This is one of the 12 organ systems in Chinese medicine.

Pericardium organ system overview #

The Pericardium is known as 心包 xīn bāo in Chinese.

In conventional anatomy the pericardium is the membrane that surrounds the heart. In Chinese medicine the Pericardium is an organ system in its own right, and it is closely bound up with the Heart it protects. It is the organ system of the emotional life and of relationship, and it has a lot to do with how open we are to other people, and how closed.

In Chinese medicine, some of the major functions of the Pericardium organ system are:

• Protecting the Heart, and deciding what is allowed through to it and what is kept out
• Carrying the joy of the Heart outward, into our relationships with other people
• Governing the emotional life, and our capacity to be close to others
• Governing the blood, together with the Liver, with which it shares the Juéyīn conformation
• Working as one of the two Ministerial Fire organ systems, alongside the Triple Burner

The Pericardium is the only one of the twelve organ systems with more than one name in the classical texts. The oldest and most common is 心主 xīn zhǔ, the Heart Ruler, or Heart Governor. 心包 xīn bāo, the Heart Wrapper, is later. There is also 心包絡 xīn bāo luò, the network of the heart wrapper, and 膻中 dàn zhōng, which is the name the Nèijīng uses when it describes this organ system as an official (more on that below), and which is also the name of an acupuncture point in the center of the chest.

心主 can be read two ways, either as “mastered by the Heart” or as “the Heart’s master.” Both readings describe something true about this organ system. It serves the Heart, and it also has some mastery over the Heart. A healthy Pericardium knows when it is time to rule over our feelings and when it is time to let our feelings rule us.

Chinese characters are often built out of smaller characters, each with its own meaning, and it can be helpful to look at those parts. The 包 bāo in 心包 is usually translated as a wrapper or envelope. The 說文解字 Shuōwén Jiězì, the first Chinese dictionary to take characters apart into their pieces, compiled around 100 CE, describes 包 as a picture of a woman carrying a pregnancy, with the child inside not yet formed. So the “wrapper” around the Heart is closer to a womb than to a bag. Heiner Fruehauf, founder of Classical Pearls and former teacher of Eric Grey, makes the same point, and connects it to the Pericardium’s role, together with the Liver, in governing the blood.

Edward Neal would like to see “pericardium” retired as a translation. In “Twenty Years of Nèi Jīng Research: What Has Been Learned?” (Journal of Chinese Medicine, issue 100), he finds no evidence relating any of these names to the anatomical pericardium, and recommends that 心主 xīn zhǔ, 心包 xīn bāo and 心包絡之脈 xīn bāo luò zhī mài be “considered references to the heart collateral network.”

Let’s dig in a bit more using the various structures and symbols associated with the Pericardium.

The Pericardium acupuncture channel #

The Pericardium channel is the channel of hand Juéyīn, and it has 9 points.

It begins in the center of the chest, connects with the Pericardium, and descends through the diaphragm, passing through the upper, middle and lower parts of the torso (the three 焦 jiāo, or burners, of the Triple Burner). A branch runs from inside the chest to emerge on the side of the chest a little below the front of the armpit, near Tiānchí PC-1. It arches over the armpit and runs down the middle of the inside of the upper arm, between the Lung and Heart channels, to the crease of the elbow at Qūzé PC-3. From there it runs down the middle of the inner forearm between the two tendons, into the palm at Láogōng PC-8, and ends at the tip of the middle finger at Zhōngchōng PC-9. A second small branch leaves the palm and runs to the tip of the ring finger.

Two of its points are especially well known. Nèiguān PC-6, the Inner Pass, sits between the two tendons of the inner forearm, a short way above the wrist crease. It is one of the most important points on the body for the chest, and for nausea of every kind. Láogōng PC-8, the Palace of Toil, is in the center of the palm, where the tip of the middle finger lands when you make a fist. It is the fire point of a fire channel, and it is traditionally where healing energy is thought to come from in the laying on of hands.

Phase Element – Ministerial Fire #

The five phases, also known as the five elements or five phase elements, is one of the most common symbolic systems used in Chinese medicine. The five phases are Fire, Earth, Metal, Water and Wood. Each phase has its own basic character and series of associations, all of which can be used to understand human health, as well as other aspects of reality.

Fire is divided into two types in Chinese medicine, Imperial and Ministerial. Imperial fire is stable, consistent and unmoving like a hearth fire, and the Heart and Small Intestine are included in this phase element. Ministerial fire is more inconsistent, can be more powerful and less controlled, and moves around the body. The Pericardium and the Triple Burner are included in this phase element.

The Pericardium’s Earthly Branch, which is covered further down, belongs to the Earth phase rather than to Fire. So even though it is a Fire organ system, the Pericardium also has some earthy qualities. It is deeply connected to the body, to the senses, and to our ability to taste the finer things in life, whether those are physical, emotional or spiritual.

Six Conformations – Juéyīn #

The six conformations is a system of diagnosis that divides the twelve organ systems into six synergistic pairs. There are a variety of ways to parse the information contained in this system, which is chiefly used when diagnosing and treating infectious conditions such as colds and flus, but has utility beyond that use.

Juéyīn can be translated as “reverting yin” or “returning yin.” The Pericardium shares this conformation with the Liver, and Juéyīn is the deepest of the six conformations, the one most hidden within the body. It is the storehouse of the blood, including the hormones.

Each of the six conformations has a job. Two of them open, two close, and two pivot. Juéyīn closes, and what it closes is the yin itself. It is described as the “death of yin,” the function that ends the yin stage of a cycle so that yang can be born again. When it closes properly, the blood is stored and circulates the way it should. When it fails to close, qi and yin rush upward in ways that are hard to control. When it closes too much, the blood stagnates.

Huángdì Nèijīng – Chapter 8 – The Minister and Envoy #

One of the most important books in Chinese medicine is the Huángdì Nèijīng or Yellow Emperor’s Inner Classic. In Chapter 8 of that text, all of the organ systems are described using language that relates to the operation of a country or state. This is a common way of symbolically discussing physiology and pathology in ancient Chinese texts.

In this chapter, it is said of the Pericardium:

膻中者，臣使之官，喜樂出焉。

“The dan zhong is the official functioning as minister and envoy. Joy and happiness originate in it.”

Paul Unschuld translation

In this system the Heart is the emperor, and the minister and envoy is the official closest to the emperor, the one who serves the emperor directly and does what the emperor asks. Other translators have compared the Pericardium to a court jester who makes the king laugh, or to the king’s butler, who carries the joy of the Heart out to everyone else.

Two different words for joy appear in the line, 喜 xǐ and 樂 lè, and both of them come out of the Pericardium.

Organ clock – 7pm – 9pm #

The Pericardium’s hours are the early evening. There is still a little light, and most creatures are still awake, but the day is over and it is time to get home, to get to safety, and to be with the people (and the animals) we share our lives with.

In October the hour and the month line up, and both of them are trending toward darkness.

Organ clock – October #

Note: The lunisolar Chinese calendar doesn’t match up perfectly with the months of the Gregorian calendar. We’re using the closest month on the Gregorian calendar that makes sense.

October is the ninth month of the Chinese calendar. Nine is the number of accomplishment, since it is the highest single number, and ten just goes back to one.

This is the time of the autumn colors. They are beautiful, and they are also a sign of the death that is so much a part of this time of year. Crops are harvested, and it is getting colder across most of the northern hemisphere. Everything is being stripped bare, and once the trees have lost their leaves you can see the hills behind them again.

So October is a month of tenderness and closeness, of celebration and harvest, and it is also a month of giving up, giving away and stripping down, and both of those belong to the Pericardium. The love we feel for the people close to us is precious partly because we know it is temporary. A healthy Pericardium lets us see the beauty in things because they are fleeting. An unhealthy one either can’t see it, or becomes obsessed with it.

The Chinese agricultural calendar has two solar terms in October. 寒露 Hánlù, Cold Dew, falls on October 8th. Its three five-day periods are 鴻雁來賓, the wild geese arrive as guests; 雀入大水為蛤, the sparrows enter the great water and become clams; and 菊有黃華, the chrysanthemums bloom yellow. Cold Dew can also be translated as “out in the open,” since cold dew collects in open fields, and one way of reading it for the Pericardium is as the openness of an open heart, along with knowing when that openness needs to be held back.

霜降 Shuāngjiàng, Frost’s Descent, falls on October 23rd. Its three periods are 豺乃祭獸, the jackals begin to sacrifice their prey; 草木黃落, the plants and trees yellow and fall; and 蟄蟲咸俯, the hibernating insects all bow down.

After October comes the Triple Burner’s month, the great quiet before the return of the light in December.

Organ clock – The branch 戌 Xū #

Every organ system is related to an “Earthly Branch” which is one of the pieces of the ancient Chinese calendar system.

The Pericardium’s branch is 戌 xū, which anciently was a picture of a ceremonial axe, usually made of jade. Heiner Fruehauf reads it as the ritual axe used to split open the chest, so that a person is open to receive spirit.

As mentioned above, 戌 is one of the Earth branches, which gives the Pericardium some of its earthy character even though it is a Fire organ system.

Organ clock – The Dog #

To make those branch symbols easier to relate to, the Chinese associated each with one of the 12 zodiac animals from Chinese astrology. The Pericardium’s animal is the dog.

The dog stands in for the kinds of animals we surround ourselves with, and it could just as easily be a house cat. These animals become almost extensions of us. They are particularly good at absorbing our emotional excesses, especially when words become difficult, and they are a symbol of loyalty and of protection, of knowing that someone has your back. Dogs also do most of their barking after sundown, which is the Pericardium’s time of day.

One of the Chinese characters for dog, 狗 gǒu, is made of two parts, a dog on the left and an old form of a hook on the right. One way of looking at it is that the Pericardium is a hook that pulls us forward on our path, or pulls us back when we have gone too far. When it isn’t working well, we can get too “hooked” into things, or be held back by our circumstances.

Many of the qualities of a healthy Pericardium are the qualities of a good dog: loyal, trusting, comforting, playful, enjoying the tastes and sights of the world, and willing to come to heel when it is time to stop running around. The same qualities out of balance describe an unhealthy Pericardium: too trusting, loyal to a fault (staying in relationships that hurt us), needy, and unwilling to come back in when it is time to draw inward.

Guard dogs appear in Chinese tradition too, standing at the gate, kind to friends and fierce to strangers, and thought especially to guard against dark influences, much as the Pericardium stands at the gate to the Heart.

Organ clock – Hexagram 23 #

The Yijing / I Ching is one of the most ancient Chinese texts. It contains 64 hexagrams and their interpretation and was used anciently, and is still used today, for divination purposes. Each hexagram is composed of 6 lines, either broken (yin lines) or solid (yang lines) or a combination of the two, meaning each has a unique type of yin/yang balance.

There are 12 special hexagrams called “tidal hexagrams” that are arrayed around the organ clock depicting the relative balance and relationship of yin and yang throughout the cycle of 12 months. The Pericardium’s is Hexagram 23, Bō 剝, five yin lines below and a single yang line at the very top. It has been translated as Stripping, Falling Away, and Erosion.

The character 剝 means to peel or to shell, and anciently it could also mean to carve. It has a knife on its right side.

Across the autumn the yin lines have been rising one at a time, from the Bladder‘s Hexagram 12 in August to the Kidney‘s Hexagram 20 in September. By October there is only one yang line left. Next month, the Triple Burner’s Hexagram 2 is all yin, and in December the Gallbladder‘s Hexagram 24 has a single yang line returning at the bottom. Hexagrams 23 and 24 are a pair. The first is the door closing on the outward, active side of life, and the second is the door opening again.

The Pericardium in clinic #

Like most organ systems, and the channels they are connected to, the Pericardium channel and organ can be used in a variety of ways in the clinic. In fact it is reductive, and inappropriate, to say that one organ system or channel “treats such and such condition,” as though that is the sum total of its impact. That said, there are general principles worth naming that will help you understand this organ system more deeply.

• The emotional life, and especially the effects of heartbreak and betrayal. Heiner Fruehauf describes betrayal as the beginning of most Pericardium problems. Afterward the Pericardium can get stuck open, so that a person feels everything and is overwhelmed by it, or stuck closed, so that real connection becomes very difficult.
• Losing ourselves in relationships, including patterns of neediness, codependency, and moving from one relationship to the next without ever feeling satisfied.
• Symptoms in the chest: palpitations, a sense of tightness or stuffiness in the chest, and irregularities of the heartbeat.
• Nausea and vomiting of many kinds, for which Nèiguān PC-6 is one of the most important points on the body.
• Sleep problems with a restless, simmering, anxious quality, where the mind can’t let go of something at night.
• Problems of the blood and the hormones, including menstrual problems, which this organ system treats together with the Liver through the Juéyīn conformation.