The Heart and Traditional Chinese Medicine (TCM)
In TCM summer corresponds to the heart. According to Chinese medicine, now is the time to focus on the heart and incorporate foods and lifestyle advice that will tonify heart. In TCM each organ corresponds not only to an element ie wood, fire, earth, metal, water, but also to a planet, mental quality, emotion, sensory organ, body part, body fluid, sense, taste or flavour and even smell. In TCM heart disease is not only represented by physical symptoms related to the hearts itself such as palpitations or angina, but also by disorders of the corresponding five element connection. For example glossitis or inflammation of the tongue, spontaneous excessive sweating, speech disorders and insomnia are all seen as heart pathologies or patterns of disharmony associated with the Heart.
In TCM the following is said to be attributed to the Heart
1. The heart contains the shen
The term Shen, in TCM refers to the spirit. In TCM however Shen means more than just what we would understand to be the spirit, it also encompasses physical vitality, mental activity and spirit. Traditionally, Shen refers to our capacity to, transform, accept change, be malleable, go with the flow. Shen is said to manifest in the eyes but is represented also by facial expression. The following human functions are attributed to Shen.
The Shen controls mental activity
Mental processes, mental functions and cognitive processes are terms often used to mean functions or processes such as perception, introspection, memory, creativity, imagination, conception, belief, reasoning, volition and emotion. Just as ancient Chinese believed that the Dipper appeared to be the central pivot of the stars, they too believed that the Shen appears to be at the heart of all mental and physical activities.
The Neijing states "The heart is the emperor of the five zang and the six fu networks... if the heart flares, then all of them will get out of line."
The Shen is represented by seven emotions
The seven emotions are seen as manifestations of the Shen.
1. Joy associated with the Heart
2. Anger associated with the Liver
3. Sadness also associated with the Liver
4. Grief associated with the Lungs
5. Fright associated with the Kidneys
6. Apprehension associated with the Spleen
7. Worry, also associated with the Spleen
Each emotion is further represented by a facial expression, body movement, gestures, and even its own noise including sighing, moaning, giggling and sobbing.
There are also five modes of operation known as the wushen hun, po, yi, zhi, and shen (this latter being the same term) that operate within within the controlling and regulating effect of the heart regulating all mental and physical activities.
hun refers to the self-awareness and self-control mechanism and is associated with the liver.
po refers to instinct and is associated with the lung.
yi refers to the ability of thinking and remembering and is associated with the spleen.
zhi refers to the function of memory and is associated with the kidney.
shen refers to the function of processing all incoming sensory and intuitive information and the body’s reaction to it and is associated with the heart
In order for the shen to be healthy it must be nourished by sufficient substances in Chinese Medicine and comprising of Jing, Qi, Yin, Yang and Blood. Deficiencies of any of these will lead to specific symptoms and most importantly identify specific treatment protocols.
Blood is regarded as a particularly important for the basis for the Shen. Extensive blood loss for example has a devastating affect: the afflicted person will be without Shen or to be rendered unconscious. See also Carahealth Blood Tonic
2. The heart governs the blood vessels
Just as in Western medicine, the heart is responsible for the movement of blood throughout the cardiovascular system. According to the Chinese, blood is primarily produced in the process of extracting food essence known as Guqi in the middle burner with the help of a healthy Spleen. Therefore weak digestion can lead to blood deficiency and result in a heart pathology. In TCM the middle burner is associated with extracting qi from food, of discarding the dregs, of assimilating the vital fluids, of transforming them into jing, and then transporting this final product up to the lung and eventually transforming it into blood which nourishes the entire body. This is akin to controlling digestion, absorption and assimilation of nutrients.
Blood provides the material basis for all aspects of mental activity and all organ networks and their associated body layers (skin, muscles, tendons, and bones). Healthy blood equals a healthy mind. Other organs involved in the process of manufacturing blood are the kidney which transforms Jing into blood. The liver assists the free flow of blood and stores the blood.
The heart circulates the blood. In the original terms of the Neijing "If the liver is supplied with blood, we can see; if the feet are supplied with blood, we can walk; if the hands are supplied with blood, we can grasp."
3. The heart reflects in the face
Chinese medicine, therefore, has traditionally regarded the face as a mirror of the condition of the heart. If heart blood is abundant, the fine vessels in the face will be well supplied, and the person will present with a rosy and lustrous complexion. The essential "looking" aspect of the four-fold system of Chinese diagnosis refers primarily to the observation of the face. Since the conditions of both blood and shen reflect here, the face can tell much about the general state of a person's physical and emotional state.
4.Sweat is the fluid of the heart
It is said that sweat is controlled by the opening and closing of pores which are known as the doors of qi. This is managed by the body's protective qi known as wei qi. Sweat and blood are said to be interchangeable. Excessive sweating will lead to blood deficiency eventually.
As is observed in the Neijing: "A person who has lost large quantities of blood does not sweat anymore, and the one that has lost large quantities of sweat does not have any blood anymore."
As Sweat is considered to be a precious substance in TCM, excessive sweating regimes such as saunas, sweat lodges and hot yoga for example can damage the blood and even be detrimental for people with symptoms of blood deficiency such as pallour, poor memory, insomnia, palpitations, shortness of breath, dizziness, fatigue and constipation
5. The heart is paired with the small intestine
The organs are either classified as zang or fu and are paired. The zang organ serves as a residence. The shen is said to reside in the heart for example. The Fu organ is a hollow organ that temporarily stores material that is to be discharged. The heart is paired with its fu organ, the small intestine, via interconnecting luo vessels.
The small intestine receives partially digested food residue from the stomach and separates it into "pure" and "impure" substances. Pure essence is then circulated to the spleen, which then transports it to the five organs. Fluids reabsorbed from the dregs are passed on to the bladder to be expelled and waste matter is expelled via the large intestine.
An interesting example of this zang fu relationship is a case of the green-eyed monster leading to heart fire and transferring to the bladder causing cystitis. This heat is transferred from zang to fu (heart to small intestine) is then carried to the bladder with the fluid wastes.
6. The heart opens into the tongue
In TCM, the heart is said to flower into the tongue. An internal branch of the heart channel connects with the tongue. The colour of the tongue body reflects the condition of heart blood. A deep red or scarlet tongue, for instance, usually indicates the presence of toxic heat in the blood. At a severe stage, toxic heat may adversely affect Shen. A pale tongue usually indicates blood deficiency.
Speech difficulties such as those resulting from stroke and speech impediments such as a lisps or stuttering, are related to a heart pathology in TCM. Even such conditions as mania are attributed to heat harassing the heart and causing Shen disturbance.
7. The pericardium protects the heart
The hearts yin yang related partner is the pericardium. The pericardium is said to surround and shield the heart. Just as an emperor is surrounded by a dense circle of intermediaries, the pericardium forms a network of pathways around the heart through which both the heart's qi and blood have to pass on their way to and from the ends of the body. If the heart is affected the pericardium must also be treated.
Patterns of disharmony affecting the heart Obstruction of the orifices of the heart
The shen is said to reside in the heart at night and in the muscles during the day. It travels in and out of the heart via the heart orifices. Pathogens can block these orifices and cause shen disturbance. Typical symptoms of shen disturbance are high fever, loss of consciousness and delerium. If the orifices of the heart becomes obscured by phlegm fire, epileptic seizures and even mania and psychosis may occur.
Heart yin or heart blood deficiency
The shen needs sufficient yin and blood to be healthy. If heart yin or the heart blood is deficient, the shen can wonder and symptoms such of insomnia, confusion, memory loss, and other mental symptoms are possible. There may be physical symptoms such as palpitations, dizziness, a pale face, dry skin and body hair, and a fine, weak and rapid pulse
Obstruction by Phlegm
If the heart yang, the heating and drying aspect is deficient, water accumulates in the upper part of the body resulting in a pattern of disharmony called "water qi intimidating the heart" (shui qi ling xin). Symptoms include palpitations, oedema, asthma and pulmonary heart disease
Blood heat causing frenetic movement of blood
Excess blood heat can damage the blood vessels resulting in haemorrhage. Nosebleeds, vomiting of blood, coughing blood, blood in stool, urine, or excessive menstrual bleeding can all be a result of excessive heat in the blood.
Angina pectoris is caused by blood stasis in the pericardium in TCM. Ancient texts frequently describe a heart attack, sudden chest pain, loss of voice, lips and face turn blue, hands and feet turn cold and blue, as a syndrome of "polluted blood attacking the heart."
Heart heat manifesting in the small intestine
Due to the zang fu relationship, heart heat may manifest as burning diarrhoea with intestinal cramping or burning urination that represents transfer of heat from small intestine to bladder.
Heart disorder affecting the tongue
Deficiency of heart blood usually causes the tongue to take on a pale colour. Mouth ulcers frequently arise from heart or small intestine heat particularly ones affecting the tip of the tongue. Stasis of heart blood often reflects in the form of purple spots in the tongue body or in the discoloration of the veins underneath the tongue. If heat toxins have invaded the pericardium, or if phlegm obscures the orifice to the heart, patients may lose control over their tongue. Stroke victims, for instance, often experience stiffness of the tongue and slurred speech.
Excessive joy injuring the heart
Under normal circumstances, joy can relieve tension, stimulate the flow of qi and blood, and harmonise the ying (nutritive) and wei (protective) qi. If joy is exaggerated, however, the qi will disperse and shen will scatter. Intense and prolonged emphasis on joy can impair a person's focus and concentration. A person who has been giggling/laughing for a long time and now has a hard time stopping and regaining control, is, at least during this particular moment, without shen (that is unable to focus).
Chinese dietary therapy to tonify the heart
In Chinese Medicine certain foods are said to enter certain channels and nourish the organ
Green foods nourish the Liver.
Yellow & orange foods nourish the Spleen and Stomach.
Red foods nourish the Heart.
White foods nourish the Lungs.
Black foods nourish the Kidneys.
A person with weak digestion or, according to TCM, a weak spleen, should include abundant yellow & orange foods such as sweet potatoes & squashes, as these are the colours that correspond to the earth element.
Red foods and the heart
For a weak heart, the advice is to eat more red foods such as tomatoes, beetroot and hawthorn berries tea or tincture, as red corresponds to the fire element and the heart organ. Other red foods include red onions, red cabbage, red adzuki beans, red kidney beans, red berries and cherries.
Bitter flavour and the heart
The bitter flavour is said to enter the heart meridian and clear heat. As heat rises in the body the heart is very often harassed by excess heat producing symptoms such as mania and insomnia. Bitter foods are said to dry damp and disperse obstruction. Bitter also clears heat. Bitter foods can be used to treat oedema and obesity or excess heat conditions including red eyes, headaches, hypertension etc. Its function of dispersing obstruction can be utilised in cough due to Qi stagnation etc. Examples of bitter tasting foods are rhubarb, apricot kernels, radicchio, endive, cos lettuce, dandelion leaves, mustard greens, burdock root and kale.
Excess bitter foods are too cooling and can damage a weak spleen and cause diarrhoea and fatigue. Bitter taste in mouth in fact and heart disease are, in some opinions closely linked. This is especially true when chest pain accompanies that bitter taste. The person experiencing both signs should suspect coronary disease and seek medical advice.
Some examples of foods and their therapeutic properties for the heart
Foods to improve Qi circulation
Basil, Caraway, Cardamom, Carrot, Cayenne, Chive, Coriander, Dill seed, Garlic, Marjoram, Mustard leaf, Orange peel, Radish, Star Anise, Tangerine Peel, Turmeric.
Foods that improve blood circulation
Anasake, Aubergine, Brown sugar, Chestnut, Chilli powder, Chive, Crab, Hawthorn berry, Mustard leaf, onion, Peach, Scallion, Sturgeon, Vinegar.
Foods that cool heat
Asparagus, Aubergine, Bamboo shoots, Banana, Chicken egg white, Clam, Elderflower, Grapefruit, Lemon, Lettuce, Millet, Mungbeans, Mungbean sprouts, Peppermint, Potato, Salt, Tofu, Watermelon, Wheat berries
Chinese dietary therapy for the Heart
Egg yolk Neutral, sweet, Ht & Ki, blood tonic, lubricates dryness.
Whole wheat Cool, sweet, Ht, Sp, Ki, Ht & Ki tonic.
Adzuki bean Neutral, sweet & sour, Ht & SI, diuretic, heals swellings, detoxifying.
Mung bean Cool, sweet, Ht & St, detoxifies, clears heat, diuretic.
Lotus seed Neutral, sweet & harsh, Sp, Ht & Ki tonic, Qi & Blood tonic, constricts the intestines.
Longan (Long Yan/Dragon's Eyes) Warm, sweet, Sp & Ht, Yang, Qi & Blood tonic, removes Blood stagnation, calms Shen.
Chinese herbal medicines to treat disharmonies of the heart
Nourish blood (bu xue): dang Gui (danggui), salvia (danshen), rehmannia (dihuang), millettia (jixueteng).
Nourish the heart and pacify shen (yang xin an shen yang ): fushen (fushen), zizyphus (suanzaoren), biota (baiziren), succinum (hupo).
Tonify qi (bu xin yi qi): ginseng (renshen), polygala (yuanzhi), longan (longyanrou), baked licorice (zhi gancao).
Warm yang (wen yang yi qi): cinnamon bark (rougui), cinnamon twig (guizhi), aconite (fuzi), alpinia (yizhiren), (zishiying).
Astringe and tonify yin (lian yin): schizandra (wuweizi), cornus (shanzhuyu), peony (baishao), mume (wumei).
Purge fire (xie huo): coptis (huanglian), gardenia (zhizi).
Clear heart heat (qing xin): rhino horn (xijiao) or water buffalo horn (shuiniujiao), forsythia (lianqiao), and the "heart" portions of bamboo leaves (zhuye) and lotus (lianzi xin; lotus embryo).
Sedate the heart and settle shen (zhen xin an shen): cinnabar (zhusha), dragon bone (longgu), oyster shell (muli), magnetite (cishi), rust (sheng tieluo).
Open the orifice of the heart (kai qiao): borneol (bingpian), musk (shexiang), acorus (shichangpu), styrax (suhexiang).
Open the orifice by dispelling heat phlegm (huo tan): bamboo sap (zhuli), ox gallstone (niuhuang), bamboo resin (tianzhuhuang), bile treated arisaema (dan nanxing), fritillaria (beimu), pinellia (banxia).
Move the blood (huo xue): persica (taoren), carthamus (honghua), cnidium (chuanxiong), achyranthes (niuxi).
Drive out blood stasis (zhu yu): leech (shuizhi), tabanus (mengchong), eupolyphaga (tubiechong), pteropus (wulingzhi).
Soften and dissipate masses (ruan jian): zedoaria (ezhu), sparganium (sanleng), anteater scales (chuanshanjia), turtle shell (biejia).
Stop bleeding (zhi xue): notoginseng (sanqi), bulrush (puhuang), bletilla (baiji), sanguisorba (diyu), cephanoplos (xiaoji), lotus nodes (oujie).
Cool the blood: red peony (chishao), raw rehmannia (sheng dihuang), moutan (mudanpi), lithospermum (zicao).
Western Herbal Medicine for the Heart
Please see also Carahealth Heart
Naturopathic treatment and causes of heart disease
Please see also Naturopathic Causes and Treatment of Hypertension
Carina is available to lecture for your group or institution on this subject.
Carina Harkin BHSc.Nat.BHSc.Hom.BHSc.Acu. is a practitioner of 11 years, complementary medicine lecturer of 4 years and mother of six in Galway, Ireland who practices what she teaches.
For an appointment call Carina directly on 083 34 66 333.
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