Visceral manifestation Lecturer: QU Hongyan

[Objects]  To master the concept of Zang-fu organs  To grasp the physiological features of five Zang organs, six Fu organs and extraordinary rgans ；  To comprehend the theory of visceral manifestation

General Introduction 1 、 Concept of visceral manifestation 2 、 Formation of theory of visceral manifestation 3 、 Features of theory of visceral manifestation

Concept What is visceral manifestation? it refers to the viscera stored inside the human body, their external physiological and pathological manifestations as well as the corresponding things and phenomena in nature.

Viscera Internal organs manifestation External manifestations and correspondences

Theory of visceral manifestation It aims at explain the morphology, structure, location, physiological function and interrelationship. It aims at explain the morphology, structure, location, physiological function and interrelationship.

Theory of visceral manifestation Anatomic knowledge Long term observation in daily life Infiltration of ancient phylosophy Medical practice experience

Features of theory of visceral manifestation Integrity of the human body itself with five zang organs as the center Unity between five zang organs and natural environments

Five zang organs Six fu organs Extraordinary fu organs Liver, heart, spleen, lung, kidney Zang fu organs Brain, marrow, pulse, uterus, bone, gallbladder Gallbladder, small intestine, stomach, large intestine, bladder, triple energizer ?

Five zang organs: generating and storing essence Six fu organs: receiving, transporting and digesting food Extraordinary fu organs: with hollow cavities resemble to six fu organs in morphology and with the function of storing essence resemble to five zang organs Features

The main contents  the main physiological functions and features of five zang organs  the relationship of five zang organs and constituents, orifices, emotions and fluids and seasons

Monarch organ （ “ 君主之官 ” ） Root of life （ “ 生之本 ” ） The monarch of five zang organs and six fu organs （ “ 五脏六腑之大主 ” ）

spirit Promote and regulate the function of zang fu organs Heart

1 Governin g blood and vessels 2 Storing spirit

Governing blood and vessels Abundant heart qi Enough blood Smoothness of vessels Normal blood circulation

The heart governs all the psychological activities, like mind, consciousness and thinking etc.

In a broad sense means the exterior manifestation of life activities (e.g. posture, complexion, eye contact, speech, responds, diet etc) In a narrow sense refers to mental activities.

(2) Relationship of heart to its constituent, orifice, emotion, fluid and season   Corresponding to vessels and manifesting on the face   Opening into tongue   Joy is heart emotion   Sweat is heart fluid   Heart corresponds to Summer   Heart is interiorly-exteriorly related to small intestine

Lung Canopy ( 肺为华盖 ) ---the location of lung is the highest of five Zang organs Delicate viscus( 肺为娇脏 ) ---the lung have sparse and delicate lobes and cannot bear coldness and warmth

Physiological functions Governing qi Governing dispersing and purifying and descending 1 water metabolism 2 Assembling vessels 4 3

Governing qi it includes governing respiratory qi and qi of the whole body.respiratory qiqi of the whole body

It means that the lung governs respiration, and is also where internal and external qi exchange.

The lung participate the production of qi The lung regulate the movement of qi of the whole body

Qi of the whole body Innate qi is inherited from parents, nourished and supplemented by acquired qi, Acquired qi refers to clear qi inhaled by the lung from nature and food essence generated by the spleen and stomach.

qi of the whole body Heart qi Lung qi Liver qi Spleen qi Kidney qi primary qi Food essence Clear qi pectoral qi

Runs through the inspiratory tract to regulate respiration Runs through vessels to promote circulation of qi and blood Descends to Dantian to nourish origninal qi Functions of pectoral qi

Pectoral qi Respiratory tract Regulate respiration vessels Promote the circulation of qi and blood Dantian Nourish the original qi

Governing dispersing and purifying and descending Dispersing means that lung qi can lift upwards and disperse outwards. Purifying and descending refers to the lung has functions of cleaning and descending inwards and downwards.

┌ Exhaling turbid qi from the body │ Dispersing ─┤ Distributing food essence │ └ Dispersing defensive qi to the skin, muscles, and interstices upwards outwards Lung qi can lift upwards and disperse outwards

Purifying & descending Inhaling clear qi from nature and transporting pectoral qi downwards below the navel to nourish original qi Transporting downwards turbid fluid generated through visceral metabolism to kidneys to generate urine Transporting downwards and inwards food essence in the lung which is transported by spleen qi to nourish organs and tissues

Governing water metabolism It means that the function of lung dispersing and descending promotes and regulates the movement, distribution and discharge of fluids of the whole body. It is the manifestation of lung governing dispersing, purifying and descending on water metabolism. Lung is the upper source of water

Assembling vessels and governing coordination Assembling vessels means that blood of the body circulate through the lung and exchange turbid qi with clear qi in the lung, and blood abundant in clear qi is transported to the whole body through vessels. And it is the embodiment of qi promoting blood. Governing coordination is a high summarization of physiological functions of the lung.

(2) Relationship of lung to its constituent, orifice, emotion, fluid and season  Corresponding to the skin and manifesting on the hair  Opening into nose  sadness is lung emotion  snivel is lung fluid  Lung corresponds to Autumn  Lung is interiorly-exteriorly related to large intestine

Spleen The origin of qi and blood( 气血生化之源 ) Barn official( 仓廪之官 ) Acquired root( 后天之本 )

Governing blood Governing transportation and transformation Spleen qi governing lifting Physiological functions spleen

Governing transportation and transformation It means that the spleen can transform food into food essence, and absorb food essence and fluid further to transport to viscera. Transporting and transforming food Spleen can digest food, absorb nutrient, transport to the heart and lung, and distribute to the whole body. Transporting and transforming water It means that spleen qi can absorb, transport and distribute water to nourish the whole body.

Let’s have a rest!

Governing blood It means that spleen qi can guide and dominate blood inside vessels to avoid bleeding. Spleen governs transportation and transformation and transformation Generating qi and blood Qi consolidates blood

Spleen qi governing lifting Spleen qi governing lifting is the movement feature of spleen qi, including sending up the clear and lifting up viscera. Spleen functions normally when its qi ascends

Sending up the clear Failure of spleen qi in deficiency to transport and transform Upper: lack of nourishment Dizziness and lassitude Middle: stagnation of turbid qi inside stomach Lower: adverse downward flow of essential qi Abdominal distension and fullness Loose stool and diarrhea

Lifting up viscera It means that spleen qi can lift to maintain the normal position of viscera to avoid prolapse. So if the spleen qi functions abnormally, patients will suffer with prolapse of uterus, prolapse of anus etc.

(2) Relationship of spleen to its constituent, orifice, emotion, fluid and season  Corresponding to muscles and governing four limbs  Opening into mouth and manifesting on lips  Anxiety is spleen emotion  Saliva is spleen fluid  Spleen corresponds to Summer  Spleen is interiorly-exteriorly related to stomach

Liver Resolute viscus （刚脏） General organ （将军之官） Liver is characterized by rising and moving, prefers smoothness and dislikes depression. （主升主动，喜条达而恶抑郁） Innate root for the woman （肝为女子之先天） Blood sea( 血海 )

Storing blood Smoothing flow of qi

  Governing smoothing flow of qi   Storing blood Physiological functions

Governing smoothing flow of qi Liver governs smooth Flow of qi The circulation of qi and blood is freely and smoothly Steady and ordered functional activities of zang-fu organs, meridians, constituents and orifices of the whole body Qi movement of the whole Body is normal Life activities Function normally

Promoting circulation of blood and body fluids Promoting spleen and stomach’s transportation and transformation and secretion and discharge of bile. Regulating emotions Promoting man’s ejaculation and woman’s menstruation Governing smoothing flow of qi

Storing blood It means that the liver can load blood, regulate blood volume and avoid bleeding. Liver storing blood to nourish itself Regulating blood volume Movement: blood is in vessels Rest: blood is in liver Avoid bleeding surpressing liver yang to avoid yang hyperactivity and bleeding

(2) Relationship of liver to its constituent, orifice, emotion, fluid and season   Corresponding to the tendon and manifesting on the nail   Opening into eyes   Anger is liver emotion   Tear is liver fluid   Liver corresponds to Spring   Liver is interiorly-exteriorly related to gallbladder

Kidneys Innate root ( 先天之本 ) Root of yin and yang of five zang organs （五 脏阴阳之本） The organ in charge of striving （作强之官） Root of consolidating （封藏之本） Lumbar area is the house of kidneys （腰为肾 之府）

Physiological functions Storing essence Governing water Governing reception of qi

kidneys storing essence means that kidneys can store and consolidate essence. It is the basic material to form and maintain life activities of the human body, the root of life activity, and the material basis for functional activities of viscera, constituents and orifices Storing essence Storing essence

Reproductive essence from parents innate essence supplement nourishment Food essence generated by the acquired essence spleen and stomach (some part ) Kidneyessence

Function of kidney essence Promoting the growth, development and reproduction of human body Promoting and regulating the qi transformation of zang-fu organs

Sex-stimulating essence It refers to a kind of refined material promoting the development and maturity of the reproductive organs and sustain the reproductive function, and is generated when kidney qi increased to a certain level. Female:49 Male:64 Female:14 Male: 16

Kidney essence Kidney qi Kidney yin Kidney yang transform With the function of moistening tranquilizing and depressing Promoting, warming and exciting Inter-restrict coordinate

Governing water It means that kidneys can control and regulate the circulation, distribution and discharge of water of the whole body. Qi transformation of kidneys is the primary promotive force for lung, spleen, triple energizer to work on body fluids metabolism. Kidney qi sends up the clear and lowers down the turbid to generate urine. Kidney qi governs the open and closure of bladder for urination.

Governing reception of qi It means that kidney qi can grasp or hold clear qi inhaled by the lung from nature to maintain the depth and rhythm of respiration to avoid superficial respiration, which is the manifestation of kidneys’ storing function in respiration. There is a saying that the lung is the monarch of qi and kidneys are the root of qi

stomachspleen lung kidneys bladder Other viscera water 头面诸窍 全身皮毛 dispersing descendin g Turbid fluids Turbid part Clear part lifting transformation

(2) Relationship of kidney to its constituent, orifice, emotion, fluid and season   Corresponding to the bone, generating marrow and manifesting on hair   Opening into ears and two lower orifices   Tear is kidney emotion   Thick saliva is kidney fluid   kidneys correspond to Winter   kidneys are interiorly-exteriorly related to bladder

Six fu organs Gallbladder Small intestine Somach Large intestine Bladder Triple energizer Function: accepting and transporting food Physiological features: to lower down and to dredge

Gallbladder Clear essence house （中精之府） Pure house （洁净之府） Middle clean house （中清之府） Gallbladder is the judging organ to make decision.( 中正之官，决断出焉 )

Physiological functions Storing and discharging bile Liver essence or liver blood Excessive liver qi liver qi bile bile gallbladder Transforms into promoting digestion and absorption of food

Governing making decision In the course of conscious mind, decision-making is attributed to the gallbladder.

Why the gallbladder is classified as a fu organ and an extraordinary fu organ? It is an organ with hollow cavity, interiorly-exteriorly related to liver, corresponds to wood of five elements. It stores bile, similar to five zang organs storing essential qi It doesn ’ t contact with food but discharges bile into the intestine to promote digestion and absorption, so it pertains to extraordinary fu organs.

Stomach Sea of food and water （水谷之海） Big barn （太仓） Spleen and stomach are acquired root （脾胃为水谷之海） Stomach prefers moisture and dislikes dryness.( 胃喜润而恶燥 ) Upper stomac h cardia pyloru s Lower stomach Middle stomach

Physiological functions Accepting and fermenting food Accepting means that the stomach can accept and contain food. Fermenting means that stomach can transform food into chyme.

Accepting and fermenting function Qi movement of the stomach Functions of spleen and stomach Qi of the whole body or healthy qi Characteristic of pulse Food essence Stomach qi qi

Physiological functions Governing descending stomach qi tends to descend, and can transport chyme down to the small intestine and large intestine. Stomach qi takes descending as its harmonious state.

Stomach qi descends Spleen qi ascends Promoting food digestion and absorption

heart promotes lung ’ s respiration lung benefits to heart ’ s promoting blood circulation heart lung Pectoral qi Relationship between heart and lung Relationship between heart and lung

Relationship between heart and spleen Relationship between heart and spleen Transportation and transformation of transformation of spleen qi Reddening effect of heart vessels Ensuring generation and distribution Promoting food essence Transforming Into blood Ensuring blood generation

Relationship between heart and spleen Relationship between heart and spleen Promoting function of heart qi Consolidating of spleen qi Smooth and moderate circulation Blood circulating inside Vessels to avoid bleeding Ensuring normal blood circulation

Relationship between heart and liver Relationship between heart and liver heartbloodspirit liverblood Spiritual soul governs stores generates houses regulates promotes

Relationship between heart and kidneys Relationship between heart and kidneys Kidneys should ascend Heart is located in the upper energizer and should descend Kidney water Heart fire Heart fire

Inter-complementation between essence and spirit heart kidney blood Qi essence spirit generates consolidates drives 化养 行摄 governs stores generates regulates consolidates