The Heart in Chinese medicine

The Heart (Xin, 心) is called the “Emperor” of the organs in Chinese medicine. It governs Blood and the Blood vessels, but in TCM it is far more than a pump — it houses the Shen (mind, consciousness and spirit). When the Heart and its Shen are stable, the mind is clear and sleep is deep; when disturbed, the result ranges from mild restlessness to insomnia, palpitations, anxiety and (in classical terms) mania. Paired with the Small Intestine in Yin-Yang relationship; element Fire; season Summer; sense organ the tongue; emotion joy; fluid sweat.

Functions of the Heart

1. Governs Blood (Xue) — pumps Blood through the vessels and is involved in the formation of Blood
2. Controls the Vessels (Mai) — the integrity and tone of the vascular system depends on Heart Qi
3. Houses the Shen — the seat of mind, consciousness, sleep, memory, awareness; the Shen rests in the Heart at night, allowing sleep
4. Manifests in the complexion — rosy, lustrous facial colour reflects healthy Heart Blood; pallor reflects deficiency
5. Opens into the tongue — the tongue tip reflects the state of the Heart; speech disorders relate to Heart function
6. Controls sweat — sweat is the fluid of the Heart; spontaneous sweating, night sweats and palpitations all link back to Heart disharmony

Heart and Small Intestine pair

The Heart is paired with the Small Intestine. The Small Intestine separates pure from impure: pure essence ascends to support Heart and Spleen; impure descends to Bladder and Large Intestine. Heart Fire descending to the Small Intestine can produce dark, scanty, burning urination — a classical Heart-to-Small-Intestine pattern.

Common patterns of Heart disharmony

1. Heart Qi deficiency — palpitations on exertion, shortness of breath, tiredness, pale complexion
2. Heart Yang deficiency — the above plus cold limbs, blue lips, chest oppression; from prolonged Heart Qi deficiency
3. Heart Blood deficiency — palpitations, insomnia with dream-disturbed sleep, poor memory, anxiety, pale lips and tongue
4. Heart Yin deficiency — restless insomnia, anxiety, night sweats, five-palm Heat, red tongue tip
5. Heart Fire blazing — agitation, mouth ulcers, scarlet tongue tip, bitter taste, burning urination
6. Heart Blood stasis — sharp stabbing chest pain (angina pattern), purple lips, palpitations
7. Phlegm misting the Heart orifices — confusion, mental dullness, sometimes seen in post-stroke and dementia
8. Phlegm-Fire harassing the Heart — agitation, mania, sleeplessness, in classical psychiatric presentations

Conditions on this site relating to Heart disharmony

Insomnia, anxiety, depression, stress, PTSD, menopausal hot flushes, hypertension, palpitations, post-stroke depression. Many fertility-related anxiety presentations also involve Heart-Kidney disharmony.

Treatment principles for the Heart

Treatment depends on the pattern but commonly uses points such as HT 7 (Shenmen) — the “Spirit Gate”, source point of the Heart channel, the primary point to calm the Shen; PC 6 (Neiguan) for chest oppression, anxiety and nausea; BL 15 (Xinshu) as the Heart Back-Shu point; and CV 14 (Juque) as the Heart Front-Mu. Formulas range from Gui Pi Tang (Heart-Spleen deficiency), Tian Wang Bu Xin Dan (Heart Yin deficiency) and Suan Zao Ren Tang (Heart Blood deficiency insomnia) to Huang Lian E Jiao Tang for Heart-Kidney disharmony.

Return to Zang-Fu organ overview or read about the Lung, Spleen, Liver and Kidney.