Back in the 1970s my father, who is a retired osteopathic physician, took acupuncture classes at Tai Sophia University—the oldest school of traditional Chinese medicine (TCM) in the United States. It was books on acupuncture on his shelves that I saw as a child that inspired me to study this esoteric medicine.
When I asked him why he did not pursue studies in this field he told me that he couldn’t “reconcile the opposing theories of the body (when compared with allopathic medicine) that TCM espoused.” Indeed, the majority of people brought up in the West cannot, either.
To this day I find it interesting when I describe TCM and its patterns of disharmony to people. Most people give me blank stares or uncertain nods. My patients try to understand what I am describing to them, and often have to ask a series of questions until they are able to grasp the general concepts of health I am attempting to get across. Yet these theories are thousands of years old and are continually applied to billions of people in Asia. And the Asian culture is not suffering for it…
Several of my patients are physicians, psychologists or chemists and their doubting stares are plentiful. I know ahead of time that when we get to the lecture part of their consultation I will have to work hard at convincing them of TCM’s concepts of the body. And I do. In some of my articles I also get feedback from readers who cannot fathom what I am sharing, thinking I am ignorant of basic anatomy and physiology. Quite the opposite is true.
The issue is that TCM does not hold the exact same views of the organs and their functions as Western medicine does. This is where the confusion arises in those whose understanding of the body is grounded in Western ideas of biology, anatomy and physiology. Can there really be a different view of the organs even though science has proven them to be a certain way? Indeed there can, when a broader view of the body is taken.
You see, when TCM developed in ancient China, no autopsies were carried out for fear of disrespecting the deceased ancestors. So what is known about each organ was discovered through thousands of years of clinical observation. As a result, the functions of one specific organ in TCM may include the functions of several organs in terms of Western medicine. And the functions of one specific organ in Western medicine may be contained in the functions of several organs in TCM. It’s a matter of terminology, since names like “kidney” and “spleen” were not used when TCM was developed, yet are now imposed on its ideas to help people understand and reconcile TCM and allopathic theories of wellness.
In a nutshell, organs are not only viewed as individual units in TCM, but also as concepts of physiology and pathology. This can all be explained through the concepts of zang-fu organ pairing, the meridian complex, the diurnal flow of qi (energy) and the five element theory. Let’s look at each briefly.
Zang-Fu Organ Pairing
TCM divides the internal organs into zang (nurturing, yin) and fu (transporting, yang) groups. The five Zang organs include the heart, liver, spleen, lungs and kidneys. Preserving vital substances is their common characteristic.
The six fu organs consist of the gallbladder, stomach, large intestine, small intestine, urinary bladder and so-called ‘triple energizer’ (the combined thoracic, abdominal and pelvic cavities). Transmitting and digesting water and food is their shared characteristic.
The theory of zang-fu organs is concerned with both the physiological functions and the pathological changes of the organs, as well as the interrelationships between them. And these functions and relationships are rooted in the pairing of the zang-fu into the following yin/yang groups: lung and large intestines, stomach and spleen, heart and small intestines, urinary bladder and kidneys, pericardium and triple energizer and gallbladder and liver.
Thus, problems with one organ may affect its partner. A simplified example is when someone has fear or anxiety about public speaking and experiences shallow breathing. Soon they also experience intestinal cramps. In Western terms we say these two things are a result of stress. While stress may be the cause, the relationship between the lungs and large intestines is exemplified.
The Meridian Complex
The meridian energy channels are the pathways in human body through which qi (vital energy) and blood circulate. They form a specific network that communicates with the internal organs and the limbs and connects the upper body to the lower body and the exterior to the interior portions of the body.
Since the meridians are distributed over the entire body, they are what link the zang-fu organs, the orifices, the skin, the muscles and the bones. That is, they bring the body into an organic whole that allows it to carry on and coordinate its systematic activities.
Each organ has a specific meridian that stems from it and connects it with its paired organ and to various parts of the body. This explains why the heart is seen to not only pump blood but also to affect mental functions (the heart meridian goes into the brain).
The Diurnal Flow of Qi
Qi is the vital energy of the body and each organ produces Qi that affects certain activities in the body. This energy moves through the body via the meridian complex. And the energy in each organ meridian is said to be at “high tide” for a two-hour period in a 24 hour cycle, before moving into the meridian of its paired organ.
The lung meridian is most active from 3 a.m. to 5 a.m. The large intestines (its paired organ) are most active from 5 a.m. to 7 a.m., and so on. This explains why people with certain respiratory diseases tend to awaken and wheeze or cough between the hours of 3 a.m. and 5 a.m.
Most of my patients who wake up with headaches between those hours find that it is due to oxygen deprivation caused either by sinus congestion or from sleeping with their nose buried in their pillows. In other words the headaches are caused by oxygen deprivation when the lungs most need oxygen while at high tide.
The Five Element Theory
The theory of the five elements holds that the world is made up of five basic substances: wood, fire, earth, metal and water. All things and phenomena in nature—as well as in the organs, tissues, physiology and pathology of the human body—can be classified into one of the five elements.
Among the five elements exists the relations of promotion and restriction. The element that promotes is called the mother, while the element that is promoted is called the child.
Since earth produces metal it is called the mother of metal. Since earth is produced by fire it is also called the child of fire. Earth organs are the spleen and stomach, metal organs are the lungs and large intestines and fire organs are the heart and small intestines.
Restriction refers to bringing something under control or restraining it. For example, the element restricting earth is wood (fallen trees cover earth), and the element that is restricted by earth is water (earth absorbs water). This in part explains why excess anger, frustration or obsessions which affect the liver (wood) can cause digestive upset which, in TCM, is the domain of the spleen (earth).
Promotion and restriction are inter-dependant. Without promotion there would be no birth and development. Without restriction, excessive growth would result in harm and damage. When TCM views organs, not only are their pairs important, but so is their element designation and how they play on other organs.
There’s More Than Meets The Microscope
When understood and taken as a comprehensive system, the TCM concepts of the meridian complex, zang-fu organ pairing, diurnal cycle of qi flow, and the five element theory can explain why the organs as viewed in Chinese medicine hold more functions than can be “proven” by biomedicine, where their functions are reduced to individual micro units. I offer two examples.
In terms of TCM, the liver stores blood, regulates the flow of blood in the body, controls the tendons, connects to the nails and opens into the eyes. Thus, the Chinese concept of “liver” refers to an entire energetic system, not merely to the organ itself. And this is why excess, deficiency and stagnation associated with the liver can effect blood circulation, the brain and nervous system, the digestive system, the endocrine system, the muscles and the tendons.
The spleen is another good example of differences, since in the West it is not seen as having much use to the body. However, the Chinese concept of the spleen holds a seat of great importance to health. In TCM, the spleen is responsible for transformation of food energy into qi and blood, and the transportation and absorption of water and nutrients through the body. It also insures that blood is held in the vessels and that organs do not become prolapsed.
Thus, the spleen covers the entire digestive system, water metabolism, blood circulation, up-bearing of clear energy to the brain, as well as controlling the muscles and limbs.
From the above concepts we can see how a problem with one organ can influence another or several others in ways not normally associated with the organs specifically. And this is why TCM doesn’t reduce signs and symptoms to specific diagnoses based on biological function. Terms like bi-polar disorder and migraine headache and cirrhosis of the liver are not used in TCM. Rather, we use concepts like “liver qi stagnation” or “heart blood deficiency” to describe and explain a syndrome or pattern of disharmony in the body that has many causes and effects… and therefore needs a broader view and approach to heal.
While wellness is viewed in more generalized and metaphoric terms in TCM, it is precisely these concepts that allow its practitioners to construct a holistic view of the body, its illnesses and to treat the whole as opposed to the part. Understanding a new concept of long-held beliefs is difficult, but can also be quite rewarding.
—Dr. Mark Wiley