THE “HEART-MIND” IN ANTIQUITY AND IN CONTEMPORARY MEDICINE
The study of ancient science and ancient medicine involves many difficulties and concerns. Science
did not exist in ancient times, simply because it is a product of the modern period. Science can even
be defined as the main cultural feature by which we could identify the modern times as different
from previous centuries. In the antiquity, science, magic and religion always remained strictly
related, to the point that they cannot be separately understood. Even cardiology did not exist in
ancient times for two fundamental reasons. First, because medicine was an integrated knowledge
without specializations and sub-specializations, which emerged only in modern times and were
institutionalized only during the past century. Second, because the cardiovascular system was not
well understood anywhere in antiquity, at least before William Harvey’s discovery of systemic
circulation in 1628. The “heart” was not understood as a pump, but for most of ancient medical
systems it remained the centre of cognitive thinking or mind, since the brain as an organ was also
largely misunderstood. According to Egyptian medicine, Ayurveda and Chinese traditional
medicine, the heart was the seat of mind, emotion and soul. Moreover, “spirits”, “energies” and
“humours” were collected by the heart and from the heart distributed through the body.
Cardiovascular system was a sort of pneumatic and energetic system where the breathing was
often view as the crucial function for the generation and circulation of spirit and energies, as well
as for the well-being of both the mind and the body. The quality of the radial “pulse” was considered
diagnostic for the physiological or pathological circulation of bodily energies as well as the vital
soul. Greek medicine inherited these traditions, carrying out the first “mechanization” of ancient
ideas which gradually lost their original meaning. Even if Aristotle maintained that the heart was
the seat of mind, Hippocratic medicine embraced a “cerebrocentric” view according to which the
brain was the only seat of mind and soul. In Galenic medical system, vital energies were definitively
substituted by the “pneuma”, which consisted of the breathing refined in the heart and in the brain,
respectively. In the heart it originated the “vital spirit” which regulated emotions and the natural
heat of the body, while in the brain it became the “animal spirit” which represented mind and will.
Nevertheless, that the “heart” was not understood in antiquity, represents exactly the main interest
for discussing cardiovascular conceptions in ancient time. Even if based on wrong assumptions,
ancient medicine paid particular attention to the study of the “pulse”, on which it produced an
impressive amount of theories and practices. The fact that the heart was wrongly considered the
centre of both emotions and mind, lead ancient physicians to postulate that emotions and thoughts
could positively or negatively influence the state and health of the heart and the whole body. In the
same way, wrong assumptions on the role of breathing in the production and circulation of spirits
and energies, lead ancient medicine, in particular the Ayurveda, to the elaboration of methods of
breathing effective not only in curing many medical problems, included heart diseases, but also in
maintaining and improving a good health.
Based on new insights on heart-brain connection, current medicine is re-discovering these ancient
ideas. From the one hand, most recent neuro-cardiological researches are demonstrating that the
heart is, in some way, a highly complex, self-organized information processing centre with its own
functional “brain” that communicates with and influences the cranial brain via the nervous system,
hormonal system and other pathways. From the other hand, Western cardiologists are applying
slow breathing techniques inspired by ancient methods, consisting of a respiratory rate of roughly
six breaths per minute, in cardiovascular patients. Several studies show that they immediately
lower resting blood pressure and permanently decrease resting blood pressure after several
weeks of consistent practice. Breathing methods and relaxation techniques taken from the past are
proving to be effective in treating hypertension, reducing angina episodes per week, improving
exercise capacity, and decreasing body weight and waist circumference. They can also reduce
serum cholesterol and LDL levels. Furthermore, they can decrease the frequency of
revascularization, suggesting that they may facilitate regression and prevent progression of
atherosclerosis, with a mechanism similar to that of statins. They favourably effects diabetes by
increasing insulin sensitivity and decreasing plasma insulin levels.
More in general, Western medicine is rediscovering the strict relationship between heart and
brain, to the point that it is possible to speak about a heart-brain system. While depression and
anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also
increases the risk of developing anxiety and depression. Promoting optimal mental health may be
important for both primary and secondary prevention of cardiovascular disease. Like lowering
blood pressure, lipids, and body weight, lowering anger and hostility and improving depression
and anxiety may also be an important intervention in preventive cardiology.
Therefore, the main interest of ancient theories, could be represented exactly by the central place
which they give to the heart in the economy of body structures and functions, as well in emotional
and cognitive processes.
Zampieri Fabio, PhD
Associate Professor, History of Medicine
Dept. of Cardiac, Thoracic and Vascular Sciences
University of Padua Medical School
Via Aristide Gabelli, 61 – 35121 Padova
Tel: +39/049/8272274
Fax: +39/049/8211642
Mobile: +39/3499303549
E-mail: fabio.zampieri@unipd.it