Here I will present a basic overview of TCM information concerning the Heart and then add a layer of information gleaned from the Organ clock (a more CCM way of looking at things). I want to do this to demonstrate how the Classical approach yields a more nuanced view than the straight organ-based TCM approach does, including a small aspect of the clinical relevance of this approach.
Disclaimer : This article was written in 2008, when I was still a student!
The Heart is a central organ system.
From the perspective of governmental metaphor, the Heart is most easily compared to the Ruler of feudal society. What does the ruler do? It’s tempting to simply say that he rules and leave it at that. However, most rulers through history have acted less as hands-on managers of their empires and acted more as figureheads – acting as moral compasses, inspiring and motivating the people when needed, acting as interpreters of Divine law and generally providing a center point around which the wheel of government turned.
The Heart is said to provide a similar function for the human body. To look at this and say that the Heart is “most important” would be erroneous. The Emperor without his ministers, without the workers, without the land – is nothing. It is an interdependent system. But, still, the Emperor is crucial and a lot of attention should be paid to those things that are crucial. We’ll do so now.
In Chinese medicine, the Heart is said to have many functions/associations:
- The Heart contains the Shen, which rules the other “spirits” of the Zang organs
- Shen, as I have explained briefly elsewhere, can be translated as “Spirit” but it contains more meaning than the normal English concept of Spirit. Many contemporary commentators talk about Shen simply as consciousness, but I feel it is more than that.
- The Heart governs the Blood Vessels
- The Heart acts as Ruler of the other organ systems
- The Heart, as related to the brain and consciousness, is in charge of many mental processes (one can see this as similar to the Heart’s function via its relationship to Shen – the fire of consciousness)
- The Heart propels the Blood
- The Heart governs speech
- There are other attributes, but these are the main ones mentioned in a variety of texts.
In truth, despite all of these things, most Heart related pathologies diagnosed in TCM have to do with mental function or, sometimes, heart organ abnormalities (such as blood stasis in the Heart yielding angina). In clinic, I mostly see Heart Qi/Blood deficiency (with palpitations and poor memory) and some version of the confusingly named “Heart Fire” resulting in insomnia, anxiety and some type of vexation.
Rarely do I see doctors diagnosing a problem with the heart when there are circulation problems (blood vessels) or speech problems. Further, I think that there should be more attention paid to the fact that, as EMPEROR of the other organ systems, the Heart may be a great place to look when a seemingly unrelated pathology is difficult to cure with the methods we would normally utilize. While I will not focus much on blood vessel or speech problems in this article – I would like to do so in the future.
For now, to help us understand the Heart a little more deeply, I offer a brief exposition of some of the basic symbols associated with the Heart on the Chinese medicine organ clock. I will then describe some ways we can use this understanding to expand on the basic information we learn from TCM literature.
What do we learn about the Heart organ system from the organ clock?
Temporal nature : 11-1pm (High Noon) and the Summer Solstice
At first glance, the pairing of the Heart with high noon makes intuitive sense. This is the time we associate with the zenith of the sun, the burning off of morning fogs, the time when all things are apparent, illuminated, complete. But look again at the symbol for the taiji and superimpose this over the organ clock. Remember these symbol fields are multi-layered and while some aren’t meant to be compared one-to-one, the flow of Yin and Yang through the organ clock (and through the days on Earth) is a crucial piece of information in our understanding of organ systems.
This is the time of the birth of the Yin. Which brings us to another temporal aspect of the Heart – it is situated at the time of the Summer solstice. The solstice is the time of the greatest day length – so again, it is all flourishing and awake and alive. However, the hidden principle is the one of the birth of the dark – for the zenith of a thing always brings about its immediate descent into expiration. What goes up must come down.
What does this tell us about the Heart? That while it is a very Yang organ, as the Emperor should be, but it also contains a deep Yin principle within it. Our professor, Heiner Fruehauf, often relates the Heart to the feminine principle – which makes sense given this information. In that way, it may be more accurate for us to think of the Heart as the Empress – or some amalgam of the Emperor and Empress. Here is perfect control, high intelligence, beauty, grace, compassion, mercy and power. It is an intensely active principle – Yang – but with this huge strength of the Yin.
Why do I say that the strength of Yin is large when it is, in reality, just the beginning of the growth of Yin? Because the entire momentum of Yin’s growth starts at this point – it somehow contains the whole force of the future splendor of Yin’s fullness. It is strong in the sense that is young, vital, and on the ascent.
I think this Yin principle is very important. At the height of summer, at the height of noon, this is when we may have the tendency to go all upward and outward – but it is crucially important that we go within, nourish our deep spiritual nature. Some cultural customs bear this out – such as the tradition of the midday siesta and the many spiritual activities that go on around the summer solstice. I think that, in some ways, the failure to do this can be seen in American capitalist culture.
The principle of constant up, out, grow, flourish is often not balanced with careful reflection, willingness to “stand down,” controlled descent and respect for the more passive aspects of the universe. This failure has penetrated the consciousness of many American people and others affected by this philosophy and may have something to do with much of the pathology we see today. More about this later.
Earthly Branch Wu : combined with the symbolism of the Horse in the Chinese zodiac
The Earthly branch Wu 午, reinforces what we’ve already discussed about the Summer Solstice – given that it is the Earthly branch associated with that part of the year. It is a picture of either a battering ram or a mortar and pestle, and thus we see again the idea of death or destruction in this life affirming and light giving symbol of the Heart. Wu 午 is also associated with the number five insofar that it is pronounced the same as 五, Wu – “five.”
This brings us to consideration of the association of the number five and the Heart. We should note that we’re talking about the fifth month when we talk about the Heart. The number five is extremely important in Chinese cosmology – witness the deep symbolism of the five elements and a whole variety of other symbolism assocaited with five. There’s just so much that I could say in this realm (and actually did, but then deleted to save your poor eyes) but I will have to stop here for the sake of article length.
The Earthly Branch Wu 午 is related to the Horse in the Chinese Zodiac.
Remember, the Earthly Branches were associated with an animal to help them be easier to understand by the common people. The Horse is a particularly fascinating symbol for the Heart, which I could talk for a long time about. But consider just a few simple items. The horse is tireless, constantly galloping away, carrying great loads, even fighting in battle – just as our physical Heart must persist throughout our lifetimes.
The horse seems to share a Shen level connection with the human being – a really close rider and horse seem to read one another’s minds, few verbal commands are needed when the relationship is strong. The horse is one of the most beloved animals in all cultures, people sometimes take better care of their horses than they do their children!
I am certain there is more to understand about the horse – I would love to hear what people come up with in the comments to this post – please post below!
As always, there are many more symbols that we can pull from the organ clock to help us understand the Heart more deeply – but let’s work with what we have so far.
How does this help us understand the Heart more completely?
There’s a lot one could say about these symbols. The most important take-home message I have received is the crucial nature of respecting the Yin nature of the Heart. However, I don’t think you should start dousing your anxiety ridden patients with cooling herbs! On the contrary, they probably need Fu Zi. Which actually brings me to an important relationship and my overall point. You’ll excuse me if I diverge a bit into conjecture and philosophical exploration? Thanks.
We often talk about the relationship of the Heart and Kidney – fire and water. They are obviously related via their Liuqi designation of Shaoyin, or lesser Yin. We learn that the Shaoyin fire of the Heart must descend through the Earth to reach the Shaoyin water of the Kidney. In doing so, the cold Kidney water, the depth of our wisdom and lineage, is animated by the pure fire of Spirit and consciousness. Wisdom without use of that wisdom is nothing but a lifeless puddle. Likewise, the pure Kidney water must be steamed up to cool and contain the sometimes over-exuberant Heart Shen. Consciousness without wisdom quickly becomes tyranny and zealotry.
This is one way that I understand the importance of using Fu Zi even in the case of patients who appear to have lots of flaring Heat – such as patients with intense insomnia and anxiety. So many TCM physicians would balk at serving Fu Zi to such a patient. To provide one example of a powerful use of this principle, let’s go to that little book known as the Shang Han Lun.
Xià zhīhòu．fù fāhàn．zhòurì fánzào bùdé mián．yè ér ānjìng．bù
ǒu bù kě. wú biǎozhèng．mài chén wēi, shēn wú dà rè zhě,gān jiāng fùzǐ tāng zhǔ zhī.
When precipitation has been used, yet sweating is then promoted so that the person in the daytime is vexed, agitated and sleepless, but by night time becomes peaceful and retching, thirst, exterios signs and great generalized heat are all absent, and the pulse is sunken adn faint, then Gan Jiang Fu Zi Tang governs (Mitchell/Ye/Wiseman version).
While I would like to think that most doctors would see patient with this picture – particularly the faint pulse – and realize that an intensely warming formula can be indicated, I think that most would still shun such strength and instead use something milder, more cooling, and most likely less effective.
One more point and then I’ll close this article. I believe that this fire-water relationship and the general Yin nature of the Heart leads us to realize the wisdom of having a well-developed spirituality. Only by combining the deep wisdom of contemplation (dwelling in the water) with the animating ecstacy of consciousness (dwelling in the fire) can we have balance. Advising our patients to nourish themselves in this way – of course without necessarily promoting a particular practice or tradition – may go a long way to helping them achieve greater health.