Note IV.

ON RUPTURE OF THE HEART FROM MENTAL EMOTION.

Sudden death from violent emotions of mind may be induced in various ways; sometimes by a sort of palsy of the heart, at other times by its over distension, the latter condition often terminating in rupture. The following references to cases of both kinds are borrowed from Zimmermann. — "Joy" — says this author, — "is much more dangerous to life than sudden grief. The instances we meet with of the fatal effects of sudden joy are more numerous than those of the latter. Sophocles, being desirous of proving that at an advanced age he was in full possession of his intellectual powers, composed a tragedy, was crowned, and died through joy. The same thing happened to Phillipides, the comic writer. We see Chilo of Lacedaemon embracing his son, who had borne away the prize at the Olympic games, and dying in his arms. Two Roman ladies, seeing their sons return from the battles of Thrasymenus and Cannæ, died in the same manner. M. Juventius Thalna, on being told that a triumph had been decreed to him for having subdued Corsica, fell down dead before the altar at which he was offering up his thanksgiving. Vaterus relates that a brave soldier, who had never been sick, died suddenly in the arms of an only daughter whom he had long wished to see. A worthy family in Holland being reduced to indigence, the elder brother passed over to the East Indies, acquired considerable riches there, and returning home presented his sister with the richest jewels. The young woman at this unexpected change of fortune became motionless, and died. The famous Fouquet died on being told that Louis xiv. had restored him to his liberty. The niece of the celebrated Leibnitz, not suspecting that a philosopher would hoard up treasure, died suddenly on opening a box under her uncle's bed which contained sixty thousand ducats. Dr. Mead tells us that, in the memorable year of the South Sea bubble, more of those went mad who acquired fortunes, than of those who lost them . . . . . . Many observations tend to prove that sudden fear has occasioned syncope, [fainting] and even death. The face grows pale, the blood seems to stop in the vena cava, or in the right auricle of the heart, the vessels become distended, and the heart itself in these cases has sometimes burst. Philip ii., king of Spain, only said to his first minister, the Cardinal Espinosa, Cardinal, know that I am master, and the minister was so much terrified that he died a few days afterwards. The same prince, perceiving that one of his ministers answered him with some hesitation, gave him a severe rebuke: the minister withdrew from the apartment, and died. Philip v. died suddenly on being told that the Spaniards had been defeated; and, on opening him, his heart was found ruptured."¹

To collect instances of rupture of the heart from agony of mind is a difficult task; partly, because such instances are, it may reasonably be supposed, of rare occurrence; and partly, because few of those which do occur are either verified or recorded. There cannot, for example, be much ground to doubt that the following case, abridged from the Annual Register, was one of this description; although, owing to the want of actual inspection, it is impossible to speak with absolute certainty on the subject. — "Mr. John Palmer, comedian, aged about fifty-six or fifty-seven years, died suddenly on the stage of the Liverpool theatre, August 2nd, 1798, whilst performing the part of the Stranger, in the play of that name. He was a man of acute and affectionate feelings, which had been much exercised by the course and events of his life. He had recently lost his wife and a favourite son, laboured in consequence under profound grief and depression of mind which he strove to overcome, and had expressed a conviction that these mental sufferings would very shortly bring him to his grave. During some days he seemed however to bear up against his misfortunes, and performed in some pieces, including the Stranger, with much success. About a week afterwards he appeared a second time in that character, when he fell a victim to the poignancy of his feelings. On the morning of the day he was much dejected, but exerted himself with great effect in the first and second acts of the play. In the third act he showed evident marks of depression; and in the fourth, when about to reply to the question of Baron Steinfort relative to his children, appeared unusually agitated. He endeavoured to proceed, but his feelings overcame him. The hand of death arrested his progress, and he fell on his back, heaved a convulsive sigh, and instantly expired without a groan. Having been removed to the scene-room, and medical aid immediately procured, his veins were opened, but yielded not a single drop of blood, and every other means of resuscitation was tried without effect. His death was by most persons ascribed to apoplexy; but Dr. Mitchell and Dr. Corry gave it as their opinion that he certainly died of a broken heart, in consequence of the family afflictions which he had recently experienced." — Unfortunately, this highly probable opinion was merely argued, and not verified, as it ought to have been, by actual inspection. On this point the friends and colleagues of the deceased actor had, it is likely, insurmountable prejudices, and the unopened body was accordingly — "interred on the 6th of August, at the neighbouring village of Walton, in a grave seven feet deep, dug in a rock."² — In like manner Mallet's tale of Edwin and Emma, in which the latter is represented as dying of a broken heart owing to the death of her lover, whose union with her had been forbidden by his parents, appears to have been founded on a real occurrence, briefly related in the subjoined extract from a letter written by the curate of Bowes, in Yorkshire. — "The young lover sickened, and took to his bed about Shrove Tuesday, and died the Sunday seven-night after. On the last day of his illness he desired to see his mistress. She was civilly received by the mother, who bid her welcome when it was too late. But her daughter Hannah lay at his back, to cut them off from all opportunity of exchanging their thoughts. At her return home, on hearing the bell toll out for his departure, she screamed aloud that her heart was burst, and expired some moments after. The then curate of Bowes inserted it in his register that they both died of love, and were buried in the same grave, March 15th, 1714." — In this case also, as in many others, the circumstantial evidence is extremely strong, but the positive proof, which might have been furnished by an examination after death, is irrecoverably lost.³

Dilatation of some of the chambers of the heart, or of the great vessels connected with them, is a lower degree of the same train of action which, when sudden and intense, occasions rupture; and, like rupture, is often induced by mental anguish and distress, only less violent, and longer continued. The remarkable instance inserted in the text is borrowed from a work by Mr. Bedingfield, who, in a letter to the author, dated April 12th, 1839, kindly furnished the following additional particulars. — "Elizabeth Creasey was about twenty-eight years of age, an interesting creature, whose unfortunate situation excited much sympathy. The poor girl had been seduced, and then abandoned; and when admitted into the hospital was in a state of extreme emaciation and debility. Her lips and cheeks were of a blueish colour, indicating an imperfect oxygenation of the blood. The action of the heart was laboured, the pulse languid, and varying from 90 to 100 in the minute. She never uttered a complaint, seldom spoke, was never known to laugh, nor seen to smile. She did not, although as patient as patience on a monument, even 'smile at grief.' Nothing appeared to excite the slightest emotion, except when any allusion was made to her removal. She would then raise her dark blue eyes, and throw an imploring look into her countenance, the meaning of which it was impossible to mistake. Neither physician nor visitor ever ordered her discharge from the hospital, where she continued for I think eighteen months, and then sank rapidly. The only morbid appearances met with after death are those detailed in the page to which you have referred;" — namely, — "the right auricle of the heart was of three times its natural dimensions, and contained & large quantity of blood, which had separated into serum, crassamentum, and coagulable lymph, as perfectly as inflamed blood does when drawn from a vein."

Although the term — broken heart — is not always used literally, but often in a figurative sense, to denote intense, or perhaps mortal sorrow, it was no doubt originally derived from the actual fact, either accidentally observed, or sagaciously conjectured by poets and moralists, habitually engaged in the study of the human passions, and of their influence on the bodily frame. Rupture of the heart from agony of mind appears to have been familiar to the penetrating genius of Shakspeare, who has frequently depicted it in the most lively manner; and the sacredness of the present subject will not be injured by one or two references, for the sake of illustration, to the works of this master mind. Thus, the well-known demand which Macbeth, anxious for the relief of his conscience-stricken queen, makes of the physician called to attend her, has a general bearing on the subject.

"Canst thou not minister to a mind diseased,
Pluck from the memory a rooted sorrow,
Raze out the written troubles of the brain,
And, with some sweet oblivious antidote.
Cleanse the foul bosom of that perilous stuff
Which weighs upon the heart?" —

The admonition of Malcolm to Macduff, when the latter is thrown into consternation on hearing of the murder of his wife and children by order of the usurper, is still more explicit.

"Give sorrow words: the grief that does not speak
Whispers the o'er-fraught heart, and bids it break."

By a poetical license the great dramatist, speaking in the person of Mark Antony, represents the death of Julius Caesar as occasioned, not by the daggers of the conspirators, but by the anguish of the ambitious chief, on seeing his well-beloved Brutus amongst their number.

"This, this was the unkindest cut of all;
For, when the noble Caesar saw him stab.
Ingratitude, more strong than traitors' arms.
Quite vanquished him: then burst his mighty heart,
And, in his mantle muffling up his face,
Even at the base of Pompey's statue,
Which all the while ran blood, great Cæsar fell."⁴

That Shakespeare was fully aware of the physical fact here intimated, is plainly shown by some other passages of this kind, where it is described with that minute and circumstantial reality which is peculiar to genius of the highest order. See particularly Coriolanus, Act V., Scene 5; — Hamlet, Act I., Scenes 2 and 5; — Julius Caesar, Act IV., Scene 2; — Lear, Act II., Scene 4; Act v., Scene 3; — Richard III., Act IV., Scene 1; — Titus Andronicus, Act II., Scene 5; Act III., Scene 2.

Several instances have been given in the text, wherein the view here taken of the immediate cause of the Saviour's death has been more or less distinctly anticipated by pious persons, on ordinary grounds, without the advantage of that scientific knowledge of the subject, from which alone demonstrative proof can be obtained. Many more might probably be added, but one or two may suffice. The first specimen is from the psalms and hymns of Dr. Watts.

"All my reproach is known to thee,
     The scandal and the shame:
Reproach has broke my bleeding heart.
     And lies defiled my name."
          Psalm 69, Part II., C. M. Verse 6.

          _______________

"Here, says the kind redeeming Lord,
     And shows his wounded side,
See here the spring of all your joys.
     That opened when I died."
          Hymns, Book III., H. 11, Verse 3.

          _______________

"Justice unsheathed its fiery sword,
     And plunged it in my heart:
Infinite pangs for you I bore.
     And most tormenting smart."
          Hymns, Book III., H. 21, Verse 7.

          _______________

"My Saviour's pierced side
     Poured out a double flood:
By water we are purified.
     And pardoned by the blood."
.     .     .     .     .     .     .     .
"Look up, my soul, to him.
     Whose death was thy desert;
And humbly view the living stream
     Flow from his breaking heart."
          Hymns, Book III., H. 9, Verses 4, 6.

          _______________

"And here we drink our Saviour's blood:
     We thank thee. Lord, 'tis generous wine
Mingled with love: the fountain flowed
     From that dear bleeding heart of thine."
           Hymns, Book III., H. 18, Verse 2.

          _______________

A curious example of this kind, although neither the source whence it is derived, nor the form in which it is presented, is entitled to much respect, occurs in the pretended Revelations of St. Bridgit, a Swedish lady, who flourished in the fourteenth century, and founded the religious order which bears her name. In these visions, or prophecies, Christ and his mother are represented as holding conversations in the glorified state concerning his life, sufferings, death, &c., on earth; wherein, amongst other circumstances, it is repeatedly stated that immediately before he expired on the cross, his heart was ruptured through pain or grief. The following description is ascribed to the mother of Christ. — "Appropinquante autem morte, cum cor prae violentia dolorum rumperetur, tunc omnia membra contremuerunt, et caput ejus, quasi modicum se erigens, inclinabatur, Os ejus apertum videbatur, et lingua tota sanguinolenta. Manus ejus retraxerunt se modicum de loco perforationis, et pondus corporis pedes amplius sustentabant. Digiti et brachia quodammodo extendebant se, et dorsum fortiter stringebatur ad stipitem. Tunc quidam dixerunt ad me, Maria, filius tuus mortuus est. Alii autem dixerunt, Mortuus est, sed resurget. Omnibus itaque dicentibus, unus adveniens, adfixit lanceam in latus ejus tam valide, ut pene per aliud latus ejus transiret. Et cum extraheretur hasta, apparuit cuspis rubea sanguine. Tunc mihi videbatur quasi cor meum perforaretur, cum vidissem cor filii mei charissinii perforatum." — The subsequent reply is attributed to Christ himself. — "Quia, quando cor meum in cruce prae vehementia doloris rumpebatur, cor tuum ex hoc quasi ferro acutissimo vulnerabatur, et libenter scindi permisisses, si fuisset voluntas mea."⁵

These passages evidently contain a reference to the prediction, long before addressed to Mary by Simeon in the temple, — "Yea, a sword shall pierce through thine own soul also;"⁶ — and plainly intimate a conviction that the heart of Christ was ruptured through excess of pain or grief. Nor does it appear wonderful that such a conclusion should have been deduced by persons of piety and intelligence from long and intense meditation on the Scriptures, when it is remembered that the following expressions, some of which have been repeatedly quoted in this treatise, are found in several of the Psalms, more especially in those which relate to the sufferings and death of Christ.

Psalm 38, v. 8. "I am feeble and sore broken. I have roared because of the disquietude of my heart."

               v. 10. "My heart panteth: my strength faileth me."

Psalm 40, v. 12. "Innumerable evils have compassed me about: mine iniquities have taken hold upon me, so that J am not able to look up. They are more than the hairs of my head; therefore my heart faileth me."

Psalm 51, v. 17. "The sacrifices of God are a broken spirit: a broken and a contrite heart, O God! thou wilt not despise."

Psalm 69, v. 20. "Reproach hath broken my heart, and I am full of heaviness."

Psalm 109, v. 22. "I am poor and needy, and my heart is wounded within me."

1) Zimmermann, On Experience in Physic, vol. ii. pp. 268, 269, 274, 275.

2) Annual Register for the year 1798, — Chronicle Section pp. 73-78

3) Johnson's English Poets, vol. 63, pp. 174-176.

4) Shakespeare's Plays, in 21 vols., 1803; — vol. x, pp. 248, 270, 27 i; vol. xvi. pp. 357, 358.

5) Memoriale Effigiatum Librorum B. Brigidse, &c., lib. i. cap. 10, p. 38; lib. ii. cap. 20, p. 45.

6) Luke, chap. 2, v. 34, 35; — John. chap. 19, v. 25-27.