DON’T GO BREAKIN' MY HEART

The ancient Greek physician Hippocrates believed in the mind-body connection.  His theory of the four humors (bodily substances) goes like this:

The human body contains blood, phlegm, yellow bile, and black bile.  These are the things that make up its constitution and cause its pains and health.  Health is primarily that state in which these constituent substances are in the correct proportion to each other, both in strength and quantity, and are well mixed.  Pain occurs when one of the substances presents either a deficiency or an excess, or is separated in the body and not mixed with others.

Humour	Season	Ages	Element	Organ	Qualities	Temperament
Blood	spring	infancy	air	liver	moist and warm	sanguine
Yellow bile	summer	youth	fire	gallbladder	warm and dry	choleric
Black bile	autumn	adulthood	earth	spleen	dry and cold	melancholic
Phlegm	winter	old age	water	brain/lungs	cold and moist	phlegmatic

His theory of the four temperaments (mental states expressed as personalities) goes like this.  Hippocrates believed that the four humors were responsible for four temperaments (from the Latin temporare, “to mix, temper, or balance”).  The sanguine personality was associated with blood and extroversion.  The choleric personality was associated with yellow bile and a quick temper.  The melancholic personality was associated with black bile and sadness. And the phlegmatic personality was associated with phlegm and affability.    In the ideal temperament, all four humors were perfectly balanced.

Four Temperaments Depicted in 18^th C. Woodcut

While modern medical science has not strictly adhered to the humoric basis of physical and mental health (we know, for example, that while the liver filters the blood, it does not produce it, nor does the brain produce phlegm), the mind-body connection at the heart of Hippocrates’ system is alive and well.  A recent study published in The European Heart Journal took a look at “broken heart syndrome” and found that the link between heart and head was more than a poetic metaphor. 

As reported in today’s NewYork Times, the brains of people who have experienced “broken heart syndrome” (known medically as Takotsubo syndrome) do not work like the brains of other people.  The researchers hypothesize that the atypical brain function is linked to physical changes in the hearts of people with Takotsubo syndrome.  The hearts of those suffering from the syndrome are marked by a sudden weakening and bulging of the left ventricle, making it resemble a narrow-necked Japanese octopus trap called a takotsubo.   Fortunately, the changes are usually temporary, but they can sometimes be fatal, as in "He died of a broken heart."

Under conditions of extreme stress, like the loss of a loved one, a normally functioning brain activates the sympathetic nervous system to stimulate the heart.  If the sympathetic nervous system behaves like an out-of-whack Hippocratic humor, the brain kicks in and stimulates the parasympathetic nervous system to balance things out.  While all of this is going on, the brain is also stimulating the limbic system, which generates and controls emotional responses to the stress. 

But the brain of someone who has suffered from a broken heart seems to fall down on its balancing act job.  The study reported in The European Heart Journal found that brain scans of volunteers who had not experienced Takotsubo syndrome showed synchronous activity among the limbic, sympathetic, and parasympathetic nervous systems, controlling and coordinating physical and emotional responses.  By contrast, the communication among those brain areas was diminished in the volunteers with Takotsubo syndrome.  The main dampening occurred in their parasympathetic nervous systems, meaning that the calming effect that should have occurred after extreme stress was muted.  

The researchers would not commit to say whether the brains of those with Takotsubo syndrome were predisposed to overreact to extreme stress, or whether extreme stress had affected their brain activity.  Still, the study makes it clear that “broken-heart syndrome” is both observable and measurable.  It is not a figment of the imagination.  

And neither are Hippocrates’ theories completely a matter of fantasy.  Modern medicine refers to humoral regulation when describing substances such as hormones that circulate throughout the body and regulate mood.  The mind-body connection is real.  It’s no Greek myth. 

 

Keep it real!

Marilyn