Five zang and six fu-organs are not entirely equivalent to the fleshy organs
Did ancient China have anatomy? The rudimentary gross anatomy of ancient times only reached the level of "knowing the person and the face but not the heart." You cut open the belly, saw the organs, and from the surface to the internal structures, you could roughly guess the basic functions of the organs. For example, cutting open a body, you see a tube from the mouth leading to the stomach and intestines, so the stomach and intestines must be responsible for digestion; seeing the lungs, which are filled with air, so the lungs must be responsible for breathing. However, the subtle functions of living organs are invisible to the naked eye. Modern medicine still needs high technology to discover many subtle physiological functions of internal organs, such as the liver producing clotting factors to quickly stop bleeding from ruptured blood vessels; or the atria releasing natriuretic peptides to promote kidney urination to reduce pressure when the atrial pressure is too high. These are all things that cannot be known through gross anatomy at the level of the naked eye.Therefore, rudimentary anatomy can only reveal the most basic functions of zang-fu organs. Other subtle functions that are difficult to observe directly with the naked eye were like black boxes to the ancients. In ancient times, only through long-term, even generational efforts, from observations of living bodies, from the process of combating diseases, from the results of physical treatments (such as acupuncture) or drug treatments, and even from practices like meditation and qigong, experience was accumulated, gradually inferring the subtle functions of zang-fu organs, forming a complete classical physiological theory.
It must be admitted that such classical theories do not fully align with contemporary medical discoveries. For example, the "kidney" in Classical Chinese Medicine (TCM) has functions such as urination and reproduction, but contemporary medicine has found that the kidney only has the function of urination, and even the adrenal glands do not have reproductive functions. Therefore, the "kidney" in TCM actually extends its functions to the ovaries and testes. But is TCM wrong? The reality is that most patients with renal failure have problems such as erectile dysfunction, decreased libido, and infertility, indicating that the kidney and reproduction are closely linked. This also shows that the predecessors of TCM, without the aid of high technology, were able to infer the close relationship between the "kidney" and reproductive functions from various external clues, which is astonishing!Another example is the "spleen" in TCM, which has the function of "transformation and transportation." The spleen in TCM actually refers to the pancreas (pancreas) rather than the spleen. "Transformation" refers to the digestion of food, and "transportation," as later explained, refers to the transportation of nutrients to the whole body. Contemporary medicine has found that the pancreas does secrete various enzymes to help the intestines digest food and also secretes hormones to regulate blood sugar into body cells, but it does not include the function of "transporting nutrients." The reality is that the nutrients absorbed by the intestines are pushed to the body's cells through the heart and circulatory system. However, if the "transportation" in TCM is understood as "regulation and control," meaning the pancreas "regulates" nutrients (especially blood sugar) into body cells, then it makes sense. After all, the ancients, without the help of modern technology, were able to reason to this extent, which is quite impressive. As for digestion, the gall bladder secreted by the liver also helps in the digestion of fats, so the "spleen" in TCM actually covers part of the liver's functions.
TCM also believes that the liver has the function of "dredging and discharging," which means maintaining the smooth and unobstructed movement of qi throughout the body. This includes the smoothness of emotions, the free flow of qi and blood, and the smooth operation of the digestive system, etc. If the function of "dredging and discharging" is abnormal, it is easy to feel depressed emotionally, and if qi and blood are not flowing smoothly, it is easy to experience bloating and pain. If the digestive system is not functioning smoothly, it will lead to bloating and constipation. However, modern medicine has found that the liver does not have the aforementioned functions. Instead, the autonomic nervous system has this characteristic of regulating the entire body. Therefore, the "dredging and discharging" function of the liver in TCM actually covers most of the functions of the autonomic nervous system. The liver's attribute in the Five Phases is "wood" , and it is the largest organ in the body, as well as a stronghold for storing and regulating materials. The attribute of the autonomic nervous system is also "wood" , and its main function is also to regulate. Therefore, it is reasonable to bind the two together.TCM believes that the heart stores the "spirit" and the spleen stores the "intention," etc. The "spirit" and "intention" seem to be phenomena of mental activity, so how could they be stored in the internal organs? At least, modern medicine does not think so. But here comes the interesting part: statistics show that among patients who have undergone heart transplant surgery, 1/10 experience changes in personality. The heart transplant recipients inherit part of the personality or habits of the original heart owner, and there are even cases where the recipient remembered the donor's name and found their family. Professor Gary Schwartz from the University of Arizona, after more than 20 years of research and investigation, concluded that the human heart may have "thinking and memory functions"; in 2022, scientists discovered a "quantum entanglement" phenomenon between the human brain and heart. Could these be evidence of the "heart storing spirit" in TCM?
TCM has found that improving gastrointestinal function through the method of "dredging and dispersing" can alleviate a patient's depressed mood. The most famous prescription is Peripatetic Powder, isn't the name of this prescription quite self-explanatory? Anatomists have discovered that the gastrointestinal tract is densely populated with about 100 billion neurons, forming the "abdominal brain" of the human body. It can issue commands and direct gastrointestinal movements without needing to follow the brain's orders, and it also has unimaginable interactions and connections with the brain. When gastrointestinal function is poor, the feedback through the vagus nerve to the brain often causes negative emotions such as fear and depression. When it detects a good "taste," it also stimulates appetite and makes people feel happy. Could this be evidence of the "spleen storing intention" in TCM?Therefore, the five zang and six fu-organs in TCM do not entirely refer to the physical organs themselves. Sometimes, they also include other physiological functions related to or closely connected with the attributes of these organs, just as the kidneys themselves do not have reproductive functions, but they are closely tied to reproductive functions. Thus, the five zang and six fu-organs are more like symbols representing a group of related physiological functions. If we can view the symbols of the five zang and six fu-organs in TCM this way, it won't be so confusing. The ancients, under simple conditions, were able to develop such medical theories, which should be a source of pride and admiration. Future generations should uphold the spirit of the ancients and further improve and promote the theories of TCM!
Inferring the functions of internal zang-fu organs from external signs
Crude anatomy can only roughly understand the basic functions of zang-fu organs and cannot reveal more subtle functions. Therefore, the internal workings of a living human body were more like a black box to the ancients. Theoretically, although the detailed operations inside the black box cannot be directly observed, by observing various signs and indications outside the black box, it is possible to analyze and infer the possible functions and mechanisms hidden inside. For example, even if one does not understand another's thoughts, one can get a glimpse from their behavior and actions. Whether the water in a teapot is hot cannot be seen, but one can indirectly know by feeling the outside of the teapot with the back of the hand; or like choosing a watermelon, although the inside cannot be seen, experienced people can judge the quality of the watermelon by tapping its surface and listening to the echo. In physics, there is a field called "helioseismology" that infers the internal conditions of the sun by observing temperature changes on its surface. Therefore, just because technology is insufficient to see the subtle functions inside zang-fu organs does not mean that medicine stops here. The ancients took a different path and developed methods to "see through" the functions of internal zang-fu organs.After long-term exploration, practice, and accumulation of experience, the ancients discovered that certain superficial tissues of the body have a closer connection with certain internal organs. Information reflecting the vitality of internal organs can also be gathered from them. For example, the eyes, tendons, nails, nipples, etc., are closely related to the vitality of the liver. Similarly, breathing, the nose, skin, hair, etc., are related to the lungs. The human body is a holographic unit , and within the human body, there are many smaller holographic units that can reflect the internal conditions. For instance, the face and the surface of the tongue are holographic units, and the artery at the radial styloid process used for pulse diagnosis is also one. Through visual observation and pulse palpation with the fingers, more information about the activities of the internal organs can be gathered. Combined with communication with the patient, this constitutes a complete information collection SOP— observation, listening, questioning, and palpation .
Just as the hidden water source within a mountain will emerge from somewhere outside the mountain, forming a spring, the spring water and the water inside the mountain are one. The rise and fall of the water stored inside the mountain will directly reflect the prosperity or decline of the spring outside the mountain. Although the internal organs are inside the human body and cannot be directly observed, the various signs reflected by the observable external tissues can be used to infer the internal zang-fu organs' functions. This is the "perspective technique" of a physician/doctor of TCM.
For example, a patient complains of insomnia, and also mentions that their tongue is prone to sores, they are easily irritated, and their urine is very yellow. Based on the symptoms described by the patient, the slightly red tongue, and the fast pulse, the doctor can roughly infer that the patient is in a state of exuberance of heart fire, which is a systemic imbalance where the heart's yang qi is excessively excited. Thus, a prescription to "clear heart fire" is given. If the patient returns for a follow-up and the symptoms have mostly disappeared, it indicates that the pathological system of "exuberance of heart fire" has returned to balance, and the previous inference was correct.
TCM diagnoses systemic-level macroscopic pathologies and treats macroscopic pathological phenomena rather than single symptoms. Often, when seeking TCM to treat disease A, disease B also improves, highlighting the difference between treating symptoms and treating the root cause.
Five zang and six fu-organs can each be further divided into yin-yang
The ancients discovered that the human body is a Tai Chi, and each zang-fu organ is also a small Tai Chi, each of which can be further divided into yin-yang, such as stomach yin, stomach yang, heart yin, heart yang, etc., all of which can be operated and handled using the same Tai Chi logic. Therefore, the Tai Chi system has fractal characteristics, and the logic and operations of Tai Chi have a universality that is independent of detail and scale.Five zang and six fu-organs also interact with each other
In addition to the imbalance of their own functions and being in a "pathological" state, there are also certain interactions between the "zang" and "fu" organs. Sometimes, the excessive or insufficient function of a certain "zang" or "fu" organ can also affect the function of another "zang" or "fu" organ. TCM refers to this as the mutual generation and restraint between zang-fu organs. "Mutual generation" is a concept of promotion, meaning that if you are well, I am well; if you are not well, I am sad. "Mutual restraint" is a concept of balance, meaning that if you are excessive, you will suppress me; if you are insufficient, I will press you in return. This will be discussed in another article.Summary
In the simple research environment of the ancients, through long-term exploration, practice, and accumulation of experience, two achievements were made:- Summarized the physiological functions of the internal zang-fu organs, which can be further refined with the discoveries of various sciences and modern medicine.
- Discovered the method of inferring the state of internal zang-fu organs from external signs, developing the TCM technique of "perspective" on the human body—observation, listening, questioning, and palpation.
