The impact of the Renaissance on Britain

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Many doctors had been trained to believe Galen's teaching that blood was made in the liver and used up by the body, and they did not want to admit that Galen, and they themselves, had been wrong. Also, Harvey could not show how blood got from the arteries into the veins, because the capillaries were too small to see until Malpighi used a microscope in 1661.

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Source A is very useful for studying Harvey's methods because it shows one of the key experiments he used. The band round the upper arm makes the veins swell, and the small swellings are the valves. When a finger presses on a vein, the section beyond it stays empty, because blood cannot be pushed backwards past a valve. This proved that blood in the veins flows only towards the heart, which contradicted Galen's teaching that the veins carried blood out from the liver to be used up by the body. Harvey had learned about the valves from his teacher Fabricius at Padua, who had described them but not understood their purpose, so the source also shows how Harvey built on earlier work.

The provenance increases its usefulness. It comes from De Motu Cordis itself, so it shows exactly how Harvey chose to present his evidence. The invitation to repeat the test on your own arm shows his new approach: he wanted evidence that anyone could check rather than an appeal to ancient authority. Because the book was printed, the picture could be reproduced accurately and spread across Europe. However, as part of Harvey's own case it shows his evidence in the most convincing light and gives no sense of the objections of his critics.

The source is also limited because it shows only one method. Harvey also dissected live cold-blooded animals, such as frogs and snakes, whose hearts beat slowly enough to watch, and he calculated that the heart pumps far more blood in an hour than the body contains, so the blood must circulate. Nor does it show what Harvey could not prove: how blood passed from arteries to veins, which was only explained when Malpighi saw capillaries in 1661. Overall, Source A is very useful for showing Harvey's experimental approach, but it gives an incomplete picture of all his methods.

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Opposition to new ideas was significant because it slowed down the acceptance of the discoveries of the Renaissance. Galen's ideas had been taught for around 1,400 years, supported by the Church and the universities, and physicians' training and status depended on them. When Vesalius showed in 1543 that Galen's anatomy contained errors, his old teacher Sylvius called him a madman. In England, the College of Physicians, founded in 1518 by Thomas Linacre, who had translated Galen, defended Galen's authority, and John Caius continued to teach Galen's anatomy to the barber-surgeons. Paré also met opposition: the Paris Faculty of Medicine objected to his books because he was a surgeon writing in French, and many surgeons kept using cautery.

The opposition to Harvey shows its significance most clearly. After De Motu Cordis appeared in 1628, John Aubrey recorded that Harvey's practice 'fell mightily' and that people thought he was 'crack-brained', while critics such as James Primrose published attacks on him. As a result his ideas took 20 or 30 years to be widely accepted. Because the new discoveries were resisted, and because they did not suggest new cures, treatment hardly changed: doctors kept bleeding and purging their patients according to the four humours until the 19th century.

However, the opposition could not stop the new ideas. The Reformation had weakened the Church's control over learning, and printing meant that books such as the Fabrica spread across Europe regardless of what opponents said. Opposition even pushed supporters to find more proof: Harvey published replies to his critics in 1649, and Malpighi's discovery of the capillaries in 1661 filled the gap in his theory. In the long term, the same pattern of resistance followed by acceptance happened again with Jenner's vaccination, Simpson's chloroform and Lister's antiseptics. Opposition therefore slowed progress, especially in treatment, but it did not prevent it.

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Chance has played a part in several famous medical discoveries, but it has rarely been enough on its own. In most cases chance only mattered because a skilled individual recognised what had happened, and many of the most important discoveries involved no chance at all.

There are clear examples of chance. In 1536-37 the army surgeon Ambroise Paré ran out of the boiling oil normally used to treat gunshot wounds and used an ointment of egg yolk, oil of roses and turpentine instead; the next morning these patients were in far less pain. In 1847 James Simpson discovered the anaesthetic effect of chloroform when he and his friends tried inhaling chemicals after dinner. In 1895 Wilhelm Röntgen discovered X-rays by accident while experimenting with cathode-ray tubes, and in 1928 Alexander Fleming noticed that a mould growing on a culture plate left out while he was on holiday had killed the bacteria around it. Pasteur's team also discovered by chance that an old culture of chicken cholera protected chickens from the disease, which led to new vaccines.

However, the role of the individual was more important even in these cases. Pasteur himself said that 'chance favours only the prepared mind'. Paré was an experienced surgeon who noticed the difference between his patients and had the courage to abandon a method recommended by authorities. Fleming was a trained bacteriologist who understood what he was seeing. Many other discoveries came entirely from careful work. William Harvey proved the circulation of the blood in 1628 through dissections, experiments and calculations. Edward Jenner tested his theory that cowpox protected against smallpox on James Phipps in 1796. John Snow investigated the Broad Street outbreak of 1854 methodically, and Robert Koch identified the bacteria causing tuberculosis and cholera through years of laboratory work.

Science and technology were also essential. The microscope allowed Malpighi to see the capillaries in 1661, completing Harvey's theory, and improved microscopes made germ theory possible in the 19th century. The structure of DNA was discovered in 1953 by Francis Crick and James Watson using Rosalind Franklin's X-ray images, and modern scanners have transformed our knowledge of the body.

Other factors turned chance discoveries into real progress. Fleming's penicillin was useless to patients until Howard Florey and Ernst Chain purified it in 1940-41, and the Second World War led the American government to pay for mass production in time for D-Day in 1944. Communication, through printed books, the Royal Society and medical journals, made sure that discoveries were shared, and government funding of research and the NHS helped new treatments reach patients.

Overall, chance has not been the main factor in important medical discoveries. It provided the spark for a few breakthroughs, but these only happened because prepared individuals recognised their importance, and they only helped patients when science, technology, teamwork, war and government developed them further. The role of the individual, supported by science and technology, has been far more important.