1757: Joseph Black discovers carbon dioxide

Joseph Black (1728-1799)

In 1668 John Mayow came very close to discovering oxygen and carbon dioxide. Perhaps the only thing stopping him from these discoveries was an early death. This left the door open for other investigators, such as Joseph Black.

In the 13th century, and again in the 17th century, Roger Bacon and Jean van Helmont described a substance they referred to as gas sylvestre.

In 1668, John Mayow noted his belief that there was a vapor arising from the blood that was exhaled during the act of respiration. Yet he passed away before he was able to make anything further of this discovery.

Other investigators performed experiments with this substance throughout the 18th century, and by the 1750s, by the time Joseph Black began his experiments with the gas, it was generally referred to as "fixed air."

So, while performing his own experiments in 1757,  Black essentially proved proved Bacon, van Helmont and Mayow correct, that a substance, be it called "gas sylvestre" or "fixed air" does exist.

By his experiments, he proved that by heating limestone the substance was released into the atmosphere.  He also proved that this substance was exhaled during the process of respiration.

Also of significance is that Black discovered that this compound was formed animals and exhaled by the lungs, thus proving Mayow correct. A picture was now forming that the purpose of the lungs was not to cool the body, but to inhale a substance vital to life, and exhale a waste product (carbon dioxide).  This wisdom would be expounded upon by great minds of the next century.

So, beginning in the 13th century, various men of genius began to question the ideas of the ancients, those that were held by the Church.  Many of them risked everything to perform, and later to announce, their discoveries to the world.  Such bravery allowed for science to slowly replace mythology in medicine.

References:

1. Tissier
2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
14. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14

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1750: Purpose of air, breathing is learned

Stephen Hales (1677-1761) 

So we are now in the year 1750 sitting among a group of fellow students at the University of Glasgow. The topic for today, says our instructor in his usual monotone manor, is the purpose of air.

He reminds us that in 1553, Michael Servetus was the first to speculate that it was the lungs that caused dark blood to become bright red, and not the heart.

In 1640, he says, William Harvey was the first to describe the systemic circulation of the blood through the vessels of the body.

In 1667, Joachim Becher published a book, "Physical Education," in which he said the four classic elements of fire, earth, air and water were no longer relevant, and replaced them with three earth forms: terra lapidea, terra fluida, and terra pinguis.  He believed terra pinguis was responsible for combustion and rusting.

Joseph Black (1728-1799)

In 1697 George Ernst Stahl changed this theory slightly and used the term phligoston (Greek term for burning up) to describe a material or principle of fire (not the fire itself) that was released into the air during combustion.  When a substance was burned, the combustible components of the burned material were released into the air, thus causing it to become impure.

This theory, says our instructor, is the generally accepted theory of today. However, it must be known that another theory, that substances are formed from atoms, that is beginning to be more generally accepted in our time.  However, before we get to that discussion let's continue our history.

In 1668, John Mayow was the first to speculate that the purpose of the lungs was not to cool the heart, but for the exchange of gases.  He believed a substance in the air -- nitro-aerial gas -- was inhaled into the lungs, and when it entered the blood stream the blood turned from a dark color to a bright red.  This, he speculated, was why venous blood was dark and arterial blood red.

He also speculated that a vapor produced by the blood was exhaled by the lungs. He did not know that nitro-aerial gas was oxygen, and he did not know that the substance produced by the blood and exhaled by the lungs was carbon dioxide. He may have made these discoveries had he not died at the young age of 35, before any of his works were published.

In 1727 and 1733 Stephen Hales published the results of experiments on air and respiration where he proved that there is no circulatory system in trees like there is in humans and animals.  (2, page 193)

So, by 1750, our present year, investigators had determined that one of these gases was fixed air that was exhaled by the lungs, and the other was a vapor that was inhaled by the lungs.

One of the students in our class is Joesph Black.  He would go on to become the first to recognize that this gas was burned off during the exhalation phase of respiration.   He discovered it "was deadly to animals, and could distinguish a flame." (1) (2, page 193-194)

References:

1. "Carbon Dioxide,"  Scienceclariied.com, http://www.scienceclarified.com/Ca-Ch/Carbon-Dioxide.html#b, observed the site on May 4, 2012 (this information is available at a variety of sources, although I chose to give sciencedaily.com credit)
2. Magner, Lois N., "History of Life Sciences," 2002, 3rd edition, New York, Marcel Dekker

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1628: William Harvey discovers circulation, and proves it

Robert Hooke discovered the respiration
was not to keep the circulation of the
blood moving. In 1553 

A book published by Andreas Vesaleas inspired physicians to investigate the human body. But, it was a book published by William Harvey that empowered physicians to truly understand the human body, and how changes in the body caused diseases. And so it is Harvey who is credited as paving the way for modern medicine.

Galen alluded to the idea that blood circulated through the body in the 2nd century. Yet in his many writings, he described blood as moving back and forth between organs in a to and fro motion. Whether he had a notion it circulated is left to speculation.

Vesaleas was the first person to publish an accurate anatomy of the body. He performed autopsies and had a painter paint what he saw, and this was published in a book, De humani corporis fabrica, in 1543. However, he erred in believing that the purpose of circulation was to cool the blood. (7, page 474)(11, page 243-4)

A contemporary of Vesaleas was Realdus Columbus (1516-1569).  He was a surgeon and professor of anatomy at Padua from 1544 until his death in 1569. He continued Servetus's work on the circulation of the blood, describing the passage of blood from the vena-cave through the pulmonary circulation, and then through the left ventricle and aorta. (8, page 70-71)

Columbus also saw that blood changes in the lungs.  (11, page 243)

Andrea Cesalpino (1519-1603) was the first to describe the idea that blood circulates through the body.  But he usually doesn't get credit for this observation because he failed to prove it.

Hieronymus Fabricius (1537-1619) studied the venous system of the human body and discovered membranous folds that he referred to as valves. He speculated that these allowed blood to flow upward. Since the blood pressure was lower the farther blood gets from the heart, these valves were necessary to prevent gravity from pulling blood to the legs and feet. This is what prevented diseases like dropsy of the feet. Today, we would refer to this as pedal edema. (14, page 92)

In other words, his discovery of valves made Fabricus wonder if the blood circulated as opposed to moved in a to and fro motion as Galen had suggested. But whether this was true or not would be left to one of his students to determine. This students name was William Harvey. (14, page 93)(15, page xxiii)

Michael Servetus discovered circulation. He discussed it in his 1553 book, although he also failed to prove it.  So the door was still wide open for a major breakthrough in science, and just the man to accomplish this task was William Harvey, who essentially took over the work of Servetus.

William Harvey (1578-1657)(11, page 242)

Medical Historian Thomas Bradford said Harvey was born in 1578 at Folkestone in Kent, and by the time he was ten-years-old he was accepted at Caius College, Cambridge, in 1593. He studied there for five years, then traveled to France and Germany, and then studied at the "celebrated" medical school at Padua. (14, page 119)

Bradford said that he studied under some of the most renowned anatomists of the era, including Dr. Fabricius. 14 page 91)(15, page xxiii)

Some say he lectured by candle light. Perhaps it was in this "light" that William Harvey was introduced to veins and valves. This wisdom, coupled with the enthusiasm of his instructor, inspired Henry to further investigate these veins and valves to learn more about them. "Perhaps," Harvey must have wondered, "Fabricius is right, that the blood does circulate." (14, page 119)

Bradford said he graduated from Padua in 1602 and began a practice in Cambridge in London.  Then, he became a physician at Bartholomew's Hospital, and in 1615 became a professor of anatomy and surgery at the college.  It was here he began his own anatomical research.  (14, page 119)

Like Andreas before him, he wasn't satisfied with the current method of just speculating about the movement of the blood and heart, or that assuming it was a knowledge that only God was privy to. He studied the heart and vessels in animals and came to the conclusion that the heart was a pump, and it circulates the blood through the body. (9, page 168-169)

How he discovered blood circulates is quite interesting. At the time it was believed blood was created by the liver. Veins and arteries pulsated to move the blood through the body. It was then absorbed by tissues.

Harvey used math to prove this was not possible. He studied how much blood went through the heart in an hour. He calculated that three times a person's weight in blood passed through the heart per hour. So, if it was produced by the liver as previously suspected, a person would simply explode.

While his comrades initially rejected his theory that blood circulates through the body, Bradford said:

King Charles took great interest in these discoveries and witnessed several experiments. He appointed Harvey his physician in 1643.  In 1633 he accompanied the king and his court to Scotland.  When "Old Parr" died the king gave the body to Harvey to dissect.  (14, page 120)

Several years after he made this discovery, and when he was 50 years old, he would publish, in 1628, Exercitatio anatomica de Motu Cordis et Sanguinis (An Anatomical Exercise on the Motion of the Heart and Blood in Living Beings).  (14, (page 119-122)

Of course, once Harvey published his discovery in his 1628 book  his medical practice took a hit, and he was criticized by a dogmatic medical profession.  (11, page 246)(14, pages 119-120)(17)

However, in the end, Harvey would be proved right, and his ideas (of course based on science as opposed to theory) would win out, and he lived long enough to see his theory become accepted, said Garrison. (11, page 246) (also see 14, pages 119-120)

Perhaps it was due to his friendship with the king that his ideas were accepted before his death in 1657. (14, page 119-122)

Garrison said William Harvey "was the "greatest name in the seventeenth century... and whose work has exerted a profounder influence upon modern medicine than that of any other man save Vesalius.. it was the most momentous discovery since Galen's time." (11, )

Charles Auffray and Denis Noble, in a 2009 article in International Journal of Molecular Science, said that Harvey may even have come close to discovering how the heart may continue beating even after it is removed from the body.  They quote Harvey as saying:

The heart of an eel and of certain other fish and animals, having been taken out of the body, beats without auricles.  Furthermore, if yo ucut it in pieces, you will see the separate pieces each contract and relax, so that in them the very body of the heart beats and leaps after the auricles have ceased to move. (17)

Auffray and Noble said:

He (Harvey) could not, in his day, take this dissection further down to discover that the rhythmic mechanism was integrated at the level of individual cells, since the cell theory was formulated by Matthias Schleiden (1804-1881) and Theodor Schwann (1810-1882) two centuries later based on observations with the microscope introduced  in practice in the life sciences of Anton van Leeuwenhoek (1632-1723) only after Harvey's death.  However, he was the first to realise that rhythmicity was a property of the smallest structures he could discern. (17)

Had he had access to the microscope, perhaps Harvey would have made similar discoveries.  Yet he did not need to make any further discoveries, considering his discovery of circulation, and his proving it, was enough to secure his spot in history books.

Despite his accomplishments, Harvey's view that the purpose of breathing was to cool the blood "retarded the development of the true physiology of respiration for a long time." (11, page 242-244)

However, Garrison further explains that Harvey's proof that all blood passes through the lungs, and circulates around the body, made it possible for physiology to become a "dynamic science."  (11, pages 244-248)

It was through this discovery  that made it possible for later investigators to inject dyes and other solutions into the vessels that resulted in many anatomical discoveries, such as:  (11, pages 244-248)

• Lacteal Vessels by Gasparo Aspelli in 1622
• Thoracic Duct by Jean Pecquet 
• The Pancreatic Duct by Georg Wirsung in 1642
• Circle of Willis in by Thomas Willis in 1664
• Capillaries in the lungs by Marcello Malpighi in 1661 (see below)

Of course each of these discoveries dispelled some ancient myth about the flow of substances through the body. For instance, Galen believed the purpose of "veins and lymphatics of the intestines carried chyle to the liver, said Garrison. This theory of Galen was disproved by the above discoveries, all thanks to the discovery that blood circulates through the body by Harvey. (11, page 246-7)

Galen believed the pulse would help determine changes in the pneuma, indicating disease. Harvey, on the other hand, described that the beating of the heart correlates with the pulse felt at the various points on the body. As the pulse is felt, this is when blood is forced through the many vessels of the body during contraction of the heart. The heart then relaxes, and this is when the heart receives blood. The strength and force of the pulse, therefore, is a direct correlation to the strength and force of the heart. (9, page 168-169)

He generally agreed with Columbus that the right ventricle of the heart pumps blood to the pulmonary arteries and then to the lungs where the blood is nourished, and the left side of the heart pumps blood to the various arteries of the body. As quoted by Osler: (9, page 170)

"I began to think whether there might not be A Movement, As It Were, In A Circle. Now this I afterwards found to be true; and I finally saw that the blood, forced by the action of the left ventricle into the arteries, was distributed to the body at large, and its several parts, in the same manner as it is sent through the lungs, impelled by the right ventricle into the pulmonary artery, and that it then passed through the veins and along the vena cava, and so round to the left ventricle in the manner already indicated." (10)

Marcello malpighi was the first to observe
capillary anastomosis, although he did not
attach importance to it.

Garrison added:

The most brilliant outcome of Harvey's experimental method was in the clearing up of the obscure matter of the physiology of respiration... Before Harvey's day, men still believed, with Galen (including Vesalius and Harvey), that the object of respiration was to cool the fiery heart, the purpose of the chest movements being to introduce air for generating vital spirits by the pulmonary vein, and to get rid of the heart's smoky vapors by the same channel. This Galenic notion was not a mere piece of symbolism, as in Richard Crashaw's (1612-1649) poem on St. Teresa (The Flaming Heart), but was part and parcel of actual belief about the physics of the circulation. "Before Harvey's time," says (Sir Clifford) Allbutt (1836-925), "respiration was regarded not as a means of combustion but of refrigeration. How man became such a fiery dragon was the puzzle." Harvey's demonstration showed that the blood is changed from venous to arterial in the lungs, but beyond that point, as even (Samuel) Pepys (1633-1703) has recorded in his Diary, no one could tell how or why we breathe (13, page 266)

Per Garrison, Pepy's wrote regarding respirations:

But what among other fine discourse pleased me most was Sir G. Ent about Respiration; that it is not till this day known or concluded among physicians, nor to be done either, how the action is managed by nature, or for what use it is." (13, page 266) 

While the Fabrica of Vesalias opened the eyes of the anatomist, the discovery that blood circulates inspired the anatomist to learn more about the physiology, or the functions of the body. In this way, he inspired people to learn more about medicine, and how medicine affects the various organs of the body. Harvey, therefore, is often referred to by many as the modern father of medicine.  (15, page xxiii)

References:

1. Tissier
2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
14. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14
18. Strathern, Paul, " A Brief History Of Medicine:  from Hippocrates to Gene Therapy," 2005, London, Robinson, page

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1668: Mayow comes close to discovering oxygen

John Mayow (1640-1679)

John Mayow learned by his many experiments that "dark venous blood is changed to bright red by taking up a certain ingredient" in the air, and he referred to this ingredient as "nitro-aerial spirit of air," or "nitro-aerial gas." (11, page 268)(7, page 475)

He also learned that blood exposed to a vacuum gave off bubbles, and he believed this to be "nitro-aerial gas." He was right, and the substance, as later proved, was oxygen. While he did not discover oxygen, he was that close. (7, page 475) (11, page 268)

He was perhaps the first person to actually "grasp the idea that the object of breathing is simply to cause in interchange of gases between the air and the blood, the former giving up its nitro-aerial spirit (oxygen) and taking away vapors engendered by the blood." (11, page 268)

Actually, many experts now believe that Mayow was the first to discover oxygen, although he never received credit because he died at the young age of 35, before his writings were published, and therefore his discoveries were forgotten by history until the 20th century.

However, he did learn that there was indeed a substance in the air, and that it was inhaled by the lungs and "necessary for all forms of life." He did learn that there was indeed a vapor arising from the blood that was exhaled by the lungs. This substance would later be discovered to be carbon dioxide. (7, page 475)

He, therefore, was the first to conclude that respiration was not to cool the blood as previously thought, but for the exchange of gases.  Instead of cooling the lungs, he believed the substance -- this nirto aerial gas -- was absorbed by the blood in the lungs, thus changing its color from dark to bright red.  (7, page 475)

If that wasn't enough, Mayow also discovered that maternal blood supplies an unborn fetus with not just food, but also with "nitro-aerial gas."(11, page 268)(7, page 475)

While he proved that respiration was not to cool the blood, he also proved the blood is not the source of its own heat.  Instead, he proved that heat was produced by the activity of the muscles of the body.  (11, page 268)

Mayow's works were  published in 1668 and 1674, although he died at the early age of 35 before his works were published.  So he was was never recognized until the turn of the 20th century. (7, page 475)

So while he doesn't often get credit by history, Mayow may actually have been the first person to discover oxygen.  Yet, unfortunately, history doesn't give credit for the first to do something, but the first to publish their discovery or invention.  This truth will play out many times in world history.  (7, page 474-5)

References: 

1. Tissier, Paul Louis Alexandre, “Pneumotherapy including aerotherapy and inhalation methods and therapy,” volume x, 1903, Philadelphia, P. Blakiston’s Sons & Co., page 19
2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
14. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14

1885: Holzapple prescribes oxygen for pneumonia

George E Holzapple believed there were cases of pneumonia where oxygen may become deficient in the blood resulting in a condition called asphyxia.  When this happens the blood essentially becomes more venous, resulting in all the muscles of respiration being called into action, resulting in more breaths that were more frequent and deeper.  He said expiration becomes more marked, and the process ends in expiratory convulsions.  (1, pages 264-265)

He said that physiologists believed these expiratory convulsions were the response sent by the medulla oblongata of the brain as a result of asphyxia. (1, page 265)

He said the vaso-motor center of the brain will also have an effect on the vessels, causing them to become constricted, resulting in "increased arterial tension (high blood pressure) and the filling of systemic veins (bulging veins, edema). (1, page 265)

The heart will beat slower, but with more force, in order to do its job.  To pump blood through narrow vessels it pumps harder, but less frequently.  It ultimately poops out and becomes a weak pump. (1, page 265)

Blood continues to make it's way to the heart, but the heart is unable to pump it through the body.  The heart, therefore, becomes enlarged, or what he refers to as "distended."  He said that as "blood return to the coronary arteries becomes more venous, the contraction of the heart becomes more and more feeble," ultimately beating with less force. (1, page 265)

He said, "The phenomena result from an insufficient supply of oxygen in disease and in health. From the infrequency and feebleness of the heart's action, the blood accumulates in the heart, lungs, and great veins.  The heart is in danger of paralysis, from overdistension all as the result of lack of oxygen." (1, page 265)

Along with causing changes in the force and contractility of the heart, and the rate and depth of breathing, asphyxia also caused a bluish tinge of the skin where oxygen was low, which was referred to as cyanosis.  (1, page 266)

He postulated that since severe pnemonia may result in asphyxia and cyanosis, that perhaps these patients might benefit from intermittent  inhalations of oxygen.

 In the beginning of the winter of 1885, at York Hospital, he was asked to attend to a 16-year-old male who had a severe case of lobar pneumonia with cyanosis. This patient was not administered oxygen and died.

In March of the same year he was asked to attend to a 16-year-old male who also suffered from severe pneumonia, cyanosis and dyspnea (he was breathing at a rate of 75-80 breaths per minute), and who was begging for relief, Dr. Holzapple said he...

...resolved to administer the very element he craved.  In a few minutes after administering oxygen cyanosis became less, the patient expressed himself as somewhat relieved, and in twenty minutes his respirations were reduced from 75 to 60 in a minute. The effects on the respiration and his color were distinctly appreciated by the parents and those around the bedside of the young man.  I repeated the administration a number of times during that day until it was no longer needed. the patient recovered rapidly. (1, page 266)

He later took care of of 15-year-old girl with lobar pneumonia. When she presented with cyanosis and dyspnea on the seventh day, and after she begged for breath, Dr. Holzapple prescribed the administration of oxygen every 3-4 hours. The patient eventually died, but he was convinced the patient lived an extra 48 hours, giving nature a fighting chance, due to the oxygen therapy. (1, page 266)

He said he didn't expect the oxygen to cure patients with pneumonia, he expected that it would, however, "assist nature so that the patient may endure the effects of the disease till nature no more needs our assistance." (1, page 266)

His advice to physicians regarding oxygen was this:

To say that you are not prepared to administer it is no excuse when death is imminent, for every physician is as well prepared as I was, or soon can be at little expense. (1, page 266)

The problem with administering oxygen during this era was the difficulty in delivering it to the patient, as no standardization was in place.  Holzapple describes the method he used as rather "crude."  He said:

I generated oxygen from chlorate of potassium and black oxide of maganese, in large test tubes heated over a spirit lamp, and with rubber tubing I conducted the gas to the bottom of a deep bucket filled with water, which I had placed to the side of the patient's head.  Then with a fan the gas bubbling out of the water was wafted to the patient's face. (1, page 266)

He acknowledged that he was not aware he had become the first to recommend the administration of oxygen to patients with pneumonia.  In the two years following his experiments physicians became aware of the benefits of oxygen for pneumonia.  However, he said:

I am inclined to think, however, that the average county practitioner has very little medical literature that refers to the use of oxygen in pneumonia, which was one reason for writing this article. I advocate the use of oxygen not only in pneumonia, but whenever it is deficient unless for special reasons contra-indicated." (6 ,page 267) 

While Holzapple demonstrated the medical usefulness of oxygen,the apparatus he used was admittedly crude, yet it also did not deliver pure oxygen.  In fact, no device was yet invented that would deliver pure oxygen to the patient.  It would still be several years before adequate technology would be discovered to transport and administer it when needed.

References:

1. Holzapple, GE, "The uses and effects of oxygen gas and nux vomica in the treatment of pneumonia," New York Medical Journal, September 3, 1887, volume 46, pages 264-267

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1665: Hook discovers purpose of respiration

Robert Hooke (1635-1703)

In 1665 Robert Hooke (1635-1703) was among the first investigators to use the compound microscope invented by Zaccharias Janssen , and this would ultimately play a significant role in both science and medicine. (11, page 256). 

In his 1665 book Micrographia "contains many fine plates, representing the histology of vegetable structures, and the first use of the term "cell" in this connection.  (11, page 250)

This book probably inspired many later investigators, including Nehemiah Grew (1641-1712) who was inspired to learn about vegetable histology and physiology, and Antony Leeuwenhoek, who was to learn more a variety of microscopic animal, plant and human objects. (11, page 250, 251)

In 1667 Hooke discovered that respiration was not to maintain circulation, as had previously been thought. (7, page 474)

Interestingly, Hook took the trachea of a dog and connected it to a "pair of bellows, and the ribs and diaphragm were removed; the dog was seized with convulsions and appeared to be dying, but revived when air was blown into the lungs. (7, page 474)

Small punctures were now made into various parts of the lungs, and by means of two pairs of bellows the lungs were kept fully distended with fresh air; the dog remained quiet and its heart beat regularly. The circulation continued although there was no alternate expansion and collapse of the lungs; moreover, a further experiment showed that even when the lungs were allowed to collapse the blood continued to circulate for some time. " (7, page 474)

By his experiment, Hooke also proved that "by blowing a bellows briskly over the open thorax of a dog, that artificial respiration can keep the animal alive without any movements of either chest or lungs... The experiment proved that the essential feature of respiration is not in its intrinsic movements, but in certain blood changes in the lungs." (11, page 267)

Such investigations would inspire other researchers such as:

• Giovannin Alfonso Borelli (1608-1679) became the first to describe muscular activity, the beating of the heart, and the function of the lungs, and digestion as purely mechanical acts, thus dispelling ancient theories. He also discovered that arteries were elastic, meaning that they could dilate and contract.
• Richard Lower (1631-1691) performed the first successful blood transfusion in 1665, taking the blood of one animal and inserting it into the animal of another. Then, in 1669, he "injected dark venous blood into the insufflated lungs, and concluded that its consequent bright color was due to the fact that it had absorbed some of the air passing through the lungs." (11, 267-268)

References:

1. Tissier
2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
14. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14

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1661: Malpighi completes Harvey's work

Marcello Malpighi (1628-1694)

So William Harvey proved that blood circulates through the body and published his proof in 1628.  Yet one thing that limited his research, almost causing it to come to a "standstill," was his inability to see where the arterial system connects with the venous system.

However, this problem would be resolved, thanks to the microscope, and thanks to the investigations of Marcello Malpighi.  He was the first to observe and report capillary anastomosis, which are the microscopic connections joining arteries and veins. (11, page 245)

Malpighi was professor at the University of Bologna.

By using a microscope in 1661, he observed the exchange of air from the lungs to capillaries in a frog.  He therefore was the first person to see the alveoli and capillary system. However, said Garrison, he did not apply much significance to this discovery (7, page 474)  (14, page 142)(11, page 252)

Garrison said that this was the missing link that Harvey was looking for regarding the complete circulation of blood through the body. However, considering Malppighi applied little significance to it, the discovery was not well regarded.  It would be left to a later investigator to complete Harvey's work. (11, page 247, 252)

A few years later, in 1665 he discovered blood corpuscles, (14, page 142) or what we refer to as red blood cells.  These cells are the main constituent in blood, and their main responsibility to is carry oxygen through the blood stream to the various organs of the body.

Malpighi's discover was verified by later observations:

• Dublin professor William Molyneux observed the capillary system in lizards in 1683.  
• William Cowper "saw the passage of the arterial into the venous current in the mesentery (membrane that attaches the intestines to the abdominal wall) of a cat in 1687 
• Anton von Leeuwenhoeck (1632-1723) observed capillaries in the larvae and feet of frogs in 1688 (14, page 142)

References:

1. Tissier
2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
14. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14
18. "Antony van Leeuwenhoik (1632-1723)," ucmp.berkeley.edu, http://www.ucmp.berkeley.edu/history/leeuwenhoek.html

1645: Van Helmont learns about air

The path for science had been established.  It began, however, under the guise of alchemy, a type of chemistry that particularly, even more so than science itself, was despised by the Church.  Yet it was this arrangement that made it possible for two great minds to investigate and learn the true contents of air and the purpose of why we breathe.

The first such great mind was that of Paracelsus, a man who was discussed in an earlier post.  He was a Swiss Alchemist who, in 1541, suggested that a substance in air was essential for sustaining life.  (6)  Of course such ideas were not well accepted by the medical profession, which generally thought of Paracelsus as a madman. (2, page 40)

The second was Jean Baptiste van Helmont , another man who was discussed in an earlier post.  He greatly appreciated the works of Paracelsus, and performed tests on the substance air, and he "recognized its true origin and defined its principle characteristics."  (1, page 19)

Van Helmont is also the first to use the term 'gas.' as something "distinct from air and water vapor." (2, page 40) (1, page 19)(16)

He believed that when God created Heaven he thus created water and air. Van Helmont performed a variety of tests to prove that water was separate from air, and that water could not be turned into air. He determined that air could be compressed and water could not, and he also deduced that "air could be reduced to one-half of its original volume under pressure." (3, page 96)

He likewise observed that water could be metamorphosed into ice, vapor and gas (his new term).  (4, page 64)

He knew he had a substance that was not water and not vapor, and he knew he had to come up with a term to describe it.  So he used the term "chaos," shortened it a bit, and came up with his new term 'gas."  He explained that "I have called this mist Gas, owing to its resemblance to the Chaos of the Ancients." (5, page 179)

Elizabeth Potter, in her 2001 book, said:

Experimentally, we see that when the flame of a candle burning on top of a water surface and enclosed in a cylinder has consumed the air, the water rises in the cylinder and extinguishes the candle.  Helmont argued that the otherwise empty space within the air contains magnale or spirit of the air.  This Magnale is also a third thing between spirit and matter, and it, not air, keeps us alive when we breathe. (3, page 96-7)

Ulf Lagerkvist, in his 2005 book, said van Helmont also, like Bacon before him, described a substance called gas sylvestre.  He came to this conclusion "as the result of burning charcoal and the fermentation of must." (2, page 40)

What he did was take 62 pounds of ash, burned it, and discovered that what was left was 1 pound of ash, according to historyworld.net. (16)

What has happened to the rest? Van Helmont is convinced, ahead of his time, of the indestructibility of matter. Indeed he is able to demonstrate that metal dissolved in acid can be recovered without loss of weight. (16)

So he now reasons that the missing 61 lbs have escaped in the form of an airy substance to which he gives the name gas sylvestre (wood gas). (16)

Another interesting tidbit about van Helmont was that he is believed by many historians to be the first physician to oppose the Hippocratic humoral theory of disease, that diseases were caused by an imbalance of the four humors: blood, phlegm, black bile and yellow bile.

He was  the first to prove that there was more to life than the four basic elements (Earth, Air, Water, fire) championed by ancient Greek philosophers, that these were not the only essential elements of life. Instead, he created some of his own theories based on his experiments.  For example, he believed the two primary elements were water and air.

Of course, like Paracelsus before him, Van Helmont was considered to be a madman by the scientific community and the medical profession.  His wisdom was simply not appreciated because it opposed accepted the accepted doctrines of Galen and other ancient philosophers.  (2, page 40)

Out of fear of persecution, van Helmont's works weren't published until after his death in 1648 by his son. While his works were ignored by most of his immediate successors, his ideas would eventually become accepted doctrine, and he would go down in history as the father of pneumatic chemistry.

References: 

1. Tissier, Paul Louis Alexandre, “Pneumotherapy including aerotherapy and inhalation methods and therapy,” volume x, 1903, Philadelphia, P. Blakiston’s Sons & Co., page 19
2. Lagerkvist, Ulf, "The Enigma of Ferment," 2005, Singapore, World Scientific Publishing
3. Potter, Elizabeth, "Gender and Boyle's Law of Gases," 2001, Indiana University Press
4. Newman, William R, et al, "Alchemy Tried in the Fire," 2002, University of Chicago
5. Lehrs, Ernst, "Man or Matter," 1958, Great Britain, Whistable Litho Ltd.
6. Jindel, S.K., "Oxygen Therapy," 2008, pages 5-8
7. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold
8. Hamilton, William, "A History of Medicine, Surgery and Anatomy," 1831, Vol. I, London, New Burlington
9. Osler, William Henry, "The evolution of Modern Medicine: A series of lectures delivered at Yale University on the Sillman Foundation in April, 1913," 1921, New Haven, Yale University Press
10. Osler, ibid, pages 170, reference referring to William Harvey: Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Francofurti, 1628, G. Moreton's facsimile reprint and translation, Canterbury, 1894, p. 48. 20 Ibid., p. 49.
11. Garrison, Fielding Hudson, "Introduction to the history of medicine," 1921, London, 
12. Baker, Christopher, editor, "The Great Cultural Eras of the Western World: Absolutism and the Scientific Revolution 1600-1720: A biographical dictionary," 2002, CT, Greenwood Publishing; Herman Boerhavve published Biblia Naturae (Bible of Nature) in 1737, which was a two volume compilation of the works of Jan Swammerdam. Can you read Latin?
13. Garrison, op cit, 266; (Samuel) Pepy's Diary, Mynors Bright's ed., London, 1900, v, 191
14. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
15. Brock, Arthur John, "Galen on the natural faculties," 1916, London, New York, William Heinemann, G.P. Putnam's Sons
16. "History of Chemistry," historyworld.net, http://www.historyworld.net/wrldhis/PlainTextHistories.asp?ParagraphID=kpt, accessed 7/6/14
17. Affray, Charles, Denis Noble, "Origins of Systems Biology in William Harvey's masterpiece on the Movement of the Heart and the Blood in Animals," April 17, 2009, International Journal of Molecular Sciences, 10(2), pages 1658-1669, found online at ncbi.nlm.hih.gov, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680639/, accessed 7/8/14