TCM Series: Zang Viscera


(c) 2012, Chraeloos Resident
Welcome everyone to the Traditional Oriental Medicine series. Thank you for coming! Please leave a donation if you like what you see and want to see more. All donations are split between the venue and myself in order to keep these events going and to enable the growth of the sim. The tip jar is one of the candles on the table. If you’d like a copy of today’s notes you can find them in another candle on the table.

Thank you for visiting Peaceful Dragon Oriental Medicine Centre! The centre is currently under construction, but is intended to be an Oriental medicine learning centre. If you have a suggestion for an activity or an event here, please contact either Xandria Winterwolf or myself.

I just want to remind everyone that none of the information presented here is advice and therefore should not be put into practice without first consulting a professional.

Today we will focus on the structure and functions of the viscera.

The main sources used today are: http://www.tcmworld.org/, “The Way of Qigong” by Kenneth S. Cohen, “Traditional Chinese Medicine” by Daniel Reid, “Natural Healing Wisdom and Know-how” compiled by Amy Rost, http://www.yinyanghouse.com/theory/, http://www.sacredlotus.com/theory/substances/qi_forms.cfm, “Essentials of Chinese Medicine, Vol. 1” edited by Zhanwen Liu and Liang Liu, “Secrets of Dragon Gate” by Dr. Steven Liu and Jonathan Blank.

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I’d like you all to take a few minutes and do this exercise with me.

You can do this standing or sitting, whatever is more comfortable for you. Straighten your spine – pretend as though there is a string someone has attached to it with a rod and is pulling up from the top of your spine. Make it tall and straight. Next, relax your joints. Let your shoulders relax, your elbows, wrists, hips, knees, ankles, everything; just let it all relax. You should almost feel heavier, as though there is more gravity pulling on you. Now, breathe deeply, bring the breath all the way through your body. Fill your meridians with the air, all the way to your toes and finger tips. Stay like this for a few minutes, breathing deeply and steadily, and try to clear your mind. Listen to the music stream if you want something to focus on. Just sit or stand and breathe, joints relaxed, and spine straight.

If you’d like to try staying this way for the discussion, by all means feel free. Make sure you stop if at any point it hurts or you feel dizzy. Any movements from this position should be slow and done in time with your breathing. Drink some water to help bring yourself back to centre when you stop.

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Zang Viscera: a collective term for the heart, lung, spleen, liver, and kidney. The heart is the governor of these organs, although they are all inter-dependent and work together to maintain vital activities within the body.

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Heart (including Pericardium)

“The heart is the lord of all organs; it is where the spirit arises.” – Plain Questions

The heart is located in the thorax above the diaphragm and it surrounded by the pericardium. It is the house of the mind, the master of blood, and the governor of the vessels. It belongs to the fire element. When working with the other zang organs, it has the function of controlling all the vital activities of the body.

The heart takes part in the formation of blood, while also promoting the circulation of blood. The qi of the heart enables it to beat. According to yin-yang theory, the qi belongs to yang, and the blood to yin. Because of this the heart can have two categories – heart-Yang and heart-Yin. Because of the hearts connection to the blood vessels, it is easy for practitioners to find any changes from the normal activities of the heart through the pulse. For example, when the heart-Qi is abundant and the blood full, the heartbeat is strong and the blood would flow smoothly. This is manifested as a regular pulse that is forceful and regular (4-5 beats per breath), as well as a red and vibrant complexion. On the other hand, if heart-Qi and heart-blood are insufficient, the heartbeat is weak and the pulse is irregular and feeble with a lustreless and pallid complexion. Also, stagnant blood would manifest as a dusky complexion, cyanotic lips, palpitation of the heart, tightness in the chest, precordial pain, and a pulse that is hesitant and intermittent.

By saying that the heart governs the mind we’re really saying two things: a) that it is the outward activities of the life of the whole body, i.e., the complete form and function of the body including complexion, expression of the eye, speech, response, movement of limbs and trunk, etc. b) it is vitality, or spirit, consciousness, and all thinking activities.

This is different from western medicine as it holds that the brain holds all these activities as a response to the external world. In CM we believe that these mental activities are attributed to the physiological functions of all five zang viscera. They came to this conclusion for two main reasons: 1. blood is the material support for mental activities, and 2. mental disorders are usually cured by methods of treating the heart. For example, if there is heat in the blood the mind may become deranged, manifesting agitation, delirium, and even loss of consciousness.

We mentioned the complexion and pulse as a sign of the state of the heart, but the tongue is another good sign. The tongue manages speech and taste – two things dependent upon the heart. The tongue is connected to a collateral meridian of the Heart Meridian of Hand-Shaoyin. For example, if the heart’s Wi and blood are abundant, the tongue will be supple and agile, speech clear and fluent and taste keen. If Qi and blood are insufficient, the tongue will be pale and taste blunted. There are many signs that will show through the tongue.

The pericardium is a membranous envelope of the heart. It acts as a shield for the heart, and promotes the circulation of qi and blood. It is not an independent organ, but part of the heart.

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Lung

The lung is a delicate organ, sensitive to heat and cold and highly susceptible to invasion by external evil qi. It is part of the metal element and is located in the chest. The lung is the commander of regulation for respiration and managing gas exchange between qi and the body.

The lung regulating qi means all the qi in the entire body. Therefore, regulation of lung qi has two meaning: a) the lung regulates respiration, and b) the lung regulates qi of the entire body.

“The lung’s respiratory function ensures that the fresh air is inhaled and the spent air is exhaled, thereby enabling the metabolic processes to proceed normally.” This should be a smooth, rhythmic process. If the lung is invaded by evil qi there can be many symptoms, including but not exclusively, tightness in the chest, cough, dyspnea, and impedance. If this exchange of fresh air and stale air does not occur, all vital activities stop.

When we say “regulating the entire body’s qi”, we mean mainly two things. First, “the lung helps in the formation of qi, especially thoracic qi. Thoracic qi is formed when the essential nutritious substances of food and drink, extracted by the stomach and transported by the spleen, is combined with fresh air inhaled by the lung.” The lung helps in the transportation of thoracic qi through the entire body via blood vessels. “Only the lung’s incessant, rhythmic and even respiration can ensure the harmonious balance of Qi’s in-out and up-down movement in the body…”

As you can see, blood circulation results form the cooperation of the heart and the lung. The lung also distributes liquids throughout the body such as food and drink that have been transformed by the spleen. As you can see, “it has an important role in the metabolism of fluids and in the maintenance of the proper balance of metabolism.” The lung also eliminates the pathogenic poisons, keeps the respiratory tract clear, and assists the large intestine in the excretion of wastes. The lung connects to the skin by opening and closing the sweat glands. The nose is the obvious external orifice for the lung. The nose helps keep out the evil qi by means of the nose hairs and intricate internal passages.

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Spleen

The spleen is located in the middle-jiao, underneath the diaphragm. It belongs to the earth element, and is connected to the stomach by means of the meridians. It has two main function: transportation and transformation, ie. “digesting food and drink, transforming them into nutritive substances, and absorbing and distributing the essential nutrients to the entire body.” It works with the stomach and the small intestine, but it she lead organ in this system.

When the spleen takes the absorbed water it transforms it into body fluids and delivers it to the lung, which then, along with the heart, distribute it throughout the body. The fluids end up back at the spleen after the organs have taken what they need from it, and the spleen goes on to deliver the waste to the appropriate organs to be excreted from the body as sweat or urine. The spleen, in its action of sending the body fluids throughout the body, helps the visceral organs stay in their proper locations. This is because the muscles, tissues, and ligaments that support the internal organs also depend upon nourishment form the body fluids. Also, the spleen ensures that the blood flows in its proper passages, and not outside them.

If the spleen lacks in its functions you’ll see a loss of appetite, loss of taste, abdominal distention, diarrhea, and other symptoms such as malnutrition, fatigue and lassitude.

The digestion of food and drink, absorption of nutritive substances and their distribution cannot take place without the spleen. Because of this it is considered the source for qi and blood. Spleen-Yang is what warms the body, digests food and drink, and facilitates the production and conveyance of the nutrients and body fluids. “Spleen-Yin is the essential nutritive substance for nourishing the spleen and the stomach and for restraining spleen-Yang.”

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Liver

The liver is located underneath the diaphragm, on the right side behind the ribs. It is connected to the gallbladder via the meridians, and is part of the wood element. “Its main functions are storage of blood, regulation of the total quantity of circulating blood, regulation of the emotions, promotion of the circulation of qi and blood, promotion of the metabolism of fluids and regulation of menses.”

In general, the amount of blood circulating is constant, but depending on your physical activity, such as running or sleeping, and emotional state, the amounts needed by the viscera will vary. If the liver is damaged it will not send out enough blood, causing dizziness, blurred vision, night blindness, numbness of the limbs, etc. If damaged, it will also not store unneeded blood, which could cause vomiting of blood, coughing up blood, nosebleeds, uterine bleeding, etc.

The blood and qi both flow through the body in the same way, so the liver not only stores the blood but the qi. If the mental outlook is optimistic, the mind at ease, then the qi and blood will be harmonious and therefore all the viscera will function properly, and vice versa.

The liver has its main manifestation in the tendons, nails, and eyes. “The liver controlling the tendons means that the relaxation or contraction of all the tendons in the body is related to liver function.” The liver is the source of nutrients for the tendons. Lack of this source will cause tremors in the hands and feet and reduced ability to flex or extend.

“All syndromes of shaking, dizziness and vertigo belong to the liver.” – Plain Questions.

In CM the nails are external portions of the tendons. When liver-blood is adequate the nails are well nourished and strong, bright, and lustrous.

The eyes require blood to see, and therefore the liver is directly linked to them. If there is a deficiency of liver-Yin, for instance, there could be blurred or impaired vision, dry and screechy eyes, and night blindness. The eyes are also connected to the other zang and fu viscera, so not all signs of the eyes would link to the liver.

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Kidney (including the vital gate)

The two kidneys are located in the posterior part of the abdomen, one on each side of the spinal column. The kidney is linked to the urinary bladder by the meridians, and is part of the water element. “Because the kidney houses the innate essence, it is the foundation of the Yin-Yang of the viscera and the source of life.” It is also known as the “innate foundation.”

The kidney stores and preserves essence. Essence has two meanings in CM: a) the basic substance which constitutes the body and maintains all vital activities, ie. qi, blood and fluids, and nutritive substances, and b) specifically the generative essence, both the prenatal and postnatal qi.

The kidney’s control reproduction, through both sexual functionality and reproductive capacity. They provide the original substance for the embryo and are the material foundation of the vital activities. The kidney’s also promote growth and envelopment through all stages of life. They also have an important part in resisting disease and delaying senescence. The last thing they do is facilitate the production of blood.

Since the kidney holds both yin and yang, it is known as the “house of Water and Fire.”

If the kidney’s are out of balance you will get signs such as hotness in the palms, afternoon fever, night sweats, wet dreams in males, and sexual dreams in females.

The kidney provides the basic motive power of the water and fluid metabolism due to its warming and evaporating functions. It controls the opening and closing of the bladder, which lets the urine flow or be retained.

The kidney’s also accept the Qi that has been inhaled by the lung. “Although the lung controls respiration, it is the kidney that maintains its regularity.” Specifically, the depth, smoothness, and evenness of respiratory movement can be maintained only if Qi inhaled by the lung has descended into and has been accepted by the kidney. This is why we practice qi gong breathing, pulling the air all the way into our lower abdomens (this is called “natural breathing”, since all animals and babies breath like this). Most adults have constricted themselves and breath shallowly into their chests. Based on CM theory, this is not good, as it stagnates the air and qi, and doesn’t allow it to reach all the viscera to complete their vital functions. Bronchitis, pulmonary emphysema and lung-induced heart disease often show symptoms of the kidney failing to accept Qi.

In CM, kidney stores essence and essence engenders marrow. This promotes bone growth and therefore growth of the body. There are three kinds of marrow: bone marrow, spinal cord, and brain. All three are derived from the kidney’s essential qi. “Bone” includes the teeth. The kidney’s are also manifest in the hair. If your hair is fast growing and healthy then your kidney’s are likely healthy. The ears are also closely related to the state of the kidneys. If kidney-essence is strong, hearing will be acute; if it is weak, it may be as extreme as deafness.

The Vital Gate

“The left is the kidney and the right is the vital gate. The vital gate is the house of essence, spirit and vitality. in the male it stores essence; in the female it maintains the uterus. Its qi communicates with the kidney.” – Classic on MEdical Problems.

The vital gate has also been said to reside between the kidneys, in both kidneys, and it was the motive force of qi (residing between the two kidneys). Most importantly, is that the vital gate is the source of genuine qi, the birthplace of the body’s warmth and energy, and it plays a part in the reproductive and sexual functions of the body.

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As a whole, the all the zang viscera take part in the metabolism of water and fluids. The process is completed with the dispersing and lowering function of the lung, the transporting and transforming function of the spleen, the conducting and facilitating function of the liver, the water-passage dredging function of the sanjiao, as well as the transforming function of the kidney.

We’ll end there today. Any questions or comments?

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