The Heart and The Blood That Moves It

The Heart and Circulation: An Integrative Model, by Branko Furst, MD. Second Edition 2020, print and ebook, Springer Nature Switzerland AG

An appreciation by David Gershan, MD

In 2020 Branko Furst published the 376 page second edition of his study The Heart and Circulation: An Integrative Model. In the introduction to the first edition, published in 2013, the author states:

It is the premise of this book to trace the development of the basic concepts in cardiovascular physiology in the light of the accumulated experimental and clinical evidence and instead of making the findings fit the standard pressure-propulsion mold, let the phenomena ‘speak for themselves.’

This premise implies something enormous—a stepping back from the narrative that had led researchers in their attempts at validating the “heart is a pump” theory, to insights that might reveal something profoundly different. In fact, the embryology, morphology, anatomy, flowpressure analyses among species, and even the modern heart models, have provided space and capacity for new ways of understanding the heart and circulation.

Dr. Furst, Professor of Anesthesiology at Albany Medical College in New York, gives a surprisingly readable account: a journey to a new understanding. In the chapter Models of the Heart we find the following story: In 1892 a physician named K. Schmid contributed an article to the Viennese Medical Weekly entitled “Ueber Herzstoss und Pulskurven” (“On heartbeat and the pulse waveforms”). Rudolf Steiner, in his 1920 course of lectures to physicians, Spiritual Science and Medicine, states:

Although this treatise is somewhat short on content, an active medical practitioner has at least noticed that we must deal with the heart as if it were a damming-up apparatus rather than an ordinary pump.

The Schmid article was published at a time when the famous researcher Otto Frank was working on a model of heart activity that contributed to the foundational mechanical explanation of heart activity. It is in this atmosphere that Steiner proclaims a deeper understanding: the sensory function of the heart and its place in the cosmic setting of sun and gold. Furst extends a mechanical explanation of the heart and circulation to a greater field of inquiry—an evolution of consciousness, to be sure.

The second edition moves the evidence of blood flow further away from the classic and prevalent pump-propulsion model. Advances in the study of the microcirculation—the smallest vessels that include the arterioles, venules, and capillaries—give a picture of flow induced by metabolic demands, not by pumping This is added to a careful discussion of non-pumped flow in the embryo, experiments that involve clamped vessels like the aorta, and increased physiologic demand with exercise. This edition also adds newer considerations of rhythm, both extremely subtle and obvious. The heart’s damming up process now gives understandings of rhythm and time and metabolism’s roles in micro- and macro-circulation. Eventually we reach a three-fold picture of the human that appears as “natural” progression from the prior insights.

The final part of this new edition explores the fourfold human and wholeness, not as a synopsis of anthroposophic knowledge, but journeyed to through the evidence of countless experiments and studies. This careful buildup to insight by Furst, chapter by chapter, and the arduous work of his investigation, invites us to look and to follow the thread!

We are looking at a masterful study. Through the lenses of phenomenology, freed thinking about what is observed, a new consciousness, and the place of that most sacred organ, the heart, in the biologic cosmos of the human being, we are invited to witness a rare scientific journey from observation to inspiration, from a mechanical vision to a greater living one.

David Gershan, MD

David Gershan, MD, who died in January 2022, was a physician practicing anthroposophic medicine in San Francisco, where he was also active in building up the life of the Anthroposophical Society especially during the pandemic.