Summary

As distinct from the Western medical concept of urinary bladder, this concept from traditional Chinese medicine is more a way of describing a set of interrelated functions than an anatomical organ. The bladder system in TCM has many other functions besides transformation and excretion. In TCM, the bladder is paired with the kidney, and the kidneys are the root of life, which makes it one of the most important energy systems in TCM. The kidneys store the deepest level of energy (the jing or essence), and are the root of all yin and yang in the body.

The Functions of the Bladder

The Heart governs ‘Blood’, according to Chinese medicine, is the emperor of all organs. In other words, they will always give their “energy” to help the Heart maintain its balance. The Hearts partner is the Small Intestine. The Stomach is the “child” of the Heart. If the Stomach is functioning well then the mother, the Heart is happy or less impacted. In this simple analogy we understand that Stomach energy must be in balance for Heart energy to be balanced.

Classification

• Zang Organ

The TCM Heart Function

• It governs Blood
• It controls the Blood vessels
• It houses the Spirit/ Mind (Shen－神)
• It manifests in the face
• It opens into the tongue
• It controls sweat

Main symptoms

• Perspiration is the “fluid” of the Heart: Perspiration comes from body fluid, and the Heart controls bodily fluids. If you find you are perspiring excessively, it can signal a Qi or energy deficiency of the Heart.
• The tongue is the sense organ related to the Heart: The condition of the Heart can be seen by observing the tongue. The tongue will be a healthy red color when this organ is in balance. If there is insufficient blood in the Heart, the tongue may appear pale.
• A Heart Deficiency has both physical and psychological effects. Physically speaking, in the case of Heart Qi or Blood Deficiency typical symptoms include low energy, palpitations, shortness of breath, night sweats or fainting.

Patterns of Disharmony

1. Heart Blood Deficiency

• This pattern is manifested by a pale face, pale lips and a pale tongue due to lack of Blood supply. Heart Blood Deficiency may eventually cause Heart Yin Deficiency because Blood is a Yin element. Dizziness is also a symptom because a lack of sufficient Blood is able to nourish the Brain. Heart Blood Deficiency hurts the Mind (神 Shen) which resides in the Heart. Therefore, it causes symptoms such as insomnia, dream-disturbed sleep, anxiety, poor memory and tendency to be scared. Another typical symptom is palpitation due to Heart Qi Deficiency which is a result of Heart Blood Deficiency. 

2. Heart Yin Deficiency

• This pattern often derives from Heart Blood Deficiency. Both patterns (Heart Blood Deficiency and Heart Yin Deficiency) share similar symptoms such as palpitations, insomnia, dream-disturbed sleep, easily scared, poor memory, restlessness and anxiety.  Blood is a type of Yin element. If Heart Blood get insufficient over a long period of time without being treated, it can eventually develop to the Yin Deficiency. Therefore, middle-aged, or elderly patients have more tendency to have Heart Yin Deficiency, while Heart Blood Deficiency is observed to be more prevalent among younger patients, especially young women. Heart Yin Deficiency may also evolve to Empty-Heat pattern, with typical manifestations of malar flush, five-palm heat and feeling of heat especially in the afternoon or evening.

3. Heart and Kidney Yin Deficiency

• Also called “Kidneys and Heart not Harmonized”, this pattern occurs when Kidney Yin is Deficient and cannot nourish the Heart Yin which thus becomes Deficient. It results in a flaring up of Empty-Heat in the Heart with accompanying symptoms such as mental restlessness, insomnia, dream disturbed sleep and nocturnal emissions. The other symptoms like poor memory, dizziness or tinnitus are due to the Kidney Yin failing to nourish the brain and opening into the ear.

4. Phlegm Misting the Heart

• This pattern is also called ‘Cold Phlegm or Mucus Obstructing the Heart Orifices’. It is similar to the pattern of ‘Phlegm Fire harassing the Heart’ (also called ‘Hot Phlegm or Mucus Obstructing the Heart orifices’), but it is a Cold Pattern here. Children can have this pattern and it is often constitutional. It can be the fundamental cause for symptoms like retardation or speech difficulties. As for adult, Phlegm together with the Wind can lead to coma, paralysis and aphasia, which happens often after a Wind-stroke attack. The Mind has no residence at the Heart if it is obstructed by the Phlegm, hence the symptoms of mental confusion, lethargic stupor, or unconsciousness. The Phlegm also prevents the tongue from moving and thus aphasia happens. It is because the Heart opens to the tongue. Due to the Phlegm obstructing the chest, vomiting and the rattling sound in the throat are also the typical symptoms. Finally, the swollen tongue with sticky coating and Slippery Pulse also shows the existing of Phlegm. 

5. Heart Blood Stagnation

• It is characterized by symptoms such as palpitations, chest pressure and stiffness as well as sharp stabbing pain in the chest, which can spread to the inner area of the left arm or to the shoulder. Since the Blood doesn’t flow smoothly, it reflected by the purple or dark color on lips, face, tongue and nails. The Stagnant Blood also blocks the Gathering Qi flow in the chest, which then fails to move Lung and Heart Qi to the hands, hence the symptoms of cold hands. This is a severe pattern that mostly derives from other Heart patterns, normally Heart Yang or Blood Deficiency, or Heart Qi Stagnation. Other than these, Heart Fire or Heart Qi Deficiency can also be the precursors. The symptoms and signs will vary depending on the origin of the pattern. If it is due to the Heart Yang or Blood Deficiency, it causes chest pain which feels like a constriction. The intensity of the pain varies from a mild pricking sensation to an intense stabbing pain. The pain typically comes in repeated bouts and is elicited by exertion or cold weather.