and when he tried to beat them with a stick, it doesn't really explain why he walked up to these dogs and tried to beat them with a stick, they then transform magically into a woman and her son, and the woman tries to bribe the boy. He resists the bribe and runs into town. They pursue him, it's very dramatic, and eventually he is rescued. So this is, of course, the Pendle witch trials have been going on for a few decades at the time, so there's already a huge hype about this, neighbor accused neighbor, 30 people are arrested as a part of this particular witch hunt, of which 17 were imprisoned. So this is when Charles I decides to get involved, he gets wind of this trouble up in Pendle and asks for the 17 imprisoned women to be brought to London to be examined by his personal physician Harvey. Now Harvey did not believe in witchcraft, but he carries out a physical examination, and this is what he writes. He says there's nothing unnatural neither in their secrets or in any other part of their bodies, so he examines them for the signs of witchcraft, moles and other strange markings, and he determines there's nothing otherworldly about these women, and they were all released, which is great. Other women who came under medical supervision weren't so lucky. Thomas Brown, who lives a little bit after Harvey, is also famously involved in witch trials, and he sent a number of women to their deaths because he did believe witchcraft was real and gave testimony to that effect. A bit of a divergence there. So was Harvey a revolutionary? I think he's not someone who saw himself as at the vanguard of the Enlightenment, which was moving towards mechanics and rationality. I mean Harvey was really about as old-fashioned as they come, both in terms of his personal politics, but also his medical politics, if we can use it in that way. And while he may have believed that the heart worked like a pump, he didn't think that the heart was a pump, and he was really against this sort of move towards natural philosophy, which is very much characterized by people like Rene Descartes, I think therefore I am, and who's sort of seeing the body more mechanically. No, Harvey says the heart is the seat of the soul, and there's nothing in my discoveries that would unseat that. I've just simply explained a little bit better how it works. And actually he advised his student, John Aubrey, and Aubrey asks him, who should I be reading? You know, what's the next new thing? And he says, no, go to the fountainhead and read Aristotle. He advises him Aristotle, Cicero, and Avicenna. And he calls the neoterics, so these new natural philosophers like Descartes, he calls them shit breaches, by which he means they're like babies in swaddling. They have no idea what they're talking about. You know, don't even bother with them. So given that this is the case, when did Harvey become this symbol of scientific advancement and rationalism, someone who swept away past superstition and brought us into the light of empirical enlightenment and science? And partially I think this is because the story of Harvey is very rhetorically useful. So for example, after the restoration, the college is in big trouble with the monarchy. It had been run by obvious reasons for many years by parliamentarians. And they utilize this relationship with Harvey, the fact that Harvey had been personal physician to Charles I, he knew his sons as a way to get back into good standing with royalty and they become the royal college with a big R. And this is perhaps why as London burned in 1666, this portrait of Harvey, which we have in our collection, very much the centerpiece of our exhibition and was actually saved from the building, one of the few treasures they took out of the college. So already being valued very highly as a symbol of physicians at the time. And so before I left to do my PhD, as I mentioned, I was assistant curator at the Royal College of Surgeons, Hunterian Museum. And if it's not clear enough from the name, Hunter is very much celebrated as the first scientific surgeon, a hero and an origin story for the surgical profession today. And while at first I might have been a bit baffled by the constant references to Harvey upon first arriving at the physicians, it's all became clear when I realized, of course, that Harvey is the physician's hunter. He's someone who doctors can trace as the first of their kind, someone interested in the observable, the repeatable and the scientific. And nowhere is that more evident than the collections of the College of Physicians of London, which is replete with images of Harvey made almost exclusively after his death. This bust was commissioned by Richard Mead, a very famous physician. It was finished in 1739. And nowhere is this love of Harvey stronger or the idea of Harvey than with the Victorians. Arguably the way that we tend to think about Harvey today as a trailblazer of science comes from this period. And here we have Thomas Huxley, who is a very famous advocate for Darwinian evolution, for vivisection and for scientific education removed from religion. I won't read this whole quote, it's very long. But he's returning to Harvey as someone who comes from a higher ideal, a higher time. He's looking to Harvey as someone to kind of justify his own beliefs. But Harvey is also romanticized by the Victorians as a great man of science, which I think can be seen quite clearly in this painting. So this is an imaginary scene of Harvey demonstrating his discovery to Charles I with his son there looking on. And this was completed by Robert Hannah from 1848. It's entirely fictitious. And we know that this didn't happen. But what the artist is drawing on here is the idea of Harvey, the Renaissance man, Harvey the physician with the ear of the king. And it's why when you look around you in this room today, you will find many images of Harvey. I also spotted one at the surgeon's hall. So not only physicians, but surgeons look to Harvey in this way. So naturally, then it makes sense that Harvey is a subject which is returned to over and over again by the College of Physicians as they define themselves as rational and scientific in the heritage of Harvey, or at least as he's imagined. In 1928, the college celebrated 300 years since Demortocortis was published. They commissioned a film, which is really terrifying to watch. You can watch it on the Wellcome Library's website. They actually vivisect animals. So they recreate Harvey's experiments. I had to edit that out of our current exhibition. And then in 1957, they celebrate the tercentenary of Harvey's death with medals, lectures, commemorative stamps. And of course, now we find ourselves in 2018, a year which arguably has no real meaning in the history of William Harvey, but certainly is one for doctors. I don't really have time to talk very much about this, but I will just say I mentioned before about the Harvey iteration. It's founded by Harvey. It's the first one he's done in his lifetime. And it's continued pretty much every year in the intervening years. It's still carried out every October. And it's where physicians are encouraged by Harvey to seek out and study the secrets of nature by way of experiment. And so it's a way, again, that physicians are reinforcing that they are experimental, they are scientific. And you get a lot of really, really great speakers over the years. Only a few years ago, Dame Kay Davies was one of the very few women who've ever given a Harvey iteration. She works in genomic medicine, and we did an interview with her for the exhibition, which was really fun. So coming to the end now, what then can I leave you with? It's really difficult as a historian to weigh in on a figure like Harvey, particularly when so many wonderful historians have already done really excellent work. So I would try really hard to think of what it is I could say as an insightful conclusion for you for having braved the snow to come to this lecture this evening. Harvey is a skilled and observant anatomist, one of the first to import the Italian tradition to England. He was very famous in his lifetime. He's closely associated with the royals. He's a Victorian icon. Harvey is what the physicians want to be seen as. But I suppose that I can only leave you with kind of my personal opinion, and that's that while Harvey was a proud Englishman, a Kentishman, whose family had been farmers and traders in the south of England for generations, Harvey was also a European. And his contributions to science and medicine come very much from that Europeanness. So while he was at Padua, he was a representative of the nation of England. It was a university that was sort of ruled by the students who assembled into houses, as it were, and by their countries of origin. But they worked together, and they were taught by professors from many, many other European countries. So France, the Netherlands, Italy, and Germany. Vesalius was from Belgium. Harvey's teacher Fabritius is Italian. So if Harvey was able to bring anything to medical science, it's because he's bringing a European tradition of anatomy home to England and for the first time doing that on English soil. So if I can then get slightly political, I would just say, if we don't have Erasmus programs, if we don't give young people the opportunity to study in other places, as I have been fortunate to be able to, with those mix of cultures and backgrounds and share their insights, how can we hope for another Harvey in our lifetime? So thank you very much for your time, for coming out to visit or to listen to this talk. And if you do find yourself in London, please, please do come to the exhibition. It's free, open Monday to Friday, nine to five. We do also have a new website for 500 years. We have lots of videos and images that you can access remotely. And if you have any questions or research inquiries, there's the information there. So thank you very much for listening.