HEART BEAT:The legacy of a past doctor is more than medical theory
WILLIAM HARVEY was born in Kent in 1578. His father was a landowner and merchant. He attended the King's School, Canterbury and subsequently Cambridge University.
He then went to the medical school at Padua where he studied under the famous anatomist Hieronymus Fabricius, who had described the presence of valves in some veins, though their significance eluded him. There Harvey received his MD degree in 1602.
When he returned to the UK he married Elizabeth Browne, the daughter of a physician of Queen Elizabeth I, in what might be described as a "good career move".
He was appointed as physician to St Bartholomew's Hospital - then, as now, a beacon of English medicine. He established a thriving private practice and also became lecturer to the Royal College of Physicians. In 1616, in a lecture derived from his own experience and experiments, he laid out his theories concerning the circulation of the blood.
He became physician to James I in 1618 and later to Charles I, was present at the battle of Edgehill in the English Civil War and reputedly hid the Royal children in the aftermath.
Although he had lectured extensively on the circulation of the blood, it was not until 1628 that he published the treatise that would ensure his place in medical history. It was entitled De Motu Cordis et Sanguinis in Animalibusor "an anatomical essay on the movement of the heart and blood in animals". He detailed his experiments and explained clearly how the circulation worked.
It wasn't a bestseller and, despite its clarity and common sense, was received unenthusiastically by the profession then largely influenced by the Faculty in Paris, still overly influenced by the dated and unscientific theories of Galen (circa 2nd century AD). Consequently, his practice suffered, but his Royal Patronage remained firm and, soon enough, his theories gained acceptance.
He had foreseen the effect his work would excite: "What remains to be said upon the quantity and source of the blood which thus passes is of so novel and unheard-of character that I not only fear injury to myself from the envy of a few but I tremble lest I have mankind at large for my enemies. Still, the die is cast and my trust is in my love of truth and the candour that inheres in cultivated minds."
Harvey was not the first to describe the circulation, but he was the first to do so with clarity and force.
Ibn al-Nafis, a Syrian, did so in Cairo in about 1290, but his work became lost when the hand of religious fundamentalism stifled Arab science and culture.
Harvey had already published when this work was rediscovered.
Uncomprehending religious orthodoxy also accounted for the last of this circulation triumvirate, the Spaniard Michael Servetus.
He published before Harvey, but with much less detail and without the corroborating experimental evidence.
In fact, his theory was contained in a book denouncing the possibility of the Holy Trinity. This infuriated Protestants and Catholics alike, and when Servetus fled France for Italy he made the mistake of passing through Geneva, where Calvin had him arrested and burned at the stake.
In 2000, Prof Will Fennell from Cork and Dr Tom Ryan from Boston, working on the principle that "all work and no play makes Jack a dull boy", inaugurated the first golf tournament for the William Harvey trophy, to be competed for by teams of cardiac physicians and surgeons from the US, Britain and Ireland and Continental Europe. A biennial tournament, this year found us in Biarritz, where the Continental team triumphed.
These doctors drawn from all over these areas included some of the best known and respected authorities in their fields and, whatever the aim, the work was not left behind.
Discussions on various aspects of the specialty, although informal, were a constant, welcome feature. Such meetings, common in many medical specialties, have another important aspect, in that they can facilitate the training of young doctors. To recommend somebody to your peers who know you and rely upon your judgment can be a powerful incentive in training placement.
From the time of Hippocrates, through Harvey and into the present day, it's what doctors do, and it works. It worked for me, and for those I helped train and place.
In this modern world, it might not meet the criteria of stifling political correctness, but to hell with that. Ours is the responsibility for training young doctors and we will not devolve it to anybody else.
Thank you William for the week; I hope we are better doctors than golfers.
• Maurice Neligan is a cardiac surgeon