In Our Time - The Heart

Episode Date: June 1, 2006

Melvyn Bragg and guests discuss the heart. Aristotle considered the heart to be the seat of thought, reason and emotion. The Roman physician Galen located the seat of the passions in the liver, the seat of reason in the brain, and considered the heart to be the seat of the emotions. It was not until the 17th century that the physician William Harvey wrote in the preface to his thesis On the Motion of the Heart and Blood in Animals, a letter addressed to King Charles I. 'The heart of animals is the foundation of their life, the sovereign of everything within them...from which all power proceeds. The King, in like manner, is the foundation of his kingdom, the sun of the world around him, the heart of the republic, the foundation whence all power, all grace doth flow'. Harvey was probably wise to address the King in this manner, for what he laid out in his groundbreaking text challenged scientific wisdom that had gone unquestioned for centuries about the true function of the heart. Organs had been seen in a hierarchical structure with the heart as the pinnacle. But Harvey transformed the metaphor into something quite different: the heart as a mechanistic pumping device. How had the Ancient Greeks and Islamic physicians understood the heart? What role did the bodily humours play in this understanding? Why has the heart always been seen as the seat of emotion and passion? And why was it that despite Harvey's discoveries about the heart and its function, this had limited implications for medical therapy and advancement? With David Wootton, Anniversary Professor of History at the University of York; Fay Bound Alberti, Research Fellow at the Wellcome Unit for the History of Medicine at the University of Manchester; Jonathan Sawday, Professor of English Studies at the University of Strathclyde.

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or wherever you get your pods. Thanks for downloading the In Our Time podcast. For more details about In Our Time and for our terms of use, please go to BBC.co.com.uk forward slash radio four. I hope you enjoy the program. Hello. The 17th century physician William Harvey wrote in the preface to his thesis on the motion of the heart and blood in animals, a letter addressed to King Charles I. Quote,

The heart of animals is the foundation of their life, the sovereign of everything within them, from which all power proceeds. The king, in like manner, is the foundation of his kingdom, the son of the world around him, the heart of the republic, the foundation, whence all power, all grace, does flow. Harvey was probably wise to address the king in this manner, for what he laid out in his groundbreaking text challenged scientific wisdom

that had gone unquestioned for about 1,500 years, about the true function of the heart. Organs had been seen in a hierarchical structure, with the heart as the pinnacle. But Harvey transformed the metaphor into something quite dense, different. The heart is a mechanistic pumping device. How had the ancient Greeks and Islamic physicians understood

the heart? What role did the bodily humours play in this understanding? Why has the heart always been seen as the seat of emotion and passion? With me to discuss the heart at David Wooden, Professor of History at the University of York, Fabo and Alberti, research fellow at the welcome

unit for the History of Medicine at the University of Manchester, and Jonathan Sorda, Professor of English Studies at the University of Strathclyde. David Wooten, what were the earliest ideas about the functioning of the heart? Well, for the Hippocratics and for Aristotle, for the ancient Greeks, the starting point is the assumption is the heart is the basis of life. And it's the, all the activities of life take place in the heart. And therefore Aristotle assumes that feelings, the imagination

are all located in the heart, as well as life itself. And it's not until, oh, about 270 B.C., where erasistratus works out how the nervous system works, that the brain becomes separated from the heart and anatomically as the location for thought. Well, just a second, let's stick with Aristotle, because Aristotle was reverence, in fact, still is, for many hundreds of years, because he thought the heart wasn't only, as I understand it,

but please say more about it, not only the centre of emotion and feeling, but also of reason, that everything with thought came from the heart. Well, technically Aristotle thinks that reason isn't located in space or time. It's immortal and eternal. But insofar as it's located in the body, it must be located in the heart. Everything that's important about the human being is in the heart. And the heart is the place where you are, as it were.

Where we might think we're in our heads. Aristotle assumes that we're in our hearts. But when we move on, I interrupted you, I'm afraid, but if you take up from where you left off, did this separation of the brain displace the heart as this center that Aristotle had given it? Well, it creates what develops as a theory where there are three key organs in the body. The liver which produces food, and the food is spread through the body through the veins and the dark blood in the veins. The heart, which becomes the centre of the red-colored blood, which we think of as arterial blood, which takes spirit through the body,

and the brain, which is the centre of the nervous system, which provides voluntary control of the body. And those three organs have, as it were, they each fulfil an essential function, but there's a hierarchy in the sense the brain is the superior, but the heart is the basis of life itself. And Galen, in 200 AD, great medical practitioner and Sinker, took that tripartite system up and developed it in his work. Yes, Galen becomes the man who establishes the tripartite system in such a way that it's unquestionable for the next 1,500 years. And Galen therefore assumes that or argues that, is convinced that.

There are really two blood systems in the body, and the heart is part of two different systems. One is the black blood system, the food system, and the other is the red blood system, the spirited system. And the heart functions in part as a place where breath, which is drawn into the heart, is heated up, mixed with blood, and then sent out through the body,

sent out through the body in the blood. And so the heart is a source of heat and a source of activity. It has a sucking and pumping motion. and blood in both the venous system and in the arterial system ebbs and flows into the heart in the way that it would do in a tidal river. It tends to go in one direction, but it goes back and forth in the heart. And we're going to come to the cultural significance on that in a moment to do. We're talking about anatomical significance in early times.

Fabine Arvetti Galen's theories were based on a connected set of principles about the bodily humours that dominated physiological and psychological theories almost until the 18th century. Can you tell us about these and how they fitted in with what David's explained about Galen's a tripartite theory. Yes, that's right. And David mentioned the heart being important for heating. And the heart and the humours are linked here,

because for Galen, everybody was composed of four different humours, phlegm, yellow bile, collar and black bile. And the proportion of those humours within the human body was partly innate and partly a result of gender and age, but also to do with the non-naturals and how one lived. So the kind of food that you ate, the exercise that you took, the rest that you had. Why are these called non-naturals?

They're the things that are outside of the body, not natural to the body. So it was the balance of these different humors within the body that determined what your emotional temperament would be, but also what your health was, because health was determined by the balance of the humus. So too much black bile or melancholy, you'd become melancholy. And the process by which this happened was that the humors would actually influence the structure of the body.

So that in anger, for instance, there was, would be a rush of collar around the heart, and the heart would become hot-blooded. It would actually be physiologically affected by this change to the Constitution. So emotions and the heart and health are fundamentally linked under the humoral system. And the four and the humors that are inside us, inside human, were thought to be linked with the earth, air, fire and water. That's right, yes. They were linked so that Flemm, is hot and dry, for instance, and melancholy is wet and moist and warm.

So there's a parallel. The human body becomes a microcosm for the celestial body. But it's also, in a sense, sealed. I mean, no disease can invade the body. The body governs itself, and so you have to do something to the body to keep inside the body, to keep the balance.

That's right. It's a very different understanding of disease that comes into play from the 19th century, the pathogenic theory of disease. It's ticking to where we are early on. Yeah, the body becomes unhealthy because of its internal balance. And this is why the kinds of treatments that are popular in the early modern period, things like bloodletting are about letting out the bad humours

and to rectify the balance, eating the right kind of food to get the right balance again. When much of Greek and Roman learning about medicine was went into the Islamic tradition, the great Islamic scholar of Insana in the time. 10th century, as I understand it, developed the idea of the heart and the complications that could happen with that. Could you tell us how he pushed it on? Because one of the books he wrote was still studied 700 years later in Europe. Yes, Abysana was very influential in his canon of medicine. He outlined the heart of the centre of the body, but stressed how important heart health was for the general psychological and physiological health of an individual. He developed a lot

of treatments for things like heart palpitations, for instance, that meant that individual should listen to their body and think about the experiences of their own hearts. So it was very interesting use of drugs in this time to moderate heart health. But it wasn't only Avicenna as well. It was Ibn Al-Naphas, who was born in 1213, who long before Harvey, I mean, 300 years before Harvey's birth, was the first person to describe pulmonary circulation. and those ideas were not discovered until much later. Although we think of Harvey as being the first person to talk about circulation

and to really shake the Galenic model, there's actually much more work going on in Islamic tradition. But why wasn't that taken up, given that Avesena's ideas were taken up, why wasn't this idea of the circulation of the blood so far in advance of Harvey? Was it not developed enough? Was it not as well-proofed as Harvey's turned out to me? I don't think, I think maybe the question is that, about proof. I think maybe it wasn't the right time. I think that it's probably connected,

not only to the way we think about medicine and our medical history in the West, but also to do with scientific progress and the notion of scientific knowledge. I think that people see what they want to see when they're developing scientific knowledge. And perhaps it wasn't the right time to believe that there wasn't an invisible pause that separated off the chambers of the heart, for instance. And the thing is that when this work became available to the West, it was actually taken up. round about the time of Harvey, but no acknowledgement was made of this previous work. Jonathan Sorda, the heart in literature and in thoughts of, in poetry, music and song, in character,

has been a very, very strong, a number of conditions the word heart describes, for instance, and we're going to that moment or two. But what about it, if we're developing into the later middle ages of the Renaissance, as the seat of truth, as in Philip Sidney, when he said, look in thy heart and write. What's happening there? I think, yeah, what's happening is that Renaissance ideas about truth and sincerity, I think, are kind of rather different from ours, in the sense that a courtier, like Sir Philip Sidney, learned all the time to control his or her behavior in the court. They kind of operated, as it were, behind a mask. And the heart became a kind of a metaphor

or a means of getting behind that mask. I mean, David has earlier on mentioned the idea of the heart as being sort of the sort of core of who you are, the kind of idea of your identity, your kind of corporeal identity, your psychological identity, being located in this organ in some way. So when Sydney says, you know, look in thy heart and right, he's saying, right, to understand the individual psychology, you have to perform this kind of interior autopsy, you have to go inside yourself in some way. I mean, in Shakespeare's writing, if you look up the word heart in a Shakespeare concordance in a kind of dictionary of the kind of language that Shakespeare is using,

you'll find that of all the words that Shakespeare's using, heart comes up again and again and again and again. Hamlet talks about searching in his heart and the notion of possessing an inscrutable heart in some way. So there's an idea of truth or inwardness that's connected to the heart, and the heart is there a sort of metaphor for thinking and being. It's not just an organ in the way that we would think of this kind of pumping mechanism operating. But do you find it linked to the ideas that have been discussed by David and Faith, linked to the anatomical development? Yeah, I think that idea of the body as a self-regulating device is very important to this, that psychological self-regulation is the purpose or the task of the balanced individual.

So what areas that we would kind of, I think, try to separate off as a sort of well, you know, that's the realm of psychiatry or that's the realm of psychology, a very kind of interlinked with corporeality. Then we are almost at the same time, perhaps a little before it's overlapping, just a century or two, about the Renaissance, the emergence of the idea of the sacred heart,

and people will have seen in statues in Roman Catholic churches, Christ with the wound and the heart being revealed, and sometimes very luridly almost in a neon way, the heart coming out. So the sacred heart, which is the sacrificial heart, which is the heart of Christ, which is the heart of God,

which is the heart of divine love and so on. That took us a long way. That's very interesting, yeah. I mean, the kind of devotion of the sacred heart actually goes back, I think, to the Middle Ages. It's an earlier sort of cult, if you like. And it takes over from the adoration of the wounds of Christ, the five wounds of Christ.

But it really gets into its own in the later 17th century. I think as part of the kind of counter-reformation, part of the sort of backlash, if you like, against Protestantism. And as you say, I mean, it's a very familiar image, I think, in our culture still, the idea of the figure of Christ who actually opens themselves up. And, you know, I think often to Protestantize,

it's seen as a rather kind of, I think your word was neon, which is sort of, you know, it's rather vulgar. Sure, my brother's not bringing, yeah. But it is, it is a rather kind of lurid demonstration of this idea of a human figure who opens their body up and shows this thing. And it's an expression of charitus, of charity, of love. But it's also part of the sort of dense symbolic language

that's operating around the heart and the blood in which you think of kind of Christ's body as being sort of literally spread out through the world. It's part of that consumption that takes place in the mass, if you like. David Wooden, Jonathan's referred to the enormous number of times Hart is referred to in Shakespeare and, of course, sort of Sydney. But Francis Bacon, it's being used all over the place, isn't it? Francis Bacon, for instance, uses the image of the cannibalized heart in his essay on friendship.

And I think that's pertinent. Could you bring that in? Well, Bacon refers back to an adage of Pythagoras, the ancient Greek philosopher, who said you shouldn't eat your own heart. And Bacon says, if you have no friend to talk to, you end up bottling things up inside yourself, and you end up eating your own heart. and this is to turn on yourself and feed on yourself, and this is a form of spiritual death. So when you say, eat your heart out,

you're actually referring back to an ancient Greek adage. In the same way, if you say learn something by heart, you're referring back to something that ancient Romans said. But if you say, speak from the heart, the notion of the heart is the inward self. I think above all what you're referring back to is the Old Testament, where God speaks in his heart

and people imagine things in their hearts. And I think what Jonathan was talking about is the connection between the idea of the heart and inwardness is above all a biblical connection which becomes very strongly entrenched with the translation of the Bible into English in the King James Version. But already it's there in Shakespeare

and it's partly the introduction of this biblical language into ordinary speech that I think we're seeing in Protestant countries, particularly, well, on the other hand in Catholic countries, there's this enormous stress on the sacramental character of the transubstantiation of the mass and therefore of the blood and of the heart of Christ as embodying that. It's interesting.

Sorry, please. I don't know. You can't go. But I'm just wondering about the notion of secrecy in all of this, because to keep something in your heart is to kind of retain it in your heart. A lock it in your heart. I mean, doesn't the Pope still have the, isn't there the idea of cardinals or bishops being created

and then kept in his heart as a kind of closed place? And I think that idea of the heart as a masked place is very important. But you keep people and you keep love and you keep. keep it in your heart, don't you? I mean, there's an Old Testament text. The fool has said in his heart, there is no God. The fool doesn't say it in public. He says it to himself, private. He whispers itself to himself. It's fascinating, isn't it? We have almost a stasis in anatomical development from Galen, modified and pushed on by Avesena and as Faye has told us later on in the early 18th century, but not taking much notice of. While that's happening, the word heart is actually beginning to command all sorts of areas in, literature through the translations of the Bible entering into several languages, I'm sure, but we can talk about our own and so and so forth. And, Faye, can you tell me what were the physiology of emotion linked with the heart around this time? Well, the physiology of emotions is primarily linked, as I've said, through the notion of the humours

and the fact that the heat and the regulation of the heat in the body is one of the things that influences emotions. What is different about the early modern period to the way we understand emotions now, is that emotions are much more physiological in nature. It wasn't until the 19th century that we think of emotions as something that is individual and psychological. So emotions are bodily events,

they're bodily happenings. They are involved with the soul, which operates in the mind, which is separate and distinct from the brain, and they operate in the body being transmitted around the body by the humours. So what happens is, if I was terrified of something,

I would experience a deep chill within my body, and my humours, my spirits would rush towards the ends of my body, resulting in maybe my hair would stand up, maybe I would get goosebumps because the spirits were rushing to the extremes of my body. At the same time, my heart would experience an immense chillness. This was as dangerous as becoming very angry, because those kinds of extremes that affected the heart could result in death. So any sudden shock or an amount of grief or an amount of rage could be dangerous

because then it would just cause an imbalance and throw the body system out entirely. So these deep-rooted physiological ideas about the emotions lasted until the 19th century they've been rethought and modified at various points, but they're still contested where emotions reside and how they work in the body. And they're

given different languages, different points. So when people were using the word hearters, we've been developed a bit now as David and Jonathan were saying, and they're talking about cold-hearted, way in the back, they think, well, that is because that's how it happens. And it isn't just... They're more than metaphors. Yeah, more than metaphors, exactly.

Can you take that on a bit, Jonathan, with some more. The number of our heartbreak, heartache, heart seas. People dying of heart, yeah. Cold-hearted, warm-hearted, loving heart. On and on it goes, doesn't it? It's a system of kind of, well, it's a language which we still operate with, but it's a language that was once based in a feeling that this was how the body operated. And I think what's kind of interesting is that we now have a completely different idea of how the body operates.

We have a kind of biomechanical model. But our language is still the older language. Well, let's stick with that. We'll get to biomechanics at about half-past nine. If we're lucky. Let's stick with that. Because if you're keeping up the literary run, you mentioned Shakespeare and what about in Spence's in the Fairy Queen something. And there's a scene there which brings dramatically to life what we're talking about. Yeah, and the Fairy Queen, I mean, this vast kind of rambling kind of mythical history of Britain that Spencer published in the 1590s, Edmund Spencer published in the 1590s.

There's a scene in the in the poem called, the house or castle castle of Alma in which the heroes voyage into the human body they're kind of like shrunk down into sort of little homunculine and they kind of go scrambling around around the body and they come in the course of their tour of the body and it's the tour

of a well governed, a well-regulated body, it's kind of didactic in that way it's trying to teach you as you read the poem what the well-regulated person should be like and as they go around the body they eventually come to the heart and they wander into the heart which is the seat of the passions and the affections

And interestingly, and I don't know if it's unique, but interestingly, Spencer imagines that these feelings, which are now personified, are female figures. They blush and they kind of seem to bear marks of shame, or they have a kind of a sort of sanguinary quality to them. And I suppose what Spencer is sort of trying to do is to take you to the very core of what it is that makes you tick. that this is, I mean, Tick is again another kind of word which is interesting. Wrong word, right. Yeah, it is the wrong word. Well, right word in other context. But this is the thing that makes you who you are

and what you are and how you behave. And I think what's difficult for us to think is that this, what's difficult for us to kind of get grasp hold of, is that this isn't a metaphor. This really is a statement of the truth. And I'd like to sort of, if you can develop that a bit, David, because although the brain, as it were, slid away from the heart,

with Galen and just before Galen it's still the heart that dominates a thought about what we are and how we define ourselves. Oh yes, I think so. At this stage we're talking about it. Absolutely, and that's because what defines you is your passions and your passions are on the one level as fair

has been saying physical, that the result of the humours you have and they express themselves physiologically. And of course it's the passions in large part that determine whether your virtuous or sinful. It's the management of the passions. And so this is a system I think which gives much less importance to thought than our cultural world

and places much more stress upon the need to have the right passions, to train your passions, to learn to manage your passions, and also to have passions. It's beliefs as well as passions, isn't it? You believe in your heart? Oh, yes, I mean, that's right, because you need a living faith, as it were, if we're talking about religion, for example,

and you don't just have that by thinking. You have that at some more physiological and spiritual level, which is located in the heart, if it's located anywhere outside the soul. We're coming to stage 16th century and this man called

Colombo who began to as it were take up after Vassalius take up the idea of what was really going on inside there

why did it take them so long to get to the point of they were doing all these advances were made through vivisection

and so they were doing that work so Colombo comes up at the where am I 16th century and he starts working on it

so first of all why takes so long briefly and then what did he find out yes Columbus 1559 is the key book and Colombo is a genius who begins a revolution

that he never quite understands himself and that he doesn't complete. And the first thing I think is to say, go back to this word vivis action. What Vesalius in 1543 has primarily been doing and he's the great founder of modern anatomy, the man who first takes anatomy beyond Galen and shows that Galen has made all sorts of mistakes

because Galen has studied anatomy by working on the bodies of apes. And Veselius works on the bodies of dead human beings and cuts them up and studies them very closely and then produces beautiful drawings showing what they're like. What Colombo goes on to do much more than Vesalius has done is work with living creatures, vivisect, dogs, fish, and so on. And therefore study, for example, the heart beating in a living fish, open it up and see exactly how it's working.

And it's because Colombo is working with living creatures that he can see the workings of the heart and the workings of the blood system quite differently from anyone before, much more closely and much more accurately. And he grasps a series of things that haven't been grasped before. Veselius has carried out one revolution. Féi referred to the idea of the blood moving from the right-hand side of the heart to the left-hand side of the heart.

Blood is made in the liver. It feeds through the heart into the arterial system. And therefore the heart has to have channels through it from the right side to the left side. Vassalius looked at the heart and he couldn't find these channels. He said in theory they're required to be there in order for there to be any blood at all on the arterial side of the body, and yet they're not there, and it seems to be impossible for blood to move across.

So Colombo, starting from that point, says, well, how is blood getting from one system to the other? And Colombo realizes that the only root by which blood can be getting one system from one system to the other is through the lungs. And so he works out that there's a circulation of blood from the right-hand side of the heart into the lungs, and back to the left-hand side of the body. And once he's done that, he then also grasps

that the heart is, as it were, moving blood around, and it's not heating it. He sees that the blood entering the heart in the veins is as warm as the blood leaving the heart in the arteries. And the heart ceases to be a furnace. And it ceases also to be mixing air into the arterial blood. That's now happening in the lungs. So the heart loses a lot of importance at this moment.

When William Harvey went to Padua at Columbus University 50 years later, was the work of Columbus he took up? Because he is the man that we credit, and most people credit, as having taken this thing forward, the circulation of that particularly. Yes. Did he find experiments on by Columbia? Well, the in-papers that he read? You don't know. Well, let's talk about Harvey. Okay, what did he write about and perceive there?

Well, Harvey's discovery of a circulation if he want to use those. that phrase really was more about in 1628 he published a work called Demortico Cordes which described with pulmonary circulation and as we've said it's already been picked up by other scholars before

now what's interesting I think about Harvey is that he's talking about the circulation in a way that becomes popularised by the work of Descartes which I'm sure we'll come to in a moment but the issue about influence is important I think because he was essentially

Aristotelian in lots of ways so we tend to think of him as a revolutionary and why I think it's less significant maybe if he's influenced by immediately preceding physicians is that he's part of a long process, stating Dr Aristotle, of trying to understand the way in which the human body is constructed. So in some areas, he's quite Aristotelian. He's not quite so radicals we tend to assume. So his work on the circulation becomes taken up because it's convenient at that point for Descartes to understand the body as a mechanised agent so that,

we can have an understanding as a mind and body is potentially separate, which secularises a body and takes away the need for the soul. So I think it's important not to focus on Harvey, as we often do as being crucial in his own right. He's part of a very long tradition. Harvey kind of thought of himself as defending an old order. I mean, that's what's rather intriguing about him, I think, because that excerpt that Melvin, you read out at the beginning of the programme

where Harvey addresses the king is a kind of a very old statement about the way in which the body and the universe and politics are somehow all linked together in a system of metaphors. And Harvey believes that implicitly. And yet what he does is to actually overthrow that hierarchy, almost kind of by mistake, as it were. And I think that, well, the thing I find so intriguing about it is, is, you know, given what we've been talking about,

that these sort of, if you like, mechanisms were known about before, it's Harvey that actually says, yeah, they are actually like machines. I mean, he sort of looks at the valves and the heart and sees a kind of, you know, a one-way system. And the kind of intriguing... He uses the word pump. He uses the word pump. Now, I think it's actually, it's the technology around him

that actually helps him to see the body in a new way. But the effect of this is to transform the heart from being this kind of mystical organ into, well, a kind of a pumping engine. You know, it's kind of redistributed. It's operation. I mean, with a great respect, I think that the idea, quite rightly, giving credit to what happened

in Islam and Colombo and so and so forth. We tended to underestimate the sort of effect that the clarity and impact of Harvey's ideas had, of course everything depends on its context. Of course things are right for the time, that's a given. But he did actually establish something which roared away with other thinkers and went into the body politic.

That part of our culture, didn't it? Well, I think... Jonathan was just saying that Harvey believes that the heart is a part of the microcosm which is also connected to the way the government works and the society works and also to the macrocosm and at the same time unintentionally he undermines that belief. And it's really quite complicated to work out what's happening in Harvey.

Here's a couple of sentences where he appeals to these traditional and old ideas. One at the very beginning in the letter to the dedication to the king, which you read out, one in the middle. But the whole thrust of the argument is to turn the body into a mechanism and thus to remove its qualities, its significance, its importance. The emotions disappear from his discussion at the heart. And it's hierarchy.

And it's hierarchical. The emotions, order, hierarchy, status, everything like that disappears out of the body and all that's left is a machine. And moreover, I'm coming, this is, I think, where Harvey is a great man, a genius. It's not that he is doing new experiments, people, Galen had done experiments. It's not that he's actually looking at new machines. I don't think there are any new machines in Harvey's world that hadn't already been there in ancient Rome.

It's that he's prepared, A, to do vivisections as Colombo had done and looked very closely of what happens in living bodies by cutting them open. But secondly, he's prepared to see that something is happening. Blood is moving very rapidly through the body. It's going in one direction only. He's fibrous before him had discovered the valves in the veins,

which showed that, as it were, blood cut, ebb and flow, as Galen had assumed. Galen had known about the valves in the heart, but it assumed they were as it were inefficient that blood went in and out of them. I don't think he had the mechanical model of a one-way valve. So when you say there aren't new machines, that's true, but people are beginning to think about machines

in different ways. They're beginning to think about them as made out of components. And I think that's very important to this discussion. You know, the Romans never thought of their machines as components. Now, if you think about the body as a kind of made up of components, then you begin to have a mechanical idea of how the body operates. And I think that's what Harvey has got at the back of his mind. Harvey certainly has got that.

The other thing he escapes from is the notion that understanding something means understanding what it's for. And Harvey says, I know the blood circulates through the body, but I don't know why. And he's the first scientist in history to say that he's seen something happen, but he can't work out what it's doing. In Aristotle, in Galen, understanding is understanding the purpose of something. That's the foundation of understanding. Harvey says, I've got this extraordinary discovery. I'm revolutionizing our understanding of the body, how the body works. but I don't actually know what this function is for.

Faye, could you tell us how Descartes took up these ideas of Harvey? Yes, I think part of the reason that Harvey is so significant to Descartes is this emphasis on the heart as pump, although I would like to point out that Harvey was also very interested in the function and meanings of the blood in its own right. So he thought of the blood as something that's alive. I think that his emphasis on the heart as a pump can be overplayed by historians. I don't think he regarded the heart just as a pump.

That's something that was taken up. Now, for Descartes, thinking about the relationship between the mind and body, in creating the notion, for instance, of a reflex, what Descartes did was try to find a way of understanding how passions worked in the body that didn't necessarily involve the soul, which was located in the mind. And by doing this, he found the pump metaphor useful. So he put that forward a lot more than Harvey did, actually,

in terms of his writing. He stressed the pump notion more. So for Descartes, we have a passion that we experience in the body. It's a physiological feeling that becomes transmitted to the mind, and then we have the cognitive response. So it's a machine-like ordering of the body, which, importantly, doesn't need a soul. That isn't to say that Descartes took the soul out

because he actually located it in the pineal gland in the brain. He gave it a material status and location in the body. But it is possible through using Harvey and the notion of the blood circulating, to think of the body as an organ that can be maintained without a soul. That's why it becomes so significant, I think. And Hobbes on this side of the channel, John Sodor, I took it up very vehemently in Leviathan, where we have the heart is the spring, other, he uses mechanical models for the whole body. I mean, yeah, I mean, it's, everything is materialistic, including God.

Well, there isn't necessarily kind of room for God other than as a sort of watchmaker. Yeah, but if it's that, yeah, that's right. Highly skilled kind of mechanic of some kind. But what's happening, I think, is that a model of the body is shifting, or a kind of way of thinking about the body is shifting. And as that shift takes place, so models of society also shift. And it seems to me very significant that, you know, in the 1620s you have Harvey writing about the king,

writing is dedicating his word to the king, and saying, well, you know, my work is also going to kind of underline just how important you are to the body politic. And then in the 1650s, when Harvey comes to sort of translate or reissue his work, of course there's a bit of a problem here. The king has been executed. You know, the king is, it's quite possible to have a Commonwealth operating without, it seems, this heart beating at its centre, this kingly heart beating at its centre. So we have to kind of think about the ways in which metaphors of politics or ways for understanding society are operating and metaphors for understanding the body are operating in the kind of way they might be interlinked with one another. And Hobbes comes along in the 1650s and says, well, maybe the way to think about society is as a balance of forces, as a kind of set of, rather like levers and cogs and springs in a clock or a watch, operating against one another to regulate the whole enterprise.

So rather than have this kind of wonderful sort of hierarchical notion of the body and the body politic as revolving, as it were, around this sun-like heart object, all you've got is this sort of ticking clock now that's operating and every single. thing kind of in harmony with another in a mechanical way. Before we take that idea on, just as almost as a digression, the obstinacy of the medical treatment at the time meant that Harvey's revolutionary, what can call them that, although they came through evolution, discoveries, didn't have any impact at all on the way people went about bloodletting, animetics and so on so.

This is one of the great mysteries of intellectual history. Harvey carries out this extraordinary intellectual revolution, and one of the things he shows is that the red, blood and the black blood, the venous blood and the arterial blood, are the same thing, that they pass rapidly through the body, turn into each other, that they're not two separate things. The whole of medical treatment was primarily founded upon the notion that the way to cure people most of the time, if they were ill, was to take out venous blood from them. And if you took out venous blood from them, you would be taking out excessive humours and they would get better.

So bloodletting is the key medical therapy. Harvey carries on bloodletting exactly as if Galen's account of how the body works is entirely true. And it carries on right through into the 1830s and 40s as being the core medical process, even as understandings of the body changed. So there's this strange world in which medical therapy is quite out of touch with advances in understanding of the functioning of the body.

Would you like to take that on, Hauai? Well, I think that what we have in modern medicine is still this emphasis on the non-naturals and the way that we live and the health and the health of the heart today still focuses on things. like how much exercise you get, whether you're stressed, whether you're anxious,

what kind of life that you have. I think that these are so deep-seated ideas about the maintenance of health that it's not simple for some sort of scientific development to change that overnight. And I hear what you're saying is that centuries on there is not very much change. But I think there's a distinction between a scientific development always and actual medical practice. They tend to diverge generally. Given the introduction of this mechanistic idea that there was a machine here,

given this sort of power of Hobbes as a thinker, how did that go through in, let's use the literary, but it was in other areas of life. How did that work its way through? Because if everything's run by mechanism, there's no right and wrong. It's a mechanism. Yeah, that's interesting. I mean, I think it's to do with, okay, think about it as the movement of fluids under pressure. I mean, that's what Harve is kind of great, you know, exploration is.

If you think about that, I mean, I think somebody's once referred to, you know, Freud discovering that, or Freud writing about sexuality as though it's about us dealing with the fact that there is this enormous amount of pressure to kind of move us in certain ways. And that becomes a kind of a model, another model, if you like, for thinking about the way humans operate as kind of hydraulic machines of some sort. So you'll find then that if we are considering a, ourselves as a kind of, you know, an operating machine of some sort, then you can't really blame the machine if it acts aberrantly. It's not the fault of the machine. Machines don't have will,

they don't have intention. What you can blame is the person that's created the machine, whether it's a malfunctioning machine or a machine that operates in a way that perhaps seems immoral. It's not the machine's fault, but it's the creator of the machine's fault, which presents something of a theological difficulty, should we say? Do you want to come in on? Well, I think that's... Hydraulic machines, I think, are particularly interesting because they level out,

and they regulate themselves in certain various interesting ways. And one of the puzzles about trying to think about machinery is how can you get it to work well? There's an extraordinary revolution that takes place in the course of the 17th century between thinking that machines are bound to be essentially defective. Watchers or clocks are always going to be, need to be corrected and put right,

and at the end of the 17th century, when people think the machines fundamentally can work extremely well, indeed so that you'll only have to tinker with them every year or two. We might have perfect machines. We might have perpetual motion machines, which is what the body is. Of the perfect machine. And once you've got the concept of the perfect machine, God as a great watchmaker can step back and let things run on forever.

But morality falls out, doesn't it? I mean, morality becomes something of a problem here. And Hobbs is that a turning point where he's almost got the concept of the perfect machine, but not quite. And one of the things about the state for Hobbs is it's constantly intervening. It's constantly controlling because the machine isn't yet perfect. And the problem is, of course, is that once you take, once you make emotions secularised and once you take away the idea that the soul is somehow controlling the body

and the soul is controlling its urges, you are left in something of a moral and ethical crisis because then without any kind of moral loading of the passions, do the passions still have the same status as they did when they drove us to do things, and should they still have the same status? So the kinds of, the things that used to be responsible for maintaining human conduct are no longer linked to the soul. But the pendulum swings that way and then instantly comes back with the romantics

when you see into the heart of things, let nature be your teacher, back it comes, that mere reason will not only get you nowhere, it'll get you in a place you don't want to be. I think it's a kind of revolt against mechanism. I think that in a way, you know, people don't, we don't like the idea

that we might be just kind of a functioning machine, a very well-oiled, very smoothly kind of compacted machine. You know, we like to think ourselves as rather more than that, as rather more precious, if you like than that. And I think when you get sort of romantic poets in the end of the 18th century, the 19th century, going back almost and retrieving the old ways of thinking about the heart,

the heart becomes such kind of been a crucial metaphor for them in their writing. It's as though they're in rebellion against this materialism that's come to surround kind of the way in which we think about the body and the human being as well, and the psyche or the soul, they're in revolt against that reduction, as they would see it. Do you see, sorry, fine. I was just going to say, I think I totally agree with you, and it's the same reason

that in the 18th century at the so-called peak of reason, of the age of reason, you get outbursts of heart religions like Methodism, which you're saying, you know, this isn't enough. Yes, exactly. Let's get back to how it actually feels inside because there is a link between the heart and truth, which is there. The idea of the heart as the metaphorical centre or as a centre in everyday parlance,

and after all most of us live our lives in everyday parlance, is still surprisingly powerful, isn't it? Is this just a hangover? the word so good, and does it now mean something different, or are we still where we were two and a half thousand years ago? Well, in part, we operate with a language that we've inherited from ancient Greek, ancient Latin, and ancient Hebrew. And so that when Wesley talks about his religious conversion as his heartwarming, in part

what he's doing is deliberately going back to a biblical language in rejecting the language of contemporary philosophers, which he thinks is rationalist, mechanist, and so forth, and giving new life to a language that he's got directly out of his reading of the Bible so that we give new life to languages we bring them back into use and they continue to work for us but do you think when people are talking about the hearts

I think what I really mean the mind but the hearts are better word and it's got more of a pedigree so we'll stick with it you can't say I'm mind broken or I feel like there's a notion of soul sickness there's an idea of soul sickness

of being kind of, but the heart is this place of feeling. I think that's the important thing. It's where we seem to feel things, not think things. And it's the opposition between thinking and feeling that we're dealing with here, I think. Well, it's not only that. I mean, we've presented Hobbes as the first modern, but Hobbes is a great reader of the original source of materialism, which is Lucretius in 50 BC,

and Lucretius assumes that you think with your heart. And so in Leviathan, Hobbes actually suggests that we may think with our heart or our brain. He's not sure where thought is. So the heart is also the location of your child. true self, which is a thinking as well as a feeling being. But I think... Yeah, I agree. I think that there's something about the fact that feeling is located in the heart

and the pang and the anxiety that we feel at certain extreme emotions has to be explained in some way. We don't actually have another way of explaining it, so I think it's not very surprising that the metaphor continues. Well, thank you very much. I will refrain from talking about heart to heart or the heart as a matter

or heartbreak or tell or anything like that. And thank you very much to Faye Barnaberti, David Wood. and Jonathan Sorday. Next week's program is on Uncle Tom's Cabin, the book that Abraham Lincoln claimed, started the American Civil War. And you can see the latest edition of this program,

you know, podcast, download, or in our time website, all that sort of stuff. Thank you very much for listening. We hope you've enjoyed this Radio 4 podcast. You can find hundreds of other programs about history, science and philosophy at BBC.co.com.uk, forward slash radio 4.