The West’s scientific approach medicine is often less holistic and more focused on a particular organ. That is why you encounter so many medical specialists in the West. Often, if an organ is failing it is removed or replaced (transplanted). Medicines treat a disease without regard for side effects than can harm surrounding organs.
The TCM explanation is quite different. Our organs are considered functional units of the whole body. What is usually thought of as an organ (i.e. heart, liver, stomach etc.) has a more complex meaning and application in TCM? An organ's anatomical make up is of secondary importance to its yin/yang properties or relationships with other organs. Known as "zang" and "fu" organs respectively, TCM identifies five yin and six yang organs.
The Yin/Yang Organs
The function of the Yin organs is to produce, transform, regulate and store fundamental substances such as Qi, blood, and body fluids. The Yin organs include the liver, heart, spleen, lungs and kidneys. The pericardium is sometimes considered a sixth Yin organ.
In general, the Yang organs are mainly responsible for digesting food and transmitting nutrients to the body. The six Yang organs are made up of the gall bladder, stomach, small intestine, large intestine, bladder and triple burner. The triple burner does not have a physical structure and is considered a functional unit. Usually, Yang organs are empty cavities while Yin organs, being the opposite by definition, do not have empty cavities.
TCM teaches us that the physiological functions of the body are based on harmonious relationships between Yin and Yang organs. The interior and exterior relationship theory states the interior belongs to Yin and the exterior belongs to Yang. This is a main TCM principle. Yin organs have more internal functions and are called interior organs. They play an important role in TCM medical theory and practice. The Yang organs, on the other hand, are believed to have more external functions and are considered exterior organs. (See table.)
Interior-exterior relationship between Yin and Yang organs
The bladder is performs the function of storing and excreting urine. If your Yin/ Yang energy balance is disturbed, bladder disharmony can lead to urinary problems such as incontinence or difficult urination. Kidney functions and bladder functions complement each other. A problem with the bladder often indicates kidney problems. We stated earlier that the lungs, spleen and kidneys all have roles in fluid metabolism and regulating the water distribution in the body. Any "turbid' water gathered by the kidneys that cannot be reused by the body is sent to the bladder for excretion as urine. TCM calls this organ’s function as "vaporization" of urine in the bladder.
The Gall Bladder
Both TCM and Western medicine agree that the gall bladder stores and secretes bile produced by the liver. A healthy liver is essential for the well functioning gall bladder. It's spreading and flowing functions allow bile to be secreted into the small intestines where it helps the digestive process. Bile secretion also supports the spleen in its transformation functions. If disharmony in the liver appears, bile secretion is affected. This can have a negative impact on other digestive functions. This gall bladder function disharmony can result in jaundice where you will develop yellow eyes and skin color as a buildup of bile in the body.
In TCM, mental disorders involving anxiety and fear are treated by restoring gall bladder harmony. The gall bladder rules decision and is related to bravery.
The heart organ represents a group of physiological functions and is the functional unit for regulating blood flow. In addition to regulating the cardiovascular system, it is responsible for maintaining nervous system functions. When the heart pumps blood is transported inside the veins and arteries around the entire body. The heart, along with the blood and vessels are a unit. In TCM, this functional relationship is known as the "ruling" of the heart.
Heart Qi refers to the pumping actions of the heart. If heart Qi is abundant and sufficient:
- the heart pumps at a normal pace
- blood moves smoothly inside the blood vessels
- the pulse is regular and strong
- the face will look brilliant
As a result, the body is able to obtain from blood the nutrients needed to sustain life. However, if heart Qi is low, blood cannot maintain an efficient flow in the blood vessels, and the pulse is weak. The patient looks pale, and the tongue also appears pale and white. Without healthy ruling of the heart, individuals will experience palpitations, chest discomfort and pain.
The heart stores the "spirit” or individual's vitality, which is reflected in the eyes, speech, reactions and overall appearance. This "spirit" refers to a person's mental, cognitive and intellectual abilities. The heart regulates mental activities by exerting control over other organs and their physiological functions. If the person possesses a good "spirit ruling" then they will be wise and have a clear and fast mind. Heart disharmony will show signs like forgetfulness, poor self esteem, and slow thought processes or reactions.
Blood is ruled by the heart and is the main fluid of this organ. Sweat comes from body fluids and is an essential and integral part of blood. Because sweat has the same origin as blood, over-sweating is considered an over use of Qi and heart blood. This can lead to symptoms such as palpitations. People who sweat abnormally usually have a heart deficiency. If such sweating is spontaneous, the disharmony belongs to a deficiency of heart Yang. If it takes place at night, the disharmony belongs to a deficiency of heart Yin.
The tongue and face are indicators for the heart and blood. The heart "opens into the tongue" because they are connected. By examine the tongue and looking for the "heart's brilliance to be manifested in the face," a lot can be determined about how your heart condition. For example, if the cheeks are bright and red then the tongue will appear pink indicating heart function is healthy, if there is blood stasis (where blood is not able to flow smoothly through the blood vessels), the face and tongue will appear purple. A sufficient blood supply is vital when providing nutrients for hair growth. Hair is thought to be the "remains of blood." If hair growth is affected, it may indicate a problem with the heart and blood.
The kidneys are a vital excretory organ that creates urine to help the body gets rid of toxins and unwanted water in western physiology. TCM view the kidneys as a very important organ that not only regulates the urinary system but also exercises control over the reproductive, endocrine and nervous systems.
The kidneys are the organs responsible for human development, because they store Jing energy. Jing is an essential substance, closely associated with life. It is needed for reproduction, growth development and maturation. For example, conception is made possible by the power of Jing, growth to maturity is the blossoming of Jing, and aging reflects the weakening of Jing. As time passes, Jing decreases, causing both vitality and kidney Qi to decline. This decline is the normal aging process.
The kidneys play an important role in water movement and balance of the whole body. The kidneys govern water by regulating its distribution and excretion. This traditionally described as the vaporizing kidneys power. They can differentiate between clean water, which is recycled and used by the body, from turbid water that is turned into urine. The separation of these two is the vaporization process.
The stomach receives fluids and food where the separation process begins.
- The unusable portions of food and fluid are sent to the intestines as waste where pure fluids (mainly water) are extracted from them.
- The pure fluids go to the spleen, which then sends them in a vaporized state upward to the lungs.
- The lungs circulate and disseminate the clear part of the fluids throughout the body.
- Whatever has become impure through use is liquefied by the lungs and sent downward to the kidneys.
- In the kidneys, the impure fluids are further separated into "clean" and "turbid" parts. The clean part is vaporized into a mist and sent upwards to the lungs, where it rejoins the cycle.
- The final impure portion goes to the bladder, where it is stored and finally excreted as urine.
Respiratory functions mainly depend on the lungs. Deep and normal breathing is controlled by the "grasping" function of the kidneys. By grasping Qi, the kidneys enable the "natural air Qi" of the lungs to penetrate deeply during the inhalation process. If there is kidney disharmony, respiratory problems such as shallow breathing or wheezing on exertion can occur. Some types of asthma are related to disorder grasping of Qi by the kidneys.
Jing is the substance responsible for producing bone marrow, which in turn, creates and supports bone growth. Therefore, bone development and repair depends on the nourishment of kidney Jing. Deficiency of Jing in children can lead to soft bones or incomplete closure of the skull bones. Teeth are made up of bone so dental problems can also indicate a kidney deficiency.
The kidneys play a role in transforming stored Jing into blood. Head hair depends on blood for its nourishment. If Jing and blood are abundant, the hair will appear bright, shiny and healthy. On the other hand, hair loss or other hair disorders can indicate a kidney deficiency or blood deficiency.
Abundant kidney Jing results in excellent hearing. A deficiency causes hearing problems like deafness or ringing in the ears (tinnitus). Other signs of low Jing are genital and urinary tract disorders such as urinary frequency or dripping urine (incontinence) are also signs of kidney disharmony.
The Large intestine
The next organ the food encounters in it’s part to digestion is the large intestine. When it receives the "impure" parts of the digested food from the small intestine it will continue to absorb water from these materials. The very last part of the digestive cycle is stools are formed and excreted through the anus. Any disharmony large intestine presents symptoms of abdominal pain, intestinal rumblings and diarrhea. Occasionally there is excessive "heat" and intestinal fluids will dry up resulting in constipation.
While in western physiology the liver is vital, it role is responsible for a few number of important body functions. Those include the production and excretion of bile, which is used to break down fat and the detoxification of blood.
TCM knows the liver's functions are different. They include control of the central nervous system, responsible for vision, and the autonomic nervous system (the part of the nervous system over which a person does not have voluntary control), and the circulatory system.
"The liver rules flowing and spreading."
It also promotes flowing and spreading movements. By stimulating flow, the liver adjusts and ensures the smooth movement of Qi, blood and body fluids, and spreads these substances to the entire body. There are three functional aspects of the liver's "flowing and spreading" activity:
- regulating Qi
- regulating emotions
- Enhancing the digestive properties of the spleen.
Controlling Qi movement
The activities of the organs and meridians are dependent on Qi movement. The flow and spread of Qi throughout the body are in turn dependent on the regulatory functions of the liver. If the liver is not functioning properly, Qi flow is interrupted. This can lead to disharmony and imbalance of Yin/Yang energy. This is a warning sign that health issue and disease may occur.
Normal emotional health depends on the harmony of Qi and blood. The liver balances emotions.
- When the liver keeps Qi flowing smoothly, a relaxed internal, emotional environment is created.
- If liver disharmony results in stagnant liver Qi, emotional disturbances like depression and anger can occur.
Improving the digestive power of spleen
There liver energy has two essential roles.
- If the liver is dysfunctional, the movement of spleen Qi will no longer be smooth. The transformation and transportation of digested food is disrupted, leading to abdominal pain, nausea, belching, diarrhea and other complications The liver's flowing and spreading functions also adjust the digestive functions of spleen.
- Blood flow and regulation is a liver function. If you move or when you exercise, the blood flows from the liver and travels to the part of body where needed. When a person rests the blood returns to the liver to be stored. If you have insufficient blood available for storage in the liver, the eyes will not be adequately nourished and become rough and dry. Another symptom is dizziness.
- The eyes are connected to the liver meridian and therefore have a close relationship. Your eyesight depends on the nourishment from blood stored in the liver. Many liver disorders can be determined from the condition of the eyes. For example, insufficient liver blood can lead to blurred vision. "Dampness and heat" of the liver and gall bladder, a condition known in western medicine as jaundice, manifests as yellow eyes.
- Tendons attach muscle to the bone. The proper movement of tendons is closely related to liver function. If the blood stored in the liver is insufficient and incapable of nourishing the tendons, symptoms like spasms, numbness of limbs and difficulty bending or stretching occur. Fingernail and toenail health is also dependent on the nourishment of blood from the liver. If the liver blood is sufficient, nails will appear pink and moist. If it is insufficient, the nails will become thin, brittle and pale.
Both the East and West agree the lungs are responsible for air exchange. Additionally, TCM states that the lungs' regulate fluid metabolism, blood circulation, autonomic nervous system, and the immune system.
There are several Qi exchanges in normal respiration. During inhalation, the lungs take in natural air Qi (a type of Qi associated the atmospheric air), propelling it downward where it meets other types of Qi. The lungs are where Qi exchange and regulation occurs. The different types of Qi combine to produce normal Qi present in the body. During exhalation, the lung expels the "impure" gasses not useful to the body. If the lungs are healthy, Qi will enter the body smoothly and respiration will be even and regular. If there is lung disharmony, respiration is weakened and normal Qi production is affected, leading to Qi deficiency.
Your lungs disseminate substances in an ascending and outward direction. For example, used air is expelled in this manner, and body fluids and food nutritive essence are directed towards the skin and hair. By regulating sweat secretion, the lungs disseminate protective Qi mainly responsible for skin immunity and healthy pores.
When the lungs take in natural air Qi during respiration, it liquefies the fluids in the airway. This illustrates descending and liquefying properties. The lungs will push these substances downwards along with food essence transformed by the spleen. This descending property is vital to maintain a normal respiratory tract.
The lung properties of descending, disseminating, and liquefying are curial for good health. If a problem occurs, you may suffer from chest discomfort, coughing, wheezing, abnormal sweating or congestion from phlegm.
The lungs control the changing and movement of water in the body. Water flows in the same directions as Qi. The lungs' ability to distribute water vapor allows it to ascend and scatter to the skin pores. This is normal sweating. Another aspect of the lungs is to liquefy and cause water vapor to descend to the kidneys, where the liquefied waste is excreted as urine.
Qi is essential for all physiological functions in the body, Lungs are very important in that they rule Qi. Regulating Qi movement is necessary for blood circulation to occur. The lungs intercept all blood and blood vessels. The Qi moves the blood throughout the body after Qi exchange occurs during breathing, Qi movement also regulates the distribution of body fluids.
The lungs are the interior organs that rule this exterior. The skin and body hair share a close relationship with the lungs. Together with the sweat glands, they are often referred to as the "exterior" of the body. By controlling the skin, sweat glands, body hair, the lungs regulate the sweating process. Lungs also maintain healthy movement and dissemination of protective Qi over the skin. Protective Qi is guards the body against "illness evils" (factors causing illness including wind, fire, dampness, dryness, cold and summer heat). If these particular lung functions are weakened, too much spontaneous sweating occurs, and the protective Qi will become weak as well. As a result, the body will have lower resistance to illness and may easily get colds, influenza, or other respiratory problems.
The nostrils create an opening for the lungs and also provide the exit for Qi from the body. A lung dysfunction can create nasal problems. For example:
- An interrupted flow of lung Qi can result in a watery nasal discharge, congestion, or a loss of sense of smell and sneezing.
- Your throat and vocal cords are extensions of the lungs. A lung deficiency can produce a coarse or low voice.
The Small Intestine
This organ is the exit for what the stomach has not completely digested. This material or matter is continues to be digested into nutrients. Like the stomach, the small intestine also separates the "pure" from the "impure." The small intestine routes:
- The "pure" (useful) part to the spleen where the nutrients will be distributed.
- The "impure" (waste) part is directed down into the large intestine. Any useless water produced in the digestion process will be sent to the bladder and stored as urine.
A healthy and well functioning small intestine is essential for normal urination and defecation. When this organ is not in balance and you may experience dysuria (difficulty or pain on urination) or loose stools. So it is said that the small intestine rules "containing and transforming."
The role of the spleen is completely different in West vs. Eastern medicine.
- In western physiology, the spleen is a large, vascular, lymphatic organ. It acts as a reservoir and filters the blood. It also plays a role in making blood early on in life.
- TCM does not indicate that it does not perform these roles. It does assists with digestion, blood coagulation and fluid metabolism in the body.
The spleen is the primary organ responsible for digestion, its main function is to transform food into essence used for Qi and blood transformation. Once the ingested food and liquids get into the body, the spleen extracts a pure nutritive essence from them. This pure nutritive essence is used for Qi production, blood and body fluids, which the spleen then transports throughout the body. Liquids extracted as pure nutritive essence are sent upwards to the lung for dissemination and redistribution. Some of this Qi is diverted and will descend to the kidney and bladder to be excreted as urine.
There can only be abundant nutritive essence for Qi and blood if the transformation and transportation functions of the spleen are harmonious. If the spleen is in disharmony, its digestive powers will be affected with abdominal distention, pain, diarrhea or malaise occurring.
First, the spleen transforms food into nutritive essence. Then the spleen sends it upwards to the heart and lungs where it is transformed into Qi and blood for nourishment of the whole body. If some food is not transformed into nutritive essence does not mean it becomes an impure substance. While the spleen ascends pure essence, the stomach, (the spleen's corresponding Yang organ), will descend the impure substances inside the digestive tract. The pure nutritive essence ascends and the impure substances descend to create a Yin/Yang balance in the digestive system.
The spleen transforms food essence while governing the movement of blood by keeping it flowing in its proper pathways in the blood vessels. When spleen Qi is sufficient, there is adequate production of Qi and blood, and blood stay within the all the blood vessels. If the spleen's functions are in disharmony, the blood escapes from its normal pathways. This can lead to symptoms such as bloody vomit, blood in the stool, blood under the skin, blood in urine, or menorrhagia (excessive menstrual bleeding).
Muscles movements and your four limbs depend on spleen power. When spleen Qi is sufficient, the limbs and muscles are healthy and strong because they are nourished by the blood and Qi. If spleen Qi is deficient, however, the muscles become weak and you may feel tired and have general malaise.
The lips and mouth are also affected by the spleen's health. If spleen function is harmonious, the mouth can distinguish the five tastes (sweet, salty, sour, bitter and pungent (spicy)), and the lips appear red and moist. If the spleen is weak lips will be pale and taste fades.
When food is eaten and properly chewed, it passes from the mouth and down the throat and into the stomach. Stomach Qi and fluid decompose it into materials to be further digested in the small intestine. This is why the stomach is known as "the sea of food and fluid", is responsible for "receiving" and "ripening" ingested food and fluids.
Food masticated food follows two paths in the stomach.
- The "pure" food is sent upwards to the spleen for transformation into nutrient particles for the body.
- The "impure" is sent downwards to the small intestine. This function is called the "descending the impure" in TCM.
It is said the spleen rules "ascending" functions, and the opposite (Yin/Yang) the stomach rules "descending" functions. When the stomach loses its descending properties then will cause symptoms like nausea and vomiting. Since the stomach is a Yang organ, it prefers a moist rather than dry environment. Too much Yang can sometimes cause "dryness fire." This can result in stomach disharmony as well. This is usually accompanied by a dry mouth and thirst.
In TCM the triple burner is a unique concept with no corresponding organ or concept in Western medicine. It has been suggested that the triple burner's function may be related to the pancreas and metabolism in the body. So far there is no clear conclusion has been reached as to the nature of this organ. When referring to the triple burner, TCM is actually describing a collective term for the upper, middle and lower burner. The Chinese word "triple burner" actually means "three parts which burn or scorch." The description of location is stated below is for the functional TCM classification of the triple burner and do not refer to the anatomical location of organs.
- The upper burner is located above the diaphragm and includes the heart and lungs.
- The middle burner is located in the region above the belly button and below the diaphragm and includes the spleen and stomach.
- The lower burner is located below the belly button, and includes the liver, kidneys, large and small intestine, and bladder.
The triple burner's functions correspond to Qi activities and the movement of water.
Classic Chinese texts refer to the three parts as:
- "Mist" for the disseminating functions of the upper burner. With this function, Qi, blood and body fluids are distributed throughout the body just as mist disperses in the environment.
- "Foam" for the digestive churning of the middle burner. When the spleen and stomach transform and ripen food, the food decomposes in a similar way to foaming.
- "Swamp" for the excretion of impure substances. The lower burner divides the "clear" from the "turbid" substances and excretes these impurities as wastes. In nature a swamp breaks down certain vegetation.
The triple burner is the name of the vessel whose purpose it is to channel or transport water, food and fluid. The triple burner is the controller of the entire circulation of body fluid. Any disharmony of the triple burner can lead to edema (fluid collection in the tissues) or difficult urination. To treat these conditions is the goal is to resume harmony of the affected organs such as the lungs, spleen or kidneys.