The two hearts in Traditional Chinese Medicine

By Melissa Carr, BSc, DrTCM

There’s a joke in Traditional Chinese Medicine (TCM) that we have two hearts and no brain. TCM texts don’t mention much, or anything, about the physical brain. Instead, the focus is on the functions of the brain, like memory, concentration, and decision making. TCM does, however, distinguish two main aspects of the heart—the physical heart and the emotional heart.

It’s not far-fetched for many of us to understand this perspective. After all, February highlights both types of hearts with Heart Month and Valentine’s Day.

The Physical Heart

Depending on which aspect of the TCM Heart is affected, a person with heart issues may appear pale, experience fatigue, and have a weak pulse; have discomfort in the chest, feel cold, and have a deep and weak pulse; or feel dizzy, have a dull pale complexion, and experience palpitations in the evening.

It’s easy to see how these symptoms can relate to physical heart problems, and with these three combinations of symptoms, a TCM doctor is likely to diagnose Heart Qi deficiency, Heart Yang deficiency, and Heart Blood deficiency, respectively.

While the TCM diagnosis and treatment approach is different from the conventional, early TCM doctors and scholars identified the physical heart as responsible for pumping blood through the blood vessels, supplying nutrition and energy to all the organs of the body. With that recognition, they titled the Heart* the “King,” the most important organ for which all the other organs will sacrifice their energy, if needed.

As such, whenever physical heart conditions arise, it’s likely that other organ systems will also show signs of imbalance, so it’s important to check the digestive, immune, respiratory, detoxification, elimination, and other systems as well.

The Emotional Heart

In TCM, specific organ systems are ascribed different emotions. The Spleen tends to worry, the Lungs manage sadness, the Kidneys hang on to fear, and the Liver rules anger. The Heart is said to house all these emotions, though its primary emotion is joy. Joy can relieve tension and counter what we perceive as the negative experiences of many other emotions. In TCM, we also identify this emotion as being able to simulate the flow of Qi and blood and bring into balance our other systems as well.

While the words joy and happiness are sometimes used interchangeably, they are different emotions. Joy is cultivated internally when a person is at peace with themselves. Happiness, on the other hand, comes from the external, triggered by other people, things, thoughts, and events. Happiness is hard to control, nearly impossible to hang on to. Joy is something that can be present even during loss.

While the Heart and joy can influence the whole of the body and mind, chronic depression, enduring anxiety, ongoing worry, lingering grief, simmering anger, shock, and trauma can also affect both the physical and the emotional Heart. Even excess happiness—for example, in the form of mania—can disperse one’s focus, energy, and ability to heal.

Some common symptoms related to a Heart imbalance include anxiety, agitation, mental restlessness, depression, insomnia, dream-disturbed sleep, nightmares, dementia, poor memory, impulsiveness, and being easily startled.

Keeping the Heart Healthy

When following TCM nutritional principles, bitter foods and herbs are used to clear signs of heat from the body, particularly the Heart—with symptoms like canker sores, red face, palpitations, anxiety, dream-disturbed sleep, and dark yellow urine. Note, it’s more about a combination of these symptoms, rather than just one or two of these symptoms to indicate the TCM pattern.

Some of these bitter foods include dark leafy greens, broccoli, Brussel sprouts, kohlrabi, dandelion, artichoke, bitter melon, barley, amaranth, quinoa, rye, chicory, and mustard. Herbs like dandelion, nettle, milk thistle, chamomile, and turmeric may be helpful.

For someone who is experiencing dizziness, fatigue, pale complexion, poor memory, anxiety, easily startled, and shortness of breath, more nourishing sweet foods and herbs are recommended, including beets, sweet potatoes, yams, pumpkin, mushrooms, squash, taro, tomato, coconut, fig, persimmon, berries, barley, amaranth, rice, millet, oats, buckwheat, flax, legumes, and animal-based proteins. Some herbs that fit the bill may include cinnamon, licorice, ginseng, goji berries, dates, dong quai, and hawthorn fruit.

Of course, a person experiencing chest pain should seek medical attention, but afterward, may benefit from pungent foods and herbs like garlic, onions, mustard greens and seeds, radishes, kumquat, pepper, basil, cinnamon, rosemary, saffron, clove, and ginger.

In addition to nutritional, exercise, and medication recommendations, The American Heart Association does not neglect the importance of our emotional, psychological, and social well-being, with advice for meditation, developing social connections including with animals, practicing gratitude, and more.

In the same vein, and based on Confucianism and Daoism, TCM has a long-standing foundation of calming the Heart. TCM advises to be poised and patient instead of chasing one desire after another, thus avoiding injuring the Heart and exhausting one’s energy.

Editor’s note: Organ names are capitalized when they describe the Traditional Chinese Medicine definition of the organ system as a whole, not just the physical organ.