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The heart is situated in the thorax and its meridian connects with the small intestine with which it is internally-externally related. The main physiological functions of the heart are: dominating the blood and vessels, manifesting on the face, housing the mind, and opening into the tongue.

Dominating the blood and vessels and manifesting on the face

Dominating the blood and vessels means that the heart is the motive force for blood circulation, whilst the vessels are the physical structures which contain and circulate the blood. The blood circulation relies on co-operation between the heart and the vessels, with the heart being of primary importance. In the forty-fourth chapter of Plain Questions, it is stated: "The heart dominates the blood and vessels."

The physiological function of the heart in propelling the blood relies on the heart qi. When the heart qi is vigorous, the blood will circulate normally in the vessels to supply the whole body. Since the heart, blood and vessels are interconnected, and there are many vessels on the face, the prosperity or decline of the heart qi and the amount of blood circulating will be reflected in changes in both the pulse and complexion. If the heart qi is vigorous and the blood ample, the pulse will be regular and strong and the complexion rosy. When the heart qi and blood are deficient, the pulse will be thready and weak, and the complexion pale. As the ninth chapter of Plain Questions says: "The glory of the heart is manifested on the face, since the blood fills up the vessels."

Housing the mind

The word "mind" has the broad meaning of the outward appearance of the vital activities of the whole body, and the narrow meaning of consciousness, e.g. spirit and thinking. The theory of the zang-fu organs states that thinking is related to the five zang organs, and principally to the physiological functions of the heart. The seventy-first chapter of Miraculous Pivot says: "The heart is the residence of the spirit." The eighth chapter in the same book also says: "The mind is responsible for the performance of activities."

This shows that mental activities and thinking have their foundation in the functions of the heart. Spirit, consciousness, thinking, memory and sleep are therefore all related to the function of the heart in housing the mind. Blood is the main material basis for mental activities. It is controlled as well as dominated and regulated by the heart. So the function of the heart in housing the mind is closely related to that of the heart in controlling the blood and vessels. Therefore it is stated in the same chapter, "The heart dominates vessels and the vessels house mind."

Opening into the tongue

"Opening" refers to the close structural, physiological and pathological relatIonship between a particular zang and one of the sense organs. The tongue is connected to the Heart Meridian interiorly, and via this connection the heart dominates the sense of taste and the speech. When the function of the heart is normal, the tongue will be rosy, moist and lustrous, the sense of taste will be normal, and the tongue will move freely. On the other hand, disorders of the heart will reflect on the tongue. For example, deficiency of heart blood may give rise to a pale tongue; flaring up of heart fire may give rise to redness of the tongue tip and ulceration of the tongue body. Stagnation of heart-blood may give rise to a dark, purplish tongue body or purplish spots on the tongue. The saying: "the heart opens into the tongue," and "the tongue is the mirror of the heart" reflect this close physiological and pathological relationship.

Appendix:

The pericardium, known as "xin bao luo", is a membrane surrounding the heart. Its meridian connects with the sanjiao with which it is externally-internally related. Its main function is to protect the heart. When pathogenic qi invades the heart, the pericardium is always the first to be attacked, and invasion of the pericardium by pathogenic qi will often affect the normal function of the heart. For example, invasion of the interior by pathogenic mild heat, which gives rise to symptoms of mental derangement such as coma and delirium, is described as "invasion of the pericardium by pathogenic heat," although the clinical manifestations are the same as those of the heart. For this reason, the pericardium is not generally regarded as an independent organ, but as an attachment to the heart.

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