Athletic Heart Syndrome and the Pulse in Humoral Medicine

Allah, Glorified and Exalted, created the heart with a specific form and structure. If the heart becomes enlarged, its function changes and it departs from its natural state, even if signs of illness are not immediately apparent. Symptoms may be delayed, particularly in athletes who exercise daily. There is wisdom in the heart’s original design, and when its form changes, the functions for which Allah created it also change.

According to contemporary medicine, Athletic Heart Syndrome is a common, non-pathological condition among athletes. It is characterized by enlargement of the heart and a slower heart rate. The condition is also known as athletic bradycardia and exercise-induced cardiomegaly. It is most common among athletes who train regularly for more than an hour per day and is usually associated with endurance sports, though it may also occur in weightlifters.

An athlete’s slower pulse is generally considered benign and is not usually associated with health risks. However, it may sometimes conceal a serious underlying medical condition, and physicians may mistakenly identify it as another disorder.

Three signs commonly appear in athletes diagnosed with Athletic Heart Syndrome: a slower heart rate, an increase in heart size, and thickening of the heart muscle walls. The pulse may decrease to approximately 40–60 beats per minute. Enlargement occurs especially in the left ventricle, which pumps oxygenated blood throughout the body. This adaptation can benefit athletes during exercise by increasing cardiac output and allowing a greater volume of blood to be pumped with each heartbeat. However, the same signs appearing in a non-athlete may indicate a heart problem. This concludes the contemporary medical description.

The author states that it has become common for people to assume that an athlete’s pulse naturally ranges from 40 to 60 beats per minute and that such a pulse is not necessarily an indication of a cold temperament. A person may have such a pulse while still being considered hot-tempered according to humoral theory. The author argues, however, that a hot-tempered athlete does not typically develop enlargement of the heart muscle because of the relative thinness of the blood. According to this view, such individuals generally have a faster pulse, often between 80 and 90 beats per minute.

In contrast, the author argues that a person of cold temperament tends to have a slower pulse. If such a person engages in intense exercise for more than an hour per day, the heart muscle may enlarge because thicker blood places greater pressure on the left ventricle as it pumps blood throughout the body. The exertion involved in exercise is said to contribute to both enlargement of the heart and increased slowing of the pulse.

The author further states that the foundations of pulse science were revealed to certain prophets and that physicians have traditionally agreed that a rapid pulse indicates hotness, while a slow pulse indicates coldness. According to this perspective, contemporary explanations of athletic bradycardia do not conform to the principles of pulse interpretation in Humoral Medicine. A rapid pulse is viewed as a sign of a hot temperament, whereas a slow pulse is viewed as a sign of a cold temperament. The author warns that misinterpreting these signs could lead to inappropriate treatment.

The traditional explanation is that the pulse represents the expansion and contraction of the arteries to regulate the innate hotness of the body through the intake of fresh air and the expulsion of wastes through breathing. When bodily hotness increases, the need for cooling air increases, resulting in a faster pulse. When bodily hotness decreases, the need for air decreases, resulting in a slower pulse. A moderate level of heat produces a moderate pulse.

Accordingly, a rapid pulse is considered a sign of hotness, while a slow pulse is considered a sign of coldness. From this perspective, individuals with sanguine (hot and wet) and yellow bile-dominant (hot and dry) temperaments tend to have faster pulses, while individuals with phlegmatic (cold and wet) and black bile-dominant (cold and dry) temperaments tend to have slower pulses.

The author cites classical medical works, including Al-Kamil fi al-Sina‘ah by Ali al-Ahwazi, Al-Nuzhah al-Mubhijah by Dawud al-Antaki, and Al-Mujaz fi al-Tibb by Ibn al-Nafis, as supporting the principle that rapidity of the pulse is an indication of heat and slowness of the pulse is an indication of coldness.

Conclusion

The author concludes that contemporary Western medical theories should not be accepted uncritically but should instead be evaluated in light of the principles of traditional medicine. He argues that the claim that enlargement of the athlete’s heart is harmless is inconsistent with the heart’s natural form and that a slow pulse remains a sign of cold temperament and departure from balance.

The article further notes that many contemporary medical theories have changed over time. Examples cited include shifting explanations for peptic ulcers, multiple sclerosis, cancer, diabetes, cholesterol, heart disease, and the effects of dietary salt. The author presents these examples as evidence that modern medical theories continue to evolve and are often revised.

The article concludes by stating that the principles of traditional medicine based on hotness, coldness, wetness, and dryness provide a framework through which contemporary theories should be evaluated. According to the author, modern theories may be accepted when they agree with these traditional principles and rejected when they contradict them.