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Updated: June 25, 2025
It is of great importance you should clearly understand these teachings of Galen, because, as I said just now, they sum up all that anybody knew until the revival of learning; and they come to this that the blood having passed from the stomach and intestines through the liver, and having entered the great veins, was by them distributed to every part of the body; that part of the blood, thus distributed, entered the arterial system by the 'anastomoses', as Galen called them, in the lungs; that a very small portion of it entered the arteries by the 'anastomoses' in the body generally; but that the greater part of it passed through the septum of the heart, and so entered the left side and mingled with the pneumatised blood, which had been subjected to the air in the lungs, and was then distributed by the arteries, and eventually mixed with the currents of blood, coming the other way, through the veins.
It was known before his time that both arteries and veins branched out. Galen maintained, though he could not prove the fact, that the ultimate branches of the arteries and veins communicated together somehow or other, by what he called 'anastomoses', and that these 'anastomoses' existed not only in the body in general but also in the lungs.
On board of her, and in company with the President of the Province, I have already visited that extraordinary network of river anastomoses and lakes, stretching between the river Madeira and the Amazons to the river Tapajos, and now I am ascending the Rio Negro, with the intention of going up as far as the junction of the Rio Branco with the Rio Negro.
It is of great importance you should clearly understand these teachings of Galen, because, as I said just now, they sum up all that anybody knew until the revival of learning; and they come to this that the blood having passed from the stomach and intestines through the liver, and having entered the great veins, was by them distributed to every part of the body; that part of the blood, thus distributed, entered the arterial system by the 'anastomoses', as Galen called them, in the lungs; that a very small portion of it entered the arteries by the 'anastomoses' in the body generally; but that the greater part of it passed through the septum of the heart, and so entered the left side and mingled with the pneumatised blood, which had been subjected to the air in the lungs, and was then distributed by the arteries, and eventually mixed with the currents of blood, coming the other way, through the veins.
The true pathology of the elephantoid diseases may thus be briefly summarized: A parent filaria in a distant lymphatic prematurely expels her ova; these act as emboli to the nearest lymphatic glands, whence ensues stasis of lymph, regurgitation of lymph, and partial compensation by anastomoses of lymphatic vessels; this brings about hypertrophy of tissues, and may go on to lymphorrhoea or chyluria, according to the site of the obstructed lymphatics.
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