Leonardo’s Heart

Wells, Francis C.

doi:10.1007/978-1-4471-4531-8_4

Leonardo’s Heart

Francis C. Wells²

Chapter
First Online: 01 January 2013

2054 Accesses
1 Citations

Abstract

Leonardo’s heart studies from the years about 1513 to 1514 represent the pinnacle of his anatomical endeavours. They integrate structural form and dynamic function in a way that called upon his extensive experience and knowledge of hydrology, engineering, mathematics, and architectural design. From the evidence of the existing notes, he entered this period of study of the heart with a Galenic perspective of the movement of the blood. It is clear from the rhetorical nature of his commentary, however, that the only way that he could satisfy his desire to truly and accurately understand the detailed function of this complex organ was by using dynamic laws, and although there is no extant record of it, acknowledging the importance of mathematical proof wherever possible. This inquisitive and original approach inevitably brought him into territory that would conflict with Galen’s concepts of the ebb and flow of the blood. Whilst Leonardo’s extant notes fall short of a direct challenge to Galen’s postulates, there are sections that clearly suggest different explanations. A good example of this is his conclusion that the air passages are not directly connected to the blood vessels in the lung, as had been suggested by Galen, and indeed by Erasistratus (304–250 B.C.E.) before him. Galen’s hypothesis explained how the vital spirits contained within the inhaled “pneuma” or air, could enter the heart. Leonardo carried out an experiment in which he inflated a pair of excised lungs and then tied off the principal airway (the trachea). In doing so, he found that there was no leakage of air from the lungs, thereby disproving Galen’s hypothesis. As far as we know, Leonardo did not offer an alternative solution to the transference of life-giving forces.

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Notes

1.
RL 19029 recto [II].
2.
Erasistratus was a Greek philosopher and anatomist, who along with Herophilus founded a school of anatomy in Alexandria. He was the first to postulate a capillary link between the arteries and the veins, the basis of Harvey’s description of the circulation of the blood. He also correctly began to describe the heart as a muscle pump and not the seat of the emotions. He also began to describe the valves of the heart and the normal rhythms and arrhythmias of the heart.
3.
RL 19071 recto.
4.
This known fact in modern embryology makes sense of Leonardo’s commentary that the heart is not the beginning of life: “The heart of itself is not the beginning of life but is a vessel made of dense muscle….” (RL 19050 verso).
5.
Antonii Mariae Valsalva was an Italian anatomist who was born in Imola, Romanga, in 1666 and died in Bologna in 1723. He described the origin of the coronary arteries from the root of the aorta in the sinuses that have since borne his name. The description was published by Giovanni Battista Morgagni in a collection of his works entitled De vita et scriptis Antonii Mariae Valsalve commentariolum (Venice 1740). The entry is on one page in one paragraph; there is a collection of small engravings and no discussion of physiological function.
6.
Codex Atlanticus 345 verso.
7.
C.A. 86 recto.
8.
Paris Manuscript E. 55 recto.
9.
C.A. 147 verso.
10.
“Cast in wax through the hole ‘n’, at the bottom of the base of the cranium before the cranium is sawn through”, and later on the same page, “Make 2 vents in the horns of the great ventricles and inject melted wax with a syringe, making a hole in the ventricle of the memoria, [IVth ventricle], and through such a hole fill the three ventricles of the brain. Then when the wax has set take away the brain [substance], and you will see the shape of the ventricles perfectly. But first put narrow tubes into the vents so that the air which is in these ventricles can escape and make room for the wax which enters into the ventricles.”
11.
Charles D. O’Malley and J. B. de C.M. Saunders, Leonardo da Vinci on the Human Body. (New York, Henry Schuman, 1952; reprint, New York, Dover, 1983), 264.
12.
B.J. Bellhouse and F.H. Bellhouse, Mechanism of closure of the aortic valve. Nature 217(5123):66–7. 1968.
13.
Kenneth Keele, Leonardo da Vinci on Movement of the Heart and Blood. (London, Harvey and Blythe, 1952), 81.
14.
M. Gharib, D. Kremers, M.M. Koochesfahani, M. Kemp. Leonardo’s vision of flow visualisation. Experiments in Fluids. 33 (2002): 219–23.
15.
Martin Kemp, Leonardo da Vinci. Experience, Experiment, Design. (London, V&A Publications, 2007), 80.
16.
Personal communication from Dr. Susan Stewart and Dr. Martin Goddard, Papworth Hospital, Cambridge, England, 2011.
17.
RL 19119 verso is very suggestive of a human right ventricle, especially with the absence of an obvious moderator band (see below).
18.
Kenneth Clark. Leonardo da Vinc,. Anatomical Drawings at Windsor Castle. Vol. III, 2nd edition. (Oxford: Phaidon, 1969), RL 19027 verso, 13.
19.
RL 19027 verso.
20.
A. Benivieni, De abditis nonnullis ac mirandis morborum et sanationum causis. Ed. G. Weber (Florence: L.S. Olschki, 1994).
21.
John Henderson, The Renaissance Hospital. Healing the Body and Healing the Soul. (New Haven, Yale University Press, 2006), 248.
22.
Martin Kemp, Leonardo da Vinci. The Marvellous Works of Nature and Man, Revised edition. (Oxford: Oxford University Press, 2006), 251.
23.
RL 19027 verso [III].
24.
Luca Landucci, A Florentine. Diary from 1450 to 1516. (London: J.M. Dent, 1927), 217. A commentary on the request for permission on 24 January 1506 to dissect a hanged criminal, from the medical students and doctors of the Studio, a well-known Florentine institution of Leonardo’s time for the study of medicine, theology, and the arts.
25.
RL 19027 verso [III] continued.
26.
RL 19051 recto [V].
27.
RL 19051 recto.
28.
RL 19027 recto [III] [end of paragraph].
29.
RL 19027 verso [IV].
30.
RL 19028 verso, translation from O’Malley and Saunders, Leonardo on the Human Body, 302.
31.
RL 19027 verso [IV].
32.
RL 19028 verso, translation from O’Malley and Saunders, Leonardo on the Human Body.
33.
RL 19028 verso.
34.
An aneurysm is an abnormal swelling or enlargement of an artery. They are described as “saccular” when they tend to bulge on one side only or “fusiform” if the dilatation is uniform around the whole vessel. As it enlarges, it is likely to rupture.
35.
RL 19027 recto [III].
36.
John Hunter, The Case Books of John Hunter FRS. Ed. Elizabeth Allen, J.L. Turk. (London, CRC Press, 1993), 36.
37.
RL 19104 verso [IV].
38.
RL 19085 recto.
39.
RL 19087 verso [II].
40.
RL 19087 recto [IV].
41.
RL 19087 recto. Small drawing at bottom right of page.
42.
RL 19028 recto [VI].
43.
RL 19028 recto [IV].
44.
RL 19028 recto [III].
45.
A syncytium is a body of tissue in which multiple cell nuclei exist in one branching mass of cellular cytoplasm.
46.
K.D. Keele, Leonardo da Vinci on Movement of the Heart and Blood. (London, Harvey and Blythe, 1952), 54.
47.
RL 19050 verso. The remainder of this section emphasises the resistance of the heart muscle to heat.
48.
Paris manuscript A 55 v.
49.
Paris manuscript A 55 verso.
50.
Forster II 131 verso.
51.
RL 19063 verso [I], “On the heart”.
52.
RL 19029 recto [I].
53.
RL 19063 verso [I].
54.
Codex Atlanticus 212 verso/468 recto.
55.
RL 19063 recto [V].
56.
A good example of a thixotropic liquid is tomato ketchup!
57.
The lack of awareness of the capillary connections between artery and vein in the lungs made the proposition of the pores in the ventricular septum a necessity for the supply of blood to the rest of the body. These fictitious pores, suggested by Galen, were surprisingly easily accepted by Leonardo.
58.
RL 19119 verso [VII].
59.
Codex Arundel (British Museum) 24 recto.
60.
Ibid.
61.
K.D. Keele, Leonardo da Vinci’s Elements of the Science of Man. (New York: Academic Press, 1983), 305.
62.
K. Clark, Leonardo da Vinci. Anatomical Drawings at Windsor Castle. (Oxford, Phaidon, 1969), 40, 43.
63.
C.D. O’Malley, J.B. de C.M. Saunders, Leonardo da Vinci on the Human Body. (New York: Greenwich House, 1982), 392.
64.
RL 19050 verso.
65.
Paris manuscript G. 1 verso.
66.
Codex Atlanticus 302.
67.
K.D. Keele, Leonardo da Vinci on Movement of the Heart and Blood. (London, Harvey and Blythe, 1952), 60.
68.
RL 19045 recto [IV].
69.
RL19045 recto [IV].
70.
RL 19030 recto.
71.
RL19128 recto.
72.
RL 19050 verso.
73.
RL 19112 recto [V].
74.
Jonathon Miller, “The anatomised heart. Understanding the pump”. In: James Peto (editor), The Heart (Wellcome Trust Collection). (New Haven: Yale University Press, 2007), 62.
75.
Paris manuscript G 1v.
76.
RL 19062 recto [I].
77.
RL 19073 recto [III].
78.
RL 19087 verso [VIII].
79.
RL 19087 verso.
80.
RL 19081 recto [III].
81.
RL 19081 recto [III].
82.
RL 19087 verso [III].
83.
RL19062 verso [III].
84.
K.D. Keele, Leonardo da Vinci on Movement of the Heart and Blood. (London, Harvey and Blythe, 1952), 71.
85.
RL 19063 verso [VI].
86.
RL 19073 verso [I].
87.
RL 19029 recto [III].
88.
RL 19081 recto [III], 3rd sentence.
89.
RL 19065 recto [I].
90.
C.D. O’Malley, J.B. de C.M. Saunders, Leonardo da Vinci on the Human Body. (New York: Greenwich House, 1982), 234.
91.
RL 19063 verso [III].
92.
RL 19119 verso, Drawing of the opened right ventricle.
93.
RL 19063 verso [V].
94.
RL 19073 verso [VIII].
95.
RL 19028 recto [II].
96.
C.D. O’Malley, J.B. de C.M. Saunders, Leonardo da Vinci on the Human Body. (New York: Greenwich House, 1982), 282.
97.
RL 19072 verso [VI].
98.
RL 19072 verso [VII].
99.
RL 19074 verso.
100.
“Percussion” is defined by Leonardo as the end of the swift motion of bodies against resisting objects. It may be simple or complex. Paris manuscript B 27 verso.
101.
RL 19062 recto [I] 3rd paragraph.
102.
RL 19063 verso [I].
103.
RL 19087 verso [I].
104.
RL 19073 verso [II].
105.
RL 19072 verso [IV & V].
106.
C.D. O’Malley, J.B. de C.M. Saunders, Leonardo da Vinci on the Human Body. (New York: Greenwich House, 1982), 220.
107.
RL 19119 verso [VIII].
108.
RL 19073 verso [X].
109.
RL 19119 recto [VII].
110.
RL 19119 recto [VIII].
111.
RL 19071 recto [III].
112.
RL 19073 verso [V].
113.
RL 19071 recto [I].
114.
RL 19071 recto [II].
115.
RL 19071 recto.
116.
RL 19074 verso [V].
117.
RL 19074 verso {VI].
118.
Paris manuscript I folio 12 verso [IV and V].
119.
RL 19073 verso [IX].
120.
RL 19028 recto.
121.
K. Clark, Leonardo da Vinci. Revised and introduced by Martin Kemp. (London: Penguin Books, 1988), 233.
122.
RL 12597.
123.
M. Kemp and D. Lorenzo, personal communication. These authorities suggest the date of 1482 for this drawing, 2009.
124.
RL 19081 recto [IV].
125.
RL 19062 recto [II].
126.
RL 19062 recto [III].
127.
RL 19062 recto [IV].
128.
RL 19062 recto [I] Second paragraph, second sentence.
129.
RL 19063 verso [II].
130.
RL 19063 recto [II].
131.
RL 19080 recto [VII] and [VIII].
132.
Mondino, Anathomia. Strasburg 1513. Ioannes Adelphus’s edition.
133.
Ibid.
134.
RL 19074 recto [II].
135.
J.I. Fann, N.B. Ingels, C. Miller, “Pathophysiology of mitral valve disease and operative indications.” In: L.H. Edmunds (ed.), Cardiac Surgery in the Adult. (New York: McGraw-Hill, 1997), 959–87.
136.
L. Axel, Papillary muscles do not attach directly to the solid heart wall. Circulation, 2004;109:3145–8.
137.
RL 19074 recto [VII].
138.
RL 19116 verso [XII].
139.
RL 19073 recto [V].
140.
RL 19093 recto [I].
141.
Kenneth Keele, Leonardo da Vinci on Movement of the Heart and Blood. (London, Harvey and Blythe, 1952), 73.
142.
RL 19119 recto [III].
143.
RL 19112 recto.
144.
TW King, An essay on the safety valve function of the right ventricle. Guy’s Hosp Rep 2:104, 1837.
145.
RL 19119 verso [X] “Right Ventricle”.
146.
RL 19062 recto [I].
147.
RL 19062 recto [I].
148.
RL 19063 recto [III]. This subtlety of description distances Leonardo’s thoughts from those of Galen, who describes the filling of the ventricles with blood directly from the liver where it is constantly formed. It also declares Leonardo’s insistence that the heart has four chambers and that the blood has to pass through the atrium before reaching the ventricle, something not recognised by Galen and his followers. Thus this is a real statement of independent thought setting Leonardo apart from the academics of his day and potentially leading him into conflict with his detractors and the “abbreviators” that he refers to in his writing.
149.
RL 19081 recto [I].
150.
RL 19081 recto [I].
151.
RL 19081 recto [II].
152.
RL 19078 verso [III].
153.
RL 19078 verso [I].
154.
Dr. Martin Goddard, Consultant Cardiac Pathologist at Papworth Hospital, Cambridge. September 2007. Ongoing work.
155.
RL 19080 recto [XI].
156.
K. Keele and C. Pedretti, Leonardo da Vinci. Corpus of the Anatomical Studies in the Collection of Her Majesty the Queen at Windsor Castle (New York, 1979).
157.
RL 19082 recto [IV].
158.
RL 19082 recto [V].
159.
RL 19074 recto [I].
160.
RL 19093 recto [IV].
161.
Rheumatic fever is an autoimmune response to a streptoccocal infection of the throat, the acute phase of which usually occurs in young children. The resulting inflammation in the valves of the heart goes on to cause calcification and fixity of the valve leaflets exactly as described by Leonardo, although the process is different from the one that he described, with the deposition of blood clot as the cause.
162.
Tow is the fibre of flax, hemp, or jute prepared for low-grade spinning and formed into a rope. (Oxford University Press: The New Shorter Oxford English Dictionary, 1993).
163.
RL 19062 verso [II].
164.
RL 19081 recto [V] and [VI].
165.
RL 19082 recto [V].
166.
K. Clark, Leonardo da Vinci. Revised and introduced by Martin Kemp. (London: Penguin Books, 1988), 230; and M. Kemp, Leonardo da Vinci. The Marvellous Works of Nature and Man, Revised edition. (Oxford: Oxford University Press, 2006), 285.
167.
K. Clark, Leonardo da Vinci. Anatomical Drawings at Windsor Castle. Vol. III, 2nd edition. (Oxford: Phaidon, 1969), 32.
168.
RL 19119 recto [IV].
169.
RL 19118 recto [V].
170.
RL 19118 recto [V cont’d].
171.
RL 19118 recto [VI].
172.
RL 19118 recto [V].
173.
RL 19118 recto [VII].
174.
RL 19116 recto [VII].
175.
RL 19118 recto [VI].
176.
RL 19118 recto [VII].
177.
RL 19117 verso [II].
178.
RL 19116 recto [II].
179.
RL 19116 recto [IV].
180.
RL 19116 recto [IX].
181.
RL 19117 verso [IV].
182.
RL 19117 verso [XII].
183.
The diameter of the sinotubular junction is 10 % less than that of the orifice of the valve. (Dr. Tirone David, personal communication, Contemporary.)
184.
RL 19082 recto [II].
185.
RL 19083 verso [III].
186.
RL 19082 recto [I].
187.
RL 19116 verso.
188.
M.Gharib and M.Kemp. Personal communication, 2009.
189.
In Codex Atlanticus 81r, Leonardo records the use of millet seeds to show the movement of water. In Codex Atlanticus 170 vb, he records the use of two colours of seeds to compare complex flow patterns within the flow of water.
190.
B.J. Bellhouse and F.H. Bellhouse, Mechanism of closure of the aortic valve. Nature 217(5123):66–7. 1968.
191.
Kenneth Keele, Leonardo da Vinci on Movement of the Heart and Blood. (London, Harvey and Blythe, 1952), 81.
192.
RL 19082 recto [VI].
193.
RL 19071 recto [XIII].
194.
RL 19071 recto [III].
195.
Breaking with the accepted Galenic description of the distribution of the blood was a slow and difficult process. The appearance of Harvey’s book, De Motu Cordis, caused something of a storm in the worlds of philosophy and medicine, which reverberated in London, causing his reputation and his practice to falter. Harvey wrote in the book, “…yet when I shall mention them [ideas of a continuous circulation], they are so new and unheard of that not only I fear mischief which may arrive to me from the envy of some persons, but I likewise doubt that every man almost will be my enemy, so much does custom and doctrine once received and deeply rooted (as if it were another Nature) prevail with everyone, and the venerable reverence of antiquity enforces.”
196.
RL 19087 verso [VIII].
197.
William Harvey, The Anatomical Exercises: De Motu Cordis and De Circulatione Sanguinis, in English Translation. Ed. Geoffrey Keynes. (1653; reprint, New York: Dover Publications, 1995), 58.
198.
Ibid., 59.
199.
RL 19069 recto [I].
200.
RL 19045 recto [IV].
201.
RL 19045 recto [I].

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Department of Cardio-Thoracic Surgery, Papworth Hospital NHS Foundation Trust, Cambridge, UK
Francis C. Wells

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Wells, F.C. (2013). Leonardo’s Heart. In: The Heart of Leonardo. Springer, London. https://doi.org/10.1007/978-1-4471-4531-8_4

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DOI: https://doi.org/10.1007/978-1-4471-4531-8_4
Published: 16 March 2013
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