Thus far we have spoken of the quantity of blood passing through the heart and the lungs in the centre of the body, and in like manner from the arteries1 into the veins2 in the peripheral4 parts and the body at large. We have yet to explain, however, in what manner the blood finds its way back to the heart from the extremities5 by the veins, and how and in what way these are the only vessels6 that convey the blood from the external to the central parts; which done, I conceive that the three fundamental propositions laid down for the circulation of the blood will be so plain, so well established, so obviously true, that they may claim general credence8. Now the remaining position will be made sufficiently9 clear from the valves which are found in the cavities of the veins themselves, from the uses of these, and from experiments cognisable by the senses.
The celebrated10 Hieronymus Fabricius of Aquapendente, a most skilful11 anatomist, and venerable old man, or, as the learned Riolan will have it, Jacobus Silvius, first gave representations of the valves in the veins, which consist of raised or loose portions of the inner membranes12 of these vessels, of extreme delicacy13, and a sigmoid or semilunar shape. They are situated14 at different distances from one another, and diversely in different individuals; they are connate at the sides of the veins; they are directed upwards15 towards the trunks of the veins; the two — for there are for the most part two together — regard each other, mutually touch, and are so ready to come into contact by their edges, that if anything attempts to pass from the trunks into the branches of the veins, or from the greater vessels into the less, they completely prevent it; they are farther so arranged, that the horns of those that succeed are opposite the middle of the convexity of those that and so on alternately.
The discoverer of these valves did not rightly understand their use, nor have succeeding anatomists added anything to our knowledge: for their office is by no means explained when we are told that it is to hinder the blood, by its weight, from all flowing into inferior parts; for the edges of the valves in the jugular16 veins hang downwards17, and are so contrived18 that they prevent the blood from rising upwards; the valves, in a word, do not invariably look upwards, but always toward the trunks of the veins, invariably towards the seat of the heart. I, and indeed others, have sometimes found valves in the emulgent veins, and in those of the mesentery, the edges of which were directed towards the vena cava and vena portae. Let it be added that there are no valves in the arteries, and that dogs, oxen, etc., have invariably valves at the divisions of their crural veins, in the veins that meet towards the top of the os sacrum, and in those branches which come from the haunches, in which no such effect of gravity from the erect19 position was to be apprehended20. Neither are there valves in the jugular veins for the purpose of guarding against apoplexy, as some have said; because in sleep the head is more apt to be influenced by the contents of the carotid arteries. Neither are the valves present, in order that the blood may be retained in the divarications or smaller trunks and minuter branches, and not be suffered to flow entirely21 into the more open and capacious channels; for they occur where there are no divarications; although it must be owned that they are most frequent at the points where branches join. Neither do they exist for the purpose of rendering22 the current of blood more slow from the centre of the body; for it seems likely that the blood would be disposed to flow with sufficient slowness of its own accord, as it would have to pass from larger into continually smaller vessels, being separated from the mass and fountain head, and attaining23 from warmer into colder places.
But the valves are solely24 made and instituted lest the blood should pass from the greater into the lesser25 veins, and either rupture26 them or cause them to become varicose; lest, instead of advancing from the extreme to the central parts of the body, the blood should rather proceed along the veins from the centre to the extremities; but the delicate valves, while they readily open in the right direction, entirely prevent all such contrary motion, being so situated and arranged, that if anything escapes, or is less perfectly27 obstructed28 by the cornua of the one above, the fluid passing, as it were, by the chinks between the cornua, it is immediately received on the convexity of the one beneath, which is placed transversely with reference to the former, and so is effectually hindered from getting any farther.
And this I have frequently experienced in my dissections of the veins: if I attempted to pass a probe from the trunk of the veins into one of the smaller branches, whatever care I took I found it impossible to introduce it far any way, by reason of the valves; whilst, on the contrary, it was most easy to push it along in the opposite direction, from without inwards, or from the branches towards the trunks and roots. In many places two valves are so placed and fitted, that when raised they come exactly together in the middle of the vein3, and are there united by the contact of their margins29; and so accurate is the adaptation, that neither by the eye nor by any other means of examination, can the slightest chink along the line of contact be perceived. But if the probe be now introduced from the extreme towards the more central parts, the valves, like the floodgates of a river, give way, and are most readily pushed aside. The effect of this arrangement plainly is to prevent all motion of the blood from the heart and vena cava, whether it be upwards towards the head, or downwards towards the feet, or to either side towards the arms, not a drop can pass; all motion of the blood, beginning; in the larger and tending towards the smaller veins, is opposed and resisted by them; whilst the motion that proceeds from the lesser to end in the larger branches is favoured, or, at all events, a free and open passage is left for it.
figures 1-2
But that this truth may be made the more apparent, let an arm be tied up above the elbow as if for phlebotomy (A, A, fig30. 1). At intervals31 in the course of the veins, especially in labouring people and those whose veins are large, certain knots or elevations32 (B, C, D, E, F) will be perceived, and this not only at the places where a branch is received (E, F), but also where none enters (C, D): these knots or risings are all formed by valves, which thus show themselves externally. And now if you press the blood from the space above one of the valves, from H to O, (fig. 2,) and keep the point of a finger upon the vein inferiorly, you will see no influx33 of blood from above; the portion of the vein between the point of the finger and the valve O will be obliterated34; yet will the vessel7 continue sufficiently distended35 above the valve (O, G). The blood being thus pressed out and the vein emptied, if you now apply a finger of the other hand upon the distended part of the vein above the valve O, (fig. 3,) and press downwards, you will find that you cannot force the blood through or beyond the valve; but the greater effort you use, you will only see the portion of vein that is between the finger and the valve become more distended, that portion of the vein which is below the valve remaining all the while empty (H, O, fig. 3).
It would therefore appear that the function of the valves in the veins is the same as that of the three sigmoid valves which we find at the commencement of the aorta36 and pulmonary artery37, viz., to prevent all reflux of the blood that is passing over them.
figures 3-4
Farther, the arm being bound as before, and the veins looking full and distended, if you press at one part in the course of a vein with the point of a finger (L, fig. 4), and then with another finger streak38 the blood upwards beyond the next valve (N), you will perceive that this portion of the vein continues empty (L, N), and that the blood cannot retrograde, precisely39 as we have already seen the case to be in fig. 2; but the finger first applied40 (H, fig. 2, L, fig. 4), being removed, immediately the vein is filled from below, and the arm becomes as it appears at D C, fig. 1. That the blood in the veins therefore proceeds from inferior or more remote parts, and towards the heart, moving in these vessels in this and not in the contrary direction, appears most obviously. And although in some places the valves, by not acting41 with such perfect accuracy, or where there is but a single valve, do not seem totally to prevent the passage of the blood from the centre, still the greater number of them plainly do so; and then, where things appear contrived more negligently42, this is compensated43 either by the more frequent occurrence or more perfect action of the succeeding valves, or in some other way: the veins in short, as they are the free and open conduits of the blood returning TO the heart, so are they effectually prevented from serving as its channels of distribution FROM the heart.
But this other circumstance has to be noted44: The arm being bound, and the veins made turgid, and the valves prominent, as before, apply the thumb or finger over a vein in the situation of one of the valves in such a way as to compress it, and prevent any blood from passing upwards from the hand; then, with a finger of the other hand, streak the blood in the vein upwards till it has passed the next valve above (N, fig. 4), the vessel now remains45 empty; but the finger at L being removed for an instant, the vein is immediately filled from below; apply the finger again, and having in the same manner streaked46 the blood upwards, again remove the finger below, and again the vessel becomes distended as before; and this repeat, say a thousand times, in a short space of time. And now compute47 the quantity of blood which you have thus pressed up beyond the valve, and then multiplying the assumed quantity by one thousand, you will find that so much blood has passed through a certain portion of the vessel; and I do now believe that you will find yourself convinced of the circulation of the blood, and of its rapid motion. But if in this experiment you say that a violence is done to nature, I do not doubt but that, if you proceed in the same way, only taking as great a length of vein as possible, and merely remark with what rapidity the blood flows upwards, and fills the vessel from below, you will come to the same conclusion.
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1
arteries
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| n.动脉( artery的名词复数 )；干线，要道 | |
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veins
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| n.纹理；矿脉( vein的名词复数 )；静脉；叶脉；纹理 | |
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3
vein
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| n.血管，静脉；叶脉，纹理；情绪；vt.使成脉络 | |
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4
peripheral
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| adj.周边的，外围的 | |
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extremities
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| n.端点( extremity的名词复数 )；尽头；手和足；极窘迫的境地 | |
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6
vessels
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| n.血管( vessel的名词复数 )；船；容器；（具有特殊品质或接受特殊品质的）人 | |
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7
vessel
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| n.船舶；容器，器皿；管，导管，血管 | |
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8
credence
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| n.信用，祭器台，供桌，凭证 | |
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9
sufficiently
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| adv.足够地，充分地 | |
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10
celebrated
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| adj.有名的，声誉卓著的 | |
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11
skilful
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| (=skillful)adj.灵巧的，熟练的 | |
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12
membranes
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| n.（动物或植物体内的）薄膜( membrane的名词复数 )；隔膜；（可起防水、防风等作用的）膜状物 | |
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13
delicacy
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| n.精致，细微，微妙，精良；美味，佳肴 | |
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14
situated
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| adj.坐落在...的，处于某种境地的 | |
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15
upwards
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| adv.向上，在更高处...以上 | |
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16
jugular
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| n.颈静脉 | |
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17
downwards
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| adj./adv.向下的（地），下行的（地） | |
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18
contrived
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| adj.不自然的，做作的；虚构的 | |
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19
erect
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| n./v.树立，建立，使竖立；adj.直立的，垂直的 | |
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20
apprehended
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| 逮捕，拘押( apprehend的过去式和过去分词 )； 理解 | |
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21
entirely
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| ad.全部地，完整地；完全地，彻底地 | |
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22
rendering
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| n.表现，描写 | |
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23
attaining
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| （通常经过努力）实现( attain的现在分词 )； 达到； 获得； 达到（某年龄、水平、状况） | |
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24
solely
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| adv.仅仅，唯一地 | |
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25
lesser
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| adj.次要的，较小的；adv.较小地，较少地 | |
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26
rupture
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| n.破裂；(关系的)决裂；v.(使)破裂 | |
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27
perfectly
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| adv.完美地，无可非议地，彻底地 | |
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28
obstructed
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| 阻塞( obstruct的过去式和过去分词 )； 堵塞； 阻碍； 阻止 | |
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29
margins
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| 边( margin的名词复数 )； 利润； 页边空白； 差数 | |
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30
fig
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| n.无花果(树) | |
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31
intervals
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| n.[军事]间隔( interval的名词复数 )；间隔时间；[数学]区间；（戏剧、电影或音乐会的）幕间休息 | |
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32
elevations
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| （水平或数量）提高( elevation的名词复数 )； 高地； 海拔； 提升 | |
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33
influx
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| n.流入，注入 | |
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34
obliterated
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| v.除去( obliterate的过去式和过去分词 )；涂去；擦掉；彻底破坏或毁灭 | |
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35
distended
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| v.（使）膨胀，肿胀( distend的过去式和过去分词 ) | |
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36
aorta
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| n.主动脉 | |
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37
artery
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| n.干线，要道；动脉 | |
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38
streak
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| n.条理，斑纹，倾向，少许，痕迹；v.加条纹，变成条纹，奔驰，快速移动 | |
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39
precisely
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| adv.恰好，正好，精确地，细致地 | |
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40
applied
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| adj.应用的；v.应用，适用 | |
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41
acting
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| n.演戏，行为，假装；adj.代理的，临时的，演出用的 | |
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42
negligently
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43
compensated
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| 补偿，报酬( compensate的过去式和过去分词 )； 给（某人）赔偿（或赔款） | |
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44
noted
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| adj.著名的，知名的 | |
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45
remains
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| n.剩余物，残留物；遗体，遗迹 | |
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46
streaked
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| adj.有条斑纹的，不安的v.快速移动( streak的过去式和过去分词 )；使布满条纹 | |
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47
compute
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| v./n.计算，估计 | |
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