The Dynamic Heart and Circulation
This essay is a substantially shortened version of Craig's
introduction to a book called "The Dynamic Heart and Circulation", of
which he is the editor. Many of the supporting references have been
removed from the text. The book will be published later this year and
is aimed at teachers, health professionals, and anyone interested in
learning about a Goethean approach to the human being. To order the
book, contact AWSNA Publications (916-961-0927 or www.awsna.org).
The liver is a chemical factory. The kidney is a waste treatment
plant. The heart is a pump. The brain is a computer.
If we lived in a more poetic age, we might say, "the heart is a
rose." But a mind at home in the mechanical world of cause and effect
can hardly avoid seeing the heart as a pump circulating the blood
through the body.
The damaging thing about mechanical models is that they tend to be
exclusive. High school or college students don't usually learn "the
heart has some functions that we can interpret in terms of a pressure
pump." Rather, they learn "the heart is a pump." Mechanical metaphors
in science all too often become fixed and literal, losing their
vibrancy and openness. This makes them easier and clearer to apply --
and also less faithful to life.
The Fluid Heart
The circulatory system is dynamic. While the brain rests firmly and
still in its protective casings, the circulatory system lives in
rhythmic movement, mediating extremes. Most of the heart, as an organ
of movement, consists of muscle fibers (myocardium). These fibers are
joined in bands that "present an exceedingly intricate interlacement"
The outer muscle fibers begin at the upper part of the heart and
sweep down in counterclockwise curves to the tip (apex) of the heart
(see figures 1 and 2). There they loop around and form the so-called
heart vortex (vortex cordis, see figure 1, middle drawing). Those
fibers that begin at the front (ventral side) of the heart enter the
heart vortex at the back (dorsal side) of the heart while those that
begin at the back sweep around to the front. These outer fibers loop
around each other, creating the vortex pattern, and then continue
into the inside of the muscular wall and spiral back upward. Some of
these fibers radiate into the papillary muscles that move the
Fibers that lie deeper at the top of the ventricles spiral down -- in
contrast to the superficial fibers -- clockwise. These fibers coil in
more tightly and form nearly horizontal loops around the body of the
ventricles before they sweep upward again to the top of the heart.
The best way to form a picture of this complex fiber arrangement is
to study figure 2 and then try to recreate the spiraling with your
hands. With repeated effort you begin to get a sense of the heart's
dynamic structure, which the English anatomist J. Bell Pettrigrew
described as "exceedingly simple in principle but wonderfully
complicated in detail."
Muscle consists of about 75% water. The spiraling and looping pattern
of the heart fibers, including the beautiful heart vortex, is an
image of fluid movement. The blood streaming through the heart also
creates loops and vortices. Like the fibers of the heart, this
movement is very complex and intricate. In a sense, what the blood
does as a fluid has become formed in the muscular structure of the
heart (see figure 3).
Figure 3. A cast of the left ventricle of a deer.
The direction of blood flow is radically altered by the heart. Venous
blood enters the right side of the heart through the superior and
inferior caval veins, which are vertically oriented (see Figures 4
and 5). From the right atrium the blood streams down into the right
ventricle and then back upward into the pulmonary artery, which
immediately branches horizontally to the right and left to enter the
Figure 5. Crossing of the caval and pulmonary veins. [after 1]
In contrast, the blood that enters the left side of the heart comes
horizontally from the pulmonary veins. From the left atrium it flows
downward into the left ventricle and loops upward into the ascending
aorta. At the aortic arch three arteries ascend into the head and
arms, while the vertically descending aorta serves the rest of the
So the right side of the heart brings vertically flowing blood into
the horizontal and the left side of the heart brings horizontally
flowing blood into the vertical. This change in orientation is
clearly evident in the drawing of the cross that is formed by the
caval veins and the pulmonary veins (Figure 5).
The streams of blood entering the right atrium from the superior and
inferior caval veins do not collide, but turn forward and rotate
clockwise, forming a vortex. The blood streaming into the left atrium
also forms a vortex, but it turns counterclockwise. When
theatrio-ventricular valves open, the blood streams into the relaxed
ventricles, again rotating, forming vortices that redirect the flow
of blood. Momentarily the blood ceases its flow and then the
semilunar valves (which separate the ventricles from the outgoing
arteries) open and the blood streams into the pulmonary artery and
The coiling, looping heart fibers create contractions that mirror and
facilitate this streaming, looping blood flow unique to each chamber.
During systole (contraction) the heart moves downward and oscillates
slightly to the sides and also rotates around its own axis. During
diastole (relaxation) it moves upward and rotates back in the
opposite direction[2, 4]. Only the heart's interwoven spiraling
muscle fibers can produce this kind of complex motion.
We see that blood flow, the form of the heart, the pattern of its
fibers, and the motion of the heartbeat are intimately entwined. We
can't think of one without the others. When we go back to the origin
of the blood and the heart in embryonic development, it is no simple
matter to say what came first. Early in its development the heart
begins to form loops that redirect blood flow. But before the heart
has developed walls (septa) separating the four chambers from each
other, the blood already flows in two distinct "currents" through the
heart. The blood flowing through the right and left sides of the
heart do not mix, but stream and loop past each other, just as two
currents in a body of water. In the "still water zone" between the
two currents, the septum dividing the two chambers forms . Thus
the movement of the blood shapes the heart, just as the looping heart
redirects the flow of blood.
The heart is the center of the circulatory system. It connects the
upper and lower parts of the body as well as, through the pulmonary
circulation, the outer (air) with the inner. The heart is continually
adapting its activity to the needs and state of the body and person
as a whole.
In strenuous activity, for example, the heart expands more in the
diastolic phase (when it receives blood) and increases its beating
rate, allowing more blood to pass through the heart and into the
lungs and muscles. But the heart is not simply pushing this blood
into the body. The lungs take in up to three times the amount of
oxygen during exercise, not only because of the increased diffusing
capacity of oxygen, but because both lung alveoli (where diffusion
occurs) and the lung capillaries dilate, letting more blood pass
through the lungs. Similarly, in the muscles the blood vessels
If, over an extended period of time, an organ needs more oxygen, it
stimulates, via growth factors, the blood vessels in the organ to
grow. This is another example of how the impulse to change and adapt
comes from the periphery. The whole circulatory system, from center
to periphery, is involved in getting more blood into the tissues that
The blood moving through the body is continually changing. After
we've eaten, for instance, the blood passes through the intestines
and takes up nutrients. The blood then enters the liver, which draws
out nutrients. The liver also detoxifies the blood, removing, for
example, bacteria or alcohol. In each organ something unique to that
organ happens to the blood. In the brain large amounts of sugar and
oxygen leave the blood. The kidneys remove metabolic waste products
and water, but also secrete hormones that regulate the production of
red blood cells. The blood is truly a special fluid in its ability to
take in and give off substances that it moves through the body. It is
in unceasing change and thereby helps the body maintain its
physiological balance and coherence.
Changes in the blood's pressure, viscosity, warmth, and biochemical
composition are communicated to the heart by means of the nervous
system, hormones, and heart and blood vessel sensory receptors. The
heart therefore exists as a perceptive center for the body via the
circulation. Steiner spoke of the heart as a sense organ for the
organism, enabling it to perceive what transpires in the upper and
lower poles of the body .
The heart does not just perceive what comes to it via the blood. It
also alters its activity - and not only to circulate more or less
blood. For example, the heart secretes a hormone in response to the
changing consistency of blood. If the blood is too viscous, the heart
secretes this hormone (natriuretic peptide) into the blood, and the
hormone stimulates the kidneys to secrete more water into the blood.
One further feature of the interplay of heart and peripheral
circulation we shouldn't overlook is the maintenance of body warmth.
Only the warm-blooded mammals and birds have completely
four-chambered hearts. The internal differentiation of the heart
corresponds to the organism's ability to maintain a high constant
body temperature despite radically fluctuating inner and outer
conditions. The beating heart muscle itself is a source of warmth for
the blood, while the peripheral circulation can expand and contract
to give off or contain warmth.
Into the Soul
Here are some English words and expressions relating to the heart:
Heartless Have a heart Hearty
Lose heart Heartrending Heavy heart
Heartbreaking Warmhearted Heartache
Coldhearted Fainthearted Hardhearted
Heart sick (sick at heart) Lighthearted Search your heart
Heartsore (sore hearted) Wholehearted Put your heart at rest
Heart-to-heart Near to my heart Take heart
You are all heart Take it to heart Heartfelt
The feelings associated with these expressions are often deep (heart
sick, heart-to-heart) and span polarities (cold- and warm-hearted;
faint- and light-hearted). What comes from the heart is authentic and
whole. It's one thing to search your brain for something or to put
your mind to something and a very different matter to search your
heart for something or put your heart into it. The heart is literally
in-dividual; it is unity and when that unity loses its center or
begins to dissolve, it's, well, heartrending.
The quality of warmth is central to the heart. Someone who is
heartless is cold. When we have a heartfelt concern, soul warmth
streams out from us. When we take heart, warmth enkindles our
courage. (Etymologically, "courage" means "heart.") And when we
gesture to someone to take heart, we emphatically raise up our arm
and ball up the fist in front of our chest. Taking heart means
gathering at our center and from there expanding into the world
through our actions.
Not only the heart moves between the polarities of contraction
(systole) and expansion (diastole). Rhythmic movement between poles,
and mediating and balancing between extremes, characterizes the
circulatory system as a whole. The blood gathers in the heart and
then flows out into the periphery, changing and exchanging with this
periphery, and then moving back to the center.
When we've grasped the circulatory system qualitatively in this way,
it's not surprising to discover its intimate connection to our inner
life of feeling. Feelings of awe and love allow us to flow out into
the world. We connect, give and learn from the world and bring the
fruits of this interaction back to a center. We experience
satisfaction and contentment. Our joy leads us back into the world.
Or we experience fear, anger, or even hate. We draw back into
ourselves when such feelings capture us, and the healthy oscillation
of the soul between inside and outside, between self and other, is
disturbed. Just as we can become completely isolated through hate, so
also we can lose ourselves in unceasing rapture.
The healthy life of the soul depends, as does the circulation, on
continual movement, on the ability to flow out and gather in. Or we
can speak in terms of the other middle system in our body, the
respiratory system: we need the rhythm between breathing out and
Our soul life and physiology are inseparable. It is well known how
stress (which means we are inwardly driven and contracted with little
inner breathing room - our soul can't oscillate) has its
physiological correlate in hypertension, where the blood, like the
soul, is under abnormally high pressure. A Swedish study found that
women who lived alone, had very few friends, and also no one to call
on if they needed help, tended to have heart rates that varied little
over the course of the day. Such low variation in heart rates is
correlated with heart disease and early death. Less socially isolated
individuals have a more varied heart rate.
The path to health involves seeing bodily processes as an expression
or outer aspect of what we are inwardly.
Mechanical models may be helpful to understand partial functions of
an organ or system, but when they become exclusive, the partial truth
becomes falsehood. We end up making the heart much less than it
really is. The image is that of a central power center that forces
blood through the body and thereby maintains the body. This is, if
you will, an egocentric view of the heart as the forceful doer. The
pump just keeps on working until it wears out - or, as in the case of
the artificial heart, keeps beating even when the person has died.
Mr. Robert Tools was the first patient to receive the AbioCor
artificial heart. After the operation in July, 2001, Mr. Tools
recovered quite well and was able to leave the hospital. He suffered
a stroke on November 11^th. Patients with an artificial heart are
always susceptible to strokes, because the blood more easily clots
when it comes in contact with the artificial material of the valves.
Normally a patient receives blood thinners to prevent clot-formation,
but this was not possible in Mr. Tools' case, since he had a tendency
to bleed internally.
After the stroke, Dr. Laman Gray, who carried out the surgery,
reported that Tools' condition "is probably a little better than a
person with a [real] heart, since we don't have to worry about the
heart itself." Gray went on to comment about another patient who had
received the AbioCor heart. This patient was making slow progress,
due to a high fever that may have damaged his organs. But, as the
reporter paraphrases Gray, "Mr. Christerson's [artificial] heart has
been working well."
On November 30, Mr. Tools died due to internal bleeding. But, as the
Los Angeles Times reported, "`Tools' death in no way means the
experiment failed,' said Dr. Mehmet Oz .... Indeed, Tools' doctors
noted that the heart continued to beat flawlessly even as he died."
Here we see the mechanism enthroned in a sad separation from the
person. The pump still continues to beat as if nothing had changed,
while the person dies. And as long as you focus on the mechanism, and
the pump continues to work, the experiment cannot be called a failure.
Very different is the view of the living, dynamic heart and
circulation. Here we see give and take, and continual change and
adaptation through interactions. We see a dynamic, perceptive center
that maintains coherence and integrity. From birth till death, the
living heart shares in our life as ensouled beings.
1. Benninghof, A. and K. Goertller. 1980. Lehrbuch der Anatomie des
Menschen, 13th edition, Band II. Munich: Urban & Schwarzenberg.
2. Katz, A. 1992. Physiology of the Heart, second edition. New York:
3. Kilner, P. et al. 2000. "Asymmetric Redirection of Flow through
the Heart," Nature, vol. 404, pp. 759-761.
4. Marinelli, R. 1989. "The Spinning Heart and Vortexing Blood,"
Newsletter of the Society for the Evolution of Science, vol. 5, no.
1, pp. 20-41.
5. Steiner, R. 1959. Introducing Anthroposophical Medicine, chapter
2. Hudson, NY: Anthroposophic Press.
This document: http://www.netfuture.org/ni/ic/ic7/heart.html
Original source: In Context (Spring, 2002); copyright 2002 by The
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