Visceral Manifestations, Zang-Fu Relationships & Vital Substances – CH. 6-7 Review

Zang Organs – Core Functions (Review)

• Heart (Xin)
  • Governs Blood & controls vessels
  • Houses the Shen (Mind/Spirit)
  • Manifests in the complexion; opens to the tongue
  • Affected by joy
• Liver (Gan)
  • Stores Blood; ensures smooth flow of Qi
  • Controls sinews; manifests in nails; opens into eyes
  • Affected by anger
• Spleen (Pi)
  • Governs T&T (transformation & transportation) of food/fluids
  • Controls Blood, muscles, 4 limbs; opens to mouth; manifests in lips
  • Affected by worry/overthinking
• Lung (Fei)
  • Governs Qi & respiration; disperses/descends Qi & Fluids
  • Regulates water passages; controls skin/hair; opens to nose
  • Affected by grief
• Kidney (Shen)
  • Stores Essence (Jing); governs birth, growth, reproduction, development
  • Produces marrow → fills brain, controls bones
  • Governs water; controls 2 lower orifices; opens to ears, manifests in hair
  • Affected by fear

Major Zang–Zang Relationships (Physiology ↔ Pathology)

Heart–Liver (Shen & Hun)

• Physiology: Heart houses Shen; Liver houses Hun (Ethereal Soul)
  • Smooth Liver Qi flow steadies Heart emotions
• Pathology: Liver Qi stagnation/Liver Fire disturb Shen
  • Heart Blood deficiency can’t anchor Hun
• Pattern example: \text{Liver Fire Insulting Heart} → irritability, palpitations, insomnia, dream-disturbed sleep

Heart–Spleen (Blood & Shen)

• Physiology: Spleen produces Blood → nourishes Heart; Heart governs Blood/houses Shen
• Pathology: Spleen Qi deficiency → Heart Blood deficiency → insomnia, poor memory
  • Overthinking damages both
• Pattern: \text{Heart–Spleen Deficiency} → palpitations, loose stools, fatigue

Heart–Lung (Upper-Jiao Coordination)

• Physiology: Heart moves Blood; Lung moves Qi (Qi pushes Blood)
• Pathology: Lung Qi deficiency impairs Heart Blood circulation; Heart Qi deficiency hampers Lung Qi
• Pattern: \text{Heart–Lung Qi Deficiency} → SOB, weak voice, spontaneous sweating

Heart–Kidney (Fire–Water Axis)

• Physiology: Heart Yang descends to warm Kidneys; Kidney Yin ascends to nourish Heart/anchor Yang
• Pathology: KD Yin ↓ → Heart Fire; HT Yang ↓ → KD cold
• Patterns: \text{Heart & Kidney Not Harmonized}, \text{Heart Fire Blazing (KD Yin ↓)}, \text{KD Yang ↓ + HT Qi ↓}
  • Palpitations, night sweats, tinnitus, weak knees

Liver–Spleen (Wood over Earth)

• Physiology: Liver Qi flow aids Spleen T&T; Liver Blood nourishes Spleen; Spleen provides Qi/Blood to Liver
• Pathology: Liver Qi stagnation invades Spleen → digestive issues; Spleen Qi/Blood deficiency fails to nourish Liver Blood
• Pattern: \text{Liver Overacting on Spleen} → alt. constipation/diarrhea, hypochondriac pain, wiry pulse

Liver–Lung (Qi Dynamic & Emotions)

• Physiology: Liver Qi assists Lung dispersing/descending; emotions: grief (LU) vs anger (LR)
• Pathology: Liver Qi stagnation → chest oppression, sighing; prolonged grief constrains LR Qi
• Pattern: \text{Liver Qi Stagnation Affecting Lung}

Liver–Kidney (Essence & Blood)

• Physiology: LR stores Blood; KD stores Essence; Blood & Essence inter-nourish (fertility, bones, brain)
• Pathology: KD Yin ↓ → Liver Yin ↓ → Liver Yang rising; chronic Liver Blood ↓ depletes KD Essence
• Pattern: \text{Liver & Kidney Yin Deficiency} → blurred vision, night sweats, weak back/knees

Spleen–Lung (Qi & Fluid)

• Physiology: Spleen produces Gu Qi → Lung forms Zong Qi; Spleen manages fluids; Lung disperses/descends
• Pathology: SP Qi ↓ → insufficient Gu Qi → LU weakness; LU Qi ↓ → fluid stagnation/damp
• Pattern: \text{Lung & Spleen Qi Deficiency}

Spleen–Kidney (Source Qi & Transformation)

• Physiology: KD Yuan Qi warms/helps SP T&T; SP sends food essence to KD → Essence
• Pathology: SP or KD Yang ↓ → cold, diarrhea, edema
• Pattern: \text{Spleen & Kidney Yang Deficiency}

Lung–Kidney (Qi Grasping & Water)

• Physiology: LU descends Qi; KD grasps Qi; LU sends fluids down; KD steams back up
• Pathology: KD Qi/Yang ↓ → can’t grasp LU Qi → asthma; LU failure to descend → edema
• Pattern: \text{Kidney Failing to Grasp Qi}

Zang–Fu Pairings (Internal–External)

• Lung ⇄ Large Intestine
• Spleen ⇄ Stomach
• Heart ⇄ Small Intestine
• Kidney ⇄ Bladder
• Liver ⇄ Gallbladder
• Pericardium ⇄ San Jiao

Key Paired Dynamics & Disorders

• HT & SI: Excess HT Fire → SI heat → scanty, burning urine; SI heat ↗︎ → HT ulcers, red tongue tip
• LU & LI: LI heat/stagnation impairs LU descending → cough; LU Qi ↓ → constipation, dry stools
• SP & ST: SP prefers ascend/dry; ST prefers descend/moist
  • SP Qi ↓ or sinking + ST rebellion → bloating, vomiting, prolapse
  • Damp injures SP→ distention, poor appetite
• LR & GB: LR stores Blood/ensures Qi flow → bile; LR Qi stagnation stops bile → hypochondriac pain, bitter taste, jaundice
• KI & BL: KI Qi/Yang ↓ → bladder failure of opening/closing → frequency, retention, painful urination

Extraordinary Fu & Zang Links

• Brain & Marrow: Rooted in KD Essence; nourished by HT-Blood, LR-Blood, SP post-natal Qi, LU Qi
• Bones: House marrow; reflect KD Essence; supported by LR tendons, SP/HT Blood, LU Qi
• Vessels: Governed by HT; circulated by LU Qi; SP makes/holds Blood; LR stores/regulates; KD Essence aids
• Gallbladder (as Extraordinary Fu): Interior–Exterior with LR; HT Shen adds courage; SP/ST assist bile
• Uterus: Depends on KD Essence, LR Qi/Blood flow, HT Blood/Shen, SP post-natal Qi

Vital Substances Overview (Ch. 7)

• Essence (Jing) – Yin, stored in KD
• Qi – Yang, vital energy
• Blood (Xue) – Yin, nourishing
• Body Fluids (Jin-Ye) – Yin, moistening

Essence (Jing)

Types

• Pre-Heaven Jing (Congenital)
  • Inherited; fixed quantity; determines constitution & lifespan; stored in KD; creates \text{Yuan Qi}
• Post-Heaven Jing (Acquired)
  • Derived from food/drink via SP/ST; renews daily; preserves Pre-Heaven Jing

Functions

• Reproduction: forms Tian Gui at puberty (menses, semen); fertility, pregnancy
• Growth & Development: embryo → aging; bones, teeth, skin; brain & spinal marrow; longevity
• Marrow & Blood Production: Jing → marrow → Blood (“Essence & Blood share origin”)
• Nourishment & Vitality: powers Zang-Fu, immunity, healing

Qi

Formation

• Components: Pre-Heaven Qi (KD Jing) + Gu Qi (food) + Qing Qi (air)
  • Merge in chest → \text{Zong Qi}
  • Activated by Yuan Qi → \text{Zhen Qi} (True Qi) → divides into \text{Ying Qi} & \text{Wei Qi}

Movement Directions

• Ascend, Descend, Enter, Exit — proper motion = health; disordered = stagnation, rebellion, sinking, collapse

Five Main Functions

1. Promoting (growth, digestion, circulation)
2. Warming (body temperature)
3. Defending (Wei Qi vs pathogens)
4. Consolidating (holds Blood/fluids, organ position)
5. Transforming (Qi-Hua: substance conversion)

Types of Qi (Key Points)

• Yuan Qi (Original) – KD
• Zong Qi (Pectoral) – chest, LU & HT
• Ying Qi (Nutritive) – within vessels
• Wei Qi (Defensive) – exterior, skin
• Gu Qi (Food) – raw material
• Zhen Qi (True) – final usable Qi
• Zheng Qi (Upright) – collective defensive force

Blood (Xue)

Nature & Formation

• Yin, dense, nourishing; anchors Shen
• Produced from Gu Qi + Qing Qi transformed by HT; Jing/Marrow contribute

Circulation Controllers

• HT: propels; LU: assists via Qi; SP: makes/holds; LR: stores/regulates volume

Functions

• Nourish & moisten; anchor Shen; lubricate sinews/skin

Pathologies

• Deficiency: pallor, dizziness, insomnia
• Stasis: stabbing pain, purple tongue
• Heat: rashes, bleeding, irritability

Body Fluids (Jin-Ye)

Classification

• Jin (thin, clear) – exterior, with Wei Qi (sweat, saliva)
• Ye (thick, turbid) – interior, with Ying Qi (synovial fluid, CSF, semen)

Metabolism

1. Generation: ST “rotting/ripening”; SP T&T; Intestines absorb
2. Distribution: SP up, LU disperse/descend, KD steam up, SJ conduit
3. Excretion: LU sweat, KD/BL urine, LI stool

Functions

• Moisten body & organs; nourish; aid Blood formation; balance Yin-Yang; detox via excretion

Interrelationships Among Vital Substances

• Essence ↔ Qi: Jing makes Qi; Qi protects/conserves Jing
• Essence ↔ Blood: Jing → Marrow → Blood; Blood nourishes Jing
• Qi ↔ Blood: Qi generates/moves/contains Blood; Blood is material basis of Qi
• Qi ↔ Fluids: Qi transforms & moves fluids; Fluids protect Qi from heat/dryness
• Blood ↔ Fluids: same origin (Gu Qi); mutually replenish & transform

Clinical Case Snapshots (Application)

• Case 1 (28 F): Fatigue, cold limbs, late scanty menses, pale tongue, deep-weak pulse → Blood & Yang deficiency (SP/HT/KD)
• Case 2 (72 M): Puffy limbs, loose stools, greasy tongue, soft pulse → Fluid accumulation; SP & KD failing T&T; Qi transformation (Qi-Hua) impaired
• Case 3 (21 yo): Acne, nosebleeds, thirst, red eyes, red tongue, rapid pulse → Heat in Blood & Fluids; LR/HT regulate; Heat consumes Fluids → Blood Heat symptoms

Ethical & Practical Implications

• Preservation of Jing via balanced lifestyle prevents premature aging
• Regulating emotions (anger, worry, fear, grief, joy) protects inter-organ harmony
• Diet & breath (Post-Heaven Qi sources) are foundational therapeutic tools
• Holistic diagnostics depend on discerning these substance & organ relationships for precise treatment