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The TCM Clock

Updated: Dec 29, 2022

A great example of the TCM Clock from

The Traditional Chinese Medicine view of the circadian cycle is represented as a 24-hour “body clock”. Each of the 12 meridians of the body is associated with a two-hour time period on the 24-hour clock. That time period represents the time of peak function for that meridian. Each meridian governs over an organ system and the associated internal functions as well as a local function along its pathway. They are each associated with a season, an element, a flavor, an emotion, and many other individual characteristics. The meridians all work together to ensure the proper flow of qi and blood throughout the body.

When symptoms of illness occur repeatedly at specific times, it indicates an imbalance or dysfunction of the associated meridian. When one meridian is imbalanced, the others often follow suit, and then suddenly multiple symptoms associated with different organ systems pop up! Luckily, TCM modalities like acupuncture and herbal therapy are incredibly helpful to bring those meridians back into balance and resolve those symptoms!

Here is a brief introduction to each of the meridians, their functions and common symptoms.

11am-1pm: Heart

The TCM heart governs over blood and blood vessels, opens to the tongue, houses the mind spirit, and manifests on the complexion. It is associated with joy, heat, and the bitter taste. Some common symptoms associated with this meridian are excessive joy, sadness, difficulty speaking, fatigue, confusion, arm pain, weak wrists, red complexion, chest pain, palpitations and insomnia.

1pm-3pm: Small Intestine

The small intestine organ system governs over the separation of the clear from the turbid. This applies quite literally to food, i.e. separating the useful nutrients from our food and breaking down the parts we don’t absorb to be excreted. It also applies to our mental processes. In Chinese medicine, it is the small intestine that governs over separating our clear thoughts from our muddied, incoherent ones. If there is an imbalance in that meridian, your digestive functioning and mental clarity may be compromised, and you may find yourself feeling gassy and bloated with low energy levels and brain fog. These symptoms may be especially noticeable from 1pm-3pm when you experience that afternoon “crash”.

3pm-5pm: Urinary Bladder

The urinary bladder is in charge of storing, transforming, and excreting fluids. This meridian works closely with the Kidney meridian in the function of transforming fluids, similar to the Kidney’s involvement in fluid filtration and excretion in western medicine. Some symptoms commonly associated with the urinary bladder meridian are back pain, urinary urgency or frequency, excessive urination or inability to urinate.

5pm-7pm: Kidney

The kidneys are extremely important in Chinese medicine. They control the lower orifices, produce marrow, govern water, and they store prenatal essence. Prenatal essence in TCM is very similar to our genetic predisposition and determines the strength of your constitution and immune system at birth. Some common symptoms associated with the kidney meridian are low back pain, weak knees, urinary dribbling or incontinence, delays in reproductive development, premature aging, tinnitus, hot flashes in the evening, night sweats, and fertility issues.

7pm-9pm: Pericardium

The pericardium protects the heart and shares many of the same functions. Many of the symptoms associated with the pericardium meridian are the same as the heart meridian, such as chest pain, palpitations, insomnia, anxiety, fatigue and mental confusion. Imbalances in the pericardium meridian can also be associated with difficulty in regulating emotions and connecting with people.

9pm-11pm: Triple Warmer

The triple warmer has the job of controlling the transportation of qi and fluids. It is responsible for warming the other organs and providing the energy and nourishment for them to function properly. Since the triple burner is so closely related with the other organ systems, it also shares many of the symptoms commonly associated with other organ systems. These include insomnia, depression, frequent illnesses, digestive issues, cold hands and feet, and abdominal pain.

11pm-1am: Gallbladder

The functions of the gallbladder in TCM are similar to the functions associated with it in western medicine. It stores and excretes bile and helps to break down foods. It is closely associated with the liver organ system, and the associated symptoms often overlap. It is also associated with decision making, courage, and the ability to sleep through the night. A deficiency in the gallbladder meridian is associated with waking very early in the morning and being unable to fall back asleep. This often occurs at around 12-1am.

1am-3am: Liver

The liver is one of the most important organ systems in TCM. It has an extremely strong influence on the other meridians and organs. It is in charge of the smooth flow of qi throughout the body, regulates the sinews and it stores the blood. When it fails to do these jobs properly, the qi stagnates and results in extreme stress, pain in the muscles and joints, improper function of the other organ systems, and bleeding issues. When the liver blood is deficient, the result is paleness, dry skin, irregular or absent menstrual cycles, fatigue, and frequent injuries of connective tissue. Many people frequently wake up between 1am and 3am or have very vivid dreams during that time. This is often a result of stagnation of the liver qi and they also experience high stress levels during the day.

3am-5am: Lungs

In addition to the obvious job of allowing us to breathe, the lungs are also in charge of dispersing qi throughout the body and maintaining our wei qi, which could also be viewed as our immune system. Some common symptoms associated with the lung meridian are chest pain, arm pain, difficulty breathing, frequent sweating, waking up with a dry mouth or throat, allergies, and asthma.

5am-7am: Large Intestine

The large intestine is in charge of transforming stools and reabsorbing fluids. The symptoms associated with the large intestine meridian are a little bit more straightforward. They often manifest as lower abdominal pain and bloating and diarrhea or constipation. The large intestine system also has an influence on the other meridians, such as the lung meridian. It is common for those who frequently experience constipation to also suffer from asthma or allergies.

7am-9am: Stomach

The stomach and spleen meridians work together to separate the nutrients from the waste products as we digest our food. The stomach is in charge of the rotting and ripening of food or the mechanical digestion of food. It is also responsible for the downward movement of qi. Common symptoms of an imbalance in the stomach meridian are gas, bloating, belching, regurgitation, nausea, acid-reflux, and stomach pain. If this meridian fails to function properly, it can cause the movement of food to slow or become stuck, resulting in what we call “food stagnation”. This is often noticeable immediately after eating breakfast which then impairs our appetite for the rest of the day.

9am-11am: Spleen

As mentioned above the spleen works closely with the stomach to separate the nutrients from the waste products in our food. The spleen absorbs the nutrients and works with the lungs to transform them into qi and blood to be circulated throughout the body. The spleen also has the functions of containment and defense. It controls the ability to contain organs, blood and fluids, and failure to do so results in prolapse of organs, bleeding, and incontinence, drooling, or sweating. The spleen also works with the lung system to maintain the wei qi, or defense qi, commonly viewed as our immune system. Some symptoms associated with imbalances in the spleen meridian are frequent illnesses, organ prolapse, loss of appetite, edema, fatigue, sweating, overthinking, lack of focus, and poor digestion.

That is a LOT of information, but…

It is very important to note that Traditional Chinese Medicine is a very complex, extensive medical system. The examples I have given here are only a few of the more commonly seen symptoms. These should not be used to self-diagnose TCM pathologies just as WebMD should not be used in place of evaluation by a properly trained physician.

One of my favorite things about Chinese medicine is that it works so incredibly well in conjunction with western medicine. Every medical modality has its time and place, and what works well for one person may not work well for another. Here at EastWest Acupuncture, we strive to bring Eastern and Western perspectives together, and we work closely with other medical professionals to ensure that our patients receive high quality, comprehensive care.

Give us a call or schedule online at EastWest Acupuncture to meet with one of our practitioners and see what other tips and tricks we have up our sleeves for your health concerns! At EastWest Acupuncture, we got you!

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