Extraordinary Organ

A brief introduction to the brain and the uterus as extraordinary organs is given as follows:

1. Brain
As early as in the book Neijing there were descriptions of the brain, one of which is as follows: “The brain is a sea of marrow. Its upper part is under the scalp of the vertex, point Baihui (Du 20) and its lower part reaches point Fengfu (Du 16).” Subsequently a further understanding of the brain was obtained; that is, it was recognized in Yixue Yuanshi (Origin of Medical Science) that “the sense organs, i.e., the ears, eyes, mouth, and nose, are in the head close to the brain. Owing to their highest and most obvious position, they may perceive objects, which will impress the brain directly and remain in the brain”. Also it was suggested in Yilin Gaicuo (Medical Correction) that thinking and memorization are the main function of the brain. As mentioned previously, the essence of the kidney produces marrow that forms the brain. The filling of the “sea” of marrow depends on the essence of the kidney. Furthermore, the heart, which houses the mind, and the liver, which dominates the unrestraint and patency of vital functions, are also related to mental activities. A tenet of traditional Chinese medicine, therefore, is that mental activity is dominated by various organs, the heart being the main one.

2. Uterus
The function of the uterus is to preside over menstruation and nourish the fetus. Internal organs and channels related to the function of the uterus are as follows:

1. Kidney. The uterus is connected with the kidney, and only when the essence of the kidney is ample can the menstrual period recur regularly, and the impregnation and growth of the fetus be possible.
2. Liver. The liver performs the function of storing blood and regulating the volume of circulating blood, which is also responsible for normal menstruation.
3. Ren Channel and Chong Channel. Both originate in the uterus. The Ren Channel regulates the functions of all the yin channels and nourishes the fetus. The Chong Channel has the function of regulating the qi and blood of the twelve regular channels. The qi and blood of the twelve regular channels pass into the uterus through the two channels, affecting the amount of menstrual flow and its cycle.

Fu Organs ( Small intestine, Gall Bladder, Stomach, Large Intestine, Urinary Bladder, Sanjiao )

1. Small intestine
The small intestine is situated in the abdomen, its upper end connected by the pylorus with the stomach and its lower end communicating with the large intestine through the ileocecum. Its channel connects with the heart, with which it is externally-internally related. Its main function is to receive and temporarily store partially digested food in the stomach. Further digesting the food and absorbing the essential substance and a part of the water in food, the small intestine transfers the residues with a considerable amount of fluid to the large intestine.

2. Gall bladder
The gall bladder is attached to the liver, with which its channel connects and with which it is externally-internally related. Its main function is to store bile and continuously excrete it to the intestines to help digestion. This function of the gall bladder is closely related to the function of the liver in promoting patency of vital energy. It is therefore said that the liver and gall bladder preside over the unrestraint and patency of vital energy.

3. Stomach
The stomach is situated in the epigastrium, its upper outlet connected by the cardia with the esophagus, and its lower outlet communicating with the small intestine through the pylorus. Its channel connects with the spleen, with which it is externally-internally related. Its main function is to receive and decompose food. That is to say, the stomach receives and temporarily stores the food mass coming from the mouth through the esophagus while partially digesting it and then sending it downward to the small intestine. That is why the function of the stomach is normal when its qi is descending and abnormal when its qi is ascending. The stomach and spleen act in co-operation and are the main organs carrying on the functions of digestion and absorption. It is said that the spleen and stomach are the source of health.

4. Large intestine
The large intestine is situated in the abdomen, its upper end connected with the small intestine by the ileocecum and its lower end communicating with the exterior of the body through the anus. Its channel connects with the lung, with which it is externally-internally related. The main function of the large intestine is to receive the waste material sent down from the small intestine and, in the process of transporting it to the anus, absorb a part of its fluid content and then turn it into feces to be excreted by the body.

5. Urinary bladder
The urinary bladder is situated in the lower abdomen. Its channel connects with the kidney, with which it is externally-internally related. Its main function is the temporary storage of urine and its discharge from the body when a certain amount has accumulated. This function of the urinary bladder is accomplished with the assistance of the qi (function) of the kidney.

6. Sanjiao
The channel of sanjiao connects with the pericardium with which it is externally-internally related. Sanjiao is not a substantial organ, but a generalization of part of the functions of some of the zang-fu organs located in different sections of the body cavity.

Sanjiao is divided into three parts:

1. Upper jiao (portion) (representing the chest) is a generalization of the function of the heart and lung in transporting qi and blood to nourish various parts of the body. It is like an all-pervading vapour.
2. Middle jiao (portion) (representing the epigastrium) is a generalization of the function of the spleen and stomach in digesting and absorption. This may be compared to soaking things in water to cause decomposition and dissolution of substances.
3. Lower jiao (portion) (representing the hypogastrium) is a generalization of functions of the kidney and urinary bladder in controlling water metabolism as well as storage and excretion of urine. It is like an aqueduct, a pathway for the flowing of water.

Kidney - The Zang Organ

The kidney locates at either side of the lumbus. Its channel connects with the urinary bladder, with which it is externally-internally related. It opens into the ear.

1. Storing essence and dominating reproduction, growth and development. The essence in the kidney, also referred to as the yin of the kidney, consists of two parts: congenital essence inherited from the parents and acquired essence transformed from the essential substances of food. The vital essence of the kidney is an important aspect of the qi (vital functions) of the kidney, greatly influencing the function of the kidney in reproduction, growth and development. Neijing gives a precise description of the physiological function of the kidney in the process of birth, growth, full development and senility: At the age of about 14 for women and 16 for men, the qi of the kidney flourishes. Women will have the onset of menstruation, and men will have seminal emission, both signifying the power of reproduction. When women reach the age of 28 and men around 32, the qi of the kidney is at its height, the body grows and develops, reaching the prime of life. When women reach the age of 49 and men around 64, the qi of the kidney starts to decline, the body begins to wither and at the same time the function of reproduction gradually fails.
2. Producing marrow, forming up the brain, dominating the bones and manufacturing blood. The kidney stores essence which can produce marrow (including spinal cord and bone marrow). The upper part of the spinal cord connects with the brain, while the bone marrow nourishes the bones and manufactures blood. The supply to the brain, the solidity of the bones, and the adequacy of the blood are therefore all closely related to the condition of the essence of the kidney.
3. Dominating water metabolism. The part of fluid sent down by the descending function of the lung reaches the kidney. There it is divided by the yang function of the kidney into two parts: clear and turbid. The clear fluid (i.e., the part which is useful) is retained, and the turbid (i.e., the waste part) flows into the urinary bladder to form urine which is excreted.
4. Receiving qi (air). Respiration is accomplished mainly by the lung, but the kidney helps through its function of controlling reception of qi (air). The distribution of the clean qi inhaled by the lung to the whole body depends not only on the descending function of the lung but also on the kidney’s function of reception and control.
5. Opening into the ear. The auditory function is dependent upon the nourishment from the qi of the kidney. Deafness in aged people is mainly due to deficiency of the qi of the kidney.

Spleen - The Zang Organ

The chanel of the spleen connects with the stomach, relating the spleen externally-internally to the stomach. It opens into the mouth. The main physiological functions of the spleen are governing transportation and transformation, controlling blood and dominating the muscles.

1. Governing transportation and transformation. Transportation implies transmission. Transformation implies digestion and absorption. The splee has the function of digesting food, absorbing its essential substances with a part of the fluid supplied, and transmitting them to the heart and the lung from where they are sent to nourish the whole body. Normal functioning of the spleen is required for good appetite, normal digestion and absorption, good nourishment and normal transmission of fluid.
2. Controlling blood. The spleen has the function of keeping the blood circulating inside the vessels and preventing it from extravasations.
3. Dominating the muscles. Normal functioning of the spleen in transportation and transformation enables the muscles to receive adequate nourishment from the food essentials and thus maintains muscle thickness and strength.
4. Opening into the mouth. The spleen and the mouth co-ordinate functionally in receiving, transporting and transforming food. When the function of the spleen in governing transportation and transformation is normal, the appetite will be good and the lips will be red and lustrous.
5. The qi of the spleen has the further function of holding and keeping the internal organs in their normal positions.

Liver - The Zang Organ

The liver is situated in the right hypochondriac region, its channel connecting with the gall bladder relating it externally-internally with the gall bladder. The liver opens into the eye. Its main physiological functions are storing blood, maintaining patency for the flow of qi (vital function), and controlling the tendons.

(1) Storing blood. The liver possesses the function of storing blood and regulating the volume of circulating blood. During rest, part of the blood remains in the liver, while during vigorous activity blood is released from the liver to increase the volume of blood in circulation to the required amount. The liver, therefore, along with the heart, supplies the tissues and organs with blood, and it influences menstruation as well.

(2) Maintaining patency for the flow of qi (vital functions) means that the liver is responsible for harmonious and unobstructed functional activities of the human body, including the following three aspects:

a. The Liver is related to emotional activities, especially depression and anger. Prolonged mental depression or a fit of anger may weaken the liver so that it is unable to promote the unrestrained and free flow of qi. Conversely, dysfunction of the liver is often accompanied by emotional changes such as mental depression and irascibility.
b. The harmonious and free-flowing functional activity of the liver promotes the functioning of the other zang-fu organs, channels and collaterals, especially those of the spleen and stomach in digestion and absorption.
c. This function of the liver also affects bile secretion, it storage in the gall bladder and excretion into the intestines.

(3) Controlling the tendons. The yin and blood of the liver nourish the tendons, keeping them in a normal state of contraction and relaxation. When the liver is supplied with ample yin and blood, the tendons are strong and free in extension and flexion.
(4) Opening itu the eye. Each zang-fu organ has certain influence on the function of the eye. However, because the liver stores blood and its channel directly communicates with the eye, it has a closer relation to ocular function, such as vision and movement of the eye, than other zang-fu organs.

Heart - The Zang Organs

The channel of the heart, located in the thorax, leads to the small intestine, and heart is thus externally and internally related to the small intestine. (Each zang organ is linked with a fu organ by a channel, a situation known as external-internal relation.) The heart also opens into the tongue. (Each zang organ opens into a sense organe which indicates a close structural or physiological and pathological relationship between the internal organs and the sense organs.) The main physiological functions of the heart are controlling blood and vessels and housing the mind.

1. Controlling blood and vessels. Vessels are the site of blood containment and circulation, the impulse of the heart sending blood incessantly through the vessels to nourish the whole body. When blood supply is sufficient and blood circulation normal, the complexion will be rosy and lustrous, and vitality full. The tissues and organs are well nourished and function properly.
2. Housing the mind. The heart is considered the main organ governing mental activities and generalizing the physiological function of the brain. Spirit, consciousness, memory, thinking and sleep are well dominated by this function of the heart. The two function of the heart have a mutual effect and correlation. According to Neijing: “The heart dominates the vessels and the vessels supply the mind.”
3. Opening into the tongue. The two functions of the heart, i.e., controlling blood and vessels and housing the mind, are closely related to the color, form, motility, and sense of taste of the tongue. This is also expressed as “the tongue is the mirror of the heart”.

ZANG-FU (Internal Organs)

The term zang-fu in traditional Chinese medicine refers to the gross anatomical entities of the internal organs. At the same time, it is also a generalization of the physiological functions of the human body. The heart, liver, spleen, lung, kidney and pericardium grouped together are known as the six zang organs. Their main physiological functions are manufacturing and storing essential substances including vital essence, qi (vital energy), blood and body fluid. The small intestine, gall bladder, stomach, large intestine, urinary bladder and sanjiao are known collectively as the six fu organs. Their main functions are to receive and digest food, absorb nutrient substances, and transmit and excrete wastes. There are in addition extraordinary fu organs including the brain and the uterus.

The zang organs are different in function from the fu, but the difference is only relative. In physiological activities, astructural and functional connection as well as co-ordination exists not only among the zang and the fu organs as separate entities, but also among the zang and the fu organs collectively, and even among the zang-fu organs on the one hand and the five sense organs and five tissues on the other. The theory of zang-fu taking the five zang organs (six including the pericardium) as core explains the peculiarity of traditional Chinese medicine, i.e. the concept of regarding the body as an integral whole physiologically and pathologically.

Attribution of Things to The Five Elements

Man lives in nature. The natural environment, such as weather changes and geographic conditions, greatly influences his physiological activities. This fact is manifest in man’s dependence on the environment, but also in his adaptability to the environment. This is known as correspondence between man and nature. Proceeding from this recognition, traditional Chinese medicine comprehensively connects the physiology and pathology of the zang-fu organs and tissues with many important natural environmental factors. These factors are classified into five categories on the basis of the five elements. Similes and allegories are used to explain the complicated links between physiology and pathology as well as the correlation between man and the natural environment. The following table shows the five categories of things classified according to the five elements.

Promoting here implies promoting growth. The order of promoting is that wood promotes fire, fire promotes earth, earth promotes metal, metal promotes water, and water in turn promotes wood. In this inter-promoting relation of the five elements, each is in the position of “being promoted” and of “promoting”, the promoting element being thought of as the “mother” and the promoted element as the “son”, forming what is known as the “mother-son” relationship. Wood for example is promoted by water, which is the “mother” of the wood, while fire is the “son” of the wood, being promoted by wood.

Acting here connotes bringing under control or restraint. In the inter-acting relation of the five elements, the order is that wood acts on earth, earth acts on water, water acts on fire, fire acts on metal, and metal in turn acts on wood. In this relationship, each of the five elements occupies the position of “being acted on” and “acting on”. Wood for example is acted upon by metal, while it acts on earth.

The Five Elements – The Theory

The theory of the five elements holds that wood, fire, earth, metal and water are basic materials constituting the material world. There exists among them an interdependence and inter-restraint which determines their state of constant motion and change.

The theory of the five elements basically explains the inter-promoting, inter-acting, over-acting and counter-acting relationship among them. Its application to traditional Chinese medicine is in classifying into different categories natural phenomena plus the tissues and organs of the human body and the human emotions and interpreting the relationship between the physiology and pathology of the human body and the natural environment with the law of the inter-promoting, inter-acting, over-acting and counter-acting of the five elements. This theory is used as a guide in medical practice.

The Inter-consuming-supporting and The Inter-transforming Relation of Yin and Yang – Part 2

Since the occurrence of a disease is the outcome of imbalance between yin and yang, all the methods of treatment should aim at reconciling the two and restoring them to a condition of relative balance. In acupuncture treatment, points on the right side may be selected to treat disorders of the left side and vice versa, while points on the lower portion of the body may be selected to treat disorders of the upper portion and vice versa. All these methods are based on the concept of regarding the body as an organic whole, and the aim of treatment is to readjust the relation of yin and yang and promote circulation of qi and blood.

The inter-transformation of yin and yang means that in certain circumstances and at a certain stage of development, each of the two aspects of yin and yang within a thing will transform itself into its opposite, i.e., yin transforms into yang and yang into yin. Whether the transformation actually takes place depends upon whether there exists the possibility of change in the thing itself. Given this possibility, the external conditions are also indispensable.

The development and change of a thing require a process and the external conditions for transformation maturing gradually. The inter-transformation between yin and yang follows this rule. According to Nei-jing: “There must be quiescence after excessive motion; extreme yang will become yin.” And, “The generation of a thing is due to transformation; the degeneration of a thing is due to transmutation.” This is precisely the meaning of the old saying: “Once a certain limit is reached, a change to the opposite direction is inevitable.” And the quantitative changes lead to qualitative change.

The Inter-transformation of yin and yang is the universal law governing the development and change of things. The alternation of the four seasons is an example. Spring with its warmth sets in when the cold winter has reached its height, and the cool autumn arrives when the hot summer has reached its climax. The change in the nature of a disease is another example. A patient with continued high fever in an acute febrile disease may have a lowering of body temperature, pallor and cold extremities with weak and thread pulse, indicating that the nature of the disease has changed from yang to yin, and then the method of treatment for this patient should be changed accordingly.

The above is a brief introduction to the theory of yin-yang, with some examples to illustrate its application in traditional Chinese medicine. In short, the relation of inter-opposing, inter-depending, inter-consuming-supporting and inter-transforming of yin and yang can be summarized as the law of the unity of opposites. Further, these four relationships between yin and yang are not isolated from one another but interconnected, one influencing the others and each being the cause or effect of the others.

The Inter-consuming-supporting and The Inter-transforming Relation of Yin and Yang – Part 1

Consuming implies losing or weakening; supporting impies gaining or strengthening. The two aspects of yin and yang within a thing are not fixed, but in a state of constant motion. Owing to their mutual conflict and support, the losing or gaining of one aspect will inevitably influence the other. For instance, consuming of yin leads to gaining of yang, while consuming of yang results in gaining of yin. On the other hand, gaining of yin leads to consuming og yang, and gaining of yang results in consuming in yin. The functional activities of human body require a certain amount of nutrient substances, resulting in a process consuming of yin and gaining of yang, whereas the formation and storing of nutrient substances depends upon the functional activities and weakens the functional energy to a certain degree, causing a process of gaining of yin and consuming of yang. But such mutual consuming-supporting does not result in absolute equilibrium. Under normal conditions these opposites maintain a relatives balance, while under abnormal conditions preponderance or discomfiture of yin or yang occurs.

In the inter-consuming and inter-supporting process, when there is any manifestation of losing the relative balance of yin and yang and failing to resume the balance, there results a preponderance or discomfiture of either yin and yang. This is the causative factor of the occurrence of disease. That is, whenever yin or yang is in a state of preponderance or discomfiture, it becomes an etiological factor. For instance, preponderance of harmful yin will consume yang, and discomfiture of yang will lead to a preponderance of yin, either of which may initiate a cold syndrome; on the other hand, preponderance of harmful yang will consume yin, and discomfiture of yin will cause a preponderance of yang, either of which stimulates a heat syndrome. However, the syndromes of cold or heat due to a preponderance of harmful factors pertain to the shi (excess) type, while those of cold or heat due to lowering the general resistance pertain to the xu (deficiency) type. These two types of syndromes are different in nature and the principles of treatment are consequently also different; i.e., the reducing (xie) method for syndromes of the shi (excess) type and the reinforcing (bu) method for those of the xu (deficiency) type.

The Opposition and Interdependence of Yin and Yang

The opposition of yin and yang generalizes the contradiction and struggle of the two opposites within an object or phenomenon. Ancient scholars used water and fire to symbolize the basic properties of yin and yang. That is to say, the basic properties of yin simulate those water, including coldness, downward direction, dimness, etc., while the basic properties of yang are like those of fire, including hotness, upward direction, brightness, etc. From this, it can bi inferred that anything that has the characteristics of quiescence, coldness, lower position (or downward direction), interior position (or inward direction), dimness, asthenia, inhibition, slowness, or which is substantial, etc., pertains to ying whereas anything that is moving, hot, in an upper position (or moving in an upward direction), exterior position (or outward), bright, sthenic, excited, rapid, non-substantial etc., belongs to yang.

Since the yin-yang nature of a thing exists only bay comparison, and moreover that a thing can be divided infinitely, its yin-yang nature is by no means absolute, but its relative. In some circumstances the two opposites of a thing may change, and so the yin-yang nature of the thing also changes. There exist the conditions of a yin aspect developing within yin, yang within yang, yang complicated with yin, and yin complicated with yang. This concept conforms with objective reality.

The tissues and organs of the human body may pertain either to yin or yang according to their relative locations and functions. Viewing the body as a whole, the trunk surface and the four extremities, being on the exterior, pertain to yang, while the zang-fu organs are inside the body and are yin. Viewing the body surface and the four extremities alone, the back pertains to yang, while the chest and abdomen pertain to yin; the portion above the waist pertains to yang and that below pertains to yin; the lateral aspect of the four extremities pertains to yang and the medial aspect to yin; the channels running along the lateral aspect of an extremity pertain to yang, while those along the medial aspect pertain to yin. When speaking of the zang-fu organs alone, the fu organs with their main function of transmitting and digesting food pertain to yang; while the zang organs with their main function of storing vital essence and vital energy pertain to yin. Each of the zang-fu organs itself can again be divided into yin and yang, e.g., the yin and the yang of the kidney, the yin and the yang of the stomach, etc. In short, however complex the tissues and structures of the human body and their functional activities, the can be generalized and explained by the relation of yin and yang.

The interdependent relation of yin and yang means that each of the two aspects is the condition for the other’s existence and neither of them can exist in isolation. For instance, without daytime there would be no night; without excitation there would be no inhibition. Hence, it can be seen that yin and yang are at once in opposition and in interdependence; they rely on each other for existence, coexisting in a single entity. The movement and change of a thing are due not only to the opposition and conflict between yin and yang but also to their relationship of interdependence and mutual support.

In physiological activities, the transformation of substance into function or vice versa verifies the theory of the interdepending relation of yin and yang. Substance pertains to yin and function to yang, the former being the basis of the latter, while the latter is the reflection of the existence of the former and also the motive force for the production of the former. Only when there are ample nutrient substances can the functional activities of the zang-fu organs are sound are they able constantly to stimulate the production of nutrient substances. The coordination and equilibrium between substance and function are the vital guarantee of physiological activities. Hence we find in Neijing: “Yin is installed in the interior as the material foundation of yang, while yang remains on the exterior as the manifestation of the function of yin.”

Yin - Yang and The Five Elements

The theories of yin-yang and the five elements were two kinds of outlook on nature in ancient China. They involved a naïve concept of materialism and dialectics and actively promoted natural science in China. Ancient physicians applied these two theories in their field, which greatly influenced the formation and development of the theoretical system of traditional Chinese medicine and have guided clinical work up to the present.

The theory yin-yang holds that every object or phenomenon in the universe consists of two opposite aspects, namely, yin and yang, which are at once in conflict and in interdependence; further, that this relation between yin and yang is the universal law of the material world the principle and source of the existence of myriads of things, and the root cause for the flourishing and perishing of things.

The theory of yin-yang mainly expounds the opposition, interdepending, inter-consuming-supporting and inter-transforming relation of yin and yang. These relationships between yin and yang are extensively used in traditional Chinese medicine to explain the physiology and pathology of the human body and serve as a guide to diagnosis and treatment in clinical world.