Development of Anatomophysiologic Knowledge regarding the Cardiovascular System: From Egyptians to Harvey

Abstract

Our knowledge regarding the anatomophysiology of the cardiovascular system (CVS) has progressed since the fourth millennium BC. In Egypt (3500 BC), it was believed that a set of channels are interconnected to the heart, transporting air, urine, air, blood, and the soul. One thousand years later, the heart was established as the center of the CVS by the Hippocratic Corpus in the medical school of Kos, and some of the CVS anatomical characteristics were defined. The CVS was known to transport blood via the right ventricle through veins and the pneuma via the left ventricle through arteries. Two hundred years later, in Alexandria, following the development of human anatomical dissection, Herophilus discovered that arteries were 6 times thicker than veins, and Erasistratus described the semilunar valves, emphasizing that arteries were filled with blood when ventricles were empty. Further, 200 years later, Galen demonstrated that arteries contained blood and not air. With the decline of the Roman Empire, Greco-Roman medical knowledge about the CVS was preserved in Persia, and later in Islam where, Ibn Nafis inaccurately described pulmonary circulation. The resurgence of dissection of the human body in Europe in the 14th century was associated with the revival of the knowledge pertaining to the CVS. The main findings were the description of pulmonary circulation by Servetus, the anatomical discoveries of Vesalius, the demonstration of pulmonary circulation by Colombo, and the discovery of valves in veins by Fabricius. Following these developments, Harvey described blood circulation.

History of cardiac anatomy: A comprehensive review from the egyptians to today

“…He implied that the brain is the origin of all the blood vessels supplying the body (Loukas et al, ). In addition, he was the first to distinguish vaguely between arteries and veins (Atkinson, ), though with no clear anatomical explanation (Bestetti et al, ).…”

“…Their discoveries were the source of basic anatomical knowledge about different structures in the cardiovascular system. In the Hippocratic Era, the major contributor to the study of cardiac structure was the school of Cos, the main member of which was Hippocrates (Bestetti et al, ). They wrote the first book detailing the anatomy of the heart and the cardiovascular system, “On The Heart.”…”

“…This structure constituted the origin of vessels that transport life to the body (Mavrodi and Paskevas, ). Hippocrates described the heart as having two ventricles connected by orifices through the interventricular septum (Hippocrates, ; Bestetti et al, ). The left ventricle was described as having thicker walls and a rougher inner texture than the right (Hippocrates, ; Harris, ).…”

“…They were not recognized as part of the heart but rather as “ears” devoid of holes that served for capturing air, and as parts of the vessels connected to the heart (Hippocrates, ; Mavrodi and Paskevas, ). Each of these vessels was connected to the heart through extensions from the cardiac wall (Bestetti et al, ). Hippocrates recognized two types of vessel.…”

“…He implied that all vessels of the body except the lungs were connected to one of the two main trunks, the “great vein” and the aorta, both originating in the heart (Harris, ). The great vein, according to Aristotle, was the trunk that branched to form the pulmonary artery and the venae cavae (Bestetti et al, ). The aorta was described as a nervous vessel bearing nervous ends (Aristotle, ).…”