Pathogenesis of Zang-Fu Organs

Pathogenesis of Zang-Fu Organs

Each zang-fu organ has its own governing qi, its own meridians, and its own specific parts, so the diseases it is prone to and the corresponding symptoms also differ. If a single organ is diseased without affecting other organs, treating that organ alone can cure the disease; if multiple organs are diseased at the same time, treating the other organs as well can also cure the disease. If a physician does not understand the zang-fu organs, he will be unable to identify the root cause of the disease and prescribe the right medication, let alone expect to cure the illness. Therefore, I will list the general principles of the zang-fu organs below, hoping that this will help people better understand the relationship between diseases and prescriptions.

The heart is the sovereign organ, where the divine spirit resides. Since the heart is a fire organ that illuminates everything, it governs the divine spirit. The spirit is bright but intangible—it is the fire energy within the heart. However, this energy is not floating in the air; rather, it is concentrated in a small spot of blood within the heart, shining brightly and smoothly, containing this energy. Thus, sometimes a radiant glow appears, which is the divine spirit. The heart also plays a role in producing blood, and several spots of blood within the heart's openings are the most refined part of the blood, serving as the source of blood production and the deep ocean of the divine spirit (6). When blood is deficient, the spirit becomes restless and causes palpitations (7); when there is stagnant blood, it also causes palpitations. If fire disturbs the blood, it leads to frustration (8). When the spirit is unclear, it causes restlessness and insomnia, as well as palpitations and anxiety. Water drinks extinguish fire, causing the heart to palpitate as well (9). If blood attacks the heart, it can lead to unconsciousness and severe pain; if phlegm enters the heart, it can cause madness; if fire disrupts the heart, it can cause insanity. The heart is closely related to the small intestine, and if heat remains in the small intestine, the urine will become reddish and irritating. If fire does not descend to the kidneys, the spirit will float (10) and dream of nocturnal emissions. The heart's meridians run up to the throat and connect to the base of the tongue. Excessive fire can cause throat obstruction (11), while insufficient fire can lead to tongue stiffness and inability to speak. Located on the front of the chest, if fire accumulates, it can cause chest tightness (12), indigestion (13), and burning pain. If fire does not disperse, it can cause chest oppression (14). The accumulation of fire in the heart is called "Fu Liang" (15), located beneath the heart, about the size of an arm. When it occurs, there is a sensation of movement in the navel (16). This is the main principle of the heart's disease.

The pericardium is the outer defense of the heart. Since the heart is the sovereign organ, the pericardium serves as the minister, so the heart is called "ruler fire," while the pericardium is called "minister fire." The pericardium announces the transformation of fire (17), and all the functions of the heart are carried out by the pericardium, including diagnosis and treatment methods, just like the heart itself.

The liver is a wind-wood organ, with the gallbladder residing within it. The gallbladder is minister fire, and wood generates fire. The liver stores blood, which is produced by the heart and flows down to the womb chamber, forming the "sea of blood." All the blood in the body is considered to be governed by the sea of blood when it comes to managing chaos (18). If the sea of blood is not disturbed, all the blood in the body will remain stable. The liver's meridians govern its specific parts, so the liver is responsible for storing blood. The reason it can store blood is that the liver belongs to wood, and wood energy is harmonious and unblocked, preventing stagnation (19). If wood stagnates, blood will not flow smoothly. If fire arises, it leads to anger, causing blood to burst out uncontrollably (20), resulting in hematemesis, irregular menstruation, and painful bleeding. If anger becomes too intense, it can lead to madness; if fire becomes too intense, the cheeks may swell, the face turn blue, and the eyes become red with headaches. Wood and fire clash with earth (21), causing dry mouth, diarrhea, loss of appetite, and regurgitation—these are all signs of wood stagnating as fire. If wood carries water-related evil forces upward, it acts as a child borrowing its mother's power (22), wreaking havoc on the spleen's meridians, leading to phlegm, diarrhea, vomiting, and headaches. Wood's nature is to release, so when food enters the stomach, it relies on the liver's wood energy to release it, and food is transformed. If the liver's pure yang energy does not rise, it cannot release food, and symptoms such as bloating and fullness are inevitable. The liver's pure yang energy is also the soul energy, so it is also responsible for storing the soul. If blood does not nourish the liver, and fire disturbs the soul, it can lead to nocturnal emissions and insomnia. The liver also governs the tendons, and conditions such as hives and skin tightening are all liver diseases. Located between the lower ribs and the lower abdomen, any pain in the lower ribs or lower abdomen is attributed to the liver. Its meridian is called "Jue Yin," meaning the end of yin. When yin reaches its extreme, it transforms into yang, so when the disease progresses to this stage, the fever becomes very high, and even a slight fever can be dangerous. The blood is often mixed with cold and heat. The liver is closely related to the gallbladder, so liver diseases can also cause acid reflux, bitterness, deafness, and dizziness. Located on the left side, many people suffer from left-side pain, and there is also movement in the left side, so the liver's main diseases are roughly as follows.

The gallbladder is connected to the liver and governs minister fire. Gallbladder juice is bitter, which is also the taste of fire. Minister fire is announced in the San Jiao, but resides in the gallbladder. If gallbladder fire is weak, it can cause fear and palpitations; if it is too strong, it can cause bitter taste, nausea, dizziness, and hearing loss, because its meridians surround the ears. When wind and fire interact on the sides of the body, the body cannot turn, and the limbs twitch. In terms of yin and yang, the qi of Shaoyang flows internally through the San Jiao and externally through the skin, serving as the core of the defensive system. If this core is disrupted, it can cause vomiting and chest fullness. When evil spirits invade the skin and compete with yin for heat, they seek warmth; when they compete with yang for cold, they seek coolness. Therefore, malaria is mainly caused by Shaoyang. Chronic wasting due to bone steaming (25) is also caused by Shaoyang, because the defensive system between the skin and the internal organs is imbalanced, and minister fire is too intense. If minister fire is accompanied by phlegm, it can cause epilepsy. If minister fire is not restrained (26), the liver's soul will also be restless, leading to frequent nocturnal emissions and dreams. Moreover, if the gallbladder's minister fire is not too strong, it is pure yang wood energy, rising to the stomach, allowing the stomach's earth to be relieved

If the skin is affected, it can cause chills and sweating (37), and if it affects the lungs, it can cause pulmonary edema and water intoxication. Because the lungs are delicate organs, they are sensitive to both fire and cold. The lungs open to the nose and are responsible for breathing, serving as the overall controller of qi. Since qi originates from the kidneys, it is the yang in the primordial water, rising through the nose, and the lungs control its intake and output. The kidneys are the source of water, while the lungs are the sky; metal and water generate each other, and the cycle of heaven and earth continues. The kidneys are the origin of water, while the lungs are the masters of qi. Any wheezing or coughing is therefore primarily the responsibility of the lungs. Located in the chest, chest pain is also the responsibility of the lungs. Located on the right side, the accumulation is called "Xi Ben" (38), and when the disease occurs, there is movement in the right side, so the lungs' function is roughly as follows.

The kidneys are water organs, containing yang in the water, generating primordial qi, rooted in the dantian, controlling breathing internally, reaching the bladder, and circulating externally as defensive qi. This qi is the yang in the water, also known as "life fire." When the kidneys have enough water, the fire hidden in the water is concealed and does not show itself (39), and the dragon and thunder do not rise (40), so the qi is sufficient and the breath is faint. If the water is insufficient, the fire cannot return to its origin, leading to shortness of breath, chronic fatigue, and various symptoms, including sore throat, hoarseness, lack of communication between the heart and kidneys, loss of semen and blood, swelling, coughing, and phlegm. If yang qi is insufficient, the water turns into phlegm, rushing into the heart and lungs, causing edema, abdominal pain, and sudden attacks of panic (41), along with diarrhea, cold extremities, and massive sweating, leading to a sudden loss of vital energy. The kidneys are also innate, responsible for storing essence; women have Tian Gui (42), while men have sperm, so when there is enough water, there is plenty of essence and blood, but when there is little water, the essence and blood are depleted. Located in the bones, bone weakness is also the responsibility of the kidneys. People with kidney disease often feel movement in the lower abdomen. When the kidneys communicate with the heart, water and fire are balanced; if they don't communicate, fire becomes even more intense. Located in the waist, it is responsible for lower back pain. Open to the ears, so if there is deficiency, it can cause tinnitus and deafness. The pupils belong to the kidneys, so if there is deficiency, the spiritual water shrinks or cataracts develop. If yang qi rises, it can cause sore throat and red cheeks. If yin is deficient, it cannot transform water, leading to difficulty urinating; if yang is deficient, it also cannot transform water, leading to difficulty urinating. The pathogenesis of kidney disease is as follows.

The bladder is the organ that stores urine, and the classics say, "It is the official of the state, storing body fluids, and when qi is transformed, it can be released." This refers to sweat, not urine. Although urine comes from the bladder, in fact, the lungs are the primary source of water, and if the upper source is clean, the lower source will also be clean. The spleen is the dam against water, and if the dam is effective, the waterways will be smooth. The kidneys are also the masters of water, and when kidney qi flows, water flows as well. The saying "when qi is transformed, it can be released" means that the bladder's qi carries body fluids upward and outward, and when it is released as sweat, it creates the image of clouds moving and rain falling. Therefore, the bladder is called the "Sun Meridian," referring to the yang in the water, which extends outward as defensive qi, being the largest manifestation of yang. External factors can damage its defensive yang, causing fever and chills. Its meridians run along the back of the body, up to the head and neck, so headaches, back pain, and stiffening of the spine are all Sun Meridian diseases. The skin and lungs are connected, and the lungs are also the source of water, so sweating requires treating the lungs, and water management also requires treating the lungs, reflecting the unity of water and sky. Located in the lower part of the body, connected to the womb, so blood clots are also diseases of water, and water clots are also diseases of blood, so the bladder's diseases are roughly as follows.

The San Jiao, originally called "jiao," is the oil film that connects the upper, middle, and lower parts of the human body. During the Tang and Song dynasties, people did not understand the shape of "jiao," thinking it was famous but had no visible form, unaware that the "Inner Canon" clearly stated, "Vertical jiao is the vertical jiao, horizontal jiao is the horizontal jiao" (43). The San Jiao

Bitter taste nourishes the heart, yang qi nourishes the blood, and blood nourishes the spleen.

(6) Deep ocean: Meaning the source.

(7) Palpitations: Heart racing and restlessness.

(8) Frustration: Inner restlessness and unease.

(9) Palpitations: Heart racing.

(10) Spirit floating: Meaning the spirit is unsettled. Symptoms include restlessness and unease.

(11) Throat obstruction: Meaning the throat is blocked and cannot breathe. This symptom is common in chronic throat diseases.

(12) Chest tightness: Cold and heat combine in the chest, resulting in hardness and pain below the heart.

(13) Indigestion: Meaning blockage and inability to pass.

(14) Chest oppression: Water or phlegm rises to the chest, with yin occupying the yang position, causing blockage. Symptoms include wheezing, coughing, and chest and back pain.

(15) Fu Liang: One of the five accumulations, a buildup in the heart. According to "Su Wen·Fu Zhong Lun": "There is a condition where the lower abdomen is swollen, with roots on all sides, and the disease is called 'Fu Liang.'" According to "Nan Jing·Wu Liu Nan": "The accumulation in the heart is called 'Fu Liang,' starting from above the navel, about the size of an arm, extending down to the heart, and if it persists for a long time, it makes people anxious and troubled."

(16) Movement in the navel: Qi moves around the four sides of the navel, indicating unrest in the organ's qi.

(17) Announcing the transformation of fire: Meaning spreading yang qi.

(18) Managing chaos: Either managing or causing chaos.

(19) Stagnation: Blocking and depression.

(20) Horizontal flow: Not following the regular flow of meridians, meaning flowing sideways.

(21) Restriction: A term specific to the Five Elements theory. Meaning restriction.

(22) Child borrowing mother's power: Here, the child refers to the liver, and the mother refers to water-related evil forces, meaning the liver uses water to attack the spleen.

(23) Indulgence: Letting go.

(24) Lower ribs: The area near the waist, close to the lower ribs.

(25) Bone steaming: Chronic wasting due to fatigue.

(26) Restraint: Meaning to restrain.

(27) Part: Meaning section or part.

(28) Middle burner: Meaning the middle burner.

(29) Hiccups: ① Referring to hiccups. ② Referring to dry heaving.

(30) Jaundice: Yellowing of the skin.

(31) Heart feels like a plate: According to "Jin Gui Yao Lue·Shui Qi Pian": "When qi is excessive, the heart feels hard, about the size of a plate, with edges like a spinning cup, caused by water, treated with Guizhi Qu Shaoyao Jia Ma Xin Fu Zi Tang."

(32) Spleen accumulation called "pi qi": According to "Nan Jing·Wu Liu Nan": "The accumulation in the spleen is called 'pi qi,' located in the stomach, about the size of a plate, lasting for a long time, causing people to lose strength in their limbs, developing jaundice, and being unable to eat properly."

(33) Spleen controls blood: This comes from "Nan Jing·Si Shi Er Nan": "The spleen wraps blood and warms the five internal organs."

In summary, the author presents many unique arguments and correct insights in this article. However, due to historical limitations, there are still shortcomings and even errors in his arguments. For example, regarding the San Jiao, the author believes that the San Jiao is equivalent to the membrane oil in modern anatomy (the greater omentum). He bases this on the discovery of water bells in the omentum during animal dissection, claiming that the omentum has the function of transporting water to the bladder, and uses this as evidence to support the "Inner Canon's" statement that "the San Jiao is the organ responsible for drainage, and water flows out through it." This narrows the concept of the San Jiao, diluting the overall perspective of the zang-fu theory.