Book of the Heart

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1 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, unconnected with 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