The heart – its ancient cultural and medical significance in the east and west
Throughout history, and across almost every culture, no other organ has been so widely and variously portrayed as the human heart. Even when the ancients knew almost nothing about the anatomy of the organ, they knew there was an object in the middle of our chests that ruled our lives and represented the core of our humanity – beating with life, beating faster with excitement or fear, breaking from grief or loss, and finally, stopping after death. Life – with all its emotions, beliefs and thoughts – centers around the heart. Over the centuries, it has become a symbol of the highest human emotions – love, truth, compassion and moral courage – embodying the moral, spiritual, and even intellectual substance of a person. To speak from the bottom of one’s heart epitomizes sincerity and honesty, whereas a heart of darkness is marked by evil and malevolence. Arguably, no other organ within the human body has generated such rich cultural significance, powerful symbolism and medical intrigue as the heart.
If one had to become ill during ancient times, you could do far worse than to find yourself in Egypt. Indeed, medical practice during the time of the pharaohs was so advanced that many of their observations and procedures would not be surpassed in the west for centuries to come, and their practices would inform both Greek and Roman medicine. They understood that disease could be treated with pharmaceuticals, recognized the healing potential of massage and essential oils/aromas, had male and female doctors with medical specializations, and appreciated the importance of cleanliness when treating patients. Indeed, the mortality rate following medical procedures in ancient Egypt is believed to be considerably less than that of any European hospital until the mid-1900’s, when cleanliness and sterilization became common practice.
Still, the ancient Egyptians routinely combined magic spells with their medicinal remedies to heal patients. And despite regularly dissecting the dead for embalming, they had little understanding of how most internal organs actually functioned. Although recognized as a pump, ancient Egyptian doctors believed that the heart (rather than the brain) was the source of intellect, emotion, memory and personality. They also believed that the heart’s channels (metu) transported air, tears, saliva, mucus, urine and semen throughout the body, in addition to blood. Similar to Chinese medicine, the Egyptians argued that good health demanded these channels must remain clear and unblocked – otherwise, disease and illness would result from their obstruction. Early Egyptians also recognized the connection between the heart and the pulse, with one ancient medical treatise saying that the heart “speaks in the vessels of all the members.”
For the Egyptians, the heart’s importance in life mirrored its importance in death . . . and the afterlife. When life finally ceased, it was believed that final judgement would be meted out in the Hall of Two Truths, where the dead were judged. Here, the goddess Ma’at would weigh one’s heart against a feather, the symbol of truth, harmony and balance. Only a heart unburdened by the weight of sin and corruption would be deemed worthy of eternal afterlife. The vital importance of the heart in determining the fate of the deceased in the afterlife was also reflected in the mummification process – while all other internal organs were removed from the body before preservation, the heart was left intact. To prevent the heart from testifying against the deceased, a heart scarab was often wrapped within the mummy’s bandages with Spell 30 from the Book of Dead inscribed on it, imploring the heart not to betray its former host: “O heart which I had upon earth, do not rise up against me as a witness in the presence of the Lord of Things; do not speak against me concerning what I have done, do not bring up anything against me in the presence of the Great God.”
While the Egyptians weighed the heart of the dead to measure its truth, the ancient Greeks likened the heart to a forge, burning impurities from the blood. Greek philosopher Aristotle believed that the heart – and not the brain – controlled the body, insisting it was the first organ to come to life and the last to die. The heart was the source of all vitality and the organ from which “all motions of the body commence.” It was also considered to be the seat of intelligence, motion and sensation. Describing it as a hot, dry organ, Aristotle believed the heart was a three-chambered organ that provided the body with its innate source of heat, while other organs surrounding it (such as the brain and lungs) simply existed to cool the heart.
Nearly five centuries later, Galen observed that no other internal organ performed such continuous, hard work as the heart and argued that the expansion and contraction of the heart signaled its role as an intelligent organ: "The complexity of [the heart's] fibers... was prepared by Nature to perform a variety of functions... enlarging when it desires to attract what is useful, clasping its contents when it is time to enjoy what has been attracted, and contracting when it desires to expel residues."
Galen was not afraid to contradict Aristotle regarding the heart’s detailed anatomy or prominence within the body (refuting the philosopher’s claim that the heart was the origin of the nerves, for instance). Advancing the theory of humors initially developed by philosopher-physician Hippocrates, Galen argued that our emotions, behaviors and health were all driven by either an excess or deficiency of these four vital body fluids: blood, phlegm, yellow and black bile. He also identified elemental conditions such as hot/cold and dry/wet as being important factors that define one’s overall health, stressing the importance of balance among all of these elements within the body to achieve wellness. Because the liver was the source of the body’s four humors, the heart was demoted to secondary importance within the body. Galen’s ideas predominated western medical thought until the mid-17th century when English physician William Harvey wrote On the Circulation of Blood (1628) that up-ended Galenic physiology.
Greek medicine is recognized as one of the earliest, holistic healing systems within western civilization. It was the original source and inspiration for many of the natural and alternative medical systems that developed in Europe and the United States during the 18th and 19th centuries, including homeopathy, naturopathy and chiropractic. While many are aware that modern western medical practice evolved from the Greek medical system, it is less well-known that early Greek medicine had a great deal in common with ancient eastern medical traditions. Like the Greeks, Ayurveda and Chinese medicine both emphasize the importance of harmonizing the health of the individual with the universal life forces and energy of nature. While Ayurveda is a humorally-based medicine, Chinese medicine focuses on establishing balance, or homeostasis, between opposite yet complementary forces within nature and the human body.
Looking to the East, the role and importance of the heart expands beyond the head and body to include the soul and spirit. In Hinduism and Buddhism, the heart is viewed as the center of life, action, emotion, consciousness, and the soul. It is defined by the principles of transformation that enable us to bridge our earthly and “higher” aspirations. As the fourth chakra (out of seven) located in the middle of our chest, it connects the lower and upper chakras (where the physical and spiritual meet), integrating the energies of heaven and earth into one harmonious, coherent whole. Located in the center of the body, this chakra includes the heart, cardiac plexus, thymus gland, lungs, breast and lymphatic system. When the heart chakra is open, we feel deeply connected to the world around us, filled with love and compassion, accepting of change, and transcending our perceived limitations. If the heart chakra is blocked or closed-off, we are likely to experience difficulty relating to others, giving way to feelings of anger, jealousy, fear or betrayal.
For centuries, Ayurveda has recognized that the human heart is really two hearts: the physical heart that performs the function of a pump, and the emotional heart that experiences joy and sorrow. On the physical level, free radicals bombard the organ while accumulated or undigested materials (ama) clog the arteries. In addition, the mental overload and emotional trauma from chronic stress releases adrenaline that can further damage the delicate fibers of the heart. Together, physical and emotional factors can both significantly impair the efficient functioning of the heart – and must both be addressed and treated to restore the organ to good health. Ayurvedic heart-friendly herbs such as Ashwagandha work on both the physical and emotional level to help heal an overworked heart by clearing away ama, sweeping away stress, and ensuring good sleep.
Arguably, no medical system assigns the heart greater importance than Chinese medicine, which views the heart as the supreme ruler responsible for maintaining internal peace and harmony over the entire bodily kingdom. Acting as a kind of benevolent leader, the heart is the force that motivates and coordinates all activity — physical, mental, emotional and spiritual. Ancient medical Chinese texts recognize that the heart is “sovereign” over all organs and represents the consciousness of one’s being. It is our heart that is ultimately responsible for enabling our intelligence, wisdom, and spiritual transformation.
One of the heart’s most important functions is to house the Shen – equivalent to the spirit or soul, but also encompassing the mind. Not surprisingly, the Shen represents one of the most complex concepts within Chinese medicine. It is the source of thought, focus, planning and intelligence. All of our mental activity and intention are a manifestation of the Shen, which resides in the heart. Indeed, the Shen is responsible for processing all incoming sensory and intuitive information, as well as supervising the body-mind reaction to it. This means that the heart not only dominates the physical blood circulation of blood, but also guides our consciousness and mental clarity, memory and intellect, and emotional balance – all fundamental to our well-being. Put another way, the heart not only keeps us alive, but allows that life to have meaning, depth and purpose.
From this perspective, the heart is responsible for organizing and integrating the mind-body-spirit that ultimately defines who we are as a person. Physically, it ensures that essential substances are delivered to all parts of our body, while carrying away waste and unwanted carbon monoxide. In addition, the heart also functions as the intersection between the psychological and physical facets of the person, where our emotions are assimilated. In this sense, the heart is truly the center of each of us as human beings – the link between the (mind) brain and the (physical) body.
When Chinese medicine speaks of the mind and its close relationship to the heart (rather than the brain), it is important to appreciate that this is a much broader concept than generally articulated in the west. Think of it as the Mind with a capital “M” that includes all aspects of our consciousness, including thinking and intelligence, emotions and memory – rather than the small, “chattering” mind. This is why Chinese medicine often attributes mental / emotional concerns, in addition to sleep issues (such as insomnia and nightmares), as arising from disordered or depleted heart energy.
When the energy of the heart is strong, we sleep soundly, think clearly, and have a good memory with clear consciousness. When properly nourished and balanced, the heart maintains our innate wisdom, contentment, and emotional equanimity. Physical vitality and mental focus both spring from a healthy heart.
When there is insufficient blood, however, the heart is unable to properly house or “root” our spirit/Shen. This often manifests as insomnia and dream disturbed sleep, mental cloudiness and forgetfulness, moodiness, concentration issues and poor memory. Likewise, prolonged emotional upheaval, personality changes, emotional imbalance, and sensory processing disorders are all manifestations of a disturbed, ungrounded or weak Shen. In extreme cases, there may even be manic behavior. Without strong, balanced energy, the heart cannot perform its duties as the “seat of our consciousness” and key aspects of our awareness will become dulled and disturbed.
The relation between reason and passion has been debated for centuries. Since Plato and Aristotle, philosophers have portrayed an antagonistic relationship between reason and emotion that pits “the head” (the seat of consciousness and awareness) against “the heart” (a sacred and emotional space). Decision making is often characterized as a competition between our emotions, automatic but prone to error, and reason, slow but rational. Cartesian dualism further emphasized the dichotomy between mind and body, and continues to influence much of modern western thinking and medicine today (driving a deep division between medicine and psychology). The heart is portrayed as the center of our feelings, whereas the head, which contains the brain, is the center of thought.
In truth, the head and the heart are not in competition with one another. Indeed, they can and do serve one another. Physically, the brain cannot function without the heart, just as the heart cannot survive without the brain – each exists and thrives in their own separate but connected realms. The heart connects and nourishes us, while the head allows us to be self-aware in that connectedness. Together, their complex network of nerves and blood vessels reach every aspect of our physical selves. Blood maintains life and helps clear away waste, while innervation reminds us that we are still, in fact, alive.
The heart-centered holism of Chinese medicine reflects a very different understanding of the loci of human awareness and intention versus the head-heart dualism of the west. Indeed, Chinese medicine stresses the holistic unity of the body and self, versus the west, which emphasizes the radical opposition (and even competition) of the material body and immaterial mind. Instead, Chinese medical theory argues that the so-called mind (as it is known in English) is “embodied” within the heart, “ruling” not only the body, but also our thoughts, feelings and awareness.
The heart is a delicate yet durable muscle that generates power and sustains life, circulating blood throughout the body’s 100,000-mile cardiovascular system. Its cardiac rhythm allows our brain to think, our lungs to breathe, and our muscles to move. This is the undeniable physical truth of the heart. But beyond that, the heart possesses very real, mind-spirit attributes and responsibilities that go beyond the physical body to impact our consciousness and awareness.
Today, the heart is known as both a technical (anatomical) masterpiece and a timeless metaphor. But it is also the source of wisdom and spirituality, the seat of our consciousness, and driver of our mental clarity. Life springs from it, as do the virtues of love, honor and courage. Furthermore, the heart ties the body to the mind and spirit. In Chinese medicine, the heart is the center of perception itself. Self awareness, as well as the ability to connect with others, have meaningful relationships, and live a fulfilling life, all characterize the essence of a strong, healthy heart. Indeed, it is a strong healthy heart that makes it possible to live with wisdom and purpose, seek truth in all things, and have meaningful connections to ourselves and the world around us.