2. Endocrine Aspects:

The Spleen and Stomach occupy a central position, and the "Wei Qi" that the human body relies on for defensive functions originates from food and water and is generated in the Spleen and Stomach. Therefore, the strength of Spleen and Stomach functions directly affects the rise and fall of Wei Qi. The "Spirit Pivot · The Chapter on the Inner Storage" states: "Wei Qi is what warms the flesh and muscles, fills the skin, enriches the pores, and controls opening and closing." It also says: "When Wei Qi is balanced, the flesh and muscles become relaxed, the skin becomes soft and supple, and the pores become dense." This demonstrates that Wei Qi is a crucial factor in clearing foreign pathogens from peripheral tissues such as muscles, skin, and mucous membranes, and it plays a role in maintaining the skin and mucosal barrier. When invading pathogens attack, Wei Qi vigorously resists them, and the fierce struggle between the two gives rise to disease. The "Plain Questions · On Malaria" states: "Wherever Wei Qi resides, it combines with pathogenic factors to cause illness." This phenomenon is very similar to the phagocytic activity of the reticuloendothelial system. Sometimes, Wei Qi can even surround invading "pathogenic factors," causing local abscesses to form, just as the "Plain Questions · On Wind" says: "Wind enters the meridians together with the Sun, spreads among the flesh and muscles, interacts with Wei Qi, and because the pathway is unfavorable, the muscles become swollen and ulcerated." This shows how similar Wei Qi is to the phagocytic activity of neutrophils in immunology. Moreover, Wei Qi's role is not limited to skin, flesh, and pores; it also protects internal organs. The "Spirit Pivot · The Chapter on the Flow of Wei Qi" states: "It initially enters the yin meridians, often flowing from the Foot-Shao Yin to the Heart, then to the Lung, then to the Spleen, and finally returning to the Kidney to complete the cycle." This indicates that Wei Qi can circulate through the meridians of various organs, much like the dispersed reticuloendothelial system and the systemic fluid circulation throughout the body. The above discussion shows that Wei Qi has a function similar to non-specific immunity in modern immunology; however, the main factor determining the rise and fall of Wei Qi is the strength of Spleen and Stomach functions. The traditional practice of using Bu Zhong Yi Qi Tang to strengthen Spleen and Stomach functions, thereby preventing colds, is a clinical application of this view. Recent domestic experimental studies have shown that Bu Zhong Yi Qi Tang can indeed improve protein metabolism in tumor-bearing organisms and increase non-specific immunity. The Isotope Laboratory of the Beijing Tuberculosis Research Institute injected animals intravenously with iodine-131-labeled plasma protein colloidal solution and measured the clearance rate in the blood as an indicator of the phagocytic function of the reticuloendothelial system. They found that herbs that strengthen the Spleen and tonify Qi, such as Dang Shen, Bai Zhu, and Huang Qi, can enhance the phagocytic function of the reticuloendothelial system; in contrast, herbs that nourish yin and clear heat, such as Sha Shen, Bai He, Bei Mu, and Huang Qin, had no such effect. The Oncology Group of the Beijing Institute of Traditional Chinese Medicine also conducted experiments showing that Dang Shen can increase the number of white blood cells in peripheral blood; Jiang Tingliang injected rabbits with extracts of this herb, which increased the proportion of neutrophils in the peripheral blood. These experiments suggest that Spleen-strengthening herbs like Dang Shen can enhance the defensive function of white blood cells and boost non-specific immunity. The Guang'anmen Hospital of the Chinese Academy of Traditional Chinese Medicine measured the phagocytic function of macrophages in 89 patients with malignant tumors, and found that their phagocytic rates were significantly lower than normal. Among them, five cervical cancer patients showed a marked improvement in macrophage phagocytic function after receiving Spleen-strengthening and vitalizing treatment. These data demonstrate that strengthening the Spleen can indeed enhance the defensive capabilities of macrophages, neutrophils, and the reticuloendothelial system, thus providing experimental evidence for the view that strengthening the Spleen can regulate non-specific immunity.

The Kidney is the foundation of innate vitality and the source of life force. The "Plain Questions · On the Principle of Vital Energy Flowing to Heaven" states: "When yin is balanced and yang is concealed, the spirit is healthy," and adds: "When yin and yang are separated, vital energy is lost." This shows that the balance of yin and yang is a prerequisite for maintaining a normal ecological environment. The root of yin and yang lies in the Kidney, which is why the Kidney is referred to as having original yin and original yang. Disruption of Kidney Qi is often the key factor leading to imbalance of yin and yang throughout the body. Modern immunology believes that the functions of T cells dependent on the thymus and B cells independent of the thymus are the main components of specific immunity, and the precursors of these two types of cells are stem cells located in the bone marrow. The "Plain Questions · On the Great Theory of Yin and Yang Correspondence" states: "The Kidney generates bone marrow," from which it can be inferred that the transformation of bone marrow stem cells into T cells and B cells is closely related to the Kidney. Therefore, by regulating Kidney Yin and Kidney Yang, it is possible to improve the body's specific immune response. The Shanghai Cancer Research Institute used crude fetal alpha-globulin as an antigen to induce an immune response in rabbits, then divided them into groups and administered Kidney-Yin-tonifying drugs and Kidney-Yang-tonifying drugs, measuring the antibody levels afterward. The results showed that Kidney-Yang-tonifying drugs could accelerate the formation of antibodies, while Kidney-Yin-tonifying drugs could prolong the survival time of antibodies, indicating that Kidney-tonifying therapy can improve specific humoral immunity. The New Medical Department of the Affiliated Hospital of Guangzhou Medical College conducted rose-petal tests on patients with chronic bronchitis due to Kidney deficiency to measure their specific cellular immunity. They found that the ratio of T cells in these patients was generally low, but after administering Kidney-tonifying traditional Chinese medicines, the ratio of T cells gradually increased, and the clinical symptoms also improved accordingly. According to a report from the Henan Provincial Health Bureau's Bronchitis Office, from the perspective of specific humoral immunity, measuring IgA in the sputum of patients with chronic bronchitis revealed that the ratio of T cells was generally low, but after administering Kidney-tonifying traditional Chinese medicines, the ratio of T cells gradually increased, and the clinical symptoms also improved accordingly.

<!-- translated-chunk:3/24 -->

Content: The results showed that after treatment with kidney-tonifying herbs such as rabbit fetal slices, the IgA content in patients' sputum tended to increase. The First Outpatient Department of the Chengdu Military Region conducted serum IgG and IgA measurements on more than 50 patients with chronic bronchitis of the kidney deficiency type; their levels were all below normal. After applying warm-kidney-yang medications via navel patch therapy, the above indicators all increased to varying degrees. These data indicate that kidney-tonifying methods can enhance T-cell transformation into lymphoblasts and promote the function of releasing lymphokines, while also strengthening the function of immunoglobulins in body fluids, thereby providing experimental evidence for the argument that "kidney qi" possesses specific immune functions.

2. Endocrine Aspects: In recent years, materials combining organ differentiation and endocrine aspects are still frequently found in discussions related to the spleen and kidneys. The kidney is the root of innate vitality and the foundation of life; it is an extremely important organ in the human body. The "Plain Questions · Discussion on Ancient Heavenly Truths" states:

"When a girl reaches the age of seven, her kidney qi becomes robust, her teeth change, and her hair grows longer; at fourteen, the heavenly癸 arrives, the Ren meridian becomes unblocked, the Chong meridian flourishes, menstruation occurs regularly, thus enabling her to bear children; at forty-nine, the Ren meridian becomes weak, the Chong meridian declines, the heavenly癸 is exhausted, the earth passage is blocked, resulting in physical degeneration and inability to conceive." Shen Kuo also said: "For women, if they lack the power of the kidney (kidney qi), they will have no beard," and he even extracted sex hormone crystals of a certain purity from human urine, named "autumn stone," which were used to treat diseases involving growth, development, and sexual characteristics (endocrine disorders). It is evident that traditional Chinese medicine has long attributed endocrine dysfunction to the kidney. After the Ming Dynasty, the warm-kidney school rose to prominence, leading to more discussions about the relationship between the kidney and the Mingmen. Zhang Jingyue stated: "The Mingmen is the root of primordial qi, the abode of water and fire; the yin qi of the five organs cannot be nourished without it, and the yang qi of the five organs cannot be generated without it. The Mingmen contains fire, which is precisely the primordial yang, or the fire of life itself." These statements all suggest that the kidney and the Mingmen are closely linked to the body's energy metabolism. In the early 1960s, Shen Ziyin and others at Shanghai First Medical College initiated experimental research aimed at elucidating the relationship between the kidney and adrenal gland endocrine functions. They first observed that six different systemic diseases—functional uterine bleeding, bronchial asthma, pregnancy-induced hypertension, systemic lupus erythematosus, coronary heart disease, and neurasthenia—all exhibited clinical manifestations of kidney yang deficiency at a certain stage of their progression. At this point, if roughly the same kidney-tonifying therapy was administered, all six diseases could achieve a certain degree of improvement. From this, it was inferred that there might be a common link of metabolic dysfunction in the pathological processes of these six diseases, with this metabolic dysfunction serving as the internal factor and kidney yang deficiency syndrome as the external manifestation. Since kidney-tonifying therapy can alleviate and eliminate kidney yang deficiency syndrome, it undoubtedly regulates the underlying metabolic dysfunction. Subsequently, through a series of experiments, it was finally discovered that patients with kidney yang deficiency had significantly lower 24-hour urinary excretion of 17-hydroxysteroids compared to normal individuals; after kidney-tonifying treatment, this level returned to normal, and concurrently, the symptoms of kidney yang deficiency also improved accordingly. The urinary 17-hydroxyl content represents the overall result of synthesis, secretion, and catabolism of adrenal cortical hormones within the body; any imbalance in these three factors will lead to changes in urinary 17-hydroxyl levels. Such imbalances are usually closely related to the hypothalamus–pituitary–adrenal cortex system. Therefore, it can be concluded that the kidney in traditional Chinese medicine, to a certain extent, possesses the functions of the hypothalamus–pituitary–adrenal cortex system; the kidney deficiency syndrome in traditional Chinese medicine, to a certain extent, is the external manifestation of insufficient hypothalamus–pituitary–adrenal cortex function; and kidney-tonifying therapy, to a certain extent, can improve the functions of the hypothalamus–pituitary–adrenal cortex system. Based on this conclusion, the reason why traditional Chinese medicine can use kidney-tonifying therapy to treat various diseases becomes self-evident. In addition to the aforementioned six diseases, the author often uses kidney-tonifying therapy to treat aplastic anemia, leukemia, tumors, hypertension, chronic nephritis, prostatitis, lumbar muscle strain, rheumatoid arthritis, and other conditions, all of which have achieved varying degrees of clinical efficacy. With a clear understanding of the above mechanisms, this provides an important avenue for exploring the reasons behind these therapeutic effects.

The spleen is the root of acquired vitality and, like the kidney, is another extremely important organ in the human body. Based on the principle that "the spleen governs transportation and transformation, capable of transforming waste into the five flavors," people generally believe that the spleen in traditional Chinese medicine has the absorption and digestion functions of the small intestine in modern medicine. In recent years, the similarities between the spleen and the pancreas in modern medicine have gradually attracted attention, leading to a preliminary elucidation of the relationship between the spleen and the endocrine system. The "Plain Questions · Discussion on Taiyang and Yangming" states: "The spleen and stomach are connected by a membrane, yet they can both transport their fluids." This shows that the anatomical position of the spleen is similar to that of the pancreas; the "Plain Questions" also says: "When the spleen is diseased, the body feels heavy, one is always hungry, and the muscles become weak," which is similar to the symptoms of diabetes. During the Ming Dynasty, Zhang Jingyue further developed these views, pointing out: "Middle consumption refers to diseases of the middle jiao; patients eat a lot and feel hungry, but their muscles do not grow, instead they become increasingly thin. This disease originates in the spleen and stomach and is called 'middle consumption' (from the 'Jingyue Complete Works')." He explicitly pointed out that diabetes, caused by pancreatic endocrine dysfunction, is one of the diseases of the spleen. In recent decades, modern medicine has discovered the gastrointestinal and pancreatic endocrine systems. First, in 1964, someone abroad injected glucose solution into the duodenum, and the insulin concentration in the blood rapidly increased, far exceeding the level achieved by intravenous glucose injection in the same organism. Later, APVD cells with special endocrine functions were discovered in the mucosa of the upper small intestine; these cells secrete several peptide hormones (such as gastrin, glucagon, secretin, cholecystokinin, and somatostatin) into the bloodstream, regulating digestion, absorption, storage, and decomposition. This regulatory function often operates under the participation of the vagus nerve, and this endocrine system including the vagus nerve is called the "gastrointestinal and pancreatic endocrine system." The spleen in traditional Chinese medicine has functions very similar to this endocrine system. Hou Can from Sun Yat-sen Medical College, starting from analyzing the symptoms of spleen deficiency—excessive salivation, dampness, abdominal distension, loose stools, acid regurgitation, nausea, etc.—believed that when the spleen yang is deficient, the tension of the vagus nerve increases. Some measured the true cholinesterase activity of patients with spleen yang deficiency and found it higher than that of the normal control group, supporting this view. Hou Can also participated in measuring the autonomic nervous function of 53 patients with chronic dysentery due to spleen deficiency and found that parasympathetic dominance accounted for 53%, while sympathetic dominance only accounted for 5%; Jiangsu New Medical College, using isolated rabbit intestinal tube experiments, found that tonifying spleen formulas such as Bu Zhong Yi Qi Tang have an inhibitory effect on intestinal peristalsis, which also supports the above view. In the aforementioned gastrointestinal and pancreatic endocrine system, the parasympathetic nerves only transmit information and regulate the increase or decrease of secretions, while insulin plays the dominant role. For example, sugar-reducing drugs promote increased insulin secretion, leading to hypoglycemia; when insulin secretion increases, it reflexively causes 1) increased secretion of gastrin (promoting the secretion of gastric acid and proteases), 2) increased secretion of secretin (promoting the release of pancreatic enzymes), 3) increased secretion of cholecystokinin (promoting bile secretion), thereby fully mobilizing the activity of the "gastrointestinal and pancreatic secretion system" and preparing it for upcoming digestion and absorption activities. This shows that the spleen in traditional Chinese medicine, in terms of its digestion, absorption, and metabolism functions, basically has the same role as the "gastrointestinal and pancreatic endocrine system" in modern medicine, with insulin playing the dominant role. The traditional Chinese medical practice of attributing diabetes to the spleen and treating it with spleen-tonifying methods to achieve effectiveness can thus find a preliminary answer.