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Traditional Chinese Medicine Internal Organ Syndromes

Heart and Pericardium Syndromes

Heart and pericardium syndromes can manifest themselves either physically -- as in some circulatory conditions such as cold hands and feet -- or in mental or emotional disturbances.

Insomnia in traditional Chinese medicine
Insomnia is a common complaint of people
with heart syndromes.

The heart governs the blood and vessels and is the seat of the mind and spirit. Generally, external pernicious influences don't affect the heart directly; instead, they typically attack the pericardium, the sac around the heart known in Chinese medicine as the "heart protector." The pericardium is considered the sixth yin organ, but its functions are typically linked with the heart. The shield between the heart and the exterior, the pericardium protects the heart from the invasion of external pathogenic factors.

In almost all disharmonies of the heart, palpitations are a key symptom. This pounding of the heart occurs in both excess and deficiency patterns.

Heart Qi Deficiency: Palpitations are the key symptom in this deficiency pattern. Other symptoms are spontaneous sweating (sweating without exertion or overheating), physical and mental fatigue, depression, pale face, and a weak pulse, especially in the heart area on the left wrist. This pattern can correspond to chronic fatigue, neurasthenia (chronic mental and physical weakness), or heart disease involving the muscle, valves, or vessels. The treatment principle for this deficiency is to tonify heart qi with standard qi tonics such as ginseng (ren shen), along with herbs that act specifically on the heart, such as Schizandra (wu wei zi) and Biota (bai zi ren).

Heart Yang Deficiency: This syndrome has all the symptoms of heart qi deficiency with the addition of cold symptoms: feeling cold in the limbs or entire body; purple face, tongue, and lips due to cold stagnating the circulation; and a slow, choppy, and intermittent pulse. A deeper, more serious condition than qi deficiency, heart yang deficiency typically corresponds to a Western diagnosis of true heart disease. The treatment is to tonify heart yang with moxibustion and herbs such as ginseng (ren shen) and aconite (fu zi).

Note: Aconite is a highly toxic herb, and it should only be used in a formula prepared and supervised by a qualified practitioner of traditional Chinese medicine.

Heart Yang Collapse: A more severe version of heart yang deficiency, heart yang collapse produces all the symptoms of qi and yang deficiency plus copious cold sweats, extreme cold in the limbs, very weak breathing, a minute pulse, and abnormal shen that precedes a comatose state. Corresponding Western diagnoses are shock or heart attack, so this syndrome requires hospitalization. In China, the person receives herbal treatment while hospitalized. Typical treatment is an intravenous drip of Salvia (dan shen) and oral doses of ginseng (ren shen) and aconite (fu zi).

Heart Blood Deficiency: This pattern of deficiency involving the blood produces symptoms of palpitations, fearfulness and a propensity to be easily startled, insomnia, excessive dreams while asleep, mental restlessness, forgetfulness, dizziness, pale face and tongue, and a thin, small pulse. The insomnia is due to an insufficient amount of blood to provide a calm foundation for the spirit. Possibly corresponding to anemia or emotional imbalances, this deficiency syndrome is treated by tonifying heart blood with herbs such as Angelica sinensis (dang gui) and longan fruit (long yan rou).

Heart Yin Deficiency: This syndrome of deficiency heat produces red cheeks, night sweats, "five palm heat," dry mouth, thirst for small amounts of water, mental restlessness, insomnia, palpitations, low-grade fever, forgetfulness, excessive dreaming, red tongue with little or no coat, and a small, rapid pulse. A person with this deficiency has difficulty remaining asleep -- the heat condition wakes them. Because the heart is the seat of the spirit, an insufficiency of calming, nurturing yin or blood in the heart results in agitation. Hypertension and hyperthyroidism can match this pattern, which is treated with herbs that clear heat and tonify heart yin such as Emperor's Teapills (Tian Wang Bu Xin Dan).

Heart Fire Uprising: This excess heat pattern produces symptoms that include a red face, dry mouth with a desire for lots of water, a red tip and prickles on the tongue with possible ulcers and pain, bitter taste in the mouth, burning urine, mental restlessness, insomnia, and a full, rapid pulse. Excess heat signs are stronger than those of heat due to yin deficiency. Some corresponding Western conditions are urinary tract infection, high blood pressure, or tongue infection. The treatment aims to clear heat and calm the spirit with acupuncture and herbs such as lotus seed sprouts (lian zi xin) and Coptis (huang lian).

Heart Blood Stagnation: This serious heart condition has symptoms of a sharp, stabbing pain in the heart area, pain that can radiate up the arm, purple face and tongue, fatigue, palpitations, and a choppy, wiry, or intermittent pulse. It sometimes occurs with heart yang or qi deficiency and includes the symptoms common to these patterns. Corresponding Western diseases are angina pectoris, coronary arte­riosclerosis, or pericarditis -- all requiring intensive medical intervention. Treatment involves regulating the qi and vitalizing the blood with circulatory stimulants such as Salvia (dan shen) and Panax pseudoginseng (san qi).

Hot Phlegm Confusing the Heart: This excess condition is characterized by excess heat causing a red face and eyes, irrational and possibly violent behavior, nonstop loud talking, anger, a red tongue with a greasy yellow coat, and a rapid, slippery pulse. It corresponds to the Western diagnoses of mental illness, mania, or encephalitis. The treatment for hot phlegm confusing the heart is to calm the spirit and clear heat and phlegm with acupuncture and herbs such as Coptis (huang lian) and Borneol (bing pian).

Phlegm Misting the Heart Opening: In this condition, which is related to the above syndrome but with less heat, symptoms include a pale tongue with a white coating, mental confusion, difficulty speaking (muttering to oneself, drooling), the sound of phlegm in the throat, and possible loss of consciousness. Some corresponding Western diseases are stroke, epilepsy, mental retardation, or mental illness. The treatment principle is to clear the phlegm and revive the consciousness with scalp acupuncture and herbs that resolve phlegm and wake up the spirit, such as Calamus (shi chang pu).

Pericardium Syndromes: The main syndrome of the pericardium is known as "heat crushing the pericardium," which is characterized by a high fever, mental confusion, convulsions, and, possibly, coma. This pattern can appear in acute febrile diseases with a high fever, such as encephalitis or pericarditis, where the sudden high temperature affects the consciousness. Treatment includes the use of acupuncture points on the pericardium meridian, along with herbs that clear excess heat, such as tree peony root (mu dan pi).

On the next page, learn about the liver, the organ that aids in detoxification, and the syndromes that affect it. Chinese medicine is adept at treating liver syndromes.

For more about traditional Chinese medicine, treatments, cures, beliefs, and other interesting topics, see:

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