empty , to be sated , to keep our souls safe , or to tempt them , to go against the gods themselves .”
Aristotle wrote that the heart was the origin and center of life and the guiding metaphor for the Greek city-state . Empedocles ( 490-430 B . C . E .) who greatly influenced Hippocrates ( he copied his work wholesale ) wrote :
In the blood-streams , back-leaping into it The heart is nourished , where prevails the power That men call thought ; for , lo , the blood that stirs About the heart is man ’ s controlling thought .
Etruscan medicine was magic and ritual based , and with the rise of Rome , this approach continued . Cato the Elder mixed magical incantations with vegetable and animal remedies , and “ relied remarkably heavily on the use of cabbage .”
Galen , the Greek physician scientist for Marcus Aurelius , was born in 129 C . E ., and when young , he doctored gladiators , learning both anatomy and surgery . Galen “ wrote eighteen books on the pulse alone . He embraced experimentation but his belief that the blood passed through tiny holes in between the ventricles froze the knowledge of the circulation for 1400 years ,” until William Harvey in 1628 accurately traced the true heart / lung / body route . Sappho , “ the great poet from the sixth century B . C . E ., grappled with her feelings through the concept of the heart .” She understood its fragility , “ how the emotions of love and fear and hope can impact the very life in our chest .”
The Middle Ages brought us the two-lobed heart symbol , and the heart was seen as the very center of all aspects of their world . Moose always tried to understand how each of his patients “ centered his heart … for the centrality of the heart to our emotional lives is not as far from the medieval scholars as we might imagine .”
During the thousand years of Byzantium , the Eastern Roman empire , “ Medieval Islamic medicine formed the roots of modern Western medicine ” and cardiac abscess , pericardial effusion , arrythmias , angina and pericarditis were described . Yet these physicians grasped also the primordial meaning of the heart .
The Renaissance brought us Michael Servetus ( 1511-1553 C . E .), a humanist who described the pulmonary circulation . Yet “ for his efforts he was burned at the stake by the Swiss , during the Protestant Reformation .”
In the Indus River Valley of ancient India , finds dating to 3000 B . C . E . show excellent public health sanitation with two-story homes with bathrooms , drainage of rainwater into the street and rubbish chutes from the walls to the outside . The Atharva Veda , written as much as 4,000 years ago , describe inspiration , expiration and blood vessel anatomy . Six hundred years before Socrates , Charaka described cavities in the heart and observed that all bodily functions depended on the heart . Charaka Samhita brilliantly described classic bacterial endocarditis , angina and cardiac syncope . In Ayurvedic medicine , “ the heart was understood as the body ’ s control center .”
The ancient Chinese were masters of pulse diagnosis . Forty centuries before Harvey , the emperor Huangdi wrote , “ All the blood is under the control of the heart and the blood current flows continuously in a circle and never stops .”
On this side of the world , the ancient Aztec priests removed the heart in a ritual sacrifice to the sun god , to maintain his strength and guide his path across the sky . The Aztecs had separate herbal treatments for heartburn and chest tightness . The Olmec people ( southeast of Mexico City , 1400-400 B . C . E .) made a clay effigy with an anatomically correct heart .
Farther north , Native American treatments included strawberries , holly , horsemint , pokeweed , sarsaparilla , wintergreen , juniper and bigleaf magnolia .
Throughout , Moose notes the emotional implications of illness , and the need to listen to the patient with your heart – not just your ears . He explains the tension and harmony between science and feelings . “ The heart has become the center of our emotions through evolution .”
Reading this , I was reminded of so many people I cared for , that awful specter of acute tamponade , the florid face of pulmonary edema and the fading , feeble pulse of rapid atrial fibrillation . But what makes me remember them so acutely is how I felt , taking their pulse : scared for them , worried I couldn ’ t help , eternally grateful for the Henry Sadlos and Bob Powells of this world , who did save them .
This scholarly work is short , but full of heart and soul . Students of history , and those who love clinical medicine , should read it .
Dr . Barry is an internist and Associate Professor of Medicine ( Gratis Faculty ) at the University of Louisville School of Medicine , currently retired and mulling her next moves .
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