Pattern of disharmony between the heart and kidney: Theoretical basis, identification and treatment

“Harmony between the heart and kidney” refers to the physiological relationship between these two zang organs in Chinese medicine, while “disharmony between the heart and kidney” (also called disharmony between fire and water) refers to the pathological state. The pattern of disharmony between the heart and kidney is widely observed in patients with insomnia, anxiety disorder and menopausal syndrome, etc.. In order to gain a full and systematical understanding of this pattern, from the perspective of ancient Chinese philosophy and zang-fu theory in Chinese medicine, we systematically reviewed and discussed the functions and physiological characteristics of the heart and kidney, the origin and development of theories relating to heart-kidney relationship, the pathogenesis and identification of the pattern, as well as the commonly used classical formulas for its treatment, including Coptis and Donkey-Hide Gelatin Decoction (Huánglián Ējiāo Tāng) and Grand Communication Pill (Jiāotài Wán). Two examples of clinical modifications of these formulas in the treatment of insomnia and menopausal syndrome are provided in this article. It should be noted that in clinical practice, these formulas should be used flexibly, and modified in accordance to the condition of the patient.