The heart and history: Prying open its secrets
No other bodily organ has inspired poets and philosophers over the centuries the way the human heart has
The heart has a mind of its own. It is prone to flutter in response to a kiss, skip a few beats in the klieg lights, brace itself in the face of treachery, and slow during slumber--except, of course, during a nasty dream. This ever vigilant organ sustains all others by pumping up to 6 gallons of blood per minute and propelling it through some 60,000 miles of tributaries to bathe, nourish, and cleanse virtually every cell in the body. A beating heart is the joyous first sign of life, and it's the sad final thump that marks the moment of death. In today's secular times, the heart has lost much of its cachet as the mansion of the soul, but it has not lost its romantic and spiritual grip on us. We all still speak of happy hearts, good hearts, heavy hearts, and brave hearts. We have all felt heartache and have even been heartsick. We've suffered when our heart's desires were not fulfilled and been bewildered by those who are heartless. Our own hearts rally for the lionhearted and yearn with the Tin Man in his desperation for a heart. We see wellness in the heartland and know instinctively that home is where the heart is.
Romance aside, there is in reality no other organ that works so hard and faithfully yet is taken so for granted. But reality has a darker side as well. The sick heart can afflict the body with profound fatigue, crushing chest pain, dizzying rhythms, and frightening breathlessness. That is the heart that the cardiologist knows, and all too well.
Cardiology is an aged medical specialty, tracing its scientific origins back to 1628 and the epochal discoveries of the British physician William Harvey. This reputed father of cardiology is credited with bringing medicine from the Dark Ages into the light of science and inquiry. His major work, De Motu Cordis, arrived around the same time that Galileo was being persecuted for his heretical view that the Earth was not the center of the universe. Harvey faired better, since his radical thought--that the heart was the all-powerful center in a circular motion of blood--appealed to the clerics of the day.
It's fortunate he was "politically correct" because he was keenly accurate. He overturned the encrusted belief that blood originated in the liver, drew spirit from the heart, and merely sloshed to and fro in its vessels. Studying living animals and human corpses, he spoke the obvious: Arteries carried blood away from the heart, veins brought the blood back, under the command of the contracting heart, which orchestrated rhythm and powered a ceaseless, closed-loop circulation of blood. For Harvey the heart was a sovereign "internal creature" that nourished and preserved the body throughout life. What he didn't imagine was just how high maintenance this sovereign creature could be.
Curiosity and technology. The heart hid its tribulations well. It took a steady stream of technology to pry open its secrets in both sickness and health. For years physicians had been guided only by their bedside observations and an occasional epiphany from a stone-cold dissected heart. The stethoscope changed that, and that was sheer accident. In 1816, faced with the impropriety of listening to a young woman's chest by placing his ear on her bosom, French physician Rene Laennec devised a long thin tube to distance himself from the damsel. In the process he and others learned that this bit of manners actually amplified sound. Suddenly, doctors could listen to the rhythms of the heart and the opening and closing of heart valves. They could detect murmurs and hear crackles from the lungs that signaled early heart failure. By detecting valve disease, doctors came to understand its perilous relationship to cardiac enlargement and failure. Bigger biceps are strong, but bigger hearts are weak.
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