The most important functions of the heart are governing the Blood and housing the Mind. Most of the pathological changes of the Heart reflect this, and involve the Blood and Mind.
If the Blood and Yin are flourishing, the “residence” of the Mind will be in a good state of health, be mentally happy and vital. If they are deficient, the Mind will suffer, the person will feel unhappy, depressed and lack vitality.
If the Mind becomes disturbed from emotional upsets, this can induce a weakness of Blood or Yin and therefore lead to symptoms of Heart-Blood or Heart-Yin deficiency.
Generally, external sources do not attack the heart, as they would attack the pericardium instead.
Heart Qi Deficiency
- Palpitations
- Shortness of breath on exertion
- Sweating
- Pallor
- Tiredness
- Listlessness
- Tongue is pale or normal color. In severe cases, the tongue could have a midline crack reaching the tip and a swelling on each side of it
- Pulse is Empty. In severe cases, the Heart pulse could feel slightly Overflowing and Empty
- Key Symptoms: Palpitations, tiredness, Empty pulse
Pathology
This pattern includes signs of Qi deficiency, such as shortness of breath, sweating, pallor, tiredness and empty pulse, and palpitations. In this case, the palpitations are light and occasional
Aetiology
- Blood loss, possibly from chronic illness or after a serious hemorrhage. The Heart governs the blood, and any serious or prolonged loss of blood will cause a deficiency of Heart Blood, which leads to deficient Heart Qi.
- Emotional problems. Particularly sadness can lead to deficient Heart Qi.
Treatment
Tonify Heart Qi, H5, P6, Ub15, Ren17 and Ren6, all with reinforcing method.
Heart Yang Deficiency
Manifests as:
- Palpitations
- Shortness of breath on exertion
- Tiredness
- Listlessness
- Sweating
- Feeling of stuffiness or discomfort in the heart region
- Feeling of cold
- Bright pale face
- Cold limbs (especially hands)
- Tongue is pale, wet and swollen
- Pulse is Deep, Weak or Knotted
Pathology
Cold hands are due to the Heart Yang not transporting the Defensive Qi to warm them.
Stuffiness in the chest is due to Heart Yang not moving Qi in the chest, leading to a slight stagnation feeling
Bright pale face is typical of Yang deficiency.
Tongue is pale because Heart Yang cannot transport enough blood to the tongue.
Tongue is wet and swollen because Heart Yang cannot transform the fluids which accumulate on the tongue.
Deep Weak pulse reflects the deficiency of Yang. A Knotted pulse (slow pulse that stops at irregular intervals) might be found in extreme cases.
Aetiology
This is basically the same as Heart-Qi deficiency. In addition, it may also come indirectly from a chronic deficiency of Kidney Yang as Kidney Yang is the source of all Yang energies in the body, so this might result from any of the causes of Kidney Yang deficiency.
Treatment
Tonify and warm the Heart Yang. H5, P6, Bl15, Ren17, Ren6, Du14. All with reinforcing, moxa is applicable.
Note: Extreme case of Heart Yang Deficiency is Heart Yang Collapse:
- Palpitations
- Shortness of breath
- Weak and shallow breathing
- Profuse sweating
- Cold limbs
- Cyanosis of lips
- Possible coma
- Tongue, very pale or bluish purple, short
- Pulse, Hidden, Minute and knotted.
Treatment
Heart Blood Deficiency
Manifests as:
- Palpitations,
- Dizziness
- Insomnia
- Dream-disturbed sleep
- Poor memory
- Anxiety
- Propensity to be startled
- Dull pale complexion
- Pale lips
- Pale, thin, slightly dry tongue
- Pulse: Choppy or Fine
- Key symptoms: Palpitations, insomnia, poor memory, pale tongue
Pathology
Heart governs the blood, if the blood is deficent, the heart will suffer and the mind is deprived of it’s “residence” and thus the dream disturbed sleep and insomnia
Dizziness is a general sign of blood deficiency, caused by blood not nourishing the brain
Dull-pale complexion reflects the deficiency of blood.
Tongue is the offshoot of the heart, so when heart blood is deficient, not enough reaches it.
The slight dryness distinguishes this tongue from the Heart Yang deficiency, which is wet.
When not enough blood reaches the tongue for a long time, it becomes thin.
Aetiology
- A diet which has not enough nourishment or lacking blood producing foods, can lead to spleen qi deficiency. Food qi is the basis for the production of blood., thus spleen deficiency over a long time can lead to blood deficiency. Blood deficiency then weakens the heart, leading to heart blood deficiency. Heart Blood deficiency is often related to Spleen Qi deficiency
- Anxiety and worry over a long period of time can disturb the mind, which can depress the heart function. Since the heart governs blood, it can lead to heart blood deficiency.
- Severe hemorrhage can lead to blood deficiency, which can lead to heart blood deficiency. In TCM, this is the cause of post-natal depression and mental confusion.
Treatment
Tonify Blood, Tonify Heart, Pacify the Mind. H7, P6, Ren14, Ren15, Ren4, Ub17, Ub20. All with reinforcing method. Moxa can be used.
Heart Yin Deficiency
- Palpitations
- Insomnia
- Dream disturbed sleep
- Easily startled
- Poor memory
- Anxiety
- Mental restlessness
- Uneasiness
- Figetiness
- Malar flush
- Low grade fever or feeling of heat in the afternoons and evenings
- Feeling “hot and bothered”
- Night sweating
- Dry mouth and throat
- 5 palm heat
- Tongue: red, no coating, redder tip and swollen with red points, deep midline crack reaching the tip
- Pulse: Floating-empty and Rapid or Fine-rapid. It may also be overflowing in both front positions and weak in both rear positions.
- Key symptoms: Palpitations, mental restlessness, feeling of heat, malar flush, red peeled tongue with deep midline crack
Pathology
This pattern includes the pattern of Heart Blood deficiency. This is because blood is yin, and must be a part of Yin deficiency. There is a difference in the insomnia, as the Heart Blood deficient person will find it difficult to fall asleep, but will sleep well. The Heart Yin patient will find it difficult to sleep and will wake up many times through the night.
Mental restlessness, malar flush, 5 palm heat, dry mouth and night sweating are all Empty heat deriving from the lack of Yin.
Heart Yin deficiency is accompanied by or caused by Kidney Yin deficiency, since the kidney yin cannot rise to cool the heart. This leads to a flare up of empty heat in the heart.
This pattern is more common in middle age or older folks when yin deficiencies are more common, where Heart Blood deficiency occurs more often in young people, especially young women.
The midline crack can appear in all the heart patterns. Shallow crack indicates a minor problem, where a deep one that extends to the tip indicates a stronger problem, especially if it reaches the tip, as the tip indicates the condition of the heart. The cracks come from the tongue not receiving enough heart yin, so it dried up and cracks like dry ground during drought.
Red peeled tongue is from lack of yin, causing empty heat. Peeled tongue indicates heart yin deficiency.
The floating empty pulse reflects Yin deficiency, often weak on both rear positions reflecting the lack of Kidney Yin, and overflowing in both front positions reflecting the flare up of Heart Empty heat.
Aetiology
Long standing worry, anxiety and excessively busy life “always on the go” can damage Yin Qi. If this leads to Yin deficiency and is accompanied by deep emotional problems and anxiety, the Mind becomes disturbed and Heart Yin deficiency develops.
This can also arise after an attack of exterior heat which consumes the body fluids and exhausts the Yin of the heart. This only happens in extremely hot countries though.
Treatment
More to come,
Heart Blood Stasis
Heart Fire
Phlegm misting the Heart
Phlegm-Fire disturbing the Heart
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