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The Wine-Dark Sea Within: A Turbulent History of Blood
A revisionist history of medicine, in which blood plays the starring role
Inspired by Homer’s description of the ebb and flow of the “wine dark sea,” the ancient Greeks conceived a back-and-forth movement of blood. That false notion, perpetuated by the influential Roman physician Galen, prevailed for fifteen hundred years until William Harvey proved that blood the heart pumps blood in one direction through the arteries and it returns through the veins. Harvey’s discovery revolutionized the life sciences by making possible an entirely new quantitative understanding of the cardiovascular system, a way of thinking on which many of our lifesaving medical interventions today depend.
In The Wine-Dark Sea Within , cardiologist Dhun Sethna argues that Harvey’s revelation inaugurated modern medicine and paved the way for groundbreaking advances from intravenous therapy, cardiac imaging, and stent insertions to bypass surgery, dialysis, and heart-lung machines.
Weaving together three thousand years of global history, following bitter feuds and epic alliances, tragic failures and extraordinary advancements, this is a provocative history by a fresh voice in popular science.
Inspired by Homer’s description of the ebb and flow of the “wine dark sea,” the ancient Greeks conceived a back-and-forth movement of blood. That false notion, perpetuated by the influential Roman physician Galen, prevailed for fifteen hundred years until William Harvey proved that blood the heart pumps blood in one direction through the arteries and it returns through the veins. Harvey’s discovery revolutionized the life sciences by making possible an entirely new quantitative understanding of the cardiovascular system, a way of thinking on which many of our lifesaving medical interventions today depend.
In The Wine-Dark Sea Within , cardiologist Dhun Sethna argues that Harvey’s revelation inaugurated modern medicine and paved the way for groundbreaking advances from intravenous therapy, cardiac imaging, and stent insertions to bypass surgery, dialysis, and heart-lung machines.
Weaving together three thousand years of global history, following bitter feuds and epic alliances, tragic failures and extraordinary advancements, this is a provocative history by a fresh voice in popular science.
384 pages, Hardcover
Published June 7, 2022
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December 28, 2024I should probably have started this one in the middle, when William Harvey finally came up with the model familiar with us today: The right side of the heart pushes blood into the lungs, where via capillary exchange the blood is oxygenated; the pulmonary vein returns this oxygenated blood to the left side of the heart, which pushes it through the rest of our body, where it eventually returns to the right side, completing the circuit.
But this description was probably about 250 pages in; pages that could have been summarized in a single sentence: "The ancient Greeks and Romans had a lot of ideas about the circulatory system and the functions of blood, all of which were wrong."
I do wonder, still, if perhaps understanding in Asia predated the Western world by a few centuries, but this book was only interested in what happened around the Mediterranean.
But this description was probably about 250 pages in; pages that could have been summarized in a single sentence: "The ancient Greeks and Romans had a lot of ideas about the circulatory system and the functions of blood, all of which were wrong."
I do wonder, still, if perhaps understanding in Asia predated the Western world by a few centuries, but this book was only interested in what happened around the Mediterranean.
August 10, 2022
تاریخ محشری (گرچه گهگاه تخصصی) از دانش ما دربارهی جریان خون. کشف سیستم گردش خون به دست ویلیام هاروی عملا پزشکی مدرن را ممکن ساخت
November 30, 2022
Dhun Sethna has written a remarkable book! The Wine-Dark Sea Within: A Turbulent History of Blood tells the riveting and amazingly fast-paced story of how we arrived at our current understanding of blood flow in the human body. What’s staggering is the almost cosmic-sized leap from the primitive reasoning on this subject by early medical thinkers around 500 BCE—Alcmaeon of Croton, Diogenes of Apollonia, Hippocrates and Praxagoras of Cos, Empedocles, Herophilius, Erasistratus, and Galen—to the pivotal concepts of their successor scientists in the 16th, 17th, and 18th centuries—John Locke, Christopher Wren, Robert Hooke, Henry Cavendish, Joseph Priestly, Joseph Black, Robert Boyle, Antoine Lavoisier, and, of course, William Harvey, to whom Sethna’s book is an homage.
Despite this massive time range of about two thousand years, Mr. Sethna’s research is meticulous and exhaustive—but in a most satisfying way. Though profiles on some of the better-known scientists are expected—Aristotle, Galileo, Leonardo, and Descartes, for example—the author also gives generous treatment to those whom most readers will have never heard of—such as Realdo Colombo, Servetus, Leeuwenhock, and Scheele. One delightfully impossible outcome of such detailed coverage is that I now yearn to read hundreds of full biographies of these minor but vital contributors to the story. (A small criticism: a timeline with all major milestones on this journey of discovery would have been enormously valuable.)
It's a very human habit to theorize solutions to difficult problems through the use of analogies. Thus, blood flow in the human body was likened to the ebb and flow of tides. Since bodies and blood were known to be warm, there was a belief that an actual internal flame existed within our hearts! There was also the notion that blood was in some way “consumed” by the body, which naturally led to the reasoning that the body must also “manufacture” it. Some of these theories—despite not being proved—endured for close to 1,500 years! Scientists wanting to advance provable knowledge faced two hurdles. First, it was difficult to oppose entrenched, mainstream thinking, and second, there was a disinclination to challenge religious thinking, which could often be life-threatening!
Nevertheless, there existed enough brave—not to mention brilliantly intellectual—scientists who did just that. I noted three pivotal discoveries: first, that blood flow in the human body is a circulatory system; that the heart is basically a pump, though early theorists attributed to it all manner of fantastic characteristics; and third, the respiratory system explains the “purpose” of the circulatory system and the heart. Brilliant English physician William Harvey “unlocked” many of the ideas supporting a circulation system by viewing the heart as a pump, and arteries and veins as pipes. But the last supporting idea for a “closed system” had to be demonstrated quantitively. “In a magnificent thought experiment,” Harvey calculated that, based on anything other than a circulation model, the heart would have to “eject 540 pounds of blood every hour”—an impossible number!
Harvey’s circulation system took over twenty years to gain acceptance, despite the work of many supporting, like-minded scientists. Finally, with an understanding of how arteries, veins, and capillaries work, how oxygenated blood travels from the heart (through arteries) outwardly to nourish the brain and body extremities, and how deoxygenated travels back to the heart (through veins) to be reoxygenated, the clear “purpose” of circulation emerges with elegance and symmetry.
Sethna modestly acknowledges that: “This book is a work of synthesis, not of original scholarship.” While it may not be original, the way Sethna has assembled and presented the research, the way he explains the what-how-and-why of circulation, and the extraordinary depth of detail he covers undoubtedly has an element of scholarship about it. An excellent book for the general reader of popular science, The Wine-Dark Sea Within: A Turbulent History of Blood is also highly suitable for those in the medical industry who wish to be informed about the rich and tumultuous history of blood circulation in humans!
Despite this massive time range of about two thousand years, Mr. Sethna’s research is meticulous and exhaustive—but in a most satisfying way. Though profiles on some of the better-known scientists are expected—Aristotle, Galileo, Leonardo, and Descartes, for example—the author also gives generous treatment to those whom most readers will have never heard of—such as Realdo Colombo, Servetus, Leeuwenhock, and Scheele. One delightfully impossible outcome of such detailed coverage is that I now yearn to read hundreds of full biographies of these minor but vital contributors to the story. (A small criticism: a timeline with all major milestones on this journey of discovery would have been enormously valuable.)
It's a very human habit to theorize solutions to difficult problems through the use of analogies. Thus, blood flow in the human body was likened to the ebb and flow of tides. Since bodies and blood were known to be warm, there was a belief that an actual internal flame existed within our hearts! There was also the notion that blood was in some way “consumed” by the body, which naturally led to the reasoning that the body must also “manufacture” it. Some of these theories—despite not being proved—endured for close to 1,500 years! Scientists wanting to advance provable knowledge faced two hurdles. First, it was difficult to oppose entrenched, mainstream thinking, and second, there was a disinclination to challenge religious thinking, which could often be life-threatening!
Nevertheless, there existed enough brave—not to mention brilliantly intellectual—scientists who did just that. I noted three pivotal discoveries: first, that blood flow in the human body is a circulatory system; that the heart is basically a pump, though early theorists attributed to it all manner of fantastic characteristics; and third, the respiratory system explains the “purpose” of the circulatory system and the heart. Brilliant English physician William Harvey “unlocked” many of the ideas supporting a circulation system by viewing the heart as a pump, and arteries and veins as pipes. But the last supporting idea for a “closed system” had to be demonstrated quantitively. “In a magnificent thought experiment,” Harvey calculated that, based on anything other than a circulation model, the heart would have to “eject 540 pounds of blood every hour”—an impossible number!
Harvey’s circulation system took over twenty years to gain acceptance, despite the work of many supporting, like-minded scientists. Finally, with an understanding of how arteries, veins, and capillaries work, how oxygenated blood travels from the heart (through arteries) outwardly to nourish the brain and body extremities, and how deoxygenated travels back to the heart (through veins) to be reoxygenated, the clear “purpose” of circulation emerges with elegance and symmetry.
Sethna modestly acknowledges that: “This book is a work of synthesis, not of original scholarship.” While it may not be original, the way Sethna has assembled and presented the research, the way he explains the what-how-and-why of circulation, and the extraordinary depth of detail he covers undoubtedly has an element of scholarship about it. An excellent book for the general reader of popular science, The Wine-Dark Sea Within: A Turbulent History of Blood is also highly suitable for those in the medical industry who wish to be informed about the rich and tumultuous history of blood circulation in humans!
December 15, 2022
Galen, a Greek physician (129-218AD), surmised the life essence ebbed and flowed inside the body, based on allegories written by Homer more than 8 centuries earlier. He also wrote and illustrated one of the earliest and most comprehensive works on human anatomy. Once he added these to his writings, it was ever thus, without dispute, for about 1500 years. Those who were misguided enough to say otherwise were condemned by The Church and various and sundry philosophers.
In fact, apparently nobody bothered to do the simplest examination of his texts until Vesalius actually looked at the bones in Galen's human anatomy books in 1543, and (spoiler alert) discovered they were drawings and measurements from the great apes. Then he spent the next couple decades trying to defend his corrections to those that labelled him a heretic. Galen's errors were blatant and should have been discovered centuries earlier. It is as egregious an error as forgetting in this era to do something as simple as spell-check a manuscript prior to submitting it for review!
In 1628, William Harvey published the first scientific proof that blood had to circulate. His proof was insufficient to satisfy others, such as Descartes, whose own "experiments" were so poorly constructed that he failed to get any consistent conclusion, so could close whatever result he liked. Harvey was beset by many others, as this excerpt shows:
Even into the 17th, there was no respect for scientific rigor and reproducibility.
This is one of the most frustrating books I have read. The first 243 pages of the book are little more than an exegesis of the errors at the intersection medical patrimony and religion. The remaining 69 pages were fun to read, since they added some factual texture to the basics of modern physiology.
In fact, apparently nobody bothered to do the simplest examination of his texts until Vesalius actually looked at the bones in Galen's human anatomy books in 1543, and (spoiler alert) discovered they were drawings and measurements from the great apes. Then he spent the next couple decades trying to defend his corrections to those that labelled him a heretic. Galen's errors were blatant and should have been discovered centuries earlier. It is as egregious an error as forgetting in this era to do something as simple as spell-check a manuscript prior to submitting it for review!
In 1628, William Harvey published the first scientific proof that blood had to circulate. His proof was insufficient to satisfy others, such as Descartes, whose own "experiments" were so poorly constructed that he failed to get any consistent conclusion, so could close whatever result he liked. Harvey was beset by many others, as this excerpt shows:
At first blush, given Harvey's sound thesis, such arguments should seem trivial. But there was a deep and dangerous aspect that lay waiting for the unwary. The human tendency to distort provocative scientific conclusions was becoming clear to Harvey. It was equally transparent that Harvey had provoked the clergy, although, for the moment, he knew neither who would follow in the lists against him nor what they would write. Between the first chill of realization and the eventual recognition lay a long shadow.
Even into the 17th, there was no respect for scientific rigor and reproducibility.
This is one of the most frustrating books I have read. The first 243 pages of the book are little more than an exegesis of the errors at the intersection medical patrimony and religion. The remaining 69 pages were fun to read, since they added some factual texture to the basics of modern physiology.
October 27, 2022
Reading this was like listening to someone who is very knowledgeable about a very specific topic ramble on and on about that topic as you nod politely while thinking about something else.
August 2, 2022
Very disappointing. Wanders between centuries while trying to describe the early history of blood.
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