The Chinese Medical Heart System
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The following is a very brief overview of the Heart system, in Chinese medicine. This system encompasses the Chinese medically defined Heart organ, the acupuncture channels associated with the Heart organ, and the mental, emotional, and cognitive aspects of a being associated with the system, as a whole. (You’ll notice “Heart” is capitalized when used to refer to this larger system of the body and not the more narrowly defined heart organ in the chest.)
It needs to be noted that it’s quite difficult to summarize this information and explain it in common English terms, as, traditionally, the Chinese had a fundamentally different way to look at and understand the human being. For example, the Chinese medically defined heart “organ” (technically, zàng) refers more to a collection of physiological actions or functions of the organ, than a tangible organ, itself (compared to the more materialistic modern sciences, where investigative and descriptive efforts would focus much more heavily on the physical heart, e.g., the various types of muscle and connective tissue).
Additionally, there are emotional aspects of the Heart “system” that are as equally important and informative of Heart imbalance as any physical symptom. In Chinese medicine, neither the physical, nor the cognitive/emotional is primary or dominant (though, any given practitioner or sub-system of the medicine may choose an emphasis). Both are varying avenues for expression of health and illness of an underlying being – it is that being that is the focus of treatment, not the “mind” or “body”.
There is a more or less standard list of functions attributed to the Heart system. These are its contribution to the whole (of the human being), or those aspects of the whole more closely associated with the Heart, keeping in mind such delineation of actions or responsibilities is, ultimately, arbitrary, as the human being is a single, complete entity (1).
The following list of functions and associations of the Heart is drawn from “Pathomechanisms of the Heart: Xin Bíng Zhi Bíng Ji” (Shí-lín, Y. & Zhèng-huá, L., 2005):
- Holds the office of monarch
- Governs the blood and vessels of the entire body
- Transports nutrients and irrigates the four limbs and the hundred bones
- Moistens the internal organs, skin, and hair
- Governs the Mind-Spirit
- Regulates Essence-Spirit, thought and consciousness
- Is the “Great Governor” and supervises the functions of the internal organs and commands the entire body
- Corresponds to the vessels, “blooms” in the face, “opens” at the tongue
- Is in exterior-interior relationship with the small intestine system. (Shí-lín, Y. & Zhèng-huá, L., 2005, p. 1)
The Heart is, thus, understood to be absolutely central to the functioning of the human being. It governs both circulation of blood, providing nourishment to all the organs, skin and hair, as well as the mind-spirit – the seat of consciousness and cognition. Furthermore, it is referred to, quite directly, as the “Great Governor”, supervising and commanding the entire body, as would be expected of the “monarch”.
Additionally, the Heart has specific correspondences with the face and tongue, the general health and appearance of these reflecting the general state of the Heart. For example, a pale complexion or tongue may likely indicate Heart weakness, specifically insufficiency of Heart Blood, and redness or heat would suggest an excess or replete state within the Heart system.
The Heart is vulnerable to damage by the “seven affects”, and most specifically sorrow, joy, anxiety, and thought (Shí-lín, Y. & Zhèng-huá, L., 2005, p. 5). Within the system of Chinese medicine, emotions are understood to be basic processes of the human being, just as urination and sweating. They have a proper place and time and should, in good health, be present in proper proportion at those times.
Chinese medically speaking, where joy is experienced spontaneously, in reaction to good news, say, this is considered a sign of a healthy Heart system. Where a person hears great news, or is in a situation typically calling for a joyful response, yet they remain unmoved or apathetic, an obstruction or deficiency of the Heart may be suspected (ultimately, any formal diagnosis is based on a collection and analysis of multiple symptoms, constituting the patient’s disease “pattern”, and never simply the presence of any isolated sign or symptom, such as a pale complexion or emotional response).
Each of the major internal organs – Heart, Spleen, Lungs, Kidneys, and Liver has specific emotions that correspond with their healthy functioning and can be used in diagnosis. Though there are different approaches in classification, variation in nuance in the nature of expression, and, in truth, a full range or family of each, these emotions are, respectively, joy, sympathy, grief, fear, and anger (2).
In health, these emotions should arise spontaneously, as appropriate for the given life event, and should fade just as easily. It is when they are repressed, denied free and proper expression, or carried to excess that they become disease-causing events (discussed below).
The Heart is of the Fire phase (xíng, aka “Element”, though that term misses the sense of movement inherent within the original Chinese, and the Five Phases are aspects of the ceaseless cycling of qì. Hence, movement is central to the concept). The emotional continuum of the Heart system, from mania to apathy, then, can be understood as similar to movements of a flame, either burning ferociously, nearly out of control, or barely flickering, with little life, or even burning out, leaving a cold, apathetic void.
Generally speaking, illness within the Heart system can be divided into obstructive-type and weakness-type. Either the all-important role of running the kingdom of the body-mind is impeded or there is some weakness disallowing such governing. As far as obstruction, repressed moods, thoughts, or feelings can obstruct the smooth flow of qì (loosely translated as intrinsic bioenergy) causing illness. Over time, this blockage of qì flow can lead to a more severe obstruction of Blood (Chinese xuè ?, “Blood” is capitalized when used in the Chinese medical sense to distinguish it from the modern medical use of the term), where deep depression or violent tendencies may arise, as a result of, or subconscious effort to “break through”, the obstruction. Such obstruction also easily leads to the generation of an internal heat and may result in bouts of severe anger or rage with heat rising leading to a flushed face or a high-pitched ringing in the ears.
Where poor diet is present, digestion may become hindered resulting in the creation of internal dampness. This dampness may find its way into the heart system and, essentially, clog the free movement of Heart qì, which may then create qì or Blood stasis, or generate an internal heat, as discussed above.
As the Heart corresponds to the Fire phase, it shares something fundamental in common with the nature of that particular phase. This commonality is shared with all aspects of life and the world that correspond with the Fire phase. For example, heat is the type of weather, and summer the season, associated with the Fire phase. Clinically, this means that the Heart system, associated with the Fire phase, is uniquely vulnerable to heat, as it also corresponds to the Fire phase. The Heart system is, in fact, often “invaded” by external heat. As could be guessed, this would cause an excess of the basic fire nature, leading to fever, thirst, or frenetic mental or emotional excitement.
Deficient-type issues of the Heart revolve around the ability to move energy throughout the body and the substances necessary to support that movement. Just as qì and Blood can be obstructed, as in the above, they can also be insufficient to perform its duties. Normal activities deplete these resources, and if not replenished through rest and proper diet, the normal depletion can become severe enough to generate symptoms, such as palpitations or increased susceptibility to anxiety and worry.
The warm, yáng aspect of movement can also be weak, leading to a pathological presence of cold with a slowing down of the Heart’s functions and the outright sensation of cold, for instance in the extremities.
It is quite typical for obstructive and deficient types of pathologies of the Heart to mix. For instance, qì deficiency can easily lead to qì obstruction, where there is too little propulsive force, thus allowing things to get backed up or blocked. Additionally, where Blood is obstructed, the body’s ability to generate more Blood is impeded, leading to a Blood deficiency. In most American patients, it is exactly these types of complex, mixed symptom patterns that present.
Most modern texts on Chinese medicine stick, largely, to the physical presentation of health and illness, with some attention given to broad psychological disorders, such as depression or anxiety. There appears to be a separation, of sorts, between symptoms and illness and the greater context or meaning of life, which is often relegated to the category of philosophy, spirituality, or religion and treated as if separate from medicine.
In this author’s opinion, medicine is, ultimately, about the reducing of suffering, and the root of suffering cannot be found in the physical body. The most powerful medicine, then, must go beyond and behind the physical body, or even the fluctuations of the emotional mind, to look at the fundamental nature of a being and their experience of life.
Clinically, this often requires a deeper investigation and an acknowledgement that the material aspect of a system is simply the physical counterpart, or expression, of a more fundamental nature of that system. For example, when understanding the Heart system as the monarch, or ruler, leader, of the body, this refers to more than just the physical heart providing nutrients to all tissues of the body through its pump action; that is merely the physical expression of running the kingdom.
In the bigger picture of life, this function has to do with the person’s acknowledging and, thus, stepping into the role of leader of their life. Where one fully recognizes the central role of themselves in their life and acts based on this awareness, order can be maintained and that spontaneous joy naturally follows. This is a person actively self-actualizing, or manifesting their destiny or innate potential. Classically speaking, a person in this state emits a certain radiance or “brilliance” (Larre, C. & Rochat, E., 1992, p. 38).
Where a person submits to the external world, where they fail to recognize the inner monarch, instead allowing their actions to be dictated by outside circumstances, the inner kingdom goes without a leader and chaos ensues (“chaos” falling within the emotional continuum of the Heart system, see endnote ii). That purpose for which the whole system of the individual was designed and created goes unrecognized and, thus, the system begins to breakdown. Where there is no guidance of the leader, no ruler to direct the movement, the active expression of the person – “correct” action – cannot be known, much less taken, and the person inevitably suffers, emotionally at first, then physically later on.
Lastly, inherent within the Heart’s central role of communicating to the whole system, via Blood flow, is the idea of emptiness. A vessel’s sole purpose is to convey, and it must be empty in order to do so. This is obvious, from a purely mechanical perspective, and needs to be more deeply investigated to reveal the importance on a non-physical level.
The vessels of the Heart, and, indeed, the Heart, itself, must maintain a basic emptiness in order to fulfill their purpose; they must always be able to allow free movement and free passage, “holding onto” nothing. On the non-material level, there is the common experience of emotional suffering experienced when emotions, thoughts, ideas, or beliefs are “held” onto only to be forced, washed away, “lost” at some point. If we were able to remain open and unattached, allowing things to pass freely, unimpeded, if we were able to simply experience the flow of life instead of trying to grasp and hold onto it we would suffer less. This makes immediate sense and is reflected perfectly in the Chinese medical conceptualization of the Heart system.
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1. Where we break up the human being into different aspects or parts we, essentially, create those aspects. That is, those individual aspects/parts are creations of our minds, ways to conceptualize, to understand, the larger entity under observation, here, for purposes of medical intervention. This is why different systems explain the human being in different ways, e.g., Chinese medicine, biomedicine, yoga and Ayurveda, etc., with none being objectively “right” or “wrong”. They are all different ways of “breaking down” a human being for purposes of interacting with it, thus making each not so much right or wrong, but, instead more or less useful for any given clinical situation. This is the essence of science, the creation of rational models (Chinese medicine, Ayurveda, etc.) that approximate reality, or some aspect of reality, such as the human being, in order to allow us to work or interact with it, such as to diagnose an illness and create a treatment plan to intervene and alleviate suffering.
2. Lonny Jarrett has authored a couple texts rooting the more physical aspects of Chinese medicine in Taoist philosophy/spirituality. He lists, on a continuum, the “virtues” and habitual behaviors of each of the Five Phases: Fire – propriety, as the virtue, with control as the excess behavior and chaos as the behavior that presents when the organ system is deficient. Water (Kidney system) – wisdom, with conservativeness as the excess behavior and recklessness as the deficient. Wood (Liver system) – benevolence, belligerence, timidity. Metal (Lung system) – righteousness, gain, loss. Earth (Spleen system) – integrity, self-indulgence, ingratiation. (Jarrett, L., 1998, p. 153)
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References
Jarrett, L. (1998). Nourishing Destiny: The Inner Tradition of Chinese Medicine. Stockbridge, MA: Spirit Path Press.
Larre, C. & Rochat, E. (1992). The Secret Treatise of the Spiritual Orchid: Su Wen Chapter Eight. Cambridge, England: Monkey Press.
Shí-lín, Y. & Zhèng-huá, L. (2005). Pathomechanisms of the Five Viscera, Volume 1, Pathomechanisms of the Heart. Taos, NM: Paradigm Publications.
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