The Book of the Heart

The Book of the Heart

by Louisa Young


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Product Details

ISBN-13: 9780007109111
Publisher: Flamingo
Publication date: 01/28/2004

About the Author

LOUISA YOUNG, a freelance journalist, is a reviewer for The Sunday Times (London), writes regularly for The Guardian (London), and contributes articles to magazines and national newspapers in the United Kingdom. She is the author of two novels and one previous nonfiction book. She lives in London.

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the history of the

anatomical knowledge

of the heart

Before embarking on the uplands of the heart's emotional and spiritual manifestations, let's look at what it undeniably is. It is a pump made of muscle, and it moves blood around the body. It took us a very long time to discover this, and the story of this discovery is both strange and beautiful.

The spiritual significance of the heart, in Egypt and elsewhere, contributed directly to anatomical ignorance of it: religious and magical beliefs precluded finding out more. The hope of, desire for and belief in some form of life after death was universal among human cultures. Who could swear it would not involve the resurrection of the body? Cutting up the body to see how it worked was, for generation on generation and across the world, taboo. Anatomical knowledge therefore depended on what butchers saw inside the animals they slaughtered, and what priests saw in the animals they sacrificed and in whose innards they fossicked for knowledge of the future. None of these was necessarily interested in anatomy; none that we know of kept a record or tried to educate others beyond passing on professional skills. The medicine men of primitive societies did sometimes open a body, but only to look for signs of magic: anatomical knowledge was not a useful thing to them.

the ancient egyptians

The Egyptians specialized in cutting the human body: their religious rites specifically required them to open the thoraxes of corpses in the course of mummification, and to remove certain organs. So why didn't they garner anatomical knowledge along the way? Those doing this cutting were embalmers, unconnectedwith medicine. Their job was to preserve the body for eternity, not to uncover its secrets. The disemboweling rites, out of respect for the body, involved only tiny cuts. Ancient Egypt had sophisticated medical and surgical practices, but they were based on limited and prescribed ancient knowledge; when the Egyptians started writing things down, contemporary anatomical investigation was not something they considered. The heart--which anyway was not removed during embalming--was above all for them a spiritual entity.

The twenty-meter-long Ebers Papyrus (1550 b.c.) contains a book which opens thus:

The Beginning of the Secret of Medicine. Knowledge of the pulse of the heart. Knowledge of the heart . . . There are vessels for every part. In each place where each healer, each priest of Sekhmet, each magician puts his fingers--on the nape, on the hands, on the place of the heart, on the two arms, on the two feet--everywhere he encounters the heart, by its channels to all the parts.

They had identified the heart, the vessels and the pulse. They were not the first: the forty clay tablets of the Mesopotamian Treatise of Medical Diagnosis and Prognosis, which is dated circa 650 b.c. but records far older Sumerian and Assyrian healing traditions, also recognized that the pulses were informative in diagnosis. (This knowledge was completely bound up in magic: a tablet from 2000 b.c. reads, "When a woman gives birth to an infant that has the heart open and has no skin, the country will suffer calamities." The Mesopotamians believed the liver to be the seat of life, and used it in divination, before it lost its status forever under Christianity: it was associated with pagan divination and low, base urges--concupiscence and lust and greed.)

Another Egyptian text, Der Grosse Medizinische Papyrus der Berliner Museum, speaks of "The system of circulation of man in which is found all his maladies . . . [the vessels] bring air to his heart and it is they that give air to every part of his body." Now, the circulation of the blood per se was not discovered and proven until William Harvey demonstrated it in 1618, but it seems the ancient Egyptians may have had an idea of it (the Atharvaveda--see page xx--mentions circulation in the vessels 2,500 years before Harvey). The Egyptians knew that air came in through the nose to the heart and lungs, and was circulated to all the limbs--which if you read oxygen for air is true, though they hadn't clarified the complexities.

The Egyptians believed that the body was fashioned by Khnum, the potter god, who "knotted the flow of the blood to the bones" and formed "the spine to give support, the testicles to move, the arm to act with vigour . . . The heart to lead, the loins to support the phallus in the act of begetting . . ." and so on, all "by the will of his heart." The heart, they thought, slowly grew larger and heavier until the age of fifty, and then began to shrink again, just as slowly. It spoke in pulses to the organs and body parts through the metu, which included blood vessels, tendons and long thin muscles, respiratory vessels and possibly the digestive system too, as they all joined together at the anus, and this speech could be interpreted by taking the pulse. (Debdeb, the ancient word for the noises made by the heart, is charmingly similar to the lubdub used by modern Western doctors.) The vessels carried secretions, humors, blood, sperm, feces, air, the breath of life and the breath of death.

These fluids moving through the vessels were considered similar to the Nile and its canals: Herodotus observed that "every month for three successive days [the Egyptians] purge themselves, for their health's sake, with emetics and clysters"--the equivalent of clearing an irrigation ditch. If the feces backed up toward the heart, you could become very sick. The heart governed the flow, and had a life, moods and requirements of its own. If it wandered--and it might--it was important to persuade it back into position: a heart in its place denoted good health. Even now, our heart can be in our mouth, or in our boots, neither of which gives us the same comfort and security as knowing that our heart is in the right place. (In the sixteenth century the equivalent was: "Your hert is in your hose, all in despaire.")

For doctors, dealing with diseases rather than wounds (doctors and surgeons traditionally carried out different functions and were often a little adversarial), the heart was paramount. Many terms for sicknesses of the heart survive in hieroglyphs. Paragraph 855 of the Ebers Papyrus is a series of explanations of terms used to describe heart sicknesses. The heart can suffer from wiauyt, old age; wegeg, weakness; fet, turning aside; maset or mas, kneeling; ad, decay. It can be weary as though from traveling far, constricted, small: all these descriptions have been associated with what we now term heart failure. Congestive heart failure might be indicated by igep, bah and meh, meaning "flooded" and "drowned." "The heart is covered up," or "a liquid of the mouth" suggests pulmonary edema and left ventricular failure, which can in extreme cases lead to frothing at the mouth. A heart that is deher, rut or nepa (bitter, dancing or fluttering) is considered by modern medical diagnosis to be enlarged or displaced, though poets and people in love might recognize the symptoms as something else. Other descriptions, eloquent if unplaceable, include sesh, the heart that spread itself out, with its metu holding feces; wesher, where it dries up; aq, where it perishes; meht, where it is forgetful (these two are caused by the breath of the lector priest); djednu, hot; depet, powerless, dark because of anger; neba, unclear, something entering from the outside; and wekh, shrouded in darkness.

The Ebers Papyrus includes what is possibly a description of angina: "He suffers in his arm, his breast and the side of his stomach. One says concerning him: It is the wadj disease. Something has entered his mouth. Death is approaching." The prognosis and symptoms are correct; wadj can mean green, arguably the skin color of someone suffering an attack of angina. What "enters" is usually a disease-causing demon. Fascinating work has been done in this area, but in many ways we remain wekh, partly because though there were separate words for the heart/soul--ib--and the organ--haty--there was a great deal of shared territory between the physical and the spiritual: the body had not yet been artificially separated from the soul. A description of what sounds like a physical heart condition might equally be an emotional or spiritual condition, or a combination of the two.

The Egyptians were themselves fairly wekh when it came to treatment: remedies to cool the heart were among the most common; amulets were popular, in the shape of an admired animal or body part--hearts appeared frequently. The amulets would be made of red stone--jasper, carnelian or red glass--or porcelain, or wax, and inscribed with a human head or with verses from the Book of the Dead to give the wearer power in the afterlife. Another "timely remedy" was "to prevent illness by having the greatness of god in your heart."

ancient china

The earliest Chinese medical texts, 3,000 years old, speak, like those of the ancient Egyptians, of the significance of the pulse. The Inner Classic of the Yellow Emperor explains how the flow of qi, vital energy which could be compared with the Greek pneuma (see page xx), round the body is vital to good health, and is measured by the pulse. When the Yellow Emperor declared that he "should like to be informed about Nature to the utmost degree and to include information about man, his physical form, his blood, his breath of life, his circulation and his dissolution; and I should like to know what causes his death and his life and what we can do about all this," his adviser Ch'i Po started to explain: "According to the final calculations Nature begins as one and ends as nine . . ." and proceeded to divide man into three, and each part into three (the heart, for example, is attended to by the element of man in the middle regions). The liver controls the soul; the heart controls the shin, the spirit or "divinely inspired part"; the spleen controls ideas and thoughts; the lungs control the inferior or animal spirits; and the kidneys control the will and resolution, aspects commonly associated with the heart in the West. The shin

cannot be heard with the ear. The eye must be brilliant of perception and the heart must be open and attentive, and then the spirit is suddenly revealed through one's own consciousness. It cannot be expressed through the mouth; only the heart can express all that can be looked upon. If one pays close attention one may suddenly know it but one can just as suddenly lose this knowledge. But shin, the spirit, becomes clear to man as though the wind has blown away the cloud.

This system is wonderfully complicated, exact and poetic, based on the system of yin and yang (the two principles of nature, female and male respectively), the four seasons and the five elements. The heart also plays the role of the king or master--xin zhu--in charge of the blood. Xin zhu, however, is an activity, not a thing. It is yang, rather than yin, and concords as follows:

Red is the colour of the south, it pervades the heart and lays open the ears and retains the essential substances within the heart. Its sickness is located within the five viscera; its taste is bitter, its element is fire, its animal are sheep, its grain is glutinous panicled millet, it conforms to the four seasons and corresponds to the planet Mars. And thus it becomes known that its diseases are located in the pulse, its sound is chih [a note in the pentatonic scale], its number 7 and its smell is scorched . . . The bitter flavour strengthens the heart . . . Extravagant joy is injurious to the heart, but fear counteracts happiness.

Again the spiritual and the physical are closely bound. Ailments were attributed to disharmony and lack of balance, caused by the wind and the weather, "noxious emanations" in heaven or wrong living.

The heavenly climate circulates within the lungs; the climate of the earth circulates within the throat, the wind circulates within the liver, thunder penetrates the heart, the air of a ravine penetrates the stomach, the rain penetrates the kidneys . . . violent behaviour and scorching air resemble thunder.

For example, "the south wind arises in the summer; its sickness is located in the heart and there are disturbances in the chest and ribs." Those who disobey the rules of summer (which include getting up early, not being weary during the daytime, not allowing yourself to get angry, enabling "the breath to communicate with the outside world" and acting "as though they loved everything outside") "will be punished with an injury of the heart," intermittent fevers during the autumn and grave disease at the winter solstice. "Those who do not conform with the atmosphere of summer will not develop their greater yang." The atmosphere of their heart will become empty.

Evil influences can follow into this emptiness. The ancient Chinese Art of the Heart shows how to keep it open to the good spirits which give essences and powers to the blood. The emptiness was not purely physical: the ideogram for heart, xin, shows the form of the heart and the beginning of the aorta, but unlike ideograms for other organs, it includes no radical indicating flesh.

The Yellow Emperor and his advisers were clearly wise; when he asked why people don't live to the age of one hundred any more, Ch'i Po answered:

Nowadays people . . . use wine as a beverage and they adopt recklessness as usual behaviour. They enter the chamber of love in an intoxicated condition, their passions exhaust their vital forces, their cravings dissipate their true [essence], they do not know how to find contentment within themselves . . . they devote all their attention to the amusement of their minds . . .

Plus a change . . . Ch'i Po harked back to a time when "hearts were at peace" and men were "pure at heart."

meanwhile in india

In India early knowledge was mostly magical, poetical and optimistic. According to the Upanishad of the Embryo:

The establishment of the seven dhatu [blood, flesh, fat, tendons, bones, marrow, sperm] occurs in the heart. In the heart there is an inner fire, and where there is fire, there is bile, and where there is bile, there is wind, and where there is wind there goes the heart. The inner fire gathers in the form of bile, and is fanned by the wind (which blows through the respiratory and digestive systems). The heart is the seat of breath, and of blood vessels. Around 1200 b.c. the magico-religious Atharvaveda was written. This is a collection of 731 hymns in twenty books, incorporating herbal drug remedies, goblins, evil spirits, sorcery, archaic medical history, popular practices of the time and a suggestion of circulation in the vessels, 2,500 years before William Harvey identified it. Veda means knowledge, sacred lore, revealed by Brahma to sages. Most of the Vedas were ancient even before they were written down; many are still active today.

Copyright© 2003 by Louisa Young

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