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 organsInternal organs

manifestationmanifestationExternal manifestations External manifestations and correspondencesand correspondences

Theory of visceral manifestationTheory of visceral manifestation

It aims at explain the morphology, structure, It aims at explain the morphology, structure,

location, physiological function and location, physiological function and

interrelationship.interrelationship.

Theory of visceral manifestation

Anatomic knowledge Long term

observation in daily life

Infiltration of ancient phylosophyMedical

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 organsFive zang organs

Six fu organsSix fu organs

Extraordinary fu organsExtraordinary fu organs

Liver, heart, spleen, Liver, heart, spleen, lung, kidneylung, kidney

Zang fu organsZang fu organs

Brain, marrow, Brain, marrow, pulse, uterus, pulse, uterus,

bone, bone, gallbladdergallbladder

Gallbladder, small Gallbladder, small

intestine, stomach, intestine, stomach,

large intestine, large intestine,

bladder, triple bladder, triple

energizerenergizer

??

Five zang organs:Five zang organs: generating and storing essencegenerating and storing essence

Six fu organs: Six fu organs: receiving, transporting and digesting foodreceiving, transporting and digesting food

Extraordinary fu organs:Extraordinary fu organs: with hollow cavities with hollow cavities

resemble to six fu organs in morphology and with the function resemble to six fu organs in morphology and with the function

of storing essence resemble to five zang organsof storing essence resemble to five zang organs

Featur

Featur

es

es

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

Governing blood and vessels

2

Storing spirit

• Governing blood and vessels

Abundant heart qiAbundant heart qi

Enough bloodEnough blood

Smoothness of vesselsSmoothness of vessels

Normal blood Normal blood circulationcirculation

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.

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

internal and external qi exchange.internal and external qi exchange.

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

The lung participate the The lung participate the production of qiproduction of qi

The lung regulate the movement The lung regulate the movement of qi of the whole bodyof 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 Runs through the inspiratory tract to regulate respirationregulate respiration

Runs through vessels to promote Runs through vessels to promote circulation of qi and bloodcirculation of qi and blood

Descends to Dantian to nourish Descends to Dantian to nourish origninal qiorigninal qi

Functions of pectoral qi Functions of pectoral qi

Pectoralqi

Respiratory tract Regulate respiration

vesselsPromote 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

upwardsupwards

outwardsoutwards

Lung qi can lift upwards and disperse outwardsLung qi can lift upwards and disperse outwards

Purifying & descending

Inhaling clear qi from nature and Inhaling clear qi from nature and transporting pectoral qi transporting pectoral qi

downwards below the navel to downwards below the navel to nourish original qinourish original qi

Transporting downwards Transporting downwards turbid fluid generated turbid fluid generated

through visceral through visceral metabolism to kidneys to metabolism to kidneys to

generate urinegenerate urine

Transporting downwards and Transporting downwards and inwards food essence in the lung inwards food essence in the lung which is transported by spleen qi which is transported by spleen qi

to nourish organs and tissuesto 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 waterLung 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!Let’s have a rest!

Governing blood

It means that spleen qi can guide and dominate blood inside vessels to avoid bleeding.

Spleen governs transportationSpleen governs transportation and transformationand transformation

Generating qi Generating qi and bloodand blood

Qi consolidates Qi consolidates bloodblood

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 Spleen functions normally when its qi ascendsits qi ascends

Sending up the clear

Failure of spleen qi in Failure of spleen qi in deficiency to transport deficiency to transport

and transformand transform

Upper:Upper: lack of nourishment lack of nourishment

Dizziness and Dizziness and lassitudelassitude

Middle:Middle: stagnation of turbid qi inside stomach stagnation of turbid qi inside stomach

Lower:Lower: adverse downward flow of essential qiadverse downward flow of essential qi

Abdominal Abdominal distension and distension and

fullnessfullness

Loose stool Loose stool and and

diarrheadiarrhea

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 bloodStoring blood

Smoothing flow of qiSmoothing flow of qi

Governing smoothing flow of qi

Storing blood

Physiological functions

Governing smoothing flow of qi

Liver governs Liver governs

smoothsmoothFlow of qiFlow of qi

The circulation of qi The circulation of qi and blood is freely andand blood is freely and

smoothly smoothly

Steady and orderedSteady and orderedfunctional activities functional activities of zang-fu organs, of zang-fu organs,

meridians, constituents meridians, constituents and orifices of the and orifices of the

whole bodywhole body

Qi movement Qi movement of the wholeof the whole

Body is normal Body is normal

Life activitiesLife activitiesFunction normallyFunction 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 qiGoverning smoothing flow of qi

Storing blood

It means that the liver can load blood, regulate blood volume and avoid bleeding.

Liver storing bloodLiver storing bloodto nourish itselfto nourish itself

Regulating blood volumeRegulating blood volume

Movement:Movement: blood is in blood is in vesselsvessels

Rest:Rest: blood is in liverblood is in liver

Avoid bleeding Avoid bleeding surpressing surpressing liver yang to avoid yang hyperactivity liver yang to avoid yang hyperactivity and bleedingand 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 It is the basic material to form and maintain life activities of the maintain life activities of the human body, the root of life human body, the root of life

activity, and the material basis for activity, and the material basis for functional activities of viscera, functional activities of viscera,

constituents and orificesconstituents and orifices

Storing essenceStoring essence

Reproductive essence from parents innate essence

supplement nourishment

Food essence generated by the acquired essence

spleen and stomach (some part )

Kidney Kidney essenceessence

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:49Male:64

Female:14Male: 16

Kidney essence Kidney qi

Kidney yin

Kidney yang

transform

With the functionof moisteningtranquilizing

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 There is a saying that the lung is that the lung is

the monarch of qi the monarch of qi and kidneys are and kidneys are

the root of qithe root of qi

stomach spleen

lung

kidneys

bladder

Other viscera

water

头面诸窍全身皮毛

dispersing

descending

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 Function: accepting and transporting foodand transporting food

Physiological Physiological features: to lower features: to lower

down and to dredgedown 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 Liver essence or liver bloodor liver blood

ExcessiveExcessive liver qiliver qi

bilebile gallbladdergallbladderTransformsTransforms

intointo

promoting promoting digestion and digestion and absorption of absorption of foodfood

• 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

pylorus

Lowerstomach

Middlestomach

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 Food essenceessence

StomachStomach qiqi

Physiological functions

Governing descending stomach qi tends to descend, and can

transport chyme down to the small intestine and large intestine.

Stomach qi takes Stomach qi takes descending as its descending as its harmonious state.harmonious state.

Stomach qi descends

Spleen qi ascends

Promoting food Promoting food digestion and digestion and

absorptionabsorption

heart promotes lung’s respiration

lung benefits to heart’s promoting blood circulation

heart lungPectoral qi

Relationship between heart and lungRelationship between heart and lung

Relationship between heart and spleenRelationship between heart and spleen

Transportation andTransportation and transformation of transformation of

spleen qispleen qi

Reddening effectReddening effectof heart vesselsof heart vessels

Ensuring generation Ensuring generation and distributionand distribution

Promoting food essencePromoting food essenceTransformingTransforming

Into bloodInto blood

Ensuring blood Ensuring blood generationgeneration

Relationship between heart and spleenRelationship between heart and spleen

Promoting function Promoting function of heart qiof heart qi

Consolidating of Consolidating of spleen qispleen qi

Smooth and moderateSmooth and moderatecirculationcirculation

Blood circulating insideBlood circulating insideVessels to avoid bleedingVessels to avoid bleeding

Ensuring normal Ensuring normal blood circulationblood circulation

Relationship between heart and liverRelationship between heart and liver

heart blood spirit

liver blood Spiritual soul

governs

stores

generates

houses

regulates

pro

mo

tesp

rom

otes

Relationship between heart and kidneysRelationship between heart and kidneys

Kidneys shouldascend

Heart is locatedHeart is locatedin the upperin the upper

energizerenergizerand should and should

descenddescend

Kidney waterKidney water

Heart fireHeart fire

Inter-complementation between essence and spirit

heart

kidney

blood

Qi

essence

spirit

generates

generates

consolidates

drives

化养

行摄

governs

storesgenerates

generates

regulates

consolidates