The Functions of the Internal Organs (Zang-Fu)

1. The Functions ofthe Internal Organs (Zang-Fu) • ECM class 6

2. The theory of the Internal Organs is often described as the core of Chinese medical theory, because it best represents the Chinese Medicine view of the body as an intergrated whole. • This theory represents a landscape of functional relationships which provide total integration of bodily functions, emotions, mental activities, tissues, sense organs and environmental influences.

3. When studying the Chinese theory of the Internal Organs, it is best to rid oneself of the Western concept of internal organs entirely. • Chinese Medicine sees each organ as a complex system encompassing its anatomical entity and its corresponding emotion, tissue, sense organ, mental faculty, colour, climate and more.

4. It is often said that Chinese Medicine disregards anatomy entirely and only considers the functional relationships: this is not entirely true. • There are many chapters of the "Yellow Emperor's Classic" and the "Classic of Difficulties" that describe the anatomy of the internal organs, muscles and bones.

5. THE INTERNAL ORGANS AND THE VITAL SUBSTANCES • One of the main functions of the Internal Organs is to ensure the production, maintenance, replenishment, transformation and movement of the Vital Substances. • Each of the Vital Substances, Qi, Blood, Essence, and Body Fluids is related to one or more of the organs.

6. The Heart governs Blood • The Liver stores Blood • The Lungs govern Qi and influence Body Fluids • The Spleen governs Food-Qi, holds Blood and influences Body Fluids • The Kidneys store Essence and influence Body Fluids.

7. THE INTERNAL ORGANS AND THE TISSUES • Each organ influences one of the tissues of the body: there is a functional relationship between certain tissues and each organ, so that the state of the organ can be deduced by observation of the tissue related to it. • Thus, the Heart controls the blood vessels and manifests in the complexion, the Liver controls the sinews and manifests in the nails, the Lungs control the skin and manifest in the body hair, the Spleen controls the muscles and manifests in the lips, the Kidneys control the bones and manifest in the hair.

8. THE INTERNAL ORGANS AND THE SENSE ORGANS • Each organ is functionally related to one of the sense organs. • This means that the health and acuity of a particular sense organ relies on the nourishment of an internal organ. • Thus, the Heart controls the tongue and taste, the Liver controls the eyes and sight, the Lungs control the nose and smell, the Spleen controls the mouth and taste, the Kidneys control the ears and hearing.

9. THE INTERNAL ORGANS AND THE EMOTIONS • The same Qi that is the basis for all the physiological processes, is also the basis for emotional and mental processes, since Qi, as we have seen, exists in many different states of refinement. • Whereas in Western physiology emotional and mental processes are attributed to the brain, in Chinese Medicine they are part of the sphere of action of the internal organs.

10. The relation between each organ and a particular emotion is mutual: the state of the organ will affect the emotions, and emotions will affect the state of the organ. • Thus: the Heart relates to joy, the Liver to anger, the Lungs to sadness and worry, the Spleen to thinking and the Kidneys to fear.

11. These emotions usually only become a cause of imbalance when they are excessive and prolonged. • By treating a specific organ, we can influence the particular emotion related to that organ and help a person to achieve a more balanced emotional state.

12. THE INTERNAL ORGANS AND CLIMATES • Chinese Medicine considers that differing climatic conditions influence specific organs. • Heat influences the Heart, wind influences the Liver, dryness influences the Lung, dampness influences the Spleen and cold influences the Kidneys. An excess of these climatic conditions for a prolonged period may adversely affect the relevant organ.

13. There are two types of Internal Organs: Yin (called "Zang") and Yang (called "Fu") organs. • The Chinese name for Internal Organs is simply "Zangfu". • Both "Zang" and "Fu" mean "organ", but an analysis of the Chinese characters can clarify the difference between the two.

14. ZANG 臟 simplified: 脏 • means organ, viscus. • The character combines radicals indicating "flesh" and "to store". • This indicates that the Yin organs are in charge of storing the vital substances.

15. FU 腑 • also means organ • The character combines radicals indicating "flesh" and "seat of government"

16. This indicates that the Yang organs are in charge of transforming food and drink to produce Qi and Blood, just as the government in ancient China was considered to be in charge of food distribution.

17. The "Simple Questions" in chapter 11 says: "The 5 Yin organs store Essence and Qi and do not excrete: they can be full but not in excess. • The 6 Yang organs transform and digest and do not store: they can be in excess but not full. In fact, after food enters the mouth, the stomach is full and the intestines empty; when the food goes down, the intestines are full and the stomach empty."

18. Thus the Yin organs store the Vital Substances, i.e. Qi, Blood, Essence and Body Fluids. • They only store pure, refined substances which they receive from the Yang organs after transformation from food.

19. The Yang organs, on the contrary, do not store but are constantly filled and emptied. • They transform and refine food and drink to extract the pure essences which are then stored by the Yin organs. • As well as carrying out this process of transformation, the Yang organs also excrete waste products.

20. The essence of the Yang organs is therefore to "receive", "move", "transform", digest" and "excrete". • The functions of the Yang organs are often summarized by the two words "chuan" and "xing" meaning "to transmit" and "to move" because they are constantly receiving, transmitting, moving and excreting substances.

21. The "Simple Questions" in chapter 9 says: "The Stomach, Small and Large Intestine, Triple Burner and Bladder are the roots of food storage, they are the residence of Nutritive Qi, they are called containers, they transform waste substances and transmit the incoming and outgoing flavours".

22. There is a close interrelationship between Yin and Yang organs: the two groups of organs are different in function but their difference is only relative. • The relationship between Yin and Yang organs is a structural-functional relationship.

23. The Yin organs correspond to structure and store the Vital Substances, while the Yang organs correspond to function. • Structure and function are interdependent and we can view each Yang organ as the functional aspect of its corresponding Yin organ.

24. For example, one can view the Gall Bladder as the functional aspect of the Liver. • Although one Yang and one Yin, the two organs can be seen as a unit, the Liver being the structure and the Gall Bladder its functional expression.

25. In the Chinese theory of the organs, the Yin organs are the core: they are more important than the Yang organs both in terms of physiology and pathology. • The Yin organs are more important because they store all the Vital Substances, while the Yang organs are their functional aspect. • There are 12 organs, 6 Yin and 6 Yang:

26. Yin organs..........Yang organs • Heart..........Small Intestine • Liver..........Gall Bladder • Lungs..........Large Intestine • Spleen..........Stomach • Kidneys..........Bladder • Pericardium..........Triple Burner

27. For each organ the following aspects will be discussed in detail: • Its main function or functions • The tissue it controls, the sense organ into which it "opens" and the part of the body on which it "manifests". • Any other function peculiar to each organ.

28. The Functions of the Heart • ECM class 6

30. The Heart is considered to be the most important of all the internal organs, sometimes described as the "ruler" or "monarch" of the internal organs. • The "Simple Questions" in chapter 8 says: "The Heart is like the Monarch and it governs the Mind ..." • The Heart's main functions are to govern Blood and blood vessels and to house the Mind.

31. The functions of the Heart • It governs Blood • It controls the blood vessels • It manifests in the complexion • It houses the Mind • It opens into the tongue • It controls sweat.

32. 1 GOVERNS BLOOD • The Heart governs Blood in two ways: • a. The transformation of Food-Qi into Blood takes place in the Heart. • b. The Heart is responsible for the circulation of Blood just the same as in Western Medicine (although in Chinese Medicine, other organs, notably the Lungs, Spleen and Liver, also play a role in the circulation of Blood).

33. A healthy Heart is essential for a proper supply of blood to all the body tissues. • When its function is impaired, i.e. Heart-Blood is deficient, the circulation of Blood is slack and the hands may be cold. • The relation between Heart and Blood is important in another way as it determines the strength of constitution of an individual.

34. Although our constitution is primarily related to the Essence and the Kidney, it is also partly determined by the relative constitutional strength of the Heart and Blood. • If the Heart is strong, Blood in ample supply and its circulation good, a person will be full of vigour and have a good constitution. • If the Heart is constitutionally weak and Blood deficient, a person will have a poor constitution and lack strength.

35. 2 CONTROLS THE BLOOD VESSELS • The state of the Heart's energy is reflected in the state of the blood vessels. • Blood vessels depend on the Heart's Qi and Blood. • If Heart Qi is strong, the blood vessels will be in a good state and the pulse will be full and regular. • If Heart Qi is weak, the pulse may be feeble and irregular.

36. 3 MANIFESTS IN THE COMPLEXION • The Heart governs Blood and blood vessels and distributes Blood all over the body. • The state of the Heart and Blood can therefore be reflected in the complexion. • If Blood is abundant and the Heart strong, the complexion will be rosy and lustrous. If Blood is deficient, the complexion will be pale or bright-white. If Blood is stagnant, the complexion will be bluish-purple, and if the Heart has Heat, the complexion will be too red.

37. 4 HOUSES THE MIND • Chinese Medicine holds that the Heart is the residence of the Mind (Shen). • The word Shen can have many different meanings and, in Chinese Medicine, it is used in at least two different contexts. • Firstly, Shen indicates the complex of mental faculties which are said to "reside" in the Heart. • In this sense, the Shen corresponds to the Mind and is specifically related to the Heart.

38. Secondly, Shen is used to indicate the whole sphere of emotional, mental and spiritual aspects of a human being. • In this sense, it is related not only to the Heart, but it encompasses the emotional, mental and spiritual phenomena of all the other organs, notably the Yin organs.

39. According to Chinese Medicine, mental activity and consciousness "reside" in the Heart. • This means that the state of the Heart (and Blood) will affect the mental activities including the emotional state. • In particular, five functions are affected by the state of the Heart:

40. Mental activity (including emotions) • Consciousness • Memory • Thinking • Sleep

41. If the Heart is strong and Blood abundant, there will be a normal mental activity, a balanced emotional life, a clear consciousness, a good memory, keen thinking and good sleep. • If the Heart is weak and Blood deficient there may be mental problems (such as depression), poor memory, dull thinking, insomnia or somnolence and in extreme cases, unconsciousness.

42. Thus, some of the Heart functions in relation to the Mind (such as memory and intelligence) correspond to the brain's mental activities from a modern medical viewpoint. • For example, the intellectual power of slow-to-learn children can, to a certain extent, be stimulated by tonifying the Heart.

43. The Heart's function of housing the Mind depends on an adequate nourishment from the Blood and conversely, the Heart's job of governing Blood depends on the Mind. • Thus there is a relation of mutual dependence between the function of controlling Blood and that of housing the Mind.

44. The Blood is the root of the Mind. • This concept is important in practice as Heart-Blood roots the Mind, it embraces it and anchors it, so that the Mind will be peaceful and happy. • If Heart‐ Blood is deficient and does not root the Mind, this will result in mental restlessness, depression, anxiety and insomnia.

45. Conversely, mental restlessness, emotional problems and sadness can induce a deficiency of Blood of the Heart causing palpitations, a pale complexion and a weak or irregular pulse. • Apart from the mental activity aspect, the Mind also affects the emotional state.

46. If the Heart is strong, the Mind will also be strong and the person will be happy. • If the Heart is weak, the Mind lacks vitality and the person will be sad or depressed or in low spirits. • If the Heart is in an excess condition, the Mind will be affected and the person may display symptoms of mental illness, such as manic depression.

47. On an emotional level, the state of the Heart determines a person's capacity to form meaningful relationships. • A healthy Heart and Mind will positively influence our ability to relate to other people, and conversely, emotional problems due to difficult relationships can weaken the Heart and the Mind. • Chinese Medicine sees the Mind closely linked to the body.

48. Essence and Qi form the physical basis for the Mind. • If the Essence is flourishing and Qi vital, then the Mind will be happy and peaceful. • Conversely, if the Essence is weak and Qi deficient, the Mind will suffer. For this reason, the glitter of the eyes shows both the state of Essence and the Mind. • Essence, Qi and Mind are called the "Three Treasures"

49. We can now discuss the nature of Shen in its second sense, i.e. not as the Mind residing in the Heart, but as the whole complex of emotional, mental and spiritual aspects of a human being. • In this sense, it is related not only to the Heart, but it also encompasses mental and spiritual aspects related to other organs, and particularly the Yin organs.

50. For this reason, it would be wrong to identify our mental and spiritual life simply with the Heart. • All 5 Yin organs influence emotions, Mind and Spirit in different ways. • Each of the 5 Yin organs is related to a certain mental aspect.