Traditional Chinese medicine own two outstanding features, their holistic point of view, and their application of treatment according to the distinction of symptom-complexes. This contains the theories of Yin-Yang, Five Elements, Zang-Fu, channels- collaterals, qi, blood, body fluid, methods of diagnosis, and diversity of symptoms. According to the traditional Chinese medicine viewpoints, the Zang-Fu organs are the core of the human body in which tissues and sense organs are linked through a network of channels and collaterals. This concept is broadly applied to the structure, diseases, diagnosis, and treatment of the human body.
Yin-Yang and Five Elements
The ancient Chinese created and developed the theories of Yin-Yang and Five Elements through their long and authentic tradition of observing nature’s cycles and changes. They held that wood, fire, earth, metal, and water were the basic substances establishing the material world.
These five basic substances were considered an indispensable part of daily life. They also noted that the physical world is in a continuous state of flux due to the dynamic movement and mutual antagonism of Yin and Yang factors.
The ancient Chinese applies these two theories in the medical field to explain the physiological activities and pathological changes of the human body. Further, this serves as a guide to the medical treatment on the basis of condition differentiation. These theories have become an important component of traditional Chinese medicine.
The Theory of Balance
The Yin Yang theory holds that all phenomena consist of two conflicting aspects, Yin and Yang. These aspects are variously defined as left and right, up and down, hot and cold, light and dark, stillness and movement, substance and function, etc. The actions and variations of Yin and Yang give energy to the growth of everything.
According to ancient Chinese beliefs, “Yin and Yang are the law of Heaven and Earth, the skeleton of everything, the parents of change, the source of birth and destruction….” Yin and Yang represent two opposite aspects of every entity and its implied conflict and interdependence.
Generally, anything that is bright, progressing, moving, ascending, hyper activity, including functional disease of the body, pertains to Yang.
The characteristics of darkness, degeneration, stillness, descending, hypo activity, including organic disease, pertain to Yin.
The nature of Yin and Yang is relative. According to Yin- Yang theory, our entire universe is divided into the two opposite but balancing aspects of Yin and Yang. For example, the day is Yang, and night is Yin, but morning is understood as being Yang within Yang, the afternoon is Yin within Yang, the evening before midnight is Yin within Yin and the time after midnight is Yang within Yin.
The Application of Yin-Yang Theory
The theory of Yin and Yang is used widely in traditional Chinese medicine to explain the structure, function, and changes in the human body. This theory serves as a guide for diagnosis or treatment.
The Human Body
The Yin-Yang theory states that the human body is an organic whole, and there is an organic connection between all tissues and structures. Yet, at the same time, each of them can be separated into the opposed aspects of Yin and Yang. Viewing the body as a whole, the portion above the waist relates to Yang and that below fits to Yin; the front is Yin and the back is Yang; the outside of the body is linked with Yang, while the interior is associated with Yin; the lateral aspect is Yang and the medial, Yin.
The Zang-Fu organs also have Yin and Yang aspects, the six Fu organs are defined as Yang while the Zang organs are Yin. Every of the Zang-Fu organs can again be divided into Yin or Yang; for example, heart Yin and heart Yang or kidney Yin and kidney Yang. However complex, all human body structures and tissues can be generalized and described by the Yin-Yang affiliation.
The Physiological Functions
According to the Yin-Yang theory, the normal vital activities of the human body is a result of the subtle balance between Yin and Yang. In traditional Chinese medicine, the physiological functions of the organs and their constituents are inseparably related to Yin and Yang.
For example, the actions (remember: action is Yang) of a particular organ are based on that organ’s substance (substance is Yin) and when either of these characteristics is absent, the organ cannot function. Thus the outcome of physiological activities is to constantly stimulate the conversion of Yang into Yin essence. If Yin and Yang cannot maintain their balance and interaction, they will separate from each other, and this separation ends the life that depends on them.
How We Get Ill
The Yin-Yang theory holds that disease is a result of an imbalance between Yin and Yang. But, it’s not that simple. The occurrence and the development of a disease are also related to Zheng Qi (body resistance or immunity as we call it) and Xie Qi (the pathogenic factors).
The Yin- Yang theory can be used to generalize the interacting relations between body resistance and anti-pathogenic factors. Once again, the pathogenic factors are divided into Yin and Yang.
If the disease is caused by Yin pathogenic factors, it may give rise to hypo activity of Yin followed by the injury of Yang. In this case, a cold disorder will result. When Yang is deficient it fails to restrict Yin in the balanced relationship between the two giving rise to Xu (shortage, insufficiency) which is a cold syndrome. The Xu heat symptoms complex, however, is caused by a Yin deficiency and Yang excess.
Pathological changes of disease are diverse, but can be generally explained in terms of Yin-Yang disproportion: Yin excess causes cold syndromes, Yang dominance leads to heat syndromes, Yang deficiency causes cold syndromes, and Yin deficiency leads to heat syndromes.
Diagnosis of Diseases
The basic contributing factor of a disease is an imbalance between Yin and Yang. Therefore, no matter how complex and volatile the medical manifestations are, they can still be explained with two categories: Yin syndromes and Yang syndromes.
The right diagnosis rests on a clear classification of Yin and Yang syndromes. The four diagnostic methods (inspection, auscultation and olfaction, inquiry, and palpation) also use Yin and Yang. For example: interior, Xu (shortage, insufficiency), and cold syndromes are considered Yin; exterior, Shi (excess), and heat syndromes are considered Yang; dim color is Yin, bright color is Yang; a low voice is Yin, and a sonorous voice indicates Yang; feeble and weak respiration is Yin, coarse breathing is Yang; superficial, rapid, and forceful pulses are Yang, slow, deep feeble, and weak pulses are Yin.
Since disproportion and instability of Yin and Yang are the basic causative factors of disease occurrence and development, treatment must readjust Yin and Yang to their basic state of mutual balance.
For example, if pathogenic heat, a Yang disease contributing factor, is excessive, it consumes the Yin fluid and affects the excessive Yang of the body. In this case, the cold methods for heat syndromes (for example, the use of herbs with a “cold” nature to cure “heat” illnesses) is the prescribed treatment.
If pathogenic cold is in excess, it will damage the Yang Qi and exert influence on the body’s remaining Yin. In this case, the heat method for cold syndromes (for example, the use of herbs with a “hot” nature to cure “cold” illnesses) is used.
Conversely, in cases where Yang excess if caused by insufficient Yin fluid failing to restrict Yang or where Yin dominance is due to Yang Qi deficiency being unable to control Yin, then treatment should reinforce the lacking of Yin or Yang.
The general principle is, “Treat Yin for Yang diseases, and treat Yang for Yin disorders.”
The Zang-Fu Organs
The Zang-Fu theory describes the physiological function, pathological changes, and mutual associations of every Zang and Fu organ. In traditional Chinese medicine, the Zang and Fu organs are not simply a part of the anatomy, but, represent the generalization of the physiology and pathology of certain structures of the human body. Zang and Fu comprise of the five Zang and six Fu organs.
The Five Zang Organs
Zang and Fu are classified by the diverse structures of their functions. The five Zang organs primarily manufacture and store essence: qi, blood, and body fluid. The six Fu organs mostly receive and digest food, absorb nutrient substances, transmit and excrete wastes.
The main physiological functions and indicators of the heart are:
- domination of blood, blood vessels, and the facial complexion;
- control of the mind;
- opening into the tongue;
The heart has an “exterior” (Biao) and “interior” (Li) relationship with the small intestine.
The lung is located in the chest, connects with the throat and opens into the nose. Its main physiological functions and indicators are:
- dominating qi and controlling respiration;
- controls the dispersion and descent of qi;
- regulating water passage;
- linking externally with skin and hair;
It also has an exterior and interior association with the large intestine.
The spleen is positioned in the middle Jiao (abdominal cavity). Its main physiological functions and indicators are:
- governing transportation and transformation;
- controlling blood;
- dominating the muscles and four limbs;
- opening the mouth, and lip complexion;
The spleen has an exterior and interior relationship with the stomach.
The liver’s main physiological functions and indicators are:
- storing blood;
- creating unrestrained conditions for qi;
- controlling the tendons and the luster reflected in the nails;
- opening into the eye;
The main physiological functions and indicators of the kidneys are:
- storing essence, controlling human reproduction, growth, and development;
- controlling water metabolism;
- receiving qi;
- producing marrow, filling up the brain, controlling the bones, manufacturing blood and influencing hair shine;
- opening into the ear, perennial ante-tract and perennial post-tract;
- connects with the urinary bladder to which it is connected from the exterior and the interior;
The Six Fu Organs
The gallbladder is attached to the liver and stores bile. There is an ancient saying regarding the close relationship between the liver and bile, “The remaining qi of the liver flows to the gall bladder and turns into the juice of essence (bile).”
Bile is continuously excreted into the intestinal lumen to assist in digestion. The bitter taste and yellow color of bile are significant in disease manifestations of a bitter taste in the mouth, vomiting of bile, jaundice, etc. As the liver and the gall bladder are externally and internally related, the gallbladder is also involved in the free-flow of qi concerning emotional activities.
Clinically, when some mental disorders or emotional symptoms such as fear and palpitation, insomnia, dream disturbed sleep, etc. occur, treatment can be applied by considering the gallbladder.
Situated below the diaphragm, the stomach’s upper opening connects with the esophagus and its lower opening with the small intestine. Its main physiological function is to receive and digest food. After the digestion, the food is sent downward to the small intestine, where the essential substances are transformed and transported by the spleen to the whole body.
The spleen and the stomach collectively are known as the “acquired foundation,” that is, their proper nourishment establishes the foundation for a healthy life. Clinical diagnosis and treatment place great stress on the strength and weakness of the stomach and spleen qi.
Generally, it is considered that whatever kind of illness occurs, if stomach qi is still strong, the prognosis will be good. The old Chinese saying states: “Stomach Qi is the foundation of the human body. When there is stomach qi, there is life. When there is no stomach qi death will follow.” Hence, preserving stomach qi is an important principle of treatment. Normal stomach qi descends. If it fails to descend, symptoms such as anorexia, fullness, pain, nausea, and vomiting may appear.
3. Small Intestine
The upper end of the small intestine attaches with the stomach, its main function is to receive partially digested food from the stomach and further divide it into clear and turbid. The small intestine transfers the turbid residues to the large intestine. The spleen transports the clean vital substances to all parts of the body, and part of the water enclosed in food to the urinary bladder.
Therefore, if diseased, the small intestine will not only affect the function of digestion and absorption but also lead to urinary problems.
4. Large Intestine
The upper end of the large intestine is connected to the small intestine by the ileocecal valve, and its lower end connects to the anus. Its main physiological function is to receive the waste material and send down from the small intestine.
In the process of transporting it to the anus, it absorbs a part of its liquid and converts it into feces. The feces is then expelled from the body. Dysfunction of the large intestine produces the symptoms of borborygmus and diarrhea; if the fluid is further exhausted, the symptoms will be constipation and so on.
5. Urinary Bladder
The main function of the urinary bladder is to store and release urine. It has an exterior and interior relationship with the kidneys. Pathologically, if the urinary bladder has a dysfunction of Qi, dysuria or retention of urine will appear. If this restrictive function is lost, there may be excessive urination or incontinence of urine.
Sanjiao is a general term for the three cavities of the body trunk. The upper Jiao contains the heart and lung, the middle contains the spleen and stomach, and the lower contains the kidney and urinary bladder.
Thus the heart and lung function is to distribute Qi and body fluid by a spreading and moistening action. The spleen and stomach must digest, absorb, and transfer the qi, blood, and body fluid transformed from the essential substances; a similar process to that of soaking in water to cause decomposition and dissolution. The kidney and urinary bladder function to transport fluids and water.
Pathological problems in any of the three Jiao will affect the organs located there.
In this article, we have addressed the basic philosophical elements of traditional Chinese medicine. In some future articles, we will provide practical information on individual traditional Chinese medicinal herbs, and formulas of medicinal herbs. Check back frequently our My Cures category.