{ "slug": "heart-and-kidney-not-communicating", "name": "Heart and Kidney Not Communicating", "pinyin": "Xin Shen Bu Jiao", "chinese": "心肾不交", "organ": "Heart and Kidney", "nature": "mixed", "family": "mixed", "summary": "The Heart is fire and the Kidney is water, and at night they are supposed to meet: the water rises to cool the fire, the fire sinks to warm the water. When the Kidney water is too low to rise, the Heart fire burns alone. Insomnia with a hot restless mind, palpitations, night sweats, a dry mouth, and a sore back all at once.", "picture": "A pot on a stove with almost no water in it. The flame has nothing to heat but the pot. Refill the water and the fire has a job again, and the kitchen goes quiet.", "signs": { "key": [ "Insomnia with a hot, restless mind, waking between one and three", "Palpitations and anxiety at night", "Night sweats, hot palms and soles", "Dry mouth and throat at night", "Sore low back, weak knees, ringing ears" ], "common": [ "Forgetfulness, poor concentration", "Dizziness", "Nocturnal emissions", "Mouth ulcers", "Dark scanty urine" ], "tongue": "Red, with a redder tip and little coat.", "pulse": "Thin and rapid." }, "causes": [ "Long Kidney yin deficiency from overwork and late nights", "Mental strain that overheats the Heart", "Menopause", "A long illness", "Daily alcohol on a dry constitution" ], "tell_apart": [ { "slug": "heart-yin-deficiency", "how": "Heart yin deficiency alone has the sleep and palpitations without the back, knees, and ears. Add the Kidney signs and the two organs have stopped meeting." }, { "slug": "kidney-yin-deficiency-with-empty-heat", "how": "When the back, teeth, and night sweats lead and sleep is secondary, the Kidney formulas come first." } ], "formulas": [ { "slug": "tian-wang-bu-xin-dan", "role": "primary", "when": "The classic formula: nourishes Heart and Kidney yin and calms the spirit.", "pinyin": "Tian Wang Bu Xin Dan", "_links": { "self": "https://www.naturalherblibrary.com/api/v1/formula/tian-wang-bu-xin-dan", "html": "https://www.naturalherblibrary.com/formula/tian-wang-bu-xin-dan" } }, { "slug": "zhi-bai-di-huang-wan", "role": "root", "when": "When the Kidney signs lead. Often combined with a calming formula.", "pinyin": "Zhi Bai Di Huang Wan", "_links": { "self": "https://www.naturalherblibrary.com/api/v1/formula/zhi-bai-di-huang-wan", "html": "https://www.naturalherblibrary.com/formula/zhi-bai-di-huang-wan" } }, { "slug": "jiao-tai-wan", "role": "minimal", "when": "Two herbs, coptis and cinnamon, to make fire and water meet. Small and sharp.", "pinyin": "Jiao Tai Wan", "_links": { "self": "https://www.naturalherblibrary.com/api/v1/formula/jiao-tai-wan", "html": "https://www.naturalherblibrary.com/formula/jiao-tai-wan" } } ], "herbs": [ { "pinyin": "Sheng Di Huang", "role": "Raw rehmannia nourishes Kidney yin and cools the Heart.", "herb_slug": "fresh-rehmannia-root", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/fresh-rehmannia-root", "html": "https://www.naturalherblibrary.com/herb/fresh-rehmannia-root" } }, { "pinyin": "Huang Lian", "role": "Coptis, a small dose, cools the Heart fire.", "herb_slug": "rhizome-of-chinese-goldthread-2", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/rhizome-of-chinese-goldthread-2", "html": "https://www.naturalherblibrary.com/herb/rhizome-of-chinese-goldthread-2" } }, { "pinyin": "Rou Gui", "role": "Cinnamon, a tiny dose, leads the fire back down to the Kidney.", "herb_slug": "cassia-bark", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/cassia-bark", "html": "https://www.naturalherblibrary.com/herb/cassia-bark" } }, { "pinyin": "Suan Zao Ren", "role": "Sour jujube seed settles the Heart.", "herb_slug": "spine-date-seed", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/spine-date-seed", "html": "https://www.naturalherblibrary.com/herb/spine-date-seed" } }, { "pinyin": "Yuan Zhi", "role": "Polygala connects Heart and Kidney and clears the mind.", "herb_slug": "root-of-thinleaf-milkwort", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/root-of-thinleaf-milkwort", "html": "https://www.naturalherblibrary.com/herb/root-of-thinleaf-milkwort" } }, { "pinyin": "Gui Ban", "role": "Tortoise plastron nourishes yin and anchors rising heat.", "herb_slug": "tortoise-plastron", "_links": { "herb": "https://www.naturalherblibrary.com/api/v1/herb/tortoise-plastron", "html": "https://www.naturalherblibrary.com/herb/tortoise-plastron" } } ], "conditions": [ "insomnia", "palpitations", "night-sweats", "anxiety", "tinnitus", "menopausal-syndrome", "forgetfulness" ], "habits": [ "Bed by eleven. The meeting of fire and water happens in the early hours, and only if you are asleep.", "A warm foot bath before bed draws the fire down.", "No alcohol, no late coffee.", "Lily bulb, lotus seed, black sesame, goji, and wheat porridge." ], "watch": [ "Sleep deepens and the one-to-three waking fades within a month.", "Night sweats and the dry mouth ease.", "The sore back follows more slowly, over two to three months." ], "sources": [ { "title": "Maciocia, The Foundations of Chinese Medicine, 3rd edition", "note": "Heart and Kidney not harmonized." }, { "title": "Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition", "note": "Tian Wang Bu Xin Dan, Jiao Tai Wan." } ], "meta": { "status": "published", "last_updated": "2026-10-12", "reviewed_by": null }, "_links": { "html": "https://www.naturalherblibrary.com/pattern/heart-and-kidney-not-communicating", "self": "https://www.naturalherblibrary.com/api/v1/pattern/heart-and-kidney-not-communicating", "index": "https://www.naturalherblibrary.com/api/v1/patterns" } }