From these particulars it appears evident to me that the motion
of the heart consists in a certain universal tension--both
contraction in the line of its fibres, and constriction in every
sense. It becomes erect, hard, and of diminished size during its
action; the motion is plainly of the same nature as that of the
muscles when they contract in the line of their sinews and
fibres; for the muscles, when in action, acquire vigor and
tenseness, and from soft become hard, prominent, and thickened:
and in the same manner the heart.
We are therefore authorized to conclude that the heart, at the
moment of its action, is at once constricted on all sides,
rendered thicker in its parietes and smaller in its ventricles,
and so made apt to project or expel its charge of blood. This,
indeed, is made sufficiently manifest by the preceding fourth
observation in which we have seen that the heart, by squeezing
out the blood that it contains, becomes paler, and then when it
sinks into repose and the ventricle is filled anew with blood,
that the deeper crimson colour returns. But no one need remain in
doubt of the fact, for if the ventricle be pierced the blood will
be seen to be forcibly projected outwards upon each motion or
pulsation when the heart is tense.
These things, therefore, happen together or at the same instant:
the tension of the heart, the pulse of its apex, which is felt
externally by its striking against the chest, the thickening of
its parietes, and the forcible expulsion of the blood it contains
by the constriction of its ventricles.
Hence the very opposite of the opinions commonly received appears
to be true; inasmuch as it is generally believed that when the
heart strikes the breast and the pulse is felt without, the heart
is dilated in its ventricles and is filled with blood; but the
contrary of this is the fact, and the heart, when it contracts
(and the impulse of the apex is conveyed through the chest wall),
is emptied. Whence the motion which is generally regarded as the
diastole of the heart, is in truth its systole. And in like
manner the intrinsic motion of the heart is not the diastole but
the systole; neither is it in the diastole that the heart grows
firm and tense, but in the systole, for then only, when tense, is
it moved and made vigorous.
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