Hektoen International

A Journal of Medical Humanities

Of metaphoric hearts

Frank Gonzalez-Crussi
Chicago, Illinois, United States


The Sacred Heart of Jesus,
c. 1767 Pompeo Batoni – Northern side chapel of Il Gesù, Rome

An indescribable nostalgia, a feeling compounded of wistfulness, the alacrity of happy memories, and the pain of regret for things irretrievably lost invades me as I evoke one of my former visits to my birthplace in Mexico City. I could tell my mother had aged together with her modest apartment: creaking floor boards; dark wood furniture hopelessly out of fashion; yellowing family portraits (my own most conspicuously) propped on the nightstand; a heterogeneous multitude of gimcracks on the shelves, such as an old widow is apt to accumulate through the years; and on the wall of her bedroom, at the head of her bed, as if to preside over her dreams, an image of the Sacred Heart of Jesus.

This image, or one of its many variants, is still found in innumerable homes throughout Mexico and most Catholic countries. It was first painted around 1767 by artist Pompeo Batoni (1708-1787) for the Jesuit church in Rome. In its original version a duly serene, beatific Savior is represented waist up, in a pink blouse, his right shoulder covered with a blue mantle, and facing the spectator in three-quarter view by virtue of a slight lateral inclination of the head. His left arm is bent so that the hand comes at mid-chest level and is holding a miraculously refulgent heart. It is presumably Jesus Christ’s own heart, which he seems to demonstrate or offer to the viewer with a gesture of his extended right hand.

In spite of its divine nature, the heart has been depicted with a striking realism: it is the fleshy, muscular organ familiar to those of us who have studied anatomy and performed dissections, except that it has been cut at the base, flush with the origin of the great vessels. Instead of these, a few small flames shoot up and a small cross emerges behind them. A crown of thorns girds the heart at its wide portion, away from the apex, and just below it one can see a transversal laceration: it is the wound inflicted by the centurion Longinus with his lance, when our Savior agonized nailed to the cross. Realistic details notwithstanding, a divine light emanates from this organ, inundating the ambience with its golden rays.

Although I grew up in this apartment, I never noticed the details of the image; it occupied a secondary place all those years. I imagine that once I, “the man of the house” as it was said, went away, the heart-wielding Christ became a tutelary presence, unerring guide and inspiration of the forlorn left behind. I now look at it attentively and ask myself: why is the heart in his divine hand so realistically rendered? After all, this is not an illustration of an anatomy textbook. The idea was to represent what an eminent cardiologist called “the metaphoric heart,”1 as opposed to the “substantive” or “morphologic” heart. In other words, the heart as symbol, as the seat of our deepest emotions and the repository of all the good and all the evil in us.

The Last Judgment (Detail), 1474-1484
Fresco by unknown Franco-Flemish
artists Cathedral of Albi, France

The heart not only held a preeminent place in the area of emotion, but it was also thought to be the seat of the intellect and the reasoning faculty. Historically, it has rivaled the brain as the organ of memory and cognition. Not in vain we say we “learn by heart” what we commit to memory. In the very word “record” there is the Latin root cor/cordis, attesting to its link with memory. In an impressive fresco at the cathedral of Albi in France, the souls of the condemned on Judgment Day are represented as huddled bodies with open books on their chests at the place of the heart: those are the ledger-books of all their past actions, good and bad. God reads each man’s heart—like a book—and based on the text therein inscribed emits a terrible judgment without appeal. As to the heart’s intellectual capacity, i.e., its identity as the seat of thought and rationality, Pascal remarked that “the heart has its own reasons, which reason itself cannot know.” Surely, to represent the “metaphoric” heart in all its ethereal and abstract majesty there was no need to resort to anatomical realism.

On the day of my visit to my maternal home, I look for an answer to this question. I find it after researching the origin of the image. Late in the seventeenth century, a French nun of the Visitandine Order, Marguerite-Marie Alacoque (1647-1690), in the Monastery of Paray-le-Monial in Burgundy, had visions in which Christ appeared to her holding out his heart. She narrated these experiences in writing. In June 1674, she described one of her visions: “the divine Heart was represented to me in a throne of fire and flame, shining on all sides, more brilliant than the sun, and transparent as crystal. The wound that he received on the Cross was visible. There was a crown of thorns around this Sacred Heart and a cross above . . .”2 To this vivid description was added the admonition of a French Jesuit, Joseph de Galliffet, who in 1726 published a book about the mystical experience of the visionary nun, and gravely pointed out that many pious persons “find more devotion in honoring the Heart of Jesus Christ as it really is in the sacred chest of the divine Savior.” This, he added, stands to reason; for if one wished to honor the hand of the Savior, one would prefer to do it in the most natural and exact expression of this hand; and “why not think the same of his Sacred Heart?”3

Frontispiece to De Culto Sacro Sancti Cordis Dei, 1726
Charles-Joseph Natoire
Bibliothèque Nationale, Paris

The illustrations in devotional books written to promote the cult of the Sacred Heart followed these guidelines. Especially noteworthy is the frontispiece of Galliffet’s book, owed to the painter Charles-Joseph Natoire (1700-1777). Here, the anatomical features are rendered in painstaking detail, including the presence of the anterior descending coronary artery and its branches; the great vessels are normally related to each other and a cross is seen to emerge from the aorta. Natoire probably copied directly from human hearts extracted at autopsy. A scholar has pointed out that his rendering, which became the model in most representations of the Sacred Heart, antedated Pompeo Batoni’s image, wrongly considered by Italian art critics as a first radical departure in the way of representing the heart in religious art.4

I ask my mother, rather imprudently, if she thought the image had helped her in any way. She was never a bigot, churchy, or pharisaical—by no means! But in the course of her answer she told me how fervently she prayed to the image asking for intercession in my favor when I encountered a crisis in my private life. I could not fail to be touched by this candor. Away from my home, living in a foreign country during this difficult time, I never felt such warm human sympathy. That crisis, like all things human, soon came to an end. And I recall an intellectually elegant article by Francis Galton (1822-1911), Victorian savant, demonstrating conclusively the uselessness of prayer in effecting material outcomes. Still, the words of my mother come “from the heart” and outline a form of love that gives short shrift to the Galtonian discourse. Yes, statistically Galton can prove his thesis, but Pascal’s dictum is not thereby invalidated: “the heart has its own reasons, which reason itself cannot know.”

There is another mystery surrounding the Sacred Heart image. Why did it take so long to appear and why did an organ so enigmatic, so charged with symbolic meanings, and about which so much has been said, written, and thought take more than one thousand six hundred years to become an object of cult? Surely, this is something to wonder at. The Catholic devotion to the realistically rendered Sacred Heart was not made official until 1765, when Pope Clement XIII allowed the Feast of the Sacred Heart with a special Mass. This was only two years after Batoni made his famous painting. Before the illustration appeared, there was scarcely a precedent for this cult. In the fifteenth century, Carthusian monks had composed eulogies to Jesus’ heart and his wounds; they had urged believers “often to kiss a picture of the Heart of Jesus,” but a formal devotion was not organized, and the images connected with these pronouncements were awkwardly depicted like Valentine-style hearts.

Shortly before my departure from Mexico, I come across a scholarly article attempting to answer this puzzle. Alice Kehoe, a scientist from Marquette University, proposed that the intense post-conquest missionary activity that took place in Mexico, characterized by the sophisticated mixture of Aztec religious symbols and Christian concepts, was an important determinant in the emergence of the Catholic cult of the Sacred Heart of Jesus.5 Pagan and Christian ideas were fused. The symbolism of Aztec sacrifice, in which the heart of the victim was extracted, was used by missionaries to reinforce the Christian meaning of the crucifixion and the chest wound of the Savior. The Council of Trent (1545-1563), which approved the religious symbols used by the Catholic Church, did not sanction the heart, but hearts were very commonly represented in friezes, sculptures, and façades of temples in colonial Mexico: the intention was devotional, but to a modern investigator they looked just “as ferocious as much of pre-conquest sculpture.”6

Thus, hearts pierced, bleeding, intact, and miraculously resplendent, were a common religious symbol in Mexico a century before Marie-Marguerite had her visions in a French monastery cell. Direct evidence between Mexican sacred hearts and the European devotion to a realistically depicted Sacred Heart, says Kehoe, “must be buried in some archive or priestly memorabilia.” But enough circumstantial evidence exists to propose that, consciously or subliminally, the minds of the foremost religious leaders were influenced by what theologians were doing in Mexico and reporting in a flood of written works that the European priests certainly read. The cult of the realistically drawn flaming heart of Jesus started in Europe and coincided with the peak of those publications. In sum, Kehoe marshals sundry arguments to show that, by a process technically known as “stimulus diffusion,” the inspiration to make the flaming heart of Jesus “an embodiment of the new humanistic Catholicism” may have actually originated in Mexico, and extended from there to France.

Fresh from having read the learned exposition, I chat with my mother in the living room of the apartment. Aware of her devotion to the Sacred Heart of Jesus, I entertain the hope that my recent reading would hold her attention. I try to repeat the erudite argumentation to the best of my ability, but half-way through my pedantic dissertation I discover she has fallen asleep on the sofa. I look at her white hair, slightly disheveled by an awkward sleeping posture, her somewhat gnarled finger joints from which the blanket that covered her lap, knees and legs has slipped away. And I realize that within that spent body beats a heart that keeps a different tempo, a rhythm that goes rallentando and cares little for ethnographic or anthropologic hypotheses.

That same heart ceased to beat altogether years ago. To have preserved it in a costly, sumptuous urn, as was done with the hearts of French kings, would have been a paltry homage for such a precious vessel, brimful of the purest, self-abnegating maternal love. Under its “substantive” mode of being, as a fleshy muscular pump, it crumbled to dust long ago. But under its “metaphoric” mode of being it lives on as a kind of transcendent hypostasis whose presence, to me, grows ever more real, more concrete, and more substantive.



  1. Jack Perloff: “The Metaphoric and Morphologic Heart: Symbol and Substance.” American Journal of Cardiology 105, no.10: 1502-1503, 2010
  2. M.-M, Alacoque & Monastère de la Visitation Paray-le-Monial: Vie et Oeuvres de Sainte Marguerite-Marie Alacoque. Paris, Editions St. Paul, 1990. See also a 1923 edition published online: http://www.abbaye-saint-benoit.ch/saints/margueritemarie/index.htm
  3. Joseph de Galliffet: De Culto Sacro Sancti Cordis Dei ac Nomini Nostri J. Cristi. Rome, 1726. This work exists in French translation as: L’excellence de la devotion au Coeur adorable de Jésus-Christ, avec le Mémore qu’a laissé de sa vie la V. M. Marguerite Alacoque religieuse de la visitation. Lyon, 1733. An English language edition is: The Adorable Heart of Jesus, with an introduction and notes by Father Richard Frederick Clark. Philadelphia, Messenger of the Sacred Heart, 1890. It is available online: http://archive.org/details/theadorableheart00galluoft
  4. Martha Mel Edmunds: “French Sources for Pompeo Batoni’s ‘Sacred Heart of Jesus’ in the Jesuit Church in Rome.” The Burlington Magazine 149, no. 1256: 785-789, 2007.
  5. Alice B. Kehoe: “The Sacred Heart, A Case for Stimulus Diffusion.” American Ethnologist 5, no.4: 763-771, Nov. 1979.
  6. John McAndrew: The Open-Air Churches of Sixteen Century Mexico. Cambridge. Harvard University Press. 1965. Page 249.



FRANK GONZALEZ-CRUSSI, MD, is an emeritus professor of pathology at Northwestern University. Since 2001, he has retired from his post as head of laboratories at the Children’s Memorial Hospital of Chicago. He has written over 200 articles in peer-reviewed journals, briefly became chief editor of Pediatric Pathology, and authored two books on the pathology of specific types of pediatric tumors. In the literary field, he has written 16 books (five in his native Spanish), most in the essay genre. Translations of his work exist in 10 languages. Dr. Gonzalez-Crussi has been the recipient of numerous awards, including a Fellowship of the John Simon Guggenheim Foundation. His latest book is Carrying the Heart (Kaplan Publishers, New York).

Highlighted in Frontispiece Spring 2013 – Volume 5, Issue 2
Spring 2013  |  Sections  |  Cardiology

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