A beating heart means you are alive. But the beating you notice — the kind that interferes — comes from somewhere other than the heart. That is the distinctive move Korean Traditional Medicine makes here, and it is a productive one. This article sets out what causes heart palpitations in Korean medicine: which organs send the message, and why.
In Summary
- In KTM, the heart governs the steady beat, consciousness, and the maintenance of life. That is most of its brief.
- Discomforting palpitations are attributed to the influence of other organs acting on it.
- The liver — liver fire arising from gan zhu mou lyu (간주모려 肝主謀慮), the scheming and planning the liver is said to govern — sets the heart beating.
- The pancreas-stomach axis — heat or damp there presses on the heart, producing unease and a sense of hurry.
- The lung and kidney act on the heart less immediately than those two.
- The lung’s relationship with the heart is more mutual support than provocation.
- The kidney holds one axis of the hot-cold, rising-falling balance. When its descending qi falls short, the heart is left exposed to fire.
- Professor Baek’s working formulation: if the qi that makes the heart beat is fire, the organ that chiefly generates that fire is the stomach — and the heart receives fire and works with it rather than producing it. Water, which slows the beat, is stored and expressed by the kidney.
- So the heartbeat sits on a balance: fire (stomach and heart) against water (kidney).
- The habits that damage kidney qi are therefore the habits that make hearts race: alcohol, poor diet and excess weight, prolonged screen use, and short sleep.
The Heart Does Less Than You Would Think
Korean Traditional Medicine (KTM), the traditional healing system of Korea also known as Hanbang (한방), assigns the heart a narrower role than the name suggests.
The heart governs the regular beat. It is bound up with consciousness and with the maintenance of life — we mark death by the heart stopping, which tells you what the tradition takes it to be responsible for.
What it does not do, in this framing, is generate the disturbance. When the beat becomes uncomfortable, the cause is understood to lie with another organ. Even in cardiovascular disease, unless congenital, the classical position is that another organ produced the condition in the vessels.
One can argue about whether that is the right account — it is disputed, and it does not map onto the biomedical picture. But it sits at the foundation of KTM, and in practice it is a productive lens: it directs attention away from the organ that is complaining and toward the one that is causing the complaint.
The Liver: Scheming Turns to Heat
The liver is, in my clinical experience, the organ with the largest influence on this symptom.
Blood that has been heated
In KTM the liver stores blood — a formulation that sits comfortably alongside the biomedical account of the liver as the organ of metabolism and detoxification. The two views differ without conflicting; they complement one another.
When heat arises in the liver for any reason, the blood it stores heats with it. The tradition calls this blood heat (허열증 血熱證). Heated blood reaches the heart, which receives blood and sends it onward, and the heart heats too.
Pathologically hot blood moves faster and prompts the heart to pump harder and quicker. That is felt as palpitations.
Alcohol, overeating, and food that does not suit the constitution all heat the liver by way of its metabolic work — and so produce blood heat and a racing chest.
Stress becomes heat by a specific route
The liver governs part of mental activity in KTM. The classical phrase is gan zhu mou lyu (간주모려 肝主謀慮) — the liver governs planning and stratagem. Mou lyu here means contriving, scheming, working something out.
The image that makes this concrete: the strategists and advisers in the old novels, whose entire occupation is devising plans. That activity is what the liver is said to govern.
So when you see something on social media that you want, and your mind begins working out how to get it — that is gan zhu mou lyu engaging. Push a plan forward, hit an obstacle, and turn the problem over hard enough, and heat is generated in the liver. Obstruction adds to it: qi that stops flowing and pools in one place produces more heat still.
That is the mechanism by which stress becomes heat in this tradition. The heated liver heats the blood, and the heart races.
Cooling the liver
- Sleep
- Less scheming, and less wanting
- Eating less
- Avoiding alcohol and food that does not suit your constitution
- Exercise, to disperse the heat
Of these, sufficient sleep at night is the most effective. If self-management is not enough, this is worth taking to a clinician rather than persisting alone.
The Kidney: The Water Side of the Balance
The kidney in KTM covers considerably more ground than the biomedical kidney. Beyond the urinary system, it is deeply involved in growth, development, reproduction, mental activity, the workings of the nervous system, and immune function. Part of the regulation of autonomic balance can reasonably be assigned to it.
Fire against water
Here is the formulation, and it is worth flagging its status. This is Professor Baek’s working framing rather than a doctrine attributable to the classical sources or to Dowon Kuon. It is offered because it makes the clinical picture legible, not as a claim about what the tradition officially holds.
If the qi that makes the heart beat is called fire (화 Fire), then the organ that chiefly generates that fire is the stomach — and it is easier to understand the heart as receiving fire and working with it than as producing it. If the qi that slows the heart is called water (수 Water), then the organ that stores and expresses water is the kidney.
Put simply: the heartbeat is strongly influenced by the balance between fire (stomach and heart) and water (kidney).
So when kidney qi is damaged or runs short, palpitations and feelings of heat both worsen. Not because the kidney acts on the heart directly, but because the counterweight has been removed.
What damages kidney qi
Alcohol. A very hot and toxic substance. Detoxifying and metabolising it burns off the water qi the body holds.
Excess weight and poor eating. High blood sugar draws qi toward the stomach and intensifies the heat there. Stronger stomach heat further dampens the kidney’s water.
Phone and screen use. Sitting still while continuously fixing attention on something and thinking is a process that burns water qi and blood in the service of work or entertainment.
Short sleep. The body spends the day consuming and accumulating waste, and is meant to be cleaned and restored during sleep. Sleep too little and you carry heat-toxin forward into the next day — a habit that erodes kidney qi.
Anyone told to sleep well and stop drinking already knows the advice. The point of setting out the mechanism is that knowing why makes it easier to actually do.
The Pancreas and Stomach
Heat or damp (습 濕) in the pancreas-spleen and stomach presses on the heart from below — the tradition’s phrasing is closer to intimidates the heart. What the patient reports is unease and a sense of hurry rather than a discrete episode of racing.
This axis works faster than the lung or kidney. It is the second of the two organs — with the liver — that reach the heart quickly.
The Lung
The lung sends qi and blood through the body, which makes its function similar to the heart’s. The two organs assist one another.
Because of that, the lung does not trouble the heart by becoming overactive the way the liver or the digestive organs do. The problem, when there is one, runs the other way: a weakened lung leaves the heart carrying more of the load, and that overload can produce palpitations.
How These Meet the Eight Constitutions
Which of these routes a given person takes depends on where those organs sit in their constitutional hierarchy. That is what the eight articles in this series work through — the Soyangin types with a recessive kidney and abundant stomach heat, the Soeumin types with a weak stomach directly beneath the heart, the wood types with heat gathering in the liver, the metal types whose qi runs toward the surface.
The overview article gathers them.
Summary
The heart keeps time. When the timekeeping becomes something you notice, look upstream — at a liver heated by planning and wanting, at a kidney whose water has been burned off by drink and short nights, at a stomach pressing from below.
Which is why the treatment for a racing heart so rarely turns out to be about the heart.
Related: Heart Palpitations in the Soyangin Constitutions · Heart Palpitations in Hepatonia
