The functioning relationships among the vital organs are key factors in the Chinese approach to the diagnosis and treatment of disease. Their predictable interactions, based on yin-yang and the Five Elements, permit the experienced Chinese doctor to diagnose the causes of disease and weakness, and to effect cures by evaluating the patterned connections and prescribing herbal medicines.
The Chinese refer to the vital organs as the wu zang and liu fu (the five “solid” and six “hollow” organs). With the exception of son jiao —the “three-points” or “triple-warmer” — the organs correspond to those of Western anatomy. The triple-warmer, one of the six hollow organs, consists of the openings to the stomach, small intestine, and bladder. As such, it is not, strictly speaking, an independent organ in the Western sense, but rather an energy system which deals with the passing of food and fluid. Later, a sixth solid organ was added to correspond to the triple-warmer and balance the system. This is the pericardium, the sack which surrounds the heart. Because the triple-warmer and the pericardium are not vital organs in the traditional Western sense, and since they are used primarily in acupuncture rather than herbal therapy, we will limit our discussion to the familiar ten: heart, lungs, liver, kidney, spleen (the five “solid” or yin organs); small intestine, large intestine, gall-bladder, bladder, stomach (the five “hollow” or yang organs).
Five Elements and Organs
These ten organs are divided into five coupled pairs. Each pair consists of a solid yin organ and a corresponding hollow yang organ, and each pair is dominated by one of the Five Elements. All other parts of the body reflect the condition and activities of the vital organs. According to the Five Elements, each of the five coupled pairs is identified with other parts of the body and with other basic natural factors which reflect or influence their activities. These factors are outlined in the chart opposite. Note that a fifth season, “mid summer” is included to correspond to the element Earth and its attendant phenomena. The Chinese love balance and are suspicious of anything that is lop-sided.
While there may be some doubt as to the accuracy of a few of the factors in this chart, there is no doubt that most of them are correct and represent real relationships in nature. This chart is used successfully by Chinese doctors in both diagnosis and treatment.
Take, for example, the liver, which belongs to the element Wood. Western medicine agrees that persons suffering from liver ailments often have symptoms of foggy vision with black spots, muscular spasms, and blemished nails. On the Chinese chart sight, muscles, and nails all belong to Wood and reflect liver functions. The emotions associated with Wood are anger and depression. Persons with volatile, overactive livers are prone to violent fits of anger followed by bouts of depression and they often shout (Wood sound) at others.
The factors associated with each of the Five Elements invariably reflect the activity of the related organs and, in turn, can be used to influence them. A child who suffers from
chronic fear (Water emotion) tends to wet his bed (urine belongs to Water), and therefore he probably has weak kidneys (Water organ). Trying to cure his fear and his bed wetting with comforting words, stern warnings, or other psychological means, will prove frustrating, perhaps even futile, for both parent and child —if indeed the problem lies in weak kidneys. Tonifying the kidneys with herbs, or herbs and acupuncture, should quickly eliminate the symptoms of fear and incontinence. Chinese medicine is still well ahead of Western medicine in tracing and treating the physical causes of mental disturbances.
The possibilities for using these patterned relationships are endless. For example, a person who suffers from chronic depression (Wood emotion) can often be cured simply by treating his liver, for depression is a clear manifestation of liver dysfunction. A person with a very red complexion (Fire color) who laughs a lot (Fire sound) probably has an over-fired heart (Fire organ). In such a case, the heart should be sedated with appropriate herbs. However, another way to treat this case is to use the victor-vanquished relationship of Water to Fire by tonifying the kidneys (Water organ). Since Water vanquishes Fire, the heart will be sedated by the tonified kidneys. Because there are so many related factors and possibilities, Chinese doctors must have a detailed account of each patient’s dietary, physical, and emotional habits. Only broad clinical experience, combined with a thorough grasp of the principles involved, enables the physician to weigh the many relevant factors for accurate diagnosis and treatment.
The yin organs, which “store but do not transmit” are considered more vital than the Yang organs, “which transform but do not retain.” Coupled organs are connected to one another by meridians, or energy channels, along which their vital energies flow. The meridians of coupled organs meet in the fingers, toes, and head. The yin-yang coupling of organs is not arbitrary. It is based on their actual functional relationships, as established by observation over many centuries.
Before going on to discuss how the connections among the organs are used in Chinese medical diagnosis and treatment, a brief description of the organs themselves is in order. Following the Chinese mode, the five yin organs (which house the five at- tributes of spirit, human-soul, animal-soul, mind, and will-power) are described according to their vital functions, while their five yang counterparts are given secondary importance:
Called the “Chief of the Vital Organs”, the heart regulates the other organs by controlling circulation of blood. It houses the spirit and thus governs one’s moods and clarity of thought. It is closely connected to liver functions by the generative mother-son relationship of Wood to Fire. Heart activity is reflected on the color of the face and tongue: a dark, reddish color indicates excess heart-energy while a pale, grey color reflects deficient heart-energy. The heart is coupled with the small intestine, which separates the pure from the impure products of digestion, controls the ratio of liquid to solid wastes, and absorbs nutrients from digested food and drink.
The liver stores blood and regulates the amount to be circulated by the heart. When man moves, the blood travels to several meridians; when man is still, the blood returns to the liver. During sleep, blood is enriched with energy in the liver and distributed to the rest of the body during activity. The liver houses the human soul, which is said to enter the foetus at the moment of birth. The popular Chinese term of endearment xin gan (literally “heart- liver”), which means “dear” or “sweet- heart,” is derived from the fact that these two organs house the most precious of human attributes: spirit and human soul. The liver is the center of metabolism, life’s most vital function, and therefore its condition is perhaps most responsible for our overall sense of physical and mental well-being. While liver dysfunction causes symptoms of anger and depression, a healthy liver is also particularly sensitive to psychosomatic injury caused by prolonged emotional fits of anger or depression. Liver condition is reflected in the eyes, muscles, finger- and toe-nails. It is coupled with the gall-bladder, whose functions are closely related to, and often inseparable from, those of the liver. The gall-bladder is called the “true and upright official who excels in making decisions.” Planning and deciding are said to be governed by combined liver and gall-bladder activity.
The spleen controls the “moving and transforming” of pure vital essence extracted by the stomach from food and drink. It is responsible for distributing nutrients and qi to the rest of the body. Spleen dysfunction is indicated by weakness or emaciation of the skin, flesh, and limbs. The spleen houses the mind. It is coupled with the stomach, which is described as “the sea of water and nourishment and the controller of rotting and ripening of liquid and solid food.” If the spleen fails to move and transform, the stomach will back up and fail to digest properly. If the stomach fails to rot and ripen food and water, the spleen cannot move and transform nutrition and qi. The harmonious functioning of these two organs is vital for proper digestion and distribution of nutrition. Western medical science does not assign the spleen any digestive functions and recognizes no functional connection to the stomach. It has been suggested therefore that the digestive functions assigned to the spleen in the Chinese system may in fact include those of the pancreas, which is located nearby and secretes such vital digestive juices as trypsin, maltase, lapase, and others.
The lungs control vital energy, qi, in both senses of the word, namely energy and breath. The lungs govern breathing, and when breath is insufficient, so is energy. The lungs extract qi from the air and transfer it to the blood through the alveoli. “Man’s breathing combines the pure vital essence of Heaven (air) and Earth (food and water) in order to form the true human-qi of the body.” The lungs house the animal-soul, which is said to enter the embryo at the moment of conception. The condition of the lungs is closely associated with that of the skin, a fact well known to Western medicine. In many animals, skin performs important respiratory functions. Lung dysfunctions usually manifest themselves as skin problems. The lungs are coupled with the large intestine, which “controls the transmitting and drainage of the dregs.” Pneumonia and influenza are generally accompanied by constipation, while the latter ailment usually causes distension of the chest.
The kidneys control water, receive the vital essence of the wu zang and liu fu —vital organs —and store it. The kidneys store both life- essence and semen-essence. Excess liquid sent by the small intestine is converted by the kidneys to urine and passed on to its coupled organ, the bladder, for storage and expulsion. Growth and development of bones and marrow are connected to the kidneys. Since the brain is the “meeting point for all marrow,” the kidneys influence brain function. They house the attribute of will- power. When kidney-qi is deficient, the symptoms are amnesia, insomnia, mental confusion, and a constant ringing inside the ears. Kidneys control the loins, lumbar region, and sacral areas of the body, and their dysfunction often causes lower back pains and the inability to straighten up. The kidneys are closely related to the adrenal cortex which produces the cortisone hormones as well as sex hormones like androgen, estrogen, and progesterone. Therefore, the kidneys and surrounding glands control all sexual functions. A recent study in America has revealed that frequent sexual intercourse helps relieve the pain of rheumatism in elderly people by stimulating production of cortisone through sexual excitation of the adrenal cortex. The therapeutic applications of sexual intercourse have long been known in China. The kidneys and bladder function closely together in moving, converting, storing, and expelling excess fluids from the system.
The above is a simplified account of the vital organs according to traditional Chinese medical theory. A full accounting would require a book in itself but it can be seen from this brief sketch that the Chinese lay emphasis on the functions of the vital organs, and the functional relationships among them. Western medicine, in contrast, stresses the location, structure, and physical description of the organs. What concerns the Chinese physician is the elaborate interplay of basic forces which ultimately regulate all bodily functions, not microscopic anatomy, biochemical formulas, or isolated phenomena. While Western medical science has managed to analyse and isolate every single functional structure in the body, right down to individual cells, nuclei, and beyond, it has less ideas of what makes the whole system tick and function harmoniously. Chinese medicine has dwelled on such questions as what is the nature of the vital energy at the root of all life? how does it work? what factors influence it? what forms does it take? Both physical and mental symptoms of health and disease are viewed as concrete manifestations of potent natural forces and vital energies at work inside the body. In treating disease, the Chinese believe they must exert a balancing on these forces and energies, rather than simply eliminate the symptoms of the disease.
Unfortunately, Western science does not readily accept as real things that cannot be directly detected and measured with the senses, or with equipment to aid them. Chinese doctors are quick to point out, however, that even the senses are mere physical entities controlled by the same unseen vital energy as the rest of the body. At best, the sense can be used to detect physical manifestations of cosmic forces and vital energy. The nature of the forces themselves has to be intuited and inferred from the evidence. The main concern of Chinese medicine during its long history has been to establish the patterns by which these forces and energies interact. To develop natural herbal techniques favorably influencing their relative balance in the body has been part of that concern.