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从血液循环的发现到血液流变学的初步探索:第一部分

From the discovery of the circulation of the blood to the first steps in hemorheology: part 1.

作者信息

Martins e Silva J

机构信息

Faculdade de Medicina de Lisboa, Lisboa, Portugal.

出版信息

Rev Port Cardiol. 2009 Nov;28(11):1245-68.

Abstract

In this article (the first of two on the subject) a brief historical review is presented of the prevailing ideas on the nature of the blood and its circulation from antiquity to the 16th century, when the problem was solved by William Harvey. On the basis of vivisection of various types of animals, Harvey constructed a general and logical model for the whole systemic circulation, which contradicted previous concepts, mainly those that had been put forward by Galen fourteen centuries before. The influence that Galen still exercised on virtually all areas of medicine justified Harvey's hesitations and scruples, forcing him to delay publishing his conclusions for thirteen years. It also explains the controversy with fellow physicians on the subject, which continued until his death. However, through careful observation and painstaking investigation, Harvey demonstrated clearly that the heart was the central organ of the circulatory system, on which depended the propulsion of the blood to the arteries and its subsequent return by different vessels, the veins, to its starting point. The blood coming from the heart was different from that which returned to the organ, the difference (in color and fluidity) being attributed to the presence of constituents which nourished the organism it irrigated. Harvey characterized blood pulsation as the result of the arteries filling with arterial blood during each heart contraction. He demonstrated that the arterial blood left the heart by contraction of the left ventricle, which happened simultaneously with contraction of the right ventricle and, in both, after the contraction of the atria. He confirmed that blood passed through the lung circulation from the right ventricle to the left atrium and from there to the left ventricle. By calculating the volume of blood pumped daily by the heart, Harvey reasoned that the blood could not be consumed by the body and would have to circulate continually through the heart and vascular network. Although Harvey did not confirm the continuity of the circulatory network, he went so far as to hypothesize the existence of minuscule imperceptible passages between arteries and veins, which was later confirmed by Marcello Malpighi, in the form of networks of capillaries. The one-way direction of blood flow was ensured by valves in the heart and veins. The model established by Harvey for blood circulation in animals and extrapolated to humans was confirmed in the following centuries. Malpighi and van Leeuwenhoek, in particular, helped clarify the composition and characteristics of blood and their importance for its perfusion of the different vessels of the circulatory network.

摘要

在本文(关于该主题的两篇文章中的第一篇)中,简要回顾了从古代到16世纪关于血液本质及其循环的主流观点的历史,当时这个问题由威廉·哈维解决。基于对各种动物的活体解剖,哈维构建了一个关于整个体循环的通用且合乎逻辑的模型,这与先前的概念相矛盾,主要是与盖伦在14个世纪前提出的概念相矛盾。盖伦在几乎所有医学领域仍然具有的影响力,证明了哈维的犹豫和顾虑是合理的,迫使他推迟了13年才发表自己的结论。这也解释了他与同行医生在这个问题上的争议,该争议一直持续到他去世。然而,通过仔细观察和艰苦研究,哈维清楚地证明了心脏是循环系统的中心器官,血液向动脉的推进以及随后通过不同血管(静脉)返回其起点都依赖于心脏。来自心脏的血液与返回该器官的血液不同,这种差异(在颜色和流动性方面)归因于滋养其所灌溉机体的成分的存在。哈维将血液搏动描述为每次心脏收缩时动脉充满动脉血的结果。他证明动脉血通过左心室的收缩离开心脏,这与右心室的收缩同时发生,并且在两者中,心房收缩之后发生。他证实血液通过肺循环从右心室流向左心房,再从那里流向左心室。通过计算心脏每天泵出的血液量,哈维推断血液不会被身体消耗,而是必须持续通过心脏和血管网络循环。尽管哈维没有证实循环网络的连续性,但他甚至假设动脉和静脉之间存在微小不可见的通道,后来马尔切洛·马尔皮基以毛细血管网络的形式证实了这一点。血液流动的单向性由心脏和静脉中的瓣膜确保。哈维建立的动物血液循环模型并外推到人类,在接下来的几个世纪中得到了证实。特别是马尔皮基和范·列文虎克,帮助阐明了血液的成分和特性以及它们对循环网络不同血管灌注的重要性。

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