Heart and Soul at Apothecaries Hall by Fay Bound Alberti

Apothecaries Hall, Blackfriars, London

On Thursday 29 June I gave a keynote lecture at the Geoffrey Flavell symposium, held at the Worshipful Society of Apothecaries, in Blackfriars, London. If you haven't visited, do check out the website and learn about the activities of the Society. It is 400 years old, having been founded as a City Livery Company (incorporated by royal charter in 1617); a major centre for the manufacture and sale of drugs at the Hall (1671-1922); the founder of Chelsea Physic Garden (in 1673) and a medical examining and licensing body since 1815. The beautiful building was partly burned down in the Great Fire of London and rebuilt; as an early modernist by training, I was delighted to discover that the symposium itself was being held in the space where Oliver Cromwell's armies had once bedded down for the night. Apparently, they made quite a mess. 

To get back to the theme of the symposium, Geoffrey Flavell was a highly respected cardio-thoracic surgeon. Born in New Zealand, he completed his training at Bart’s in London. In 1939, he became the resident surgical officer at the Brompton Hospital. And he worked, during the Second World War with Sir Archibald Mcindoe, of Guinea Pig fame, in treating severely burned patients. Flavell was appointed consultant at the London Hospital in 1950, where he worked for 30 years.

In keeping with Flavell's specialism, the title of this year's Symposium was ‘The Heart, Health and Culture: An Exploration in Medicine and the Humanities’. It gave me a chance to revisit my earlier work on the history of the heart, in health and disease. My book Matters of the Heart: History, Medicine and Emotion (Oxford University Press, 2010) explored the meanings of the heart as both symbol and organ. It looked at why we have two very different ideas about the heart in our culture: the heart as a Hallmark symbol sold on millions of cards every year and the heart as a pump, responsible for the circulation of the blood.


In my book, and in my paper, my theme was this: for centuries, medical practitioners in the West held the heart to be the centre of emotion, thought and feeling. Before the rise of the brain qua mind, the heart was the most important organ of the body, which was frequently viewed in cardiocentric ways: the heart was all that mattered in the end. With the rise of scientific medicine and neuroscience, the decline of religious explanations for our existence (and the decline of the soul in the material tradition), the heart became a material object. It might beat excitedly when we see a loved one, but not because our soul was moving through the heart. It might feel like our hearts would break, but not because our hearts were overwhelmed by the melancholic humours of the ancient world. Hormones began to offer a new explanation; hormones produced by the new emotional centre of the body: the brain.

Of course, the heart still continues to thrive at the level of popular culture. The brain governs emotions in name only. Nor is the brain the only contender for the title of emotional organ par excellence, as my book This Mortal Coil: The Human Body in History and Culture (Oxford University Press, 2016) argues. Other organs – notably the gut – are coming into their own. Like the heart, they are seen as sites of hormone production (and even, more controversially as systems of cellular memory). We are listening to the body more and more, though as we do, we must acknowledge the gaps in scientific medicine; the ways in which narratives of healing are leaving holism behind.

These are the themes I talked about at the symposium, reflecting my enduring interests in the history of the body and the history of emotion. How do we explain what we feel, and how has that changed over the centuries? Why are some organs given more importance than others? Why do heartfelt emotions and gut feelings have so much sway? Or really: why shouldn’t they? We feel with our gut and our heart, after all.

One of the most fascinating aspects of the symposium for me – a day that brought together historians and theologians, surgeons, GPS and ethicists – was how emotional our attitudes towards the body are, even for surgeons. Making a choice as a transplant specialist for instance - to operate or not operate - involves all the surgeon's clinical training, of course, but it also impacts on his and her emotional experience. Patients are not just bodies, but living, breathing people with families and loved ones. We want surgeons to be coolly efficient, but we also need them to be human.

The ways we intellectualise the body in medicine, talk about it, take it apart physically and metaphorically, doesn’t take away from the fact that we exist and experience the world, for good and ill, in our bodies. We feel emotional about what happens to our bodies (and those of our loved ones) just as we did in the past, albeit for different reasons. One of the themes that crosses boundaries between scientists and non-scientists is the question of what makes us quintessentially human. We might talk about the word ‘soul’ (and most of us believe we have one), though there is no agreement on what it is, or what it does.

In the 17th-century philosopher Rene Descartes’ time (he of the 'I think therefore I am' doctrine), things were simpler: the soul lurked behind the eyebrows. It was the space where the physical body met the emotional and spiritual body. It was also why so many emotional expressions involved the raising or furrowing of the brows. Today the soul is often placed in the brain (and sometimes seen as synonymous with the mind and consciousness). Far more often it exists as a nebulous, free-floating entity that is, and yet is not, linked to our religious beliefs.

Sometimes, the soul is still placed in the heart. When I ask people to point to their minds, more often than not they point at their heads. When I ask them to point to their ‘selves’, they point to their heart. The heart remains an emotional centre, then, and not just in language. The heart remains a symbol of our inner selves, of truth, of passion. Outside the narrow confines of medical textbooks, it can’t ever be reduced to a pump.



A Victorian Valentine's card from the Wellcome Images collection

This Mortal Coil by Fay Bound Alberti

Our August guest is Fay Bound Alberti, who with join us next year as a History Girl, posting on the 15th of the month, alternating with Marie-Louise Jensen after Y.S. Lee leaves us in November.

About Fay

Dr Fay Bound Alberti is a writer and historian specializing in Britain and Europe, 1500-1950. She has published widely on the histories of medicine and science, gender, the body and emotions. Dr Bound Alberti co-founded the Centre for the History of Emotions at Queen Mary College, University of London where she remains Honorary Senior Research Fellow. Other areas of interest include early modern illness and disease, the history and ethics of cosmetic surgery, the relationship between mind and body and gender politics – now and in the past. Fay’s most recent book is This Mortal Coil: The Human Body in History and Culture (Oxford University Press, 2016)

I’ve always been interested in the body, and how we talk about it. When I was eight my mother explained to my brother how they had been connected in her womb through their combined umbilical cords: ‘mine attached to yours’, she said, which didn’t sound quite right to me. I could sense the determination in her words though, the sense of ownership involved in explaining their physical bond. At secondary school my sex education lessons, brutally indifferent to feelings, resolved that physical conundrum, but not the sense of wonder by which we – wriggling in embarrassment on high wooden stools – tried to imagine what lurked beneath our skin. At university, I learned how long men and women had been trying to understand the human body; to account for the gift of life as well as the those ‘thousand natural shocks that flesh is heir to.’ (Hamlet, III, I, 1755) To this end Shakespeare was our ‘contemporary,’ at least according to Jan Kott; his characters experiencing their physical and emotional worlds as dramatically as we do. 

18^th century allegorical depictions of the temperaments formed by the four humours: melancholicus. By: J. D. Nessenthaler. Credit: Wellcome Library.  

But there’s the rub. We experience the world differently from Hamlet. Our bodies are not viewed the same today as they were in Shakespeare’s time. Across seventeenth-century Europe came the arrival of tools like the microscope by which people could know the workings of the body through the only sense that came to matter: sight. The four humours that had explained health, disease and even personality for thousands of years fell from grace, though humoral treatments like ‘bleeding’ continued into the nineteenth century. The ‘mortal coil’ described by Hamlet, the political and social world we inhabit, was also transformed – the rise of democracy and secularism in the West and the end of the ‘great chain of being’ (a hierarchy that kept us all in check) giving rise to individualism and the modern, introspective self. Today it is the brain, not the heart, that is the centre of our feelings, memories and identities, though the symbolism of the heart survives. 

Valentine Card, 1928. Credit: Wellcome Library.

How did the brain come to dominate? Here as elsewhere, philosophical change accompanied technological and scientific change. The French philosopher René Descartes moved the soul from the heart, which had recently been confirmed as a pump by the English physician William Harvey, to the pineal gland, located behind the eyebrows. Mind and body were torn asunder; in time, ‘mind’ (which once described soul), simply meant brain. From the nineteenth century, scientific medicine gave rise to new ways of viewing the body through measurement and comparison. New norms were created. Gender and racial differences were etched into the fabric of our bodies – into the shape of our skulls, the structure of our skeletons, the thickness of our skins. Scientific medicine provided new rules to follow, new versions of the truth that were not driven by the imagination, folklore or symbols. But like any other narrative, it was a product of its time, creating stories that rationalised racism and sexism. 

Descartes: The Nervous System. Diagram of the brain and the pineal gland. From De Homine (1662). Credit: Wellcome Library.

Through a series of case studies into the history and meanings of the skin, fatness, the female breasts and genitals, the tongue and the skeleton, This Mortal Coil considers how we have invested each of our body parts with meanings that reveal the needs of culture, politics and society. Thus seventeenth-century women’s tongues were so dangerous in an age of political uncertainty that the ‘scold’s bridle’ was needed to keep them in check. From the nineteenth century, when the industrial age privileged efficiency, being ‘fat’ represented waste and inefficiency, heaping moral outrage on the (increasingly lower-class) obese. In the 1950s the possession of small breasts was redefined as a psychiatric problem, easily fixed by a new type of medical practitioner: the cosmetic surgeon. Today the threat of the female genitals, a source of terrifying power for Shakespeare as for Freud, is contained by language: how much safer is it to see the vagina as a ‘birth canal’ rather than a source of untamed physical pleasure? 

Belgian Iron bridle that fitted over the head of a woman sentenced for being a ‘scold’.

Portrait of Leicester jail keeper Daniel Lambert, (1770 –1809), once the fattest man in Britain and celebrated (not shamed) for his size. Credit: Wellcome Library.

Transparent, jelly-filled breast implant. Credit: Wellcome Library.

Metaphors matter because they shape our worlds, whether depicting the brain as a computer or the pubic hair as a lady garden. Illness is a battle we fight against invaders: we win or we lose, we live or we die. In conventional medicine we are divisible into separate systems and organs. There is no soul or immaterial essence. Yet many of us still believe in one. The heart might be a pump that beats 120,000 times a day, sending blood, nutrients and oxygen around the body. But some people maintain heart transplants move more than an organ, transferring the personality, habits and memoriesof the donors. Today the separation of mind and body suggests we can take control of our physical shell, disciplining it through exercise or cosmetic surgery in search of that perfect ideal. We regard our bodies objectively, as though distinct from the self that lives in our brains. Yet the incidence of mental illness is increasing. As is the demand for whole-body treatment. We are arguably more dis-eased about our bodies than ever before.

Ultimately, This Mortal Coil explores the stories we tell about the body. It does not demonise modern medicine. Nor does it suggest that we were all better off when we lived, like my mother, in a pre-modern world of imagination where we could each lay claim to our bodies without the intervention of science. But this book does ask whether the decline of holistic views of the body, that saw our minds, bodies and emotional worlds as part of a functioning, social whole, has done us a disservice. For surely we are more than the sum of our parts.

 Fay Bound Alberti This Mortal Coil (Oxford: Oxford University Press, 2016).