The Evolution of Methodologies and Trends in Circulation Research

Abstract

THE EVOLUTION OFMETHODOLOGIES AND TRENDS IN CIRCULATION RESEARCH CARL J. WIGCERS, M.D. ScD.* No observing layman can be other than impressed with the tremendous achievements in diagnosis and treatment of cardiovascular diseases that have taken place during the present century. No discerning cardiologist today disputes the part that the surge of interest in basic and applied research has played in these amazing advances. No investigator who steals time from his research work can fail to marvel at the remarkable changes that methods for investigating the circulation have undergone in the last fifty years. I am not a medicalhistorian, hence must make the hackneyed announcement that, while the interpretation and opinions expressed are based on reflections made during nearly fifty years of participation in circulation research, they are not necessaiily those approved by historians or by my coUeagues. During the long period of activity that it has been my unusual privilege to enjoy, I have become keenly conscious of the fact that sound data are subject to different interpretations. I. The Heritage ofCharles Darwin While the word "evolution" in the title is used in its etymologic sense, I cannot refrain from briefly referring to the heritage handed down to us by Charles Darwin. He was induced, after more than twenty years of reflection, to appear before the Linnaean Society of London, July I, 1858, to enunciate formally his view that plants and animals could * Professor Emeritus ofPhysiology, School ofMedicine ofWestern Reserve University, Cleveland , Ohio; Honorary Professor ofPhysiology, The Frank E. Bunts Educational Institute, Cleveland, Ohio. This essay is adapted from an address given at the dedication ofthe Ruth Cummings Pavilion, Michael Reese Medical Center, Chicago, Illinois, December 15, 1958. 86 Carlf. Wiggers · Circulation Research Perspectives in Biology and Medicine · Autumn 1939 not have been created in their present forms but that they arose through a process ofevolution by natural selection—meaning, by the latter term, "the preservation of favorable induced characteristics and variations and the destruction of those that are injurious." His lecture was foUowed a year later by the publication of The Origin ofSpecies by Natural Selection. Alfred R. Wallace presented the concept independently in 1858, but he recognized Darwin's priority, which dated back to 1838. Darwin's more chaUenging work, pubHshed in 1871, The Descent ofMan, aroused bitter controversy with orthodox theologians. However, as expressed by E. G. Conklin, evolution today has become "a central theme in biology, the connecting strand on which all details of science can be strung." This, ofcourse, includes the heart and circulation. In 1874 Ernst Haeckel formulated the corollary biogenetic law which stated that ontogeny—the embryologie development ofthe individual—is but a repetition of phylogeny—the formation of the species to which the individual belongs. Inferences drawn from the comparative physiology of the heart also formed a substantial part of the evidence that WilHam Harvey adduced, a century before Darwin, in favor of a propulsive circulation of the blood. Operating within the laws of evolution, the human fetal circulation develops into its adult form according to the same pattern as that of animals lower in the phylogenetic scale; hence arrest of its embryonic development results in congenital anomalies and, indeed, occasionally in reversion of the circulation to amphibian patterns. A biologicaHy minded anatomist pointed this out in 1902, during my medical training, but I never dreamed that, through the patient studies of Maud Abbot, Helen Taussig, and others, the door would be opened for imaginative surgeons to develop, through the agency of animal expérimentation, technics leading to their correction. The doctrine ofevolution has also made it possible to apply information gained on amphibian hearts to those of mammals, including man. For instance, early observations ofKronecker, Marey, and Gaskeil on amphibian hearts furnished Wenckebach, Mackenzie, and other discerning cHnicians a basis for interpreting certain irregularities of the human heart. Patients afflicted with a variety of functional and organic disturbances ofthe heart owe a lasting debt ofgratitude to Charles Darwin. 87 II. Beginnings ofAnimal Experimentation on Circulation The term "evolution" in its etymologic sense has one feature in common with the term as used by biologists: in both cases a primary "something" must be sought from which evolution can take place, and...