The Shape of the Heart by Pierre Vinken. Elsevier, £12.82, pp 206. ISBN 0 444 82987 3. Rating: ★★★
Have you ever wondered why the iconographic representation of the heart differs from its true anatomical shape? This question has intrigued Dr Pierre Vinken, a former neurosurgeon turned publisher, who explores this intellectual conundrum in this historical monograph.
In 1962 the art historian Erwin Panofsky was similarly perplexed. He noted that the valentine heart shape has been used since prehistoric times and was seen in Palaeolithic cave paintings in Spain. The first chapter of Vinken's book surveys the representation of the heart in these ancient times. We learn, for example, that the oldest known representation of the heart is the 3000 year old Olmec effigy vessel found in Mexico. Hippocrates described the heart as round and pyramid shaped, while Galen, who exerted medical influence for centuries, described the heart as a cone with the tip pointing downwards.
In the 14th century Guy de Chauliac described the heart as an inverted pine cone with the tip pointing downwards, not up—a description that was essentially unchanged in the works of Vesalius and even in Gray's Anatomy. This pine cone representation was used in medieval Spain, where large numbers of “heart shaped” silver gilt boxes were produced. Early pine cone representations of the heart can be seen in the early 14th century paintings of Giotto's Caritas in Padua. Scalloping of the heart in icons was noted in medieval times, perhaps because it was thought that the heart had three chambers instead of two, as was previously thought. This fundamental error can be attributed to Aristotle, and it was continued in the writings of Avicenna's Canon.
The final section of the book covers the contribution of the Dutch grammarian Hendrik Spiegel to the debate about the heart's shape. Spiegel was the author of a famous allegorical Dutch poem “Hertspiegel” (Heart mirror), which was essentially a long introspective series of books about his views on moral philosophical issues. Spiegel's allegory, devoted to a cave shaped like the interior of the human heart, was turned into an engraving by the artist Saenredam as the Antrum Platonicum. The complexity of meaning and symbolism about the heart in Spiegel's work are explained here in some depth.
This monograph has been well researched and is profusely illustrated with black and white drawings. The footnotes are scholarly, and the reference list is extensive. It is an interesting and unusual contribution to the literature on medical history.