SA HISTORY OF THE LUNGS
Introduction
Galenic and Aristotelian views of the lungs influenced physicians throughout the early modern period. During the Renaissance, however, new knowledge of the lungs were gained through anatomical observation. Physicians during the Renaissance understood the connection between the lungs and respiration and between life and breath, but anatomy texts still grasped tightly to the notion of balance purported by ancient medical authorities. Similarly, in general these texts emphasized empirical descriptions and practical knowledge about the lungs. For example, when Leonardo Da Vinci deals with the lungs, the primary purpose is to show the structure of the lungs and to describe the importance of other organs and structures in the body that work cooperatively with them. Authorities like Galen and Aristotle are often mentioned, but their theories are neither supported nor rejected. In contrast to philosophers and physicians before him, da Vinci does not attempt to provide bold theories on the origin or existence of the lungs, but rather provides simple clinical explanations through observation.
During the first half of the 16th century, pre-Vesalian anatomists primarily stressed that the function of the lungs was to cool the air from the heart. These physicians (Alessandro Benedetti, Alessandro Achillini, Andres de Laguna, and Niccolo Massa) described the lungs in the context of nature's purpose for them. Not only could the lungs counteract the anger and heat of the heart by cooling air from it, lungs could also change breath into food for the vital spirit. Anatomical writers of this time seemed to have an accurate sense of the position of the lungs and functions of different attributes (i.e. the sponginess of the lungs facilitated greater air intake and intercostal muscles powered air intake). They had also discovered that the lungs consisted of five lobes, three on the right and two on the left. Their theories as to why there were so many lobes were not as accurate. For example, they theorized that the lungs had five lobes so that if one were to fail, the others would be able to assume function accordingly.
Seventeenth-century physician William Harvey makes several observations about the lungs in Lectures on the Whole of Anatomy. Although Harvey's views often coincide with those of the ancient authorities, such as Aristotle and Galen, he offers a particularly striking departure. Unlike Galen, Harvey regarded the lungs as the most important organ in the body, rather than the liver. The five-lobe structure of the lung is established by Harvey's time, and his writings support that the divisions act as a "security" system: if one lobe is unhealthy, another can take up its work. He sided with the Aristotelian notion that spirit is not from air, but from blood, and he linked the constitution of the lungs with the temperament of a person. According to Harvey, boldness is a sign of hot lungs, while timidity is a sign of cold lungs. Consistent with Aristotle, Harvey maintains that man has both the hottest blood and the fullest lung capacity, which allows him to keep his weight upright. This positioning, Harvey argues, is the key to man's nobleness and dominance over other animals. Interestingly, Harvey also commented on the positive correlation between the health of the lungs and physical activity, an idea that is usually perceived as a 20th century phenomenon.
Questions to consider: Why did Harvey believe the lungs were linked to a person's temperament? Why did physicians use the function of the lungs to argue for the nobleness and superiority of man? What was the relationship between the lungs and the heart?
A Collection of Quotations from Original Sources and Images of the Lungs:
Antiquity
Galen, ca. 200 A.D.
"Blood passing through the lungs absorbed from the inhaled air, the quality of heat, which it then carried into the left heart."
"The lung, for example, has all the properties which make for easy evacuation; for it is very soft and warm and is kept in constant motion."
The Middle Ages
Avicenna, 980-1037
"In the case of the lung the moisture is not inherent in its nature but is derived from the nourishment which comes to it. The lung is fed by a very "hot" blood, because there is much bilious humour in the blood going to the lung. A great excess of moisture accumulates in the lung from the gaseous products of the whole body as well as from the materials which flow down to it from the "head."
"In actual fact the liver is intrinsically moister than the lung, whereas the lung is as it were constantly sprinkled with moisture; it is the fact that the moisture lingers in it that make it so soft (to the feel). "
Master Nicolaus, ca. 1150-1200
[[missing text?? didn't scan in???--check hard copy]]
The Renaissance
Leonardo Da Vinci, 1452-1519 (illustration from Da Vinci's text)
"From the heart, impurities or 'sooty vapors' are carried back to the lung by way of the pulmonary artery, to be exhaled to the outer air."
"The substance of the lung is dilatable and extensible like the tinder made from a fungus. But it is spongy and if you press it, it yields to the force which compresses it, and if the force is removed, it increases again to its original size."
"The gust of wind driven out of the lung in the generation of a large breath comes from the aid of the abdominal wall which compresses the intestines, and they elevate the diaphragm which compresses the lungs."
Pre-Vesalian Anatomists:
"If the force of anger suddenly bursting forth cleverly stirs up flames, reason straightaway checks them by frequent cooling of the heart with the breath of the spirit from the hollow fistulae of the lungs. Thus anger, otherwise implacable, is easily calmed."-- Alessandro Benedetti ,1497
"The function of breathing is given the lungs, continuously drawing in and expelling the breath.... The lung changes the breath, as the liver changes the chyle, into food for the vital spirit. It is spongy, thin, hollow with empty fistulae in addition to veins and arteries. It holds the spirit and contains much blood. A very thin membrane covers the lung... [The lung] has the shape of an oven or, as they say, a cow's hoof."--Alessandro Benedetti, 1497
"There are five lobes of the lung, two on the left side, three on the right. The third is a cushion for the inferior vena cave and the artery in the direction of the heart."--Alessandro Achillini, 1520
"Certainly the whole temperament very much follows the constitution of the lungs"--Andres de Laguna, 1535
"As far as the structure of the lungs is concerned there is no need for me to proceed further since their use is sufficiency known to all. They minister to the heart and furnish it with cool air. Their substance is quite thin and spongy so that they may more easily draw the spirit into themselves.... Furthermore, on the account of many causes the lungs are divided into five lobes. The first of these is that in the case of any calamity to one part, another part of the lung can render assistance. Second, the lungs move more readily and swiftly than if they were not divided into lobes...."--Andres de Laguna, 1535
"The lung is divided into two parts by the mediastinum to prevent any harm to one part if the other is injured. The entire substance of the lung is made up of five fibers or lobes. The function of the lung is to cool the heart with its intake of air. This air is not a pure element but an airy body and thus can nourish, although Galen, that great philosopher, thought he understood it in another sense, for air prepared in the lung itself nourishes or restores the spirit"-- Niccolo Massa, 1559
"The lung is also a sort of cushion for the heart.... The lung is also necessary for the formation of the voice and for strength; it is useful for containing good air in itself and keeping bad air out while the good is retained when anyone smells bad odors."--Niccolo Massa, 1559
William Harvey, 1653
"Wheresoever matter has fallen into the lung, evacuation is by cough and by reason of the site of the body; a natural demonstration that vital spirit for the veins, arteries and voice is abundant in the region of the highest rib."
"Pre-eminence [of the lung]: nothing is especially so necessary neither sensation nor aliment. Life and respiration are complementary. There is nothing living which does not breathe nor anything which breathing which does not live."
"The lungs make the spirits and indicate the nourishment wherefore more worthy than the liver if honor is judged by benefit."
Conclusion