A Brief History of the Heart: In Pictures

As I mentioned over on the Farm, I've been looking up images of the heart in conjunction with my current preoccupation with impending surgery (not until March, I hope). For someone interested in the visual arts in general, and design in particular, the history of ways in which human beings have imagined the heart visually offers a fascinating journey into imagination and understanding.

Metaphor-makers that we are, human beings have to understand new concepts in terms of what they already know. I remember a history of science professor once telling us that the real breakthrough in modern understanding of heart function didn't occur until the hydraulic pump was invented, because until then we had no way to envision what was going on. I'm not entirely convinced that this is the case, since William Harvey's understanding of the pumping action of the heart was in place by the early seventeenth century, and the hydraulic ram is an eighteenth-century invention; ideas about pumping in general had also been around since the Middle Ages. But the popular understanding of the relationship between the heart and the pulse must certainly been made clearer to the general public after sophisticated pumping devices became more commonplace.

There are several terrific websites available on the heart and the history of what we know about it (one of the best is the PBS program, The Mysterious Human Heart; see also the Franklin Institute's online exhibit, The Human Heart). But most histories start with Harvey, and the more intriguing ideas are those that preceded our modern notions.

Take, for example, this illuminated drawing of the circulatory system from a thirteenth-century medical miscellany (Oxford). I show this to my art and design history students as an example of Medieval secular manuscripts, and they hoot over the goofiness of it. But if that little circle in the middle of the chest is supposed to be the heart, it's clear that the illustrator had some notion of the relationship between heart and veins. If it simply acknowledges the connections between vessels and the heart, without really understanding how it all worked, it's still interesting that folks were poking around in bodies trying to figure out what exactly was going on.

Or consider this Persian image, from The Medicine of Akbar (via the National Library of Medicine's Historical Anatomies site), which suggests a similar view of the heart and the veins.
The "anatomical squat" as I like to call it is a common pose in early medical documents. Sometimes annotations and rubrications can be entertaining, because they describe (in languages I don't read) what's going on in the drawings, at both ends of the digestive system, and are frequently placed in amusing contexts. What's clear, though, is that the image of the heart with which we're familiar today isn't intuitively obvious.

As printing and graphic arts burgeoned beginning in the sixteenth century, lovely illustrations appeared in anatomical treatises, such as this woodcut from Anatomiae, by Johann Drylander, published in 1537 (from the University of Toronto's Anatomia, an exhibit of prints from the Thomas Fisher Library). The catalogue description indicates that even if functions weren't completely fathomable, the artist could still depict what he saw.
Anatomy of the heart, pericardium reflected and heart ventricles incised. Aorta, superior vena cava, pulmonary vessels and diaphragm shown. Structures shown in isolation. Anterior view.

As much as I admire what earlier illustrators accomplished, I can't help but think that living in this particular technological moment has its rewards. For one, digital imaging machines and programs of all varieties are making it possible not only to explore the physiology of the heart in ways that the early theorists couldn't imagine, but to use these technologies to fix what ails us. Some of what's produced is quite beautiful:

This particular image (as well as the one used to open this post), by medical illustrator Patrick Lynch (available from Wikimedia Commons; his medical illustration portfolio is on his website) shows just how lovely instructional media can be thanks to the new technological tools available to talented artists. And as much as I appreciate the efforts of the early physicians, I'm thankful to live in a time when the visual arts, married to advances in medicine, can provide us with the technology and expertise to repair hearts that don't work.