The Pericardium According to Traditional Chinese Medicine (TCM)

This article is part of a series explaining the body’s organ systems from the perspective of Traditional Chinese Medicine (TCM) and Five Elements Theory.

The Pericardium is not considered to be an organ system in some TCM schools of thought. This means the Pericardium does not fit into Five Elements Theory, which relates each organ system to one of the Five Elements – Water, Fire, Wood, Metal, or Earth – and to a season, as well as to other corresponding qualities such as taste, emotion, and so on. 

However, because of its relationship with the Heart, it could be argued that the Pericardium shares the qualities corresponding to the Element of Fire, along with the other qualities corresponding to the Heart in Five Elements Theory.

Note: “Pericardium” (with a capital “P”) refers to the TCM concept and channel (or energetic pathway) of that name in TCM, and “pericardium” (with a lower-case “p”) refers to the organ or physiological structure itself.

Functions of the Pericardium

The pericardium is the protective membrane that surrounds and protects the physical heart. 

TCM classifies the Pericardium (PC) as a Yin organ. TCM has many different expressions for the Pericardium including: “Master of the Heart” (Xin Zhu), “Envelope of the Heart” (Xin Bao), and “Connecting Channel of the Envelope of the Heart” (Xin Bao Luo). All of these definitions point to the pericardium as functioning to physically protect the heart.

Among the different traditions within TCM, there is ambiguity and even some confusion concerning the functions of the Pericardium

Many TCM traditions prefer to consider the Pericardium as two separate entities – an organ, and a channel (or energy pathway) – each with distinct functions and natures.

The pericardium is linked to the heart physiologically. The Pericardium is linked to the San Jiao energetically, according to channel theory. You will see this later in the discussion of the Pericardium channel pathway.

There is a saying in TCM that the Heart is the Emperor and the Pericardium protects it.

"The Spiritual Axis in chapter 71 states: The Heart is the Ruler of the five Yin organs and six Yang organs, it is the residence of the Mind and it is so tough that no pathogenic factor can take hold in it. If the Heart is attacked by pathogenic factor, the Mind suffers, which can lead to death. If the pathogenic factor does attack the Heart, it will be deviated to attack the Pericardium instead. For this reason, the Heart has no Stream Transporting point."

(Spiritual Axis (Ling Shu Jing),1981, as cited in Maciocia, 2005, p. 165)
"Conversely, the Selected Historical Theories of Chinese Medicine states: The Triple Burner protects the Internal Organs on the outside and the Pericardium protects the Heart on the outside."

(Wang Xin Hua,1983, as cited in Maciocia, 2005, p. 165)

Many texts reference five Yin organ systems and six Yang organs. This is because those texts view the Pericardium as nothing more than an appendage of the Heart and do not differentiate it as an organ system separate from the Heart.

The functions of the Pericardium are more or less the same as those of the Heart, which has seven principal functions:

  • Governs the blood
  • Controls the blood vessels
  • Manifests in complexion
  • Houses the mind (shen)
  • Connects to joy
  • Opens into the tongue
  • Controls sweat

Functions of the Pericardium as an Organ according to TCM

  • Protects the Heart
  • Governs Blood and houses the Mind – like the Heart
  • Invigorates and/or cools the Blood
  • Stimulates or calms the mind
  • When protecting the Heart in cases of acute febrile disease, manifesting in high fever and delirium, the Pericardium may become obstructed by heat

Acupuncture point examples of how the Pericardium affects the Heart

  • PC 6 lifts mood and treats depression
  • PC 7 calms the Mind; this point is used to treat emotional problems caused by relationship difficulties
  • PC 5 resolves Phlegm from the Pericardium to treat mental confusion. The term “Phlegm Misting the Orifices” presents as mania, schizophrenia, delirium, etc.  

The Pericardium is located in the center of the chest and influences Gathering Qi and, by proximity, the Heart and the Lungs. Because of its location, the Pericardium propels the Qi and Blood for the Heart and Lungs. It is because of this action that common symptoms include dysfunction along the channels of the chest, causing tightness, stuffiness, distension, oppression, or chest pain.

Functions of the Pericardium as a Channel

  • Affects the area of the center of the chest
  • Influences Gathering Qi, Heart and Lungs
  • San Jiao and Pericardium form a linking Yin (Internal) and Yang (External) channel pair

It should be noted that the Pericardium is most frequently mentioned in acupuncture texts. Herbal texts only mention the Pericardium in relation to febrile diseases that manifest with high fever, delirium, mental confusion, and aphasia. 

"Simple Questions, chapter 8 states: The Pericardium is the ambassador and from it joy and happiness derive."

(The Yellow Emperor's Classic of Internal Medicine: Simple Questions. 1979, as cited in Maciocia, 2005, p. 166)

The Pericardium, like the Heart, houses the Mind (shen). Generally, what affects the Heart has already affected the Pericardium first.

Clinically:

  • Blood deficiency of the Heart and Pericardium: depression and slightly anxious
  • Heat in the Blood: causes agitation and restlessness
  • Phlegm obstructing the Pericardium/Heart: causes mental confusion

The Pericardium is responsible for “movement” towards others – i.e. relationships. The Pericardium’s connection to the Liver (through the Jue Yin channel connection) also causes movement of the “Ethereal Soul” (the spiritual aspect of the Liver), from the ego towards others in social relationships and familial interactions.

The Pericardium is responsible for facilitating healthy interactions with other people in social, love, and family relationships.

The Pericardium and the Uterus

As discussed in previous articles, the Uterus is related to the Kidneys via the channel called the Bao Luo and the Heart via a vessel called the “Uterus Vessel,” Bao Mai. 

The Bao Mai is related to the Pericardium by way of the Heart.

"The Pericardium (Xin Bao) is a membrane wrapping the Heart on the outside … the Uterus connects downward with the Kidneys and upwards with the Heart where it receives the name of 'Connecting Channel of the Envelope of the Heart' (Xin Bao Luo)."

(Wang Xin Hua, 1983, as cited in Maciocia, 2005, p. 168)

Pathologies of the Pericardium may affect menstruation, and may be a contributing factor for painful or irregular cycles experienced by women who are under a lot of stress.

Clinical Examples:

  • Blood deficiency of Pericardium: scanty periods or amenorrhea 
  • Pericardium Fire leading to heat in the Blood: heavy periods
  • Blood stasis in Pericardium: painful periods

The Pericardium Channel of Hand JueYin

Note: “Cun” is a TCM form of measurement. One cun is equivalent with the width of the interphalangeal joint (the top part of your thumb). A cun is based on your client’s body measurement.

diagram showing TCM energy pathways of Pericardium system
Image with the kind permission of www.amanualofacupuncture.com (Deadman et al., 2005)

The Primary Channel

  • Originates in the center of the chest, connects with the Pericardium, and descends through the diaphragm to the abdomen, passing through the upper, middle and lower jiao

Branch 1

  • Runs from the inside of the chest to emerge in the costal region 3 cun inferior to the anterior axillary fold (armpit), near PC 1
  • Arches over the axilla, and follows along the antero-medial aspect of the upper arm, between the Lung and Heart channels to the cubital fossa of the elbow (PC 3)
  • Descends the forearm between the tendons of the palmaris longus and flexor carpi radialis muscles to reach the palm at PC 8 (Laogong)
  • Travels from the palm along the tip of the finger to terminate at its tip at PC 9

Branch 2

  • Arises from the palm at PC 8 and follows the tip of the radial aspect of the ring finger to its tip. Note: the San Jiao (SJ) channel begins at the ulnar aspect of the tip of the ring finger

(Deadman et al., 2005, p. 367)

References

  • Deadman, P., Al-Khafaji, M., & Baker. K. (2005). A Manual of Acupuncture. East Sussex: Journal of Chinese Medicine Publications.
  • Hyunbae,K. (2007). Handbook of Oriental Medicine (3rd ed.). Harmony & Balance Press.
  • Kastner, J. (2004). Chinese Nutritional Therapy. Jeorg Thieme Verlag.
  • Maciocia, G., & Xin Ming, S. (2005). The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. London: Churchill Livingstone.
  • Pitchford, P. (2002). Healing with Whole Foods (3rd ed.). Berkeley, CA: North Atlantic Books.
  • Spiritual Axis (Ling Shu Jing) (1981). People’s Health Publishing House, Beijing, first published c. 100 BCE.
  • Wang Xin Hua (1983). Selected Historical Theories of Chinese Medicine (Zhong Yi Li Dai Yi Lun Xuan). Jiangsu Scientific Publishing House, Jiangsu.
  • Wiseman, N. (ed., trans.), & Ellis, A. (trans.) (1996). Fundamentals of Chinese Medicine. (Rev. ed.) Brookline, MA: Paradigm Publications.
  • The Yellow Emperor’s Classic of Internal Medicine: Simple Questions (Huang Ti Nei Jing Su Wen) (1979). People’s Health Publishing House, Beijing, first published c. 100 BCE.
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Teri began her studies in energy medicine as part of her own personal development journey, and continues to to learn and integrate that knowledge into her practice. Teri is the founding practitioner of Calandra Center for Health & Wellness in Schaumburg, Illinois. She is licensed by the State of Illinois in acupuncture (L.Ac.), and board certified through the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).