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  Affairs of the Heart
  

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By: Nicholas Lee, M.D.
To any doctor who has been trained in today's medical schools, the idea that the heart may not be a pump after all would, at first sight, appear to be about as logical as a suggestion that the sun actually rises in the West or that waterfalls flow upwards. So strongly is the pump concept ingrained in the collective medical psyche that even trying to think otherwise is more than most people can manage. Yet Rudolf Steiner, a man not given to unscientific or slipshod thinking, was quite clear on the matter and reiterated time and again that the heart is not a pump. "Today, external theory makes the heart a pump, pumping the blood through the body. So one would have to see in the heart the organ that regulates the circulation. Actually, the reverse is true. The circulation is more original, and in its movements the heart gives a resounding of what goes on in the circulation. The blood drives the heart, not the heart the blood."(1)

This question has been addressed more recently by Ralph Marinelli and his co-workers whose recently-published paper refutes the generally-accepted pressure propulsion premise of heart function and confirms the observations of Rudolf Steiner.(2)

Having gotten over the initial difficulty of thinking what has previously been thought to be unthinkable, any unbiased reader must surely admit that Marinelli et al make a convincing and well-referenced case for their conclusions. For a start, they draw attention to the sheer volume of work which the heart would have to do if it were solely responsible for pumping inert blood through the vessels of the circulatory system. Blood is five times as viscous as water, and if the propulsion premise is accepted, the heart would have to pump 8000 liters of blood a day in a body at rest and considerably more during activity, through millions of capillaries the diameters of which are sometimes smaller than the red blood cells themselves - a huge task for a relatively small, muscular organ weighing only 300 grams. This is an unlikely concept which is compounded by the inherent undesirability of a system which would need excessive pressure generated at its source for sufficient pressure to remain at the periphery.

Once the questions start being asked, the anomalies in currently-accepted dogma manifest themselves. For instance, if the blood is pumped under pressure out of the left ventricle into the aorta during systole, it would be expected that the pressure pulse would cause the aortic arch to try and straighten out, as happens in any Bourdon tube pressure gauge. In practice, the exact opposite happens, and the curve increases, indicating that the aorta is undergoing a negative, rather than a positive, pressure.

Another paradoxical finding concerns the mechanics of fluid flow under pulsatile pressure. When a pressure pulse is applied to a viscous fluid in a closed vessel, the liquid initially resists movement through its own inertia. The pressure, therefore, peaks before the fluid velocity peaks. In the aorta, exactly the opposite happens where peak flow markedly precedes peak pressure, a fact which was observed in 1860 by Chauvau Cortet. So just what is going on inside the circulation?

As Marinelli et al point out, the pressure propulsion model of blood circulation rests on four major premises: 1) blood is naturally inert and must, therefore, be forced to circulate; 2) there is a random mix of the formed particles in the blood; (3) the cells in the blood are under pressure at all times; 4) blood is amorphous and is forced to fill its vessels and take on their form.

All of these premises can be shown to be faulty. For example, far from having a random mix of the blood components in vessels, the cellular elements arrange themselves in a highly organized flow pattern in which the heavier red blood cells flow nearest to the axis of the vessels while the lighter platelets are nearer to the periphery. All of the formed elements are surrounded by a sleeve of plasma which is in contact with the vessel wall. However, a major misconception about how the blood circulates is the assumption that it flows in a laminar fashion, whereas the main pattern appears to be the vortex - an observation also made by other workers(3) -which leads to a whole new concept of circulatory dynamics, one which goes a long way towards explaining the close interaction between the heart and the blood, both of which are derived from the same embryonic material. Much of the experimental work carried out by Marinelli and his colleagues is based on elucidating the mechanics of vortex-based fluid flow, and their work describing a perpetual vortex in the left ventricle makes fascinating reading.

As Rudolf Steiner pointed out, the clues to circulatory physiology are to be found in embryology,(4) and two of the main embryological observations have been that the blood starts circulating before the heart has been fully formed and that it circulates in a spiraling fashion. Not only may these streams spiral around their own longitudinal axes, but even around each other as in the single-stage tube heart of the chick before the valves have developed. The spiraling of the blood flow is mirrored in the musculature of the heart and arteries, both of which move in a twisting motion which augments the momentum of the blood as it circulates.

So why are we concerned about the way in which the blood circulates and the ‘heart as a pump’ paradox? Do we not already know enough about the circulation in conventional terms for all practical purposes? No. Is all this really relevant? Yes. Not only should truth be sought for its own sake, but therapy based upon faulty premises can only be bad therapy. As Marinelli et al point out in their paper, "Since we have observed that the blood has a highly dynamic form and an ordered blood corpuscle motion and
orientation, we should be able to develop devices and techniques to detect small deviations from group and individual norms and, thus, form a basis for very early diagnosis of cardiovascular disease, which remains the number one cause of death in the United States. Novel, more effective therapies for cardiovascular disease hopefully will also evolve from this new perspective on cardiovascular physiology."

Nicholas Lee, MD
The Medical Communication Consultancy
Rora House
Queens Road
Simon's Town 7995
South Africa

References
1 Steiner R. Welche Bedeutung hat die okkulte Entwicklung des Menschen fuer seine Huellen... und sein Selbst? 2nd Lecture (GA 145). 1975. Quoted in Husemann F., Wolff 0. The Anthroposophical Approach to Medicine. Vol n. 1989. New York. Anthroposophic Press, p. 342.
2 Marinelli R, Furst B., van der Goe H., McGinn A., Marinelli W. The Heart Is Not a Pump: A Refutation of the Pressure Propulsion Premise of Heart Function. Frontier Perspectives. 1995.5:15-24.
3 Stonebridge PA., Brophy CM. Spiral Flow In Arteries? Lancet 1991.338:1360-1361.
4 Steiner R. Spiritual Science and Medicine. 1920. Rudolf Steiner Press. London. 24-25.

    





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