The Heart is Not a Machine, it is a Work of Art

In the following video Alexander Tsiaras calls the development of the human heart magnificent oragami as the heart forms with cells developing  at a rate of one million per second.

Conception to birth — visualized

It is generally believed that the heart acts as a pressure pump forcing an inert fluid through the lungs and through the bodily tissues and organs. There is evidence that this is not the case and that it is more accurate to view the heart as an organ which regulates the dynamic activity of the blood.

Here  Walter Alexander reviews Branko Furst’s radiacal alternative:

… the possibility that the dominant paradigm is deeply flawed is what Branko Furst, MD, explores in The Heart and Circulation: An Integrative Model in 2014 and in “The Heart: Pressure-Propulsion Pump or Organ of Impedance” in the Journal of Cardiothoracic and Vascular Anesthesia in 2015. In these, he marshals the evidence against the standard propulsion pump model and presents an alternative that may open new avenues for understanding circulation and, ultimately, pharmacotherapy. As a vascular anesthesiologist in a tertiary care medical center, Dr. Furst holds hemodynamic monitoring and support of circulation at the core of his acute-care concerns.

To challenge the prevailing paradigm in any field is difficult, and in the case of heart function, with its notoriously complex dynamics, myriad of interrelated influencing factors, and vast diagnostic and therapeutic implications, it is a prodigious undertaking. Dr. Furst has provided more than 800 supporting references in his book and the journal article. It is far beyond the scope of this article to fairly represent the range of this content. However, we will attempt to review the basic argument and rationale for such a challenge and give the reader a  compass for delving more deeply into the underlying research.

In the article THE HEART IS NOT A PUMP:
A REFUTATION OF THE PRESSURE PROPULSION PREMISE OF HEART FUNCTION
Ralph Marinelli writes the following:

Implicit in the notion of pressure propulsion in the cardiovascular system are the following four major concepts.
(1) Blood is naturally inert and therefore must 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) The blood is amorphous and is forced to fill its vessels and thereby takes on their form.
However, there are observations that challenge these notions. It is seen that the blood has its own form, the vortex, which determines rather than conforms to the shape of the vascular lumen and circulates in the embryo with its own inherent biological momentum before the heart begins to function. Just as an inert vortex in nature pulses radially and longitudinally, we tentatively assume that blood is also free to pulse and is not subject to the pulse-restricting pressure implied in the pressure propulsion concept. The blood is not propelled by pressure but by its own biological momenta boosted by the heart.

 

The recent advances in non-invasive imaging allows the dynamics of the circulatory system to be studied in much more accurate detail than ever before. And it is beginning to be obvious that the current understanding of the heart as a mechanical pump is false.

Frank Chester discovered the chestahedron, 7 sided polyhedron with surfaces of equal area. He discovered this by combining art and science. From studying this form he made many further discoveries including discoveries about its relationship with the human heart as demonstrated in this video.

Craig Holdridge gives a good description of the relationship between heart and blood:

We’ve arrived at a picture of the intricate streaming, turning, looping blood flow through the heart that follows a different pattern in each of the four chambers. The coiling, looping heart fibers create contractions that mirror and facilitate this dynamic coursing of the blood. The heart muscle does not work, as we often imagine it does, opening and closing as we can do with our fist, first forming a fist (systole) and then relaxing the fist (diasole). Rather, the heartbeat (cardiac cycle) includes a much more complex array of movements. During systole the heart moves downward and oscillates slightly to the sides and also rotates around its own axis. During diastole it moves upward and rotates back in the opposite direction. 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 and the pattern of its fibers, and 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 (see Brettschneider’s preface to Woernle’s chapter in this book). Maybe it’s also just our mechanical way of thinking that wants to see a clearly directional cause and effect relation between the heart and the blood instead of a more living relation of mutual dependency.

This mutuality shows itself during the embryonic development of the heart. 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 by 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 gives the parameters for the inner differentiation of the heart, just as the looping heart redirects the flow of blood. Blood movement and heart differentiation belong together.

In describing the heart as a machine we produce a conception of it which is far removed from reality. It needs to be understood in its true, dynamic, living nature.

 

115 thoughts on “The Heart is Not a Machine, it is a Work of Art

  1. walto: And BTW, John–it’s not Kantian science that turns Charlie on, it’s Goethian science.

    D’oh!

  2. CharlieM: I have never used the term Kantian science and I do not claim to practice it.

    Sorry, Goethian science.

    I believe that all science should rest on empirical grounds.

    So that’s why you’re so much into people who use visions on the astral plane as grounds for their conclusions?

    Shauberger was successful in his use of water precisely because of his observational thoroughnes. He studied water intently.

    “Studied” is perhaps the wrong term. From what you’ve quoted to far, he stared intently. Goethian science seems to involve a lot of navel-gazing, as far as I can tell. That’s the opposite of “empirical”.

    Have you even looked into the results of Shauberger’s work on water systems or do you just dismiss it because it sounds like woo to you?

    The latter. But I do have a sensitive woo detector.

  3. CharlieM: So now you are saying that I do look at thetrees (details) but I misinterpret what they mean. I’ll admit that is a possibility.

    No, that’s not what I’m saying. I think you occasionally mention a tree, but you don’t really look at it, you just flash it because you have a vague impression of something treelike that you imagine supports your opinion of the forest.

    I have not made such a bold claim. I am claiming that because red blood cells display autonomous movement, blood cannot be regarded as an inert fluid.

    Unless that autonomous movement significantly affects blood flow, an inert fluid is an excellent first approximation, and nothing you have mentioned indicates otherwise.

  4. CharlieM: The quantity of capillaries and their total surface area are not small scale figures.

    There’s a fine example of you nodding vaguely in the direction of a tree, claiming that it tells you something about the forest. Your ability to quote irrelevant facts is apparently a triumph of Goethian science.

  5. CharlieM: We have some points of agreement here. The heart is not the sole source of the blood’s movement.

    You do not say that there is no evidence that the blood moves on its own, you say there is no evidence that this happens to any significant degree. I think we are making a wee bit of progress here.

    We are making no progress, and the points of agreement are visible only if you blur your vision enough that you can’t distinguish between two fingers and three. Quantification is crucial in science, though obviously not in Goethian science, which is a different animal, possibly a pikachu. The additional sources of blood movement are both minor and nothing like what you claimed them to be; in particular, they’re the sort of thing that happens to inanimate fluids. The fact that erythrocytes can wiggle has nothing to do with claims that blood moves on its own.

  6. John Harshman: red blood cells display autonomous movement, blood cannot be regarded as an inert fluid.

    People get dysentery from drinking water with autonomous thingules in it all over the world. Does that mean that their water cannot be regarded as an inert fluid?

  7. walto: John Harshman: red blood cells display autonomous movement, blood cannot be regarded as an inert fluid.

    People get dysentery from drinking water with autonomous thingules in it all over the world. Does that mean that their water cannot be regarded as an inert fluid?

    Clarification: that wasn’t me; it was Charlie.

  8. John Harshman: The point is that there is no opposition between works of art and machines, so being a work of art is no argument that the heart is a machine. What is it, then, that makes the heart not a machine? What do you mean when you say “work of art” and when you say “machine”?

    I agree that there is no opposition. By comparing the heart to a work of art I was thinking of its development as a well choreographed dance. When I think of a machine I picture something composed of parts which have no intrinsic mobility of their own, it takes external forces to move them. The heart on the other hand being living substance does have intrinsic mobility.

    I would say that when we imagine living systems to be machines we are anthropomorphically picturing nature as a copy of human constructions whereas it should be the other way round. Human constructions are invariably copied from the natural world, either consciously or unconsciously.

  9. RoyLT: It seems to me pretty clear that you are trying to argue that the heart is not the dominant supplier of motive force for the bloodstream.Despite the fascinating findings of a couple of the studies that you linked, they do not change the fact that the heart does the lion’s share of work in moving blood around the body.There are no doubt other parts of the circulatory system that contribute to blood flow, but I would bet the house that all of those effects combined are dwarfed by the mechanical pumping power of the heart.

    I know that the circulatory system is extremely complex and I do believe that the blood has its own momentum. Some experts use a formula which is the fluid system equivalent to Ohm’s law which I don’t think is an appropriate simplification for the circulation which is not a rigid,mechanical, closed system.

    The blood needs to move quickly through the major arteries to which the heart certainly contributes greatly, but it also needs to flow slowly through the capillaries in order to achieve the necessary exchange of substances. The blood, vessels and heart must all work in a coordinated way and the blood is very active in this process.

  10. PeterP: Yes,Charlie’s claim is absolutely ludicrous.take for example a simple calculation: cardiac output.cardiac output (CO) is calculated using stroke volume (SV) and heart rate (HR) where CO=SV X HR and in a average human (154 lbs or so) at rest that result is about 5 liters per minute or 300 liters per hour or 7200 liters per day or in gallons 1.3/min; 79/hr; and 1902/day.If charlie has data that demonstrates this is a minimal (trivial?) amount of blood flow from the heart’s pumping of the blood I’d be sure interested in seeing it!

    The other factor that would contribute to blood flow in a body with no heart beat would be gravity which results in lividity, a pooling of the blood at the lowest point in the body of the deceased individual.Red cell ‘wiggling’ contributes nothing to blood flow through the body which is why people immediately keel over once the heart stops beating and why initiation of CPR is so critical with a victim who has no heart beat.

    I have no problem with the claim that the heart raises the blood pressure. It converts the kinetic energy of the blood flowing into the ventricles into pressure which can be measured in the arteries.

    Walter Alexander:

    In mature circulation, Dr. Furst suggests, rhythmic interruption of blood flow by the ventricles pressurizes a pulsatile flow. But this pressure is not the primary engine of systemic circulation. Instead, it is the force behind the rhythmic operation of the heart valves. The pressure sustained by the heart in its joining of the pulmonary and systemic circulations is essential for maintenance of normal physiology, but it is not the primary cause of the moving circulation. Locally, the immediate metabolic demands at the level of the tissues and microcirculation self-regulate blood flow, and, globally, a polarity persists in a dynamic tension between the lung’s supplying of oxygen and the peripheral tissues’ consumption of it. The heart, in this model, is a feedback organ of impedance that maintains a 1:1 balance in flow between the pulmonary and systemic circulations. Its function is ram-like, converting kinetic energy into pressure and maintaining it in the systemic and pulmonary arterial compartments.

    An important difference between the pump model of left ventricular propulsion and Dr. Furst’s proposed model is that the former treats the blood as an inert fluid transported by mechanical force, while the latter sees it as a dynamic fluid organ that gains movement through its essential mediating of metabolic processes via reciprocal relationships with the physiological life of the tissues it supplies with oxygen and nutrients.

    Of course if the heart stops beating then the blood stops flowing we die. That does not go against anything I have presented.

    That’s all I have for today.

  11. CharlieM: The heart on the other hand being living substance does have intrinsic mobility.

    That’s magical thinking. You’re confusing a property of certain living things — for which they have particular mechanical systems, incidentally — with a property of life itself. A great many organisms are entirely motionless. “Being living substance” does not confer “intrinsic mobility”. And that error permeates your entire understanding of circulation.

    CharlieM: I know that the circulatory system is extremely complex and I do believe that the blood has its own momentum.

    That’s more magical thinking, and I don’t think you are using “momentum” in anything like its usual meaning. What you mean is that the blood itself provides a major part of its motive force. But what evidence is there for your belief?

    CharlieM: Of course if the heart stops beating then the blood stops flowing we die. That does not go against anything I have presented.

    Yes it does. You claim that the blood moves itself. If that were true, stopping the heart would not stop the blood.

  12. PeterP: However, I would be very interested in seeing any data you have that can match cardiac output in flow, volume, and pressure.

    Not sure what you are asking here. Match it with what?

    Maybe this is relevant to what you are looking for:

    Among the observations most confounding to a heart-as-propulsion-pump model, the instances where cardiac output rises in the presence of a compromised or disabled pump stand out. Partially isolating the heart from the circulation through aortic cross-clamping, as is typically done during aortic surgery and in experimental settings, should lead to disastrous reductions in cardiac output. But increases in cardiac output of up to 25% in some cross-clamped aortic surgery patients and in an animal model beg explanation

  13. CharlieM: Maybe this is relevant to what you are looking for:

    This, too, is relevant to what you are looking for.
    I do like Dr. Brengelmann’s style.
    Mr. Alexander, otoh, is a freelancer with a background in creative writing, not medicine, writing about his pet peeve in a journal on hospital formulary management. Why that venue, I wonder?

  14. CharlieM: The blood needs to move quickly through the major arteries to which the heart certainly contributes greatly, but it also needs to flow slowly through the capillaries in order to achieve the necessary exchange of substances.

    Hence the difference in diameter between the average capillary and the Femoral Artery. Not unlike every fluid delivery system ever designed by any engineer (whether closed or open).

    CharlieM: The blood, vessels and heart must all work in a coordinated way and the blood is very active in this process.

    ‘Is very active in this process’ is a vague and empty statement. Your claim here is completely vacuous unless you can suggest some quantifiable ratio. What proportion of the blood pressure (or volumetric output or any other metric that you like) of an average human being (not one that is dying or having open-heart surgery) do you think the heart contributes versus all of the other factors involved? It sure sounds like you’re arguing that the heart is providing less than 50% of that pressure, and I suspect that you will have a very hard time finding anything in literature published in reputable medical journals which will support that kind of claim.

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