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Lower, Richard

Lower, Richard

(b. Tremeer, near Bodmin, Cornwall, England, 1631; d. London, England, 17 January 1691)

medicine, physiology.

Lower came from an old, affluent family with an interesting history. His grandmother, Mary Nicholls, was related to Anthony Nicholls, a member of the Long Parliament. His mother, Margery Billing, was of Hengar, the largest house in the district; and when Lower married Elizabeth, daughter of John Billing of Hengar, in 1666, the house came into the Lower family. Lower’s father, Humphry, inherited Tremeer, the Lower family estate, and bequeathed it to Edward, Richard’s older brother. Richard’s younger brother, Thomas, a physician, was later imprisoned with the Quaker leader George Fox for his religious beliefs. Lower was also related to the dramatist Sir William Lower.

Lower was admitted from Westminster School to Christ Church, Oxford, in 1649. He took his B.A. in February 1653 and his M.A. in June 1655. In April 1663 he wrote to Boyle that he had been put out of his place “above a year and a half since for not being in orders,” an in June 1665 he took both the B.M. and doctor of physic degrees by accumulation. By this time Lower had spent several years at Oxford in close association with its famous circle of science devotees. He worked particularly closely with Thomas Willis, appointed Sedleian professor of natural philosophy in June 1660, whom he served for many years as research assistant.

In 1666 Lower moved from Oxford to London, where Willis had recently moved, principally to establish a medical practice. He settled at first in Hatton Garden, but during the next decade moved several times, in each case to a more fashionable location. He was admitted candidate of the Royal College of Physicians on 22 December 1671 and fellow on 29 July 1675. After Willis death in 1675, Lower’s successful medical career flourished even more. According to Anthony Wood he was “esteemed the most noted physician in Westminster and London, and no man’s name was more cried up at court than his.d Lower, having strong Protestant and anti-Popish sentiments, was closely identified with the Whig party, and his later career followed its fortunes. In the 1680’s, with the discreditation under Charles II of the Whigs and the ascendance and accession of James II. Lower fell into some disrepute: he lost his court appointment and steadily lost much of his practice. Nevertheless, he carried on for several years, probably spending much of his time in Cornwall, until his death in 1691. In his will he left money to St. Bartholomew’s Hospital in London and to the French and Irish Protestant refugees.

Lower was invited to join the Royal Society early in his residence in London, and for a few years he was closely associated with the society and its various scientific activities. After receiving mention several times in the minutes for 1666, Lower himself was “introduced” to the society by Robert Boyle on 2 May 1667. He was formally admitted on 17 October 1667, and in November, after having been considered as early as June, he was invited to take up the post of curator. Lower refused this offer, but on 21 November he was appointed to a committee to audit the society’s accounts.

The sorry state into which the society was falling despite Lower’s efforts is reflected in an entry in the minutes for 29 June 1668, in which Lower was “desired … to make a list of particulars necessary for the making of anatomical experiments.“Lower himself dropped from regular participation in the society’s affairs by March 1669, probably to attend more fully to his medical practice; in 1678 he formally resigned his fellowship.

During his few, intensely active years with the Royal Society, Lower did much of the work that established his reputation as perhaps the best seventeenth-century English physiologist after Harvey. He was concerned principally with two areas of investigation: transfusion and cardiopulmonary function. His interest in both problems can be traced to his days at Oxford, but the fame of his investigations and many of his most fruitful results owed a great deal to his association with the Royal Society.

Apparently transfusion was attempted at Oxford in the late 1650’s. There, according to later accounts, Christopher Wren tried to convey certain medicinal liquors directly into the bloodstream using quills and special bladders. Familiar with these earlier attempts, Lower in 1661 expressed interest in using similar procedures to transmit broth and other nutritive fluids directly into the bloodstream. In a letter to Boyle dated 18 January 1661, Lower expressed his “fancy to try, how long a dog may live without meat, by syringing into a vein a due quantity of good broth“and described his intended procedure as follows: “I shall try it in a dog, and I shall get a tin pipe made, about two inches long, and about the usual bigness of a jugular vein, and hollow, which I may put into the vein.,..”1

By 8 June 1664, Lower was able to write to Boyle in London about a more daring experiment: he intended to “get two dogs of equal bigness [and] let both bleed into the others vein... ,”2 As Lower was to explain retrospectively in his Tractatue de corde (1669), he was led from the broth experiment to the transfusion attempt by observing how harmoniously the blood of different animals mixed with various injected substances. It was natural to “try if the blood of different animals would not be much more suitable and would mix together without danger or conflict.”3 It is quite possible that Lower was influenced as well by reports of discussions at the Royal Society late in 1663. At one of these, Timothy Clarke had described his method of infusing certain medicinal preparations directly into the veins of dogs, and an unnamed fellow of the society proposed “to let the blood of a lusty dog into the veins of an old one, by the contrivance of two silver pipes fastened to the veins of such two dogs.”4

With his ideas crystallized, it took Lower only a few months to perfect the requisite experimental technique. He performed the first successful transfusion at Oxford late in February 1665, transfusing blood “from an artery of one animal into a vein of a second.“The Royal Society soon heard of these results, and in early 1666, after several months’ interruption due to plague and the London fire, society members were busy making their own investigations into transfusion. In June 1666 John Wallis, who had been present at Lower’s successful experiment at Oxford the previous February, reviewed Lower’s success; and the society, through Boyle, requested a full account from Lower. This was officially received in September, replicated at the society in November, and printed in Philosophical Transactions (December 1666). By mid-1667 Lower had joined the society.

Meanwhile, in Paris, Denis—without proper citation —had appropriated Lower’s techniques and applied them to human transfusion. The Royal Society was outraged and Lower, sensitive to his colleagues’ concerns, tried and succeeded at human transfusion. On 12 December 1667 the procedure was firmly established in England with its second successful trial, this a public one before a large crowd.

Lower’s second major area of physiological investigation was cardiopulmonary function. Again, his interest can be traced to his Oxford days. Already in 1658 Lower and Willis were looking into the fundamental problem from which, when solved, all of Lower’s principal results were to derive: the reason for the perceived difference in color between venous and arterial blood.

Willis formulated his own answer to this problem in his Diatribae duae (Oxford, 1659), a two-part essay on fermentation and fevers. Willis assumed that the blood, composed of five chemical principles, is normally in a state of gentle fermentation. But when the blood reaches the chambers of the heart the already fermenting fluid effervesces further. As the blood passes through the heart, “its mixture is very much loosned, so that the Spirits, together with the Sulphureous Particles, being somewhat loosned, and as it were inkmdled into a flame, leap forth, and are much expanded, and from thence they impart by their deflagration, a heat to the whole.”5

Lower himself at first accepted this theory of a sudden, energetic enkindling of the blood in the closed chambers of the heart as an explanation for the lighter, more vivid appearance of arterial blood. He made it the basis of an essay written in defense of Willis, the Diatribae Thomae Willisii… de febribus vindicatio adversus Edmundum De Meara (1665). A few years after writing the Vindicatio, however, Lower’s own ideas were to change substantially. The changes derived from certain subtle unorthodoxies he permitted himself in 1665 and, even more, from his positive, fruitful association with the Royal Society, which allowed his doubts to develop into open disagreement with Willis’ ideas.

Lower’s early departures were evident in a few scattered passages of the Vindicatio. Thus, while elaborately defending Willis’ theory of an accension of the blood in the heart, Lower nevertheless introduces an idea nowhere evident in the Diatribae duae: that the lungs (which were given no clear role by Willis) serve not only to discharge the soot resulting from the “fire” in the heart, but likewise serve to impregnate the blood passing through them with the “nitrous pabulum“of the air.6 Willis, like Lower after him, had alluded to a “nitrosulphureous ferment implanted in the heart,” but only Lower explicitly referred to a pabulum in the lungs that “impregnated” the blood.

Furthermore, in other passages in the Vindicatio, Lower refers in detail to the analogies between accension in the heart and air-controlled combustion.7 He even mentions an experiment in which the heart of a vivisected animal is revived by blowing in air, with the mouth, through a tube into the chyle vessels or vena cava.8 Finally, in a slightly different context, Lower describes active expulsion of blood from the heart during cardiac systole;9 Willis, by contrast, had spoken merely of blood being “wheeled about after a constant manner, as it were in a water Engine.”10

These minor unorthodoxies apparently played on Lower’s mind for several years. Then, at the Royal Society, Lower began to collaborate with Hooke, who for some time had been interested in respiratory physiology. Already in 1664 Hooke had tried to determine whether the efficacy of the lungs depended on their motive effect on the blood or on the role they played in admitting air to the body. In 1667 he perfected an experimental technique that allowed him to keep the lungs motionless and inflated, even with the chest cavity fully exposed. Hooke pricked holes in the lungs and blew a continuous stream of air through the motionless lungs of a dog by a bellows arrangement.

In October 1667 Hooke and Lower began to collaborate on cardiopulmonary experiments. Upon Hooke’s suggestion, they attempted together to determine the exact effect on the blood of its passage through the lungs; and to accomplish this by altering the normal route, bypassing the lungs, and transmitting blood directly from the pulmonary artery to the aorta through an air-free channel.

Preliminary results from these experimental techniques had an enormous impact on Lower’s thinking. He was now able for the first time to observe closely the appearance of the blood, both as it left the right ventricle of the heart and before it entered the lungs, and as it returned from the inflated lungs via the pulmonary vein. Lower could now see clearly that only exposure to the air in the lungs altered the blood’s appearance; whereas blood still appeared venous as it left the right ventricle, it was already arterial as it moved from the lungs to the left ventricle. Thus the bright, scarlet color of arterial blood depended on contact with the air and not on effervescence in the heart (which should have occurred as surely in the right as the left ventricle). Lower could also observe closely the continual, rapid, and vigorous pumping action of the heart, which now seemed clearly to be unrelated to a postulated effervescence in the cardiac chambers.

An intense period of reconceptualization and experimentation followed this work at the Royal Society, and led Lower to the publication of his Tractatus de corde (London, 1669), which comprised five chapters. The fourth chapter quickly reviews the history of transfusion and presents Lower’s principal results; the fifth surveys Lower’s thoughts on chyle and its transformation into blood.

The first three chapters of the De corde are exclusively concerned with the heart, the blood, respiration, and circulation. Lower begins with detailed descriptions of the muscular anatomy and nerve supply of the heart, comparisons of the fibrous structure of the human heart with that of other animals, and an account of the heart’s contractive and expulsive movements. He now denies that there is any nitrosulfureous ferment in the heart and explains that the blood is “too inert to effervesce so violently and suddenly in the Heart or its Vessels,”11 Lower stresses the movement of the blood by the active cardiac systole (an early emphasis of his) and pointedly asks, “If the blood moves through its own power, why does the Heart need to be so fibrous and so well supplied with Nerves?”12

Lower also reports experiments he performed to determine the velocity of circulation. In one of these, by taking the average capacity of the left ventricle, counting the number of beats per hour, and estimating the total quantity of blood in the body, he finds that all the blood passes through the heart thirteen times per hour. In another experiment Lower drains almost all the blood from a dog, through the cervical arteries, within three minutes. Both experiments clearly suggest that there can be no profound difference between venous and arterial blood, since overall circulatory velocity is too great to allow drastic transformation.

Finally, Lower comes to a series of experiments on the influence of the air on blood color. He reports that he once held different views on this matter, confessing that he had “relied more… on the authority and preconceived opinion of the learned Dr. Willis than my own experience.”13 Acknowledging his indebtedness to Hooke, Lower presents the new experimental basis for his greatly modified thinking. He reports his observation that blood withdrawn from the pulmonary artery “is similar in all respects to venous blood,”14 and claims that this would not be so if a cardiac effervescence were responsible—as he once believed—for the different appearance of venous and arterial blood. Exposure of the blood to the air is the crucial occurrence, which, he explains, can be further established by blocking of the trachea and noting the still-venous appearance of blood that passes through the air-blocked lungs. This proves definitively that the bright red color of arterial blood is “due to the penetration of particles of air into the blood” it is the “nitrous spirit of the air” that normally enters the blood in the lungs.

TheTraclates de cored was quickly recognized as a major new work on physiology. Warmly reviewed in the Philosophical Transactions for 25 March 1669, it won plaudits both in England and abroad and in a short time dramatically changed the thinking of many about the role of the heart and the lungs. Even Willis was deeply impressed. In 1670 Willis published an essay, De sanguinius accensione, in which he abandoned his old views for Lower’s new ones and applauded “the most learned Doctor Lower“for making him see the light.

Mayow, whose Tractatus quinque of 1674 was to represent the next major breakthrough in respiratory physiology, was also greatly influenced. The favorable reception proved enduring, and for many years Lower’s Tractatus de corde continued to be cited as an important and authoritative work, clearly in the high Harveian tradition of “anatomical experiment.” In the next century, too, Lower continued to receive credit. His accomplishments were enthusiastically acknowledged by Senac in his Traité de la structure de coeur (Paris, 1749) and by the influential Boerhaave. The De corde itself was published in a Leiden edition as late as 1749.

After the De corde Lower published only one minor work on anatomical physiology, the Dissertation de origin catarrh (London, 1672). Here Lower codified the ideas and experiments he and Willis had performed to show that no passage existed for discharging serous fluids from the cerebral ventricles through the palate and nose; Willis had already reported similar results in chapter twelve of his Cerebri anatome (1664), as had Lower himself in the Tractatus de corde. Other medical works bearing Lower’s name appeared in later years, but none of these can be definitively traced to Lower’s pen. It seems clear that after the De corde, Lower’s active interest in physiology gave way to a vigorous cultivation of his medical practice, and it was as a physician that he concluded his career.

NOTES

1.The Works of the Honourable Robert Boyle, Thomas Birch, ed., V (London, 1744), 518.

2.Ibid., 525-526.

3. Lower, Tractatus de corde (London, 1669), 173.

4. Thomas Birch, The History of the Royal Society, I (London 1756-1757), 303.

5. Thomas Willis, The Remaining Medical Works of… Dr.Thomas Willis (London, 1681), 59.

6.Diatribae Thonrae Willisii… do fcbrihus rindicatio adversus Eduntndcun De Meara (London, 1665), p. 116.

7.Ibid., 117-119.

8.Ibid., 125-126.

9.Ibid., 59.

10. Willis, Remaining Medical Works, 64.

11. Lower, Tractatus de corde, 62.

12.Ibid., 64.

13.Ibid., 163.

14.Ibid., 164.

BIBLIOGRAPHY

I. Original Works. Lower’s principal works have been referred to above. Two of the medical works that are variously attributed to him are Bromographia (Amsterdam, 1669) and Receipts (London, 1700). Diatribae Thomae Willisii… de febribus vindicatio adversus Ednwndunt De Meara exists only in contemporary Latin eds. Tractatus de corde (London, 1669), however, has been reprinted in facs. and translated by K. J. Franklin as vol. IX in R. T. Gunther, Early Science in Oxford (Oxford, 1932). De origine calarrhi has also been reproduced in facs. and translated, this by Richard Hunter and Ida Macalpine (London, 1963).

Lower also published several minor papers in Philosophical Transactions. Among them are “On Making a Dog Draw His Breath Like a Broken-winded Horse,” 2 (1667), 544-546 ; and “An Observation Concerning a Blemish in an Horses Eye…,” 2 (1667), 613-614.

Many references to Lower’s work and opinions can be found in Thomas Birch, The History of the Royal Society, 4 vols. (London, 1756-1757), and in A. Rupert and M. B. Hall, eds., The Correspondence of Henry Olderling (Madison, Wise., 1966- ). Correspondence between Lower and Boyle is found in Thomas Birch, ed., The Works of the Honourable Robert Boyle, V (London, 1744), 517-529.

II. Secondary Literature. There is no comprehensive study of Richard Lower, but a number of works are of considerable interest and usefulness. Among these are John F. Fulton, A Bibliography of Two Oxford Physiologists : Richard Lower (1631-1691), John Mayow (1643- 1679) (Oxford, 1935), which is much more than a bibliography ; Francis Gotch, Two Oxford Physiologists : Richard Lower and John Mayow (Oxford, 1908) ; Ebbe C. Hoff and Phebe M. Hoff, “The Life and Times of Richard Lower, Physiologist and Physician,” in Bulletin of the History of Medicine,4 (1936), 517-535 ; and K. J. Franklin, “Biographical Notice,” which accompanies his trans. of Lower’s De corde (see above).

Of great help for particular aspects of Lower’s work are Franklin, “Some Textual Changes in Successive Editions of Richard Lower’s Tractatus de corde,” in Annals of Science,4 (1939), 283-294 ; “The Work of Richard Lower,” in Proceedings of the Royal Society of Medicine,25 (1931), 7-12 ; Leonard G. Wilson, “The Transformation of Ancient Concepts of Respiration in the Seventeenth Century,” in Isis,51 (1960), 161-172 ; and T. S. Patterson, “John Mayow in Contemporary Setting,” ibid.,15 (1931), 47-96, 504- 546.

Also worth consulting are Michael Foster, Lectures on the History of Physiology(Cambridge, 1901); Marjorie Hope Nicolson, Pepys’ Diary and the New Science (Charlottesville, Va., 1963); Kenneth Dewhurst, “An Oxford Medical Quartet,” in British Medical Journal,2 (1963), 857-860; and Hebbel E. Hoff and Roger Guillemin, “The First Experiments on Transfusion in France,” in Journal of the History of Medicine and Allied Sciences,18 (1963), 103-124.

Theodore M. Brown

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