All lessons Module 4: Organ by organ Lesson 1
Heart and Pericardium
A redder tip, a crack reaching the tip, a pulse that leaps up or falters at left cun: which Heart pattern are you reading, and which finding separates the neighbours?
After this lesson you know where to read the Heart (the tip of the tongue and left cun), you know the tongue and the pulse of all Heart and Pericardium patterns, you separate the tricky pairs by the coating, the shape and the pulse, you know which pulses and tongues need a doctor first, and you read a tongue and a pulse from finding to principle.
Know by heart
- Where you read the Heart. On the tongue the tip; at the pulse left cun. A redder tip is Heat in the Heart: with yellow coating Full, without coating Empty; mnemonic: the tip says where, the coating says Full or Empty.
- Pale: Qi, Yang or Blood. Heart-Qi deficiency: Pale, empty. Heart-Yang deficiency: Pale, wet, Swollen; deep, weak, knotted when severe. Heart-Blood deficiency: Pale and Thin; choppy or thin; mnemonic: wet is Yang, thin is Blood, otherwise Qi.
- Red: Yin or Fire. Heart-Yin deficiency: Red without coating, redder tip; thin-rapid or floating-empty. Heart-Fire: Red, redder tip, yellow coating; rapid, overflowing at left cun. If both chi are empty and there is lower backache and tinnitus, it is Heart and Kidneys not harmonised.
- Phlegm: sticky and slippery. Phlegm-Fire: Red, sticky yellow coating; slippery-rapid. Phlegm misting the Mind: Swollen, thick sticky white coating; slippery; mnemonic: yellow agitates, white draws a veil.
- Purple and faltering. Heart-Blood stasis: Purple, full veins under the tongue; choppy, wiry or knotted. Heart-Qi stagnation (textbook): slightly Pale-Purple sides at the front; pulse without strength, very slightly overflowing at left cun; mnemonic: purple at the front is the chest.
- The crack to the tip and the Pericardium. A long midline crack reaching the tip belongs to the Heart: on its own it is constitutional, with a red tip or coating in it a pattern. Heat in the Pericardium: Deep-Red, dry, without coating; thin-rapid; with fever and confusion.
- Red flags. A pulse that skips or is irregular: ECG. Chest pain, cold sweat with a barely palpable pulse, blue lips with breathlessness, or fever with confusion: emergency services (112 in Europe, 999 in the UK, 911 in North America).
The rest of this lesson is reference.
Three practice questions from this lesson
Where do you read the Heart on the tongue and at the pulse?
- The sides of the tongue and left guan
- The tip of the tongue and left cun
- The centre of the tongue and right cun
Answer: The tip of the tongue and left cun. The tip is the zone of the Heart, left cun the position of the Heart at the pulse. The sides and left guan belong to the Liver, right cun to the Lungs.
A tongue is Red with a redder tip. Which finding best separates Full from Empty-Heat in the Heart?
- The moisture: dry when Full, wet when Empty
- The coating: yellow when Full, none when Empty
- The tip: clearly redder when Full than when Empty
Answer: The coating: yellow when Full, none when Empty. Red with yellow coating is Full-Heat (Heart-Fire); Red with little or no coating is Empty-Heat (Heart-Yin deficiency). Both have the redder tip, and both can be dry.
What does a long, deep midline crack reaching the tip mean on an otherwise normal tongue in someone without complaints?
- Constitution: a Heart sensitive to emotional strain
- Heart-Yin deficiency: the crack runs to the tip
- Stomach-Yin deficiency: a crack in the centre is the Stomach
Answer: Constitution: a Heart sensitive to emotional strain. The crack to the tip belongs to the Heart. On its own, without a red tip, Empty-Heat or coating in it, it mainly says something about constitution (textbook knowledge). The wide crack in the centre that does not run to the tip belongs to the Stomach.
The rest of this lesson
In the course you get the step-by-step explanation with illustrated tongues and animated pulse models, 16 case-based practice questions, 20 spaced-repetition flashcards, the pitfalls, the bridge to physiology and the visual trainer. This lesson belongs to module 4: Organ by organ.