Traditional Chinese Medicine and Modern Physiology, February 21, 1979

Traditional Chinese Medicine and Modern Physiology, February 21, 1979

Traditional Chinese Medicine shares obvious commonalities with modern physiology in both basic theory and herbal formulation theory.

1. On the Concept of Spleen Qi

In traditional Chinese medicine theory, the spleen is an acquired organ responsible for transportation and transformation, controlling blood, governing muscles, and overseeing thinking... This demonstrates that the spleen's functions are extremely broad. It encompasses the small intestine's absorption function and the liver's biochemical functions in modern medicine, as well as part of the hematopoietic function and the nervous system's role. According to "Huang Di Nei Jing · Su Wen," "The spleen and stomach are connected by a membrane," enabling the spleen to deliver its fluids to the stomach. This indicates that the spleen and stomach physiologically possess characteristics of both the small intestine and the pancreas. The spleen and stomach are the granaries of the body, where the five flavors originate, capable of transforming waste into usable substances and releasing the five flavors. The spleen and stomach absorb nutrients and participate in a series of transformations of these nutrients. "People with spleen problems feel heavy and hungry, and their muscles weaken" ("Huang Di Nei Jing"). "Middle consumption is a disease of the middle burner, where people eat a lot and feel hungry, but their muscles don't grow and they become increasingly thin. This disease is also a result of spleen and stomach issues, leading to 'middle consumption'" ("Jing Yue Quan Shu").

All of the above discussions show that the spleen not only participates in a series of biochemical transformations of nutrients, but may also have endocrine functions similar to those of the pancreas. Modern medicine has conducted relatively in-depth research on the gastrointestinal, pancreatic endocrine systems, and the vagus nerve of the digestive system. First, in 1964, it was discovered that injecting glucose directly into the duodenum resulted in a much higher increase in blood insulin levels compared to intravenous injection. This suggested that there might be some endocrine factor in the gastrointestinal mucosa that reflexively triggers an increase in insulin. Soon after, researchers found that there were endocrine-active cells in the mucosa of the stomach and upper small intestine, named APVD cells. These cells secrete several hormone-like substances into the bloodstream to regulate gastrointestinal functions. Currently, gastrin, secretin, glucagon, cholecystokinin, and enterogastrone have been isolated, purified, and their molecular structures have been determined. Together with the already-known insulin and the vagus nerve system that participates in the functions of these hormones, they form the gastrointestinal, pancreatic endocrine system, in which insulin plays a dominant role. This gastrointestinal, pancreatic endocrine system is crucial for the body's digestion, absorption, transport, and metabolism, and its function can be considered similar to that of the spleen in traditional Chinese medicine. Why does insulin play such a dominant role in this endocrine system? Animal experiments have shown that the hypothalamus regulates the feeding center, with the appetite center located on the outer side and the satiety center on the inner side. When blood sugar rises, people feel full; when blood sugar falls, they feel hungry. The key to regulating blood sugar levels is the level of insulin: when insulin levels rise, blood sugar falls and appetite increases. At the same time: ① Gastrin increases, and the secretion of gastric enzymes and gastric acid also increases; ② Pancreatic enzymes increase, and cholecystokinin increases (resulting in more bile). The increase in these hormones further stimulates the appetite center. After feeling full, the body reflexively lowers insulin levels, and the secretion of these hormones decreases accordingly. From this, we can see how important insulin's level is in this endocrine system.

2. On the Concept of Kidney Qi

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The kidney is the foundation of postnatal life. As stated in "Plain Questions: On the Primordial Truth of Ancient Times," "At seven years old, a girl's kidney qi is flourishing, her teeth are replaced and her hair grows longer; at fourteen, the Tian Gui arrives, the Ren Mai becomes unblocked, the Tai Chong Mai flourishes, and menstruation occurs on time." Shen Kuo remarked, "If a woman lacks the power of the kidney (qi), she will have no beard." This illustrates the close relationship between kidney qi and endocrine function. By the Ming Dynasty, the Mingmen School held that the Mingmen is attached to the kidney, serving as the abode of essence and spirit, the seat of primordial qi, the root of the five zang organs and six fu organs, and the foundation of the twelve meridians. However, the Mingmen is also the abode of water and fire, where the yin qi of the five zang organs cannot be fully replenished, and the yang qi cannot be properly stored without it. The kidney is the foundation of prenatal life; the right kidney is the kidney, while the left kidney is the Mingmen. The Mingmen has its own "fire" or "heat," which refers to primordial yang. Primordial yang and primordial yin influence the balance of metabolism, the stability of body fluids and electrolytes, and the growth, development, and aging of the organism, thereby manifesting the characteristics of both sexes and reproductive functions. Recently, some have argued that the essence of the kidney lies primarily in the hypothalamus-pituitary-adrenal cortex system. We believe this only reflects part of the kidney's functions. Nevertheless, it reminds us that we should not understand the kidney's functions solely from an anatomical perspective but rather from a physiological standpoint, especially considering its neural and endocrine roles. Modern endocrinology has advanced rapidly. Recent research on brain physiology suggests that the hypothalamus receives both external and proprioceptive stimuli, records metabolic processes, and then regulates seven vital functions through neural and endocrine pathways: ① energy balance; ② fluid balance; ③ thermoregulation; ④ sleep; ⑤ circulation and respiration; ⑥ growth and development; ⑦ reproductive function. In addition, the hypothalamus also regulates four major endocrine systems: the adrenal glands, thyroid gland, gonads, and growth hormone. From the above, it can be seen that, apart from nutritional functions, the hypothalamus-pituitary-adrenal cortex system essentially aligns with the concept of the kidney in traditional Chinese medicine. Therefore, the essence of the kidney can be considered to belong to the hypothalamus-pituitary-adrenal cortex system. Regarding this assertion, Mr. Shen Ziyin began conducting a series of experimental studies in the early 1960s, confirming that patients with kidney yang deficiency exhibit a significant reduction in 11-hydroxycorticosteroid excretion over a 24-hour period.

3. On the Concept of Liver Qi

The liver is closely related to metabolism. The TCM saying, "The liver opens to the eyes," encompasses the influence of various factors, including the liver itself, as well as neural and humoral elements. According to "Spiritual Pivot: Pulse Extent," "Liver qi flows into the eyes; when the liver is harmonious, the eyes can distinguish the five colors." Typically, TCM holds that "when liver yin is deficient, both eyes become dry and irritated; when liver blood is insufficient, night blindness or blurred vision may occur." The "Treatise on Causes and Symptoms of Various Diseases" describes "night blindness." Sun Simiao was the first to use pig liver to treat night blindness with success, revealing that such conditions were actually caused by vitamin A deficiency. Vitamin A is absorbed into the body and mainly stored in the liver, indicating a very close relationship between the liver and vitamin A metabolism. The primary role of vitamin A in vision is to form the light-sensitive substances within visual cells; the photoreceptor cells in the human retina respond to reflected light.