William Osler.

The growth of truth as illustrated in the discovery of the circulation of the blood : being the Harveian oration delivered at the Royal college of physicians, London, October 18, 1906 online

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The growth of Truth

The Growth of Truth

Illustrated in the Discovery of the
Circulation of the Blood



OCTOBER 18, 1906











ONLY those of us, Mr. President and Fellows, who have
had the good fortune to hold the distinguished position
which by your kind grace, Sir, I hold to-day, only those
of us who have delivered the Harveian Oration, can
appreciate the extraordinary difficulties besetting a
subject, every aspect of which has been considered, very
often too, by men who have brought to the task a com-
bination of learning and literary skill at once the envy
and the despair of their successors. But I take it, Sir,
that in this Ambarvalia or commemorative festival for
blessing the fruits of our great men, ordained definitely
as such by him whose memory is chiefly in our minds
to-day, our presence here in due order and array,
confers distinction upon an occasion of which the
oration is but an incident. But, honour worthy of such
a theme should be associated with full knowledge of
the conditions under which these great men lived and
moved ; and here conies in the real difficulty, because it
is rarely possible to bring the fruits of independent
critical investigation into their lives and works. Par-
ticularly hard is it for those of us who have had to live
the life of the arena : our best efforts bear the stamp of
the student, not of the scholar. In my own case, a deep


reverence for the mighty minds of old, and a keen
appreciation of the importance to our profession of
a study of history, may be put in the scales against
defects as to the appreciation of which I have still
remaining sufficient self-detachment. The lesson of the
day is the lesson of their lives. But because of the
ever-increasing mental strain in this age of hurry, few
of us have the leisure, fewer still, I fear, the inclination,
to read it thoroughly. Only with a knowledge of the
persistency with which they waged the battle for Truth,
and the greatness of their victory, does the memory of
the illustrious dead become duly precious to us.

History is simply the biography of the mind of man ;
and our interest in history, and its educational value to
us, is directly proportionate to the completeness of our
study of the individuals through whom this mind has
been manifested. To understand clearly our position in
any science to-day, we must go back to its beginnings,
and trace its gradual development, following certain
laws, difficult to interpret and often obscured in the
brilliancy of achievements laws which everywhere
illustrate this biography, this human endeavour, working
through the long ages ; and particularly is this the case
with that history of the organized experience of the
race which we call science.

In the first place, like a living organism, Truth grows,
and its gradual evolution may be traced from the tiny
germ to the mature product. Never springing, Minerva-
like, to full stature at once, Truth may suffer all the
hazards incident to generation and gestation. Much of
history is a record of the mishaps of truths which have
struggled to the birth, only to die or else to wither in
premature decay. Or the germ may be dormant for
centuries, awaiting the fullness of time.


Secondly, all scientific truth is conditioned by the
state of knowledge at the time of its announcement.
Thus, at the beginning of the seventeenth century, the
science of optics and mechanical appliances had not
made possible (so far as the human mind was con-
cerned) the existence of blood capillaries and blood
corpuscles. Jenner could not have added to his Inquiry
a discourse on immunity ; Sir William Perkin and the
chemists made Koch possible ; Pasteur gave the condi-
tions that produced Lister ; Davy and others furnished
the preliminaries necessary for anaesthesia. Every-
where we find this invariable filiation, one event follow-
ing the other in orderly sequence ' Mind begets mind,'
as Harvey says; 'opinion is the source of opinion.
Democritus with his atoms, and Eudoxus with his chief
good, which he placed in pleasure, impregnated Epi-
curus; the four elements of Empedocles, Aristotle;
the doctrine of the ancient Thebans, Pythagoras and
Plato; geometry, Euclid' (De Generatione}.

And, thirdly, to scientific truth alone may the homo
mensura principle be applied, since of all mental treasures
of the race it alone compels general acquiescence. That
this general acquiescence, this aspect of certainty, is
not reached per saltum, but is of slow, often of difficult,
growth marked by failures and frailties, but crowned
at last with an acceptance accorded to no other product
of mental activity is illustrated by every important
discovery from Copernicus to Darwin.

The growth of Truth corresponds to the states of
knowledge described by Plato in the Theaetetus acquisi-
tion, latent possession, conscious possession. Scarcely
a discovery can be named which does not present these
phases in its evolution. Take, for example, one of the
most recent : Long years of labour gave us a full know-


ledge of syphilis; centuries of acquisition added one
fact to another, until we had a body of clinical and
pathological knowledge of remarkable fullness. For
the last quarter of a century we have had latent posses-
sion of the cause of the disease, as no one could doubt
the legitimate inference from discoveries in other acute
infections. The conscious possession has just been
given to us. After scores of investigators had struggled
in vain with the problem, came Schaudinn with an
instinct for truth, with a capacity to pass beyond the
routine of his day, and with a vision for the whole
where others had seen but in part. It is one of the
tragedies of science that this brilliant investigator, with
capabilities for work so phenomenal, should have been
cut off at the very threshold of his career. The cancer
problem, still in the stage of latent possession, awaits
the advent of a man of the same type. In a hundred
other less important problems, acquisition has by slow
stages become latent possession ; and there needs but
the final touch the crystal in the saturated solution
to give us conscious possession of the truth. But when
these stages are ended, there remains the final struggle
for general acceptance. Locke's remark that 'Truth
scarce ever yet carried it by vote anywhere at its first
appearance ' is borne out by the history of all discoveries
of the first rank. The times, however, are changing ;
and it is interesting to compare the cordial welcome of
the pallid spirochaete with the chilly reception of the
tubercle bacillus. Villemin had done his great work,
Cohnheim and Salmonson had finally solved the prob-
lem of infectivity, when Koch published his memorable
studies. Others before him had seen the bacillus, but
the conscious possession of the truth only came with
his marvellous technique. Think of the struggle to


secure acceptance! The seniors among us who lived
through that instructive period remember well that
only those who were awake when the dawn appeared
assented at once to the brilliant demonstration. We are
better prepared to-day ; and a great discovery like that
of Schaudinn is immediately put to the test by experts
in many lands, and a verdict is given in a few months.
We may have become more plastic and receptive, but
I doubt it ; even our generation that great generation
of the last quarter of the nineteenth century, had a
practical demonstration of the slowness of the accepta-
tion of an obvious truth in the long fight for the aseptic
treatment of wounds. There may be present some who
listened, as I did in October, 1873, to an introductory
lecture at one of the largest of the metropolitan schools,
the burden of which was the finality of surgery. The
distinguished author and teacher, dwelling on the
remarkable achievements of the past, concluded that
the art had all but reached its limit, little recking that
within a mile from where he spoke, the truth for which
he and thousands had been striving now a conscious
possession in the hands of Joseph Lister would revo-
lutionize it. With scores of surgeons here and there
throughout the world this truth had been a latent posses-
sion. Wounds had healed per primam since Machaon's
day; and there were men before Joseph Lister who
had striven for cleanliness in surgical technique; but
not until he appeared could a great truth become
so manifest that it everywhere compelled acquiescence.
Yet not without a battle a long and grievous battle, as
many of us well knew who had to contend in hospitals
with the opposition of men who could not not who
would not see the truth.

Sooner or later insensibly, unconsciously the iron


yoke of conformity is upon our necks; and in our
minds, as in our bodies, the force of habit becomes
irresistible. From our teachers and associates, from
our reading, from the social atmosphere about us we
catch the beliefs of the day, and they become ingrained
part of our nature. For most of us this happens in
the haphazard process we call education, and it goes on
just as long as we retain any mental receptivity. It
was never better expressed than in the famous lines
that occurred to Henry Sidgwick in his sleep :

We think so because all other people think so;

Or because or because after all, we do think so ;

Or because we were told so, and think we must think so;

Or because we once thought so, and think we still think so;

Or because, having thought so, we think we will think so.

In departing from any settled opinion or belief, the
variation, the change, the break with custom may come
gradually; and the way is usually prepared; but the
final break is made, as a rule, by some one individual,
the masterless man of Kipling's splendid allegory, who
sees with his own eyes, and with an instinct or genius
for truth, escapes from the routine in which his fellows
live. But he often pays dearly for his boldness.
Walter Bagehot tells us that the pain of a new idea
is one of the greatest pains to human nature. ' It is, as
people say, so upsetting ; it makes you think that, after
all, your favourite notions may be wrong, your firmest
beliefs ill-founded ; it is certain that till now there was
no place allotted in your mind to the new and startling
inhabitant ; and now that it has conquered an entrance,
you do not at once see which of your old ideas it will
not turn out, with which of them it can be reconciled,
and with which it is at essential enmity.' It is on this
account that the man who expresses a new idea is very


apt to be abused and ill-treated. All this is common
among common men, but there is something much
worse which has been illustrated over and over again
in history. How eminent soever a man may become
in science, he is very apt to carry with him errors
which were in vogue when he was young errors that
darken his understanding, and make him incapable of
accepting even the most obvious truths. It is a great
consolation to know that even Harvey came within the
range of this law in the matter of the lymphatic system
it is the most human touch in his career.

By no single event in the history of science is the
growth of truth, through the slow stages of acquisition,
the briefer period of latent possession, and the for us
glorious period of conscious possession, better shown
than in the discovery of the circulation of the blood.
You will all agree with me that a Fellow of this college
must take his courage in both hands who would, in this
place and before this audience, attempt to discuss any
aspect of this problem. After nearly three centuries of
orations the very pictures and books in this hall might
be expected to cry out upon him. But I have so taken
my courage, confident that in using it to illustrate
certain aspects of the growth of truth I am but obeying
the command of Plato, who insists that principles such
as these cannot be too often or too strongly enforced.
There is a younger generation, too, the members of
which are never the worse for the repetition of a good
story, stale though it may be in all its aspects to their
elders; and then there is that larger audience to be
considered to which the season is never inappropriate
to speak a word.



The sixteenth century, drawing to a close, had been
a period of acquisition unequalled in history. Brooding
over the face of the waters of mediaevalism, the spirit of
the Renaissance brought forth a science of the world
and of man which practically created a new heaven and
a new earth, and the truths announced by Copernicus
and Galileo far transcended

the searching schoolmen's view
And half had staggered that stout Stagyrite.

Among other things, it had given to medicine a new
spirit, a new anatomy, and a new chemistry. In the
latter part of the fifteenth century Hippocrates and
Galen came to their own again. A wave of enthusiasm
for the fathers in medicine swept over the profession ;
and for at least two generations the best energies of its
best minds were devoted to the study of their writings.
How numerous and important is that remarkable group
of men, the medical humanists of the Renaissance, we
may judge by a glance at Bayle's Biographic Medicate,
in which the lives are arranged in chronological order.
From Garbo of Bologna, surnamed the expositor, to
Rabelais, more than 150 biographies and bibliographies
are given, and at least one-half of these men had either
translated or edited works of the Greek physicians. Of
our founder, one of the most distinguished of the group,
and of his influence in reviving the study of Galen and
so indirectly of his influence upon Harvey, Dr. Payne's
story still lingers in our memories. Leonicenus, Linacre,
Gonthier, Monti, Koch, Camerarius, Caius, Fuchs,
Zerbi, Cornarus, and men of their stamp not only
swept away Arabian impurities from the medicine of


the day, but they revived Greek ideals and introduced
scientific methods.

The great practical acquisition of the century was
a new anatomy. Vesalius and his followers gave for
the first time an accurate account of the structure of
the human body, and while thus enlarging and correct-
ing the work of Galen, contributed to weaken the
almost divine authority with which he dominated
the schools. Nearly another century passed before
chemistry, in the hands of Boyle and others, reached
its modern phase, but the work of Paracelsus, based on
that of the ' pious Spagyrist ', Basil Valentine, by show-
ing its possibilities, had directed men's minds strongly
to the new science. Of the three, the new spirit alone
was essential, since it established the intellectual and
moral freedom by which the fetters of dogma, authority,
and scholasticism were for ever loosened from the
minds of men.

Into this world, we may say, stepped a young Folke-
stone lad, when, on the last day of May, 1593, he
matriculated at Cambridge. Harvey's education may
be traced without difficulty, because the influences
which shaped his studies were those which had for
a century prevailed in the profession of this country.
We do not know the reason for selection of Caius
College, which, so far as I can gather, had no special
connexion with the Canterbury school. Perhaps it was
chosen because of the advice of the family physician, or
of a friend, or of his rector ; or else his father may have
known Caius; or the foundation may already have
become famous as a resort for those about to ' enter
on the physic line '. Or, quite as likely, as we so often
find in our experience, some trivial incident may have
turned his thoughts towards medicine. When he came


up in 1593, there were those of middle age who could
tell racy stories of Caius, the co-founder of the college,
against whose iron rule they had rebelled. 'Charged
not only with a show of a perverse stomach to the
professors of the Gospel, but with Atheism/ the last
days of Caius's noble life were embittered by strife and
misunderstanding. Doubtless the generous souls among
them had long since learned to realize the greatness of
his character, and were content to leave ' the heat of his
faith to God's sole judgement, and the light of his good
works to men's imitation', with which words, half
a century later, the inimitable Fuller concludes a short
sketch of his life. I like to think that, perhaps, one
of these very rebels, noting the studious and inquisitive
nature of Harvey, had put into the lad's hand the little
tractate, De libris propriis, from which to glean a know-
ledge of the life and works of their great benefactor.

The contemplation of such a career as that of Caius
could not but inspire with enthusiasm any young man.
No one in the profession in England had before that
time reached a position which I may describe as
European. An enthusiastic student and the friend of
all the great scholars of the day ; a learned commentator
on the works of the Fathers ; the first English student
in clinical medicine; a successful teacher and practi-
tioner ; a keen naturalist ; a liberal patron of learning
and letters ; a tender and sympathetic friend Johannes
Caius is one of the great figures in our history. Nor
need I dwell, before this audience, on his devotion to
our interests, other than to say that the memory of no
Fellow on our roll should be more precious to us.
Four years hence, on October 6, will occur the quater-
centenary of his birth. As well in love as in gratitude,
we could celebrate it in no more appropriate manner,


and in none that would touch his spirit more closely,
than by the issue of a fine edition of his principal works
(including the MS. annals of the College). For the
preparation of this there are those among us well fitted,
not less by veneration for his memory than by the
possession of that critical scholarship which he valued
so highly.

When Harvey set out on the grand tour, Italy was
still the mater gloriosa studiorum ; to which one hundred
years earlier, so tradition says, Linacre on leaving had
erected an altar. The glamour of the ideals of the Re-
naissance had faded somewhat since the days when
John Free, an Oxford man, had made the ancient learn-
ing his own ; and had so far bettered the instruction of
his masters that he was welcomed as a teacher in
Padua, Ferrara, and Florence. In a measure, too, the
national glory had departed, dimmed amid the strife and
warfare which had cost the old republics their indepen-
dence. Many years earlier Fracastorius, one of our
medical poets, had sung of her decadence :

To what estate, O wretched Italy,
Has civil strife reduc'd and moulder'd Thee !
Where now are all thy ancient glories hurl'd ?
Where is thy boasted Empire of the world ?
What nook in Thee from barbarous Rage is freed
And has not seen thy captive children bleed? 1

And matters had not improved but had grown worse.
In the sixteenth century Italian influence had sunk
deeply into the social, professional, and commercial life
of England, more deeply, indeed, than we appreciate ; 2
and it was not for a generation or two later that the
candlesticks were removed from the Cisalpine towns to

1 Syphilis. Englished by N. Tate, 1686.
. 2 Italian Renaissance in England, Einstein. Macmillan, 1902.


Montpellier, Paris, and Leyden. In 1593 a well-to-do
young Englishman who wished to study medicine
thoroughly went to North Italy, and most naturally to
Padua' fair Padua, nursery of the arts 'whose close
affiliations with us may be gathered from the fact that,
of universities next to Oxford and Cambridge, she has
given us more Presidents than any other. In the years
that had passed since Vesalius had retired in disgust, the
fame of its anatomical school had been well maintained
by Fallopius, Columbus, and Fabricius, worthy succes-
sors of the great master. Of each may be said what
Douglas says of the first named : ' In docendo maxime
methodicus, in medendo felicissimus, in secando expertissi-
mus.' While the story of Harvey's student life can
never be told as we could wish, we know enough to
enable us to understand the influences which moulded
his career. In Fabricius he found a man to make his
life-model. To the enthusiastic teacher and investigator
were added those other qualities so attractive to the
youthful mind, generous sympathies and a keen sense
of the wider responsibilities of his position, as shown in
building, at his own expense, a new anatomical theatre
for the University. Wide as was the range of his
master's studies, embracing not alone anatomy but
medicine and surgery, the contributions by which he is
most distinguished are upon subjects in which Harvey
himself subsequently made an undying reputation. The
activity of his literary life did not begin until he had
been teaching nearly forty years, and it is a fact of the
highest significance that, corresponding to the very
period of Harvey's stay in Padua, Fabricius must have
been deep in the study of embryology and of the
anatomy of the vascular system. His great work on
generation was the model on which Harvey based his


own, in some ways, more accurate studies studies in
which, as my colleague Professor Brooks of the Johns
Hopkins University has pointed out, he has forestalled
Wolf and von Baer.

The work of Fabricius which really concerns us here
is the de Venarum Ostiolis. Others before him had
seen and described the valves of the veins, Carolus one
of the great Stephani, Sylvius and Paul Sarpi. But an
abler hand in this work has dealt with the subject, and
has left us a monograph which for completeness and for
accuracy and beauty of illustration has scarcely its equal
in anatomical literature. Compare Plate VII, for ex-
ample, with the illustrations of the same structures in
the Bidloo or the Cowper Anatomy, published nearly
one hundred years later; and we can appreciate the
advantages which Harvey must have enjoyed in working
with such a master. Indeed, it is not too far-fetched to
imagine him, scalpel in hand, making some of the very
dissections from which these wonderful drawings were
taken. But here comes in the mystery. How Fabricius,
a man who did such work how a teacher of such wide
learning and such remarkable powers of observation,
could have been so blinded as to overlook the truth
which was tumbling out, so to speak, at his feet, is to
us incomprehensible. But his eyes were sealed, and to
him, as to his greater predecessors in the chair, clear
vision was denied. The dead hand of the great Per-
gamite lay heavy on all thought, and Descartes had not
yet changed the beginning of philosophy from wonder
to doubt. Not without a feeling of pity do we read of
the hopeless struggle of these great men to escape from
slavish submission to authority. But it is not for us in
these light days to gauge the depth of the sacred venera-
tion with which they regarded the Fathers. Their


mental attitude is expressed in a well-known poem of

Browning's :

those divine men of old time

Have reached, thou sayest well, each at one point
The outside verge that rounds our faculty,
And where they reached who can do more than reach ?

Willing to correct observations or to extend anatomy
by careful dissection, it was too much to expect from
them either a new interpretation of the old facts or
a knowledge of the new method by which those facts
could be correctly interpreted.

The ingenious explanation which Fabricius gave of
the use of the valves of the veins to serve as dams or
checks to the flow of the blood, so that it would not
irrigate too rapidly and overflow the peripheral vessels
to the deprivation of the upper parts of the limbs
shows how the old physiology dominated the most
distinguished teacher of the time in the most distin-
guished school of Europe. This may have been the
very suggestion to his pupil of the more excellent way.
Was it while listening to this ingenious explanation of

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Online LibraryWilliam OslerThe growth of truth as illustrated in the discovery of the circulation of the blood : being the Harveian oration delivered at the Royal college of physicians, London, October 18, 1906 → online text (page 1 of 3)