Although there was quite a lot that medieval people hadn’t yet discovered about the human body, their keenness of their observation shouldn’t be underestimated. While they might not have understood the circulatory system quite as thoroughly as we do now, they did know there was a pretty reliable indicator of physiological or psychological stress: the pulse.
Avicenna’s twelfth century Canon of Medicine has a whole section devoted to the pulse. He begins by saying, “the pulse is a movement within the vessels of the ‘spirit’ that consists of relaxation and contraction to cool down the ‘spirit’ with air”. Though we probably wouldn’t think of the pulse as bringing “cooling” air around the body now, we do know that circulation is indeed supplying oxygen to all of our organs and extremities. Avicenna also notes that the pulse consists of movements (contraction and relaxation) and rests – two of each. We now call this systole (contraction) and diastole (relaxation), terms that may be more recognizable in terms of blood pressure (systolic and diastolic).
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The Canon of Medicine is detailed in its description of male versus female pulses, as well as younger versus older pulses, and it even compares pulse to musical tempo and intervals following Galen. (An irregular heartbeat is still called cardiac “dysrhythmia” or “arrhythmia”.) Avicenna, always mindful of his student readership, gives students of medicine some helpful mneumonics to make it easier for them to remember the different types of pulses when they are diagnosing. These include “gazelle”, “wormy”, “ant-like”, “sawlike”, and “mouse-tail”, among others.
Most importantly, Avicenna tells us how to take a pulse. He writes that the best way is to “examin[e] the pulse in the left forearm” for three reasons: it is “easy to access, [there is] very little difficulty in detecting it, and [it has a] straightforward position near the heart”. He suggests that “examining the pulse should be done with the arm at the side”. His reasons are that it “increases the width and height of the pulse and decreases its length in thin individuals”. Although we might no longer agree with this logic, it is no doubt easier to detect a pulse in an arm that has a lot of blood flowing into it – in this case, thanks to gravity. The forearm is also a fairly subtle pulse point to use for sneaky detection, as we shall see.
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Avicenna is quite aware that it’s not just illness that can disrupt the pulse, but also emotions. He says, “At the time of the pulse examination, the individual should be free of anger, joy, exertion, and other reactions; should not have overeaten or be hungry; and should have not quit long-term habits or acquired new ones.” This will help with the overall diagnosis.
While Avicenna is not the only person to have noticed that people’s pulses speed when they are feeling strong emotions, his work was studied by the most learned men in medieval Europe. At least one of them, so the story goes, used his knowledge of pulses to detect a lie.
In the Gesta Romanorum is the tale of a knight who suspects that his wife is committing adultery, though she has vehemently denied it. Frustrated, the knight goes to a “cunning clerk”: a man who has been educated. He invites the clerk to dinner to help him prove his suspicions, and the clerk accepts, entering into what seems to be a casual conversation with the lady, while secretly conducting a medieval polygraph test:
he took hold of her hand; and, as if accidentally, pressed his finger upon her pulse. Then, in a careless tone, adverting to the person whom she was presumed to love, her pulse immediately quickened to a surprising degree, and acquired a feverish heat. [Her pulse, as Avicenna writes, is attempting to cool her.] By and by the clerk mentioned her husband and spoke of him in much the same way as he had done of the other; when the motion of her pulse abated, and its heat was entirely lost. Whereby he plainly perceived that her affections were alienated; and moreover that they were placed upon the very person respecting whom she had been accused. Thus, by the management of a learned clerk, the knight ascertained the truth of his suspicion.
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As with modern polygraphs, which still measure things such as pulse and blood pressure, the results of this clerk’s test are spurious at best. After all, who wouldn’t have an elevated heart rate when a stranger begins to ask questions in front of your husband about a person he’s accused you of having an affair with?
Elevated pulse can only signify physiological or emotional stress, not explain it, but it’s certainly interesting to note that people are still attempting to read the pulse as its very own lie-detector, just as they have for millennia.
For more medieval medical knowledge, check out the Canon of Medicine, and for more tales of clerks, knights, ladies, and adultery, check out the Gesta Romanorum.
Top Image: Left arm and hand along with their blood vessels. From the Persian MSS of the Zakhira-i Khvarazm Shahi of al-Jurjani and the Tashrih-i Mansuri of Mansur.
By Danièle Cybulskie
Although there was quite a lot that medieval people hadn’t yet discovered about the human body, their keenness of their observation shouldn’t be underestimated. While they might not have understood the circulatory system quite as thoroughly as we do now, they did know there was a pretty reliable indicator of physiological or psychological stress: the pulse.
Avicenna’s twelfth century Canon of Medicine has a whole section devoted to the pulse. He begins by saying, “the pulse is a movement within the vessels of the ‘spirit’ that consists of relaxation and contraction to cool down the ‘spirit’ with air”. Though we probably wouldn’t think of the pulse as bringing “cooling” air around the body now, we do know that circulation is indeed supplying oxygen to all of our organs and extremities. Avicenna also notes that the pulse consists of movements (contraction and relaxation) and rests – two of each. We now call this systole (contraction) and diastole (relaxation), terms that may be more recognizable in terms of blood pressure (systolic and diastolic).
The Canon of Medicine is detailed in its description of male versus female pulses, as well as younger versus older pulses, and it even compares pulse to musical tempo and intervals following Galen. (An irregular heartbeat is still called cardiac “dysrhythmia” or “arrhythmia”.) Avicenna, always mindful of his student readership, gives students of medicine some helpful mneumonics to make it easier for them to remember the different types of pulses when they are diagnosing. These include “gazelle”, “wormy”, “ant-like”, “sawlike”, and “mouse-tail”, among others.
Most importantly, Avicenna tells us how to take a pulse. He writes that the best way is to “examin[e] the pulse in the left forearm” for three reasons: it is “easy to access, [there is] very little difficulty in detecting it, and [it has a] straightforward position near the heart”. He suggests that “examining the pulse should be done with the arm at the side”. His reasons are that it “increases the width and height of the pulse and decreases its length in thin individuals”. Although we might no longer agree with this logic, it is no doubt easier to detect a pulse in an arm that has a lot of blood flowing into it – in this case, thanks to gravity. The forearm is also a fairly subtle pulse point to use for sneaky detection, as we shall see.
Avicenna is quite aware that it’s not just illness that can disrupt the pulse, but also emotions. He says, “At the time of the pulse examination, the individual should be free of anger, joy, exertion, and other reactions; should not have overeaten or be hungry; and should have not quit long-term habits or acquired new ones.” This will help with the overall diagnosis.
While Avicenna is not the only person to have noticed that people’s pulses speed when they are feeling strong emotions, his work was studied by the most learned men in medieval Europe. At least one of them, so the story goes, used his knowledge of pulses to detect a lie.
In the Gesta Romanorum is the tale of a knight who suspects that his wife is committing adultery, though she has vehemently denied it. Frustrated, the knight goes to a “cunning clerk”: a man who has been educated. He invites the clerk to dinner to help him prove his suspicions, and the clerk accepts, entering into what seems to be a casual conversation with the lady, while secretly conducting a medieval polygraph test:
he took hold of her hand; and, as if accidentally, pressed his finger upon her pulse. Then, in a careless tone, adverting to the person whom she was presumed to love, her pulse immediately quickened to a surprising degree, and acquired a feverish heat. [Her pulse, as Avicenna writes, is attempting to cool her.] By and by the clerk mentioned her husband and spoke of him in much the same way as he had done of the other; when the motion of her pulse abated, and its heat was entirely lost. Whereby he plainly perceived that her affections were alienated; and moreover that they were placed upon the very person respecting whom she had been accused. Thus, by the management of a learned clerk, the knight ascertained the truth of his suspicion.
As with modern polygraphs, which still measure things such as pulse and blood pressure, the results of this clerk’s test are spurious at best. After all, who wouldn’t have an elevated heart rate when a stranger begins to ask questions in front of your husband about a person he’s accused you of having an affair with?
Elevated pulse can only signify physiological or emotional stress, not explain it, but it’s certainly interesting to note that people are still attempting to read the pulse as its very own lie-detector, just as they have for millennia.
You can follow Danièle Cybulskie on Twitter @5MinMedievalist
Click here to read more articles from the Five-Minute Medievalist
Top Image: Left arm and hand along with their blood vessels. From the Persian MSS of the Zakhira-i Khvarazm Shahi of al-Jurjani and the Tashrih-i Mansuri of Mansur.
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