What is the ‘Heart’ in Traditional Chinese medicine?

Although the way things are phrased in traditional medical texts seems strange or mystical, most of it translates quite well into modern language, if we take the time to understand. The observations made by physicians of the time may provide useful insights into how the body works and its systems integrate. The traditional texts were written thousands of years ago, most notably, in the Huangdi Neijing 2600BC. All theoretical traditional Chinese medicine (TCM) organs will be in italics, and physical Western medicine (WM) organs in normal text, for the reader to distinguish the difference. In both Western and TCM, each organ system has many functions, this article - What is the 'Heart' in TCM, will aim to translate them using into biological functions that the physicians of the time may have been observing.


  1. The Heart governs blood
  2. The Heart controls the blood vessels

Both modern medicine and traditional Chinese medicine can agree on these two functions of the Heart. The cardiovascular system makes up the heart, blood vessels, and blood. 


3. The Heart houses the Shen

The Shen roughly translates to the mind or spirit. It is the part of us that perceives ourselves and the outside world. Our mental and emotional state depends on Shen, it is our ability to think, recall memories, recognise and show feelings, and understand signals from all our senses (smell, sight, sound, touch, and taste).[1]

So what’s the connection to the Heart

Many functions of the Shen correlate to the functions of the brain in Western medicine. The brain receives stimuli from our senses and decides what is important for us to notice. The brain can recognise emotions but it is in the heart that we ‘feel’ them. 

For example, Takotsubo cardiomyopathy or broken heart syndrome is recognised as a stress-induced condition which causes the ballooning of the left ventricle.[2] This condition typically happens after the death of a loved one and if there are underlying neurological or psychiatric conditions.[2]

It is well known that heart disease has a negative impact on cognition most likely explained by the consequences of reduced oxygen levels in the blood. Coronary heart disease comes with a 45% increased risk of dementia or cognitive impairment and could accelerate cognitive decline by 66%.[3,4]

There is also a positive correlation between mental health disorders and coronary heart disease, which have similar risk factors and pathophysiology. Dysfunction and dysregulation of the autonomic nervous system and hypothalamic-pituitary-adrenal axis are found in mental health disorders. This causes various heart rate irregularities, inflammation, and increased platelets which may then have a negative effect on the brain and cognition.[5]


4. The Heart opens into the tongue

In TCM, the colour of the tongue body reflects the quality of Blood, e.g. a pale tongue reflects Blood deficiency, a purple tongue reflects Blood stagnation. The Heart governs blood and controls blood vessels. The tongue is a muscle, directly affected by the quality of blood circulation. Recently in Western medicine, there have been links discovered between the microorganisms living on the tongue, characteristics of the tongue, and the presence and severity of heart failure. Heart failure may present with a red tongue with yellow coating and the presence and quantity of certain types of bacteria.[6]


5. The Heart reflects in the complexion

6. Sweat is the fluid of the Heart


  1. Maciocia G. The foundations of Chinese medicine. Second Edition. Churchill Livingstone; 2005.
  2. Boylan LS. Brain-heart connections. American Academy of Neurology, 2020 [cited 2020 May 29]. Available from: https://n.neurology.org/content/brain-heart-connections
  3. Deckers K, Schievink SH, Rodriquez MM, van Oostenbrugge RJ, van Boxtel MP, Verhey FR, Köhler S. Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis. PLoS One. 2017;12(9). Available from: https://search.proquest.com/docview/1936800540?accountid=14620&pq-origsite=summon
  4. Bleckwenn M, Kleineidam L, Wagner M, Jessen F, Weyerer S, Werle J, Wiese B, Lühmann D, Posselt T, König HH, Brettschneider C. Impact of coronary heart disease on cognitive decline in Alzheimer’s disease: a prospective longitudinal cohort study in primary care. Br J Gen Pract. 2017 Feb 1;67(655):e111-7 Available from: https://bjgp.org/content/67/655/e111
  5. De Hert M, Detraux J, Vancampfort D. The intriguing relationship between coronary heart disease and mental disorders. Dialogues in clinical neuroscience. 2018 Mar;20(1):31. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016051/
  6. Antipolis, S. Tongue microbes provide window to heart health. European Society of Cardiology Press Release, 2020. Available from: https://www.escardio.org/The-ESC/Press-Office/Press-releases/Tongue-microbes-provide-window-to-heart-health