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World J. Surg. 28, 938945, 2004DOI: 10.1007/s00268-004-7553-7WORLDJournal ofSURGERY 2004 by the Societe
Internationale de ChirurgieSurgical HistoryRichard Lower, M.D., Physician and Surgeon (16311691)Arthur J. Donovan, M.D.Keck School of Medicine, University of Southern California, 2025 Zonal Avenue, 90033 Los Angeles, California, USAPublished Online: September 9, 2004Abstract. Richard Lower (16311691) was a follower of William Harvey
and conducted extensive studies of the physiology of the cardiovascular and
respiratory systems. He employed surgery as a key component of his experimental work. He described and employed cardiac massage and maintained arterial oxygenation through positive-pressure respiration. Making
good use of these procedures, he established the role of the lungs in the
admixture of air to the blood. Lower performed exchange transfusion in
dogs and transfused the blood of a sheep into a human. He recognized the
role of blood transfusion in replacing blood lost from hemorrhage or other
causes. In his work on exchange transfusion, he employed extracorporeal
vascular conduits, including arterial heterografts. Through surgical experiments he established that all mesenteric lymph passes through the thoracic duct to the subclavian vein. He performed a variety of procedures
through an open thorax, closed the thoracotomy, and observed the animals
over a period of days. Lower has not received the recognition he deserves as
a pioneer surgical investigator.Richard Lower (Fig. 1) was born in 1631, three years after William
Harvey had published De Motu Cordis. Harvey had accurately described the circulation, recognizing the heart as a pump, with the
continuous flow of blood from the arterial system into the venous
system and then back to the heart. Richard Lower was his staunch
defender and expanded on the basic understanding of the circulatory system as described by Harvey. He did this by precise anatomic
dissection and extensive experimentation, utilizing surgery as a
technique in his investigations. He deserves recognition as the first
surgical experimentalist of the modern medical or post-Harvey era.BiographyRichard Lower was born at Tremeer, the family home in Cornwall,
in 1631 (Fig. 2). He was one of three sons of an old Cornwall family.
He studied at Westminster School in London and entered Christ
Church at Oxford from which he received a B.A. degree in 1653, an
M.A. degree in 1655, and an M.D. degree in 1665. During these
years Oxford was...