As one of the Three Treasures (see p. 126) the human Shen is a ‘stepped-down’ version of the universal Shen, which is greater than the individual. The universal Shen is found in most religious traditions, under many different names. It can manifest as an experience of the union of our self with the essential oneness of all things, reached sometimes via our presence in the gaps between thoughts during meditation.

Presence in the moment is the purest form of the human Shen. The quality of being awake, aware and responsive at every level of our being is its highest manifestation. Notwithstanding its connection to the universal Shen it must remain anchored in reality, responding to the demands of all physical circumstances. This is the nature of ‘propriety’, the virtue which results from correct use of the Heart’s spiritual capacity. When pure awareness, free from attachment, engages with the demands of physical existence, correct and appropriate behavior results. In this way, the Shen is the link between Heaven and Earth, as the Emperor, the Son of Heaven, was considered to embody Heaven on Earth in his rulership.

Movement of Fire energy: outwards

The movement of Fire has similarities to the movement of Wood, in that both, being Yang, have a tendency to go upwards when the element is out of balance. Fire, when it rages out of control, roars upwards, and pathogenic Fire creates symptoms in the upper part of the body, such as headaches, red or painful eyes in the case of Liver Fire, mouth ulcers in the case of Heart Fire or bleeding gums in the case of Stomach Fire. In all these cases, it also creates mental restlessness and agitation, often with insomnia, as the Fire rises up to disturb the Shen.

In a state of balance the Fire energy radiates outwards, like light, as it extends its influence through the circulation to all parts of the body. Its characteristic manifestations, however, are in the complexion and the eyes, both in the upper part.

Fire emotion: joy

The Chinese character for the emotion of the Heart is perhaps mistranslated as ‘joy’, since:

Etymological study yields the meaning of ‘joy and pleasure derived from eating’.

(Fujido’s Etymological Dictionary, from Matsumoto & Birch 1998 p. 33)

The emotion of the Heart in tranquility, therefore, is a kind of contentment, without overt or noisy expression. Excessive joy is one of the causes of disease and has to be avoided. Too much elation or excitement, as from good news or celebrations, can cause imbalance or illness.

There are times, also, when excessive elation without apparent cause can be a symptom of illness. An extreme example of this is seen in mania, when there is great excitement, but the sufferer is not grounded in reality, or responding appropriately to circumstances, indicating that the Shen is disturbed. We are more likely, however, to meet people with a Fire imbalance who remain almost inappropriately cheerful in spite of pain or distress. Contentment is a quality of the Shen, and although contentment may be an inappropriate response to illness, it makes it easier to bear. We need to note this response as a diagnostic sign, however much we may warm to it.

The Nei Jing Su Wen says that ‘Excessive shen is laughter that does not stop; empty shen is grief’, and sometimes lack of joy can indicate a problem with the Fire Phase. How do we distinguish lack of joy from the grief of Metal? We can notice the person’s responsiveness to warmth. If there is a problem in Metal, she remains cut off, unresponsive. A receiver with a problem in Fire will become more animated in response to cheerfulness from the giver, but will soon relapse into ‘lack of joy’ if the stimulation stops.

Fire color: red

Red is the color which we naturally associate with Fire. Being the color of oxygenated blood, it also gives the rosy tone which accompanies a healthy heart and circulatory system.

A florid, unvaryingly red skin tone is likely to indicate the pathogenic Fire which accompanies extreme Heat in the Stomach, Liver or Heart, rather than an imbalance in the Ki of the Fire meridians themselves. A Fire imbalance may cause easy blushing, as the Heart responds over-readily to emotional stimulus, or there may be a permanent, though slight, rosy tinge to the face around the eyes or mouth.

Fire sound: laughing

We saw in the quote from the Su Wen above that ‘excessive shen is laughter that does not stop’. Excessive or inappropriate laughter may well be a sign that the Fire energy is out of balance. Because we accept that laughter is a natural way to ease awkwardness in social situations, we may forget that it is also a diagnostic sign; people with a Metal imbalance or a Wood imbalance are unlikely to resort to laughter when nervous or embarrassed, since they have their own characteristic ways of reacting. Laughter is also winning and appealing, so that it is easy to overlook the inappropriateness of a receiver’s laughter when speaking about the death of her father (to give an actual example), since the constant laughter or giggling appears to be, indeed is, part of an attractively bubbly personality. In this type of Fire manifestation, the laughter may actually become part of the tone of voice, so that it seems to have a constant gurgle of laughter behind it, and the speech is often extremely fast.

The other side of the Fire imbalance is the second half of the quote – ‘empty shen is grief’. If Fire appears to be lacking, the receiver will often seem quiet and almost mournful, and laughs little unless encouraged by a display of warmth from another person.

Fire odor: scorched

This is not often encountered in clinical practice, but some receivers with a Fire imbalance may smell like scorched ironing.

Fire sense organ: the tongue

The Fire Phase is related to the tongue because of its ability to communicate, as the organ of speech, and not as the organ of taste, which is the connection between the mouth and the Earth Phase. Of course, speech is not the only means of communication between humans; a more intimate and open way of speaking one to another is with the eyes, and in fact the Shen is said to be visible in the eyes.*

The tongue is the means by which we ‘speak our hearts’ to each other, and express our emotional responses to the outside world. The responsiveness of Fire generates a connection with the tongue and with communication in general. Speech problems, such as stuttering or dumbness, are usually treated via the Fire meridians. Excessive laughter and very fast speech are signs of a Fire imbalance, as are confused or incoherent speech or the delirium of a high fever or mental disorder.

The tongue is considered to be a ‘sprig of the Heart’, and although it is mainly the tip of the tongue which reflects the Heart’s condition in tongue diagnosis, tongue ulcers anywhere on the tongue body are a sign of pathogenic Fire in the Heart.

Fire taste: bitter

The bitter taste of medicinal herbs is ‘drying and hardening’, like Fire. Because the bitter flavor drains Dampness, bitters are a traditional digestive remedy in both West and East, both in medical and culinary traditions. Bitter foods include rye, broccoli, chicory, turnip, watercress, herbs such as thyme, marjoram and parsley, liver, pumpkin seeds, green tea, black tea and chamomile. If there is pathogenic Fire present, there is often a bitter taste in the mouth.

Fire season: summer

The hottest season of the year is obviously that which belongs to Fire. It is the season of light and heat, of Yang at its peak of expansion and richness of manifestation. Energy has extended itself as far as it can go, out to the flowers and fruits of each plant; animals and birds have reared their broods of young. It is at this point, or rather, after the 10 days of Earth stillness at the end of this season (see p. 267), that the transition to Yin, the return to the cool, the dark, the still, must begin; there is nowhere else to go.

It is unusual for the Fire-starved peoples of the Northern world to dislike summer; but the Northern summer is a mild and temperate affair. In more tropical latitudes, the extended period of heat can be a great strain on health, especially if there is already pathogenic Heat or Fire within. Those who dislike hot weather or whose symptoms worsen after a holiday in a hot climate are likely to be suffering from Heat, but not necessarily from an imbalance in any of the Fire meridians.

Fire climate: hot

As mentioned above, excessive external heat can place the body under strain. The Fire meridians suffer particularly, since the Blood must move faster around the circulatory system to cool itself at the Exterior, which puts pressure on the Heart and Heart Protector, and the Triple Heater must attempt to maintain a constant body temperature. A prolonged stay in a hot climate may produce an imbalance in these meridians.

The adverse effects of a hot climate will be felt first by those who already have internal Heat symptoms, or a constitution which tends to be Hot. To those with a Cold constitution, or with internal Cold, a Hot climate will be beneficial. If there is Dampness present, however, it is likely to combine with the Heat, and symptoms of discomfort will result; common sites for Damp-Heat symptoms are the digestive system, joints and the skin.

Fire time of day: 11am–3pm and 7–11pm

The Heart and Small Intestine meridians have their peak of energy at midday, the hottest, lightest and most Yang time of day. Chinese tradition considers it unhealthy to work during this time, and a rest after lunch is thought to be necessary to refresh the mental and digestive powers.

The time of the Heart Protector, ‘from whom joy and pleasure derive’, and its companion, the Triple Heater, is in the evening, after the day’s work is done and there is time for family and social relationships. If one of these meridians is out of balance, there may be a drop in energy during this time which is different from everyday tiredness, since the energy may revive again after 11pm. It is important that, if the receiver has a consistent Heart Protector or Triple Heater diagnosis, she endeavors to go to bed while this tiredness lasts, since a Fire meridian imbalance affects the quality of sleep in general.

The Heart in TCM

In TCM, the Heart is the essential center of the Fire element and of the being; all the other Fire meridians are protectors or agents of the Heart. By a curious paradox, the Heart actually does very little, compared with, say, the Spleen or the Liver. Its main function is to provide a home for our Shen. According to Ted Kaptchuk, the ‘job specification’ of the Emperor, the Son of Heaven, was similarly undemanding (lecture in London, UK, November 1989). The Emperor had to participate in certain rites at certain specific times, as mediator between Heaven and the Empire; a high-profile function, but with little actual work. The performance of these rites, however, was thought to avoid the catastrophes which, according to Chinese philosophy, result from disharmony between Heaven and Earth – floods, epidemics, famine and so on. In providing a physical home for the Shen, the ‘divine spark’ of consciousness, the Heart has a similar function, that of unifying Heaven and Earth in man.

The home of the Shen

As has already been extensively discussed, the Shen is that quality in us which is variously translated as spirit, mind, consciousness or awareness. In order for the Heart to house the Shen, it must itself be tranquil, and empty of disturbing emotions.

In your Heart there is love, don’t love too deeply. In your heart there is hate, don’t hate too deeply, because too much of any of these will attack the Shen

Sun Simiao, The One Thousand Ducat Prescription Book (quoted in Matsumoto & Birch 1983)

Much of Taoist spiritual practice and meditation was designed to nourish and root the Shen, since the Shen’s presence was necessary for health and long life; if the Shen became scattered or uprooted it was impossible to recover from a disease. The luster of the eyes, traditionally linked with the condition of the Shen, is still today an element in TCM prognosis for any disease; if the eyes are lustrous, even if the disease is serious, the prognosis is good.

In ancient China, many conditions where the Shen, or consciousness, became scattered or uprooted would now be classified as shock, coma or critical states of illness with delirium; and many of these are still fatal, although technological methods of intensive care do often result in recovery. Other disorders where the Shen is scattered are nowadays classed as mental illnesses, such as schizophrenia, where the sufferer lives in another reality; his Shen is elsewhere; and recovery is as difficult today as it was then.

Epilepsy is another condition in which the Shen is affected, and this was thought to be due to Phlegm misting the holes in the Heart. Less serious states in which the Shen is affected are blackouts, or periods of amnesia, often linked with Deficiency of Blood, which then fails to nourish the brain or anchor the Shen.

Shen/Blood relationship

In fact, the tranquil resting place for the Shen in the Heart is provided by the Blood. Deficiency of Blood in general, either from failure of the Spleen to provide enough Food Ki and Food Essence for its manufacture, or from inefficient storing by the Liver, can result in the Heart’s not holding enough Blood to nourish and anchor the Shen. We must remember here that Blood is not just a body fluid, however life-giving and full of nutrients and oxygen. The Heart confers Shen upon the Blood and marks this imperial gift with the imperial seal of the red color. It has a spiritual, psychological component, in that it provides us with our sense of satisfaction and completion. If there is enough Blood in the Heart, the Shen is happy to be there, to be securely linked to a physical body in which it can function. If there is not enough Blood, the link becomes more tenuous, and the Shen is anxious; symptoms can manifest such as depression or insomnia (although usually once the person falls asleep he can stay asleep), anxiety and poor memory.

Conversely, the Shen can influence the Blood. If the Shen is strained by emotional problems over a long time, the Heart function can itself suffer. Since the Heart transforms Food Ki and Food Essence into Blood by infusing it with Shen, the production of Blood can be disrupted by the insecurity of the Shen. ‘When the Heart is longing, how can Blood be made?’

Emotions and the Heart

The Heart does not have the same emotional connotations in TCM as it does in Western tradition, since all the organ pairs in the Five Element system are connected with an emotion, and the burden of repression of these emotions is mainly carried by the Liver. The Heart, in ideal circumstances, is an embodiment of the spaciousness of pure, unattached awareness; in such conditions, emotions may come and go, but they do not affect the Shen, which radiates out accompanied by contentment (‘joy’) and compassion. In the average emotional life, however, our consciousness is attached to our emotions, so that they stay and register with us for a while, and tend to produce physiological effects in our Ki and Blood. The Heart can therefore be affected by all the emotions.

Heart Blood

Blood is made in the Heart, so that problems with the Heart function affect the Blood, and problems with the Blood affect the Heart. It is common for too much thinking and worry to deplete the Blood, because it exhausts the Spleen, which provides Food Ki and Food Essence for the making of Blood. Repressed or unacknowledged emotion of any kind can also affect the Liver, causing Blood Deficiency, which depletes the Blood in the Heart. When Heart Blood is Deficient, the general symptoms of dizziness, insomnia, depression and poor memory are accompanied by anxiety and palpitations.

Heart Blood can also stagnate as a result of repressed emotion (linked with the Liver in TCM, as above) which causes Stagnation of Ki and then Blood in the chest. This causes stuffiness, constriction or discomfort (Stagnation of Ki) or severe fixed pain (Stagnation of Blood) in the chest, with palpitations, as well as the other general symptoms of Ki or Blood Stagnation (see pp 121, 124).

Heart Fire

Heart Fire often results from the rising of Liver Yang or Liver Fire which accompanies anger, although any of the emotions will cause a build-up of Heat over time which can overheat the Heart and cause Heart Fire. Characteristic symptoms are agitation, insomnia, thirst, palpitations and ulcers on the tongue.

Empty Heat

Empty Heat is caused by Deficiency of Heart Yin, an increasingly common condition which results from emotional stress accompanied by the depleting effects of our modern lifestyle on Kidney Yin. Heart Yin Deficiency or Empty Heat in the Heart may manifest with any of the general symptoms of Yin Deficiency (see p. 138), together with insomnia, restlessness, anxiety and palpitations.

Heart Ki and Yang

Sadness or emotional frustration over time can affect the Ki of the Heart, via the Lungs, which partner the Heart in the Big Ki of the chest. This results in fatigue, shortness of breath and slight palpitations. When Heart Ki is Deficient, it may progress to Heart Yang Deficiency, which manifests as poor circulation, chilliness and discomfort in the chest as well as the above symptoms. Kidney Yang Deficiency from overwork can also affect Heart Yang, in which case copious pale urination and a cold, sore lower back may accompany the chest symptoms, and insomnia is likely.

Sweating

Any condition involving the Heart may be accompanied by sweating, since the secretion corresponding to the Fire Element is sweat. This will not be overall sweating, however, such as the spontaneous sweating which accompanies Ki Deficiency or the night sweats of Empty Heat. Characteristically, Heart-related sweating occurs as a result of emotional disturbance or nervousness; sweaty palms are the classic Heart indication, but the armpits and feet may also sweat.

Circulation

The Heart is said to ‘govern’ the Blood in TCM; apart from the transformation of Food Ki into Blood, which takes place in the Heart, the Heart is ultimately responsible for the circulation of the Blood and the condition of the blood vessels; ‘ultimately responsible’, because this function is shared by the Heart Protector. The pericardium or Heart Protector was thought to assist the Heart’s pumping action by constricting it, as is indicated by one of its alternative names, Heart Constrictor.

The complexion and the eyes

The condition of the Heart is said to manifest in the complexion, and this depends to a great extent on the circulation. If the condition of the Blood and the circulation is good, the complexion is healthily tinged with pink and the skin is soft and supple, whereas an unvaryingly red face may indicate Fire in the Stomach or Liver, as well as the Heart. The Heart also has a connection with the eyes, since the Shen manifests in them; and presence, vitality, luster and expression are the characteristics of Shen in the eyes.

Speech

Our hearts speak to each other through our tongues. Since the Heart is said to ‘open into the tongue’, speech problems such as stammering or aphasia (dumbness) are treated as Heart related in TCM.

The Heart in Zen Shiatsu Theory: Integration

Masunaga’s concept of the Heart’s function differs very little from the classical version. In the Zen Shiatsu ‘cycle of the meridians’, the Heart and Small Intestine complete the work begun by the Stomach and Spleen. The amoeba has taken in and broken down its nourishment; now the Small Intestine must assimilate that nourishment, and the Heart must integrate it, so that it becomes part of the amoeba’s substance. This function takes place not only on the physical level of nourishment, but on every level. Emotionally, mentally and spiritually too, the Heart and Small Intestine assimilate and integrate the material which the Stomach and Spleen have taken in and processed. The Heart integrates what the Small Intestine has assimilated, and transforms it into an aspect of the physical and emotional manifestation of each unique individual.

Core of emotional being

An ancient Chinese fable about a legendary physician tells how he performed surgery to cure two men of their conditions by transplanting their hearts one into the other. But when the men returned home their whole physical identity had altered, so that their families did not recognize them. This shows the integrative power of the Heart in the Oriental medical tradition. Our consciousness, the Shen stored in our Heart, shapes and forms our identity on all levels. The Heart, as we now know, is the principal generator of the human electromagnetic field.

The entire watery matrix of our bodies is interconnected by complex charge-coupled fields that receive around 60 pulsations of electromagnetic energy from our beating heart each minute. From that perspective, our heart becomes a synchronizing electromagnetic master clock influencing the entire living matrix. Every cell in the body is in intimate electromagnetic contact with the toroidal-shaped magnetic field of the heart. Consequently, the heart constantly mediates between our thoughts, feelings and actions

(Maret 2003)

Anything which we assimilate into the mental and physical complex of our being alchemically becomes us as our Shen animates it – this is the transformative power of Fire at work. Masunaga’s concept of the Heart as integrating what the Small Intestine assimilates reflects the same view of the Heart as the center and creator of our individual being.

Emotional response

According to Masunaga, who followed the ancient texts closely in his interpretation of the Heart’s function, the Heart works to integrate the input from the five senses and generate appropriate internal responses. If our Heart, our center, is unstable our responses are inappropriate. Psychological symptoms then develop, listed in Zen Shiatsu as tension and neurosis, jumpiness, oversensitivity, poor concentration and memory and paranoia. These will express themselves in physical symptoms such as sweaty palms, palpitations and nervous stomach.

Emotional and physical tension

Where the Heart is weak and vulnerable, the body will develop physical tension and armoring in an attempt to protect it. Masunaga ascribes many of the classical Heart symptoms to physical tightness, such as stammering caused by tightness in the tongue, and a feeling of oppression in the solar plexus, caused by tension of the abdominal muscles. He also includes the sensation of something stuck in the throat, which in TCM is a typical Liver Stagnation symptom of emotional origin, and rigid palms; both of these are associated with the meridian pathway.

Meditation and reflection

The movement of energy in the amoeba in the Heart and Small Intestine phase is inwards, assimilating sense impressions into the emotional core. Masunaga explains this as the ‘resting’ phase of the Heart, the Yin period of stillness which alternates with Yang in the rhythm of the heartbeat. The posture which he chose to symbolize this stillness is the prayer position, which emphasizes the Heart and Small Intestine meridians. Withdrawal into stillness in the core of our self must alternate with outward responsiveness in order to maintain balance in our emotional life. Thus the movement of the Heart energy is similar to that of the blood in and out of the heart organ or to the in-and-out pulsation of our field.

The Heart Meridian and How to Treat it

The classical Heart meridian emerges from the deepest part of the armpit and travels down the arm between the biceps and the triceps (on the medial part of the anterior surface of the arm in the anatomical position), towards the little finger, where it ends at the lateral side of the little finger-nail (Fig. 14.2).

Fig. 14.2 (A) Heart meridian, points, Hara diagnostic area and Bo point. (B) Heart meridian, back diagnostic area and Yu points.

Masunaga extended the meridian into the chest, throat and legs. In the chest, the meridian ascends from the Hara diagnostic area, running under the edges of the sternum to the approximate level of the third intercostal space, where it branches, curving laterally over the chest towards the armpit where it joins the classical meridian. In the throat, the meridian runs along both sides of the floor of the lower jaw, connecting with the root of the tongue. On the leg, the Heart meridian lies just posterior to the traditional Kidney meridian, on the posterior surface of the thigh adductors, medial to the semitendinosus muscle, and in a straight line down the medial portion of the gastrocnemius in the lower leg, and on the medial side of the Achilles’ tendon, to curve under the foot into the pad of the heel.

The Hara diagnostic area is a small circle just below the meeting of the ribs and sternum (Fig. 14.2A).

The diagnostic area on the back is the area surrounding the 4th, 5th and 6th vertebrae, between the shoulder blades (Fig. 14.2B).

Meridian significance and function

In Masunaga’s theory, a meridian’s location embodies its function. The place of the Heart and Small Intestine meridians in his meridian cycle is ‘inside’. When we stand in the anatomical position, the Heart meridian in the arm and leg is close to the core of our structure, our central axis between Heaven and Earth.

The meridian in the torso physically traces the core of our being, rising from the diagnostic area in the solar plexus up the central part of the chest. If we mentally picture its partner, the Small Intestine, as it ascends the entire length of the back, it is clear that the two meridians together are connected with the longitudinal structure of the Central Channel. They physically outline the central core of the body, in the same way as the Kidney and Bladder.

The Heart meridian in the chest is wonderfully sensitive and accessible to Shiatsu, but work on the chest often provokes an emotional release, so is best treated towards the end of the session, when the whole meridian has been primed and strengthened. Work on the meridian in the legs in prone position is stabilizing and grounding for the receiver with a Heart diagnosis. The Heart meridian extension under the jaw connects with the root of the tongue; when it is particularly tight there may be a tension around the issue of communication.

Treatment procedure

Note: If there are current emotional problems as well as a Heart diagnosis, the receiver may feel too vulnerable if the meridian is worked in the supine position throughout. It would be better to work as much as possible in the side or prone position to stabilize the Heart Ki before finishing with the chest and throat areas, which can only easily be worked in supine.

1. The Heart meridian in the arm can be palmed and thumbed in the supine or side positions, as long as the receiver’s arm is taken as far as comfortably possible above his head, which brings the meridian to the surface. It can also be worked in a similar stretch in the sitting position, with your fingertips reaching into the meridian as you grasp the receiver’s arm, which is bent behind his head. For ease of illustration, the supine position is shown in Figure 14.3.

2. The legs are an excellent place to approach the Heart meridian when you want to bring the receiver’s Ki down. The easiest way to locate the meridian is to imagine the leg as a long box, with the meridian on the top surface of the medial corner. To locate it by muscle anatomy, it follows the medial border of the semitendinosus, and takes a straight line down till it curves under the foot into the center of the heel. The angle of pressure is straight down to the floor in prone position (Fig. 14.4), horizontal in the side position.

3. Following the border of the Achilles’ tendon, posterior to the Kidney meridian, the Heart descends the heel bone until it curves under the edge of the foot to end in the center of the pad of the heel. The angle of pressure changes on the heel bone; it ceases to apply from the back to the front of the leg, and becomes directed in towards the center of the area being worked on (normal perpendicular pressure).

4. The first part of the meridian in the chest lies just under the edges of the sternum, up from the Hara diagnostic area to roughly the level of the 3rd rib. You need to angle your pressure from the edges of the sternum underneath the bone to reach the meridian. Here the ulnar edges of the hands is shown, but fingertips between the intercostal spaces also work well (Fig. 14.5A).

5. The fingertips are the most suitable tool for working the rest of the meridian in the chest (Fig. 14.5B). It curves in a heart-shape outwards from the sternum, somewhat like the shape of a 1950s strapless dress. On large-breasted women, the meridian may lie on the outer breast tissue, so you need to avoid excessive pressure and use focus, intention and Hara to aid penetration.