The cardiology of Valentine’s Day

On 14 February we celebrate romance, often by exchanging Valentine’s cards decorated with heart symbols. Legend has it that in the 3rd century AD a Roman priest, Valentine, (now Saint Valentine) was executed for helping Christians escape punishment. It is believed that just before his death he sent an affectionate note to the daughter of the jail keeper—the very first Valentine’s card. 

My question is: how did the red heart image, with its bottom-shaped top and pointy lower end, become involved with our Valentine’s messages and, specifically, become a representative of our love and affection? 

The Ebers Papyrus dating back to 3500 BC records that ancient Egyptians considered the heart to be the origin of all body channels that transported blood, air, and urine to the rest of the body. They believed that human intelligence rested in the heart, which, in their view, was the centre of human emotions and actions. Around 800 BC, Homer agreed, adding that the heart was the source of human courage and bravery. By 500 BC Greek medical thinking was split about the heart’s functions. One doctrine held that the brain was the centre of the soul, mind, and consciousness; the other doctrine held that the heart was the vehicle of the soul as it used vessels to distribute life to the whole body. By around 460 BC, in the era of Hippocrates, some of the heart’s structures were identified in detail. During the subsequent eras of Aristotle, Galen, and others, and certainly by the 1400 AD era of Leonardo Da Vinci, the holistic and soul-related notions relating to the heart were abandoned and medical interest was focused on cardiac structure and function.

Despite scientific developments in the Middle Ages, the heart became enshrined as the site and symbol of human passion. It was during that period that today’s red heart emblem became popular as a token to exchange between lovers. Just why the heart took that specific pictorial shape is unclear, but one suggestion is that its origin dates to 7th century BC, in the city-state of Cyrene (in present-day Libya). The juice of the seed of the silphium plant, now extinct, was used as a form of birth control. That plant was so important to the local economy that coins were minted depicting parts of the plant’s seed, which resemble today’s symbolical heart shape. 

Exchanging Valentines gained popularity in 17th century England and in the Victorian times the tradition became more elaborate, with the heart shape decorated with ribbons and bows.

So on 14 February to maintain a romantic tradition in the age of advanced medical sciences, with the reality of cardiological advances, heart transplants, artificial intelligence, and communication equipment that defies imagination, we may as well forget reality, accept the formulations of the past, and greet our loved ones with a nice card, with a heart on it, of course. 
—George Szasz, CM, MD

Suggested reading
Clemens M. Silphium, the ancient contraceptive herb driven to extinction. Accessed 12 February 2020. www.ancient-origins-net/artifacts-ancient-technology-silphium-ancient-co....

Jager E. Reading the book of the heart from the middle ages to the twenty-first century. Accessed 12 February 2020.

Loukas M, Youssef P, Gielecki J, et al. History of cardiac anatomy: A comprehensive review from the Egyptians to today. Clin Anat 2016;29:270-284. 

McDonell K. The shape of my heart. Accessed 12 February 2020.

This post has not been peer reviewed by the BCMJ Editorial Board.

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