Visceral manifestation Lecturer: QU Hongyan. [Objects] To master the concept of Zang-fu organs To...
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Transcript of Visceral manifestation Lecturer: QU Hongyan. [Objects] To master the concept of Zang-fu organs To...
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