1. Explanation of the Five Organs and Six Bowels:

Heart (Xin)

The heart is located in the left side of the chest, above the diaphragm and below the lungs, round and pointed at the bottom, resembling a lotus flower, protected by the pericardium. The heart forms a system with the small intestine, vessels, face, tongue, etc. In the Five Elements, the heart belongs to fire, being the most yang of the organs, governing blood vessels, housing the spirit, and being the master of life. The heart corresponds to summer among the four seasons.

Physiological Functions of the Heart:

1. The heart governs blood vessels.

This means the heart has the role of managing blood and promoting blood circulation in the vessels, including both governing blood and governing vessels. Blood refers to the blood itself. Vessels, also known as meridians, are the channels through which blood flows. The heart and vessels are interconnected, forming a closed system that serves as the hub of blood circulation. The heart beats regularly, requiring three conditions: abundant heart qi, sufficient blood, and unobstructed vessels.

2. The heart houses the spirit.

The meaning of spirit: In TCM, the spirit has three main meanings: First, it refers to the functions and laws of material movement and change in nature. As the saying goes, “The unmeasured yin and yang is called spirit” (Su Wen, Tian Yuan Ji Da Lun). Second, it refers to the totality of life activities in the human body. Generally referred to as the broad sense of spirit. The external manifestations of life activities, such as the overall image of the body, complexion, eye spirit, speech, responses, and body movements, all fall within the scope of spirit. In other words, all external manifestations of the body are reflections of life activities. Third, it refers to people’s mental, conscious, and thinking activities. This is the spirit that the heart governs, generally referred to as the narrow sense of spirit.

Essence and qi are the material basis for the spirit. The physiological functions of the heart in housing the spirit have two aspects: First, it governs thinking, consciousness, and spirit. Under normal circumstances, the clear heart receives and reflects objective external things, engaging in mental, conscious, and thinking activities. Second, it governs life activities. “The heart is the master of the body, the root of all things” (Yin Shan Zheng Yao, Preface). The clear heart is the master of life activities in the human body. The five organs and six bowels must operate under the unified command of the heart to carry out coordinated normal life activities. The heart is the ruler, and all organs and bones obey the heart. The heart houses the spirit and serves the purpose of the spirit. “The heart is the great master of the five organs and six bowels, where the spirit resides” (Ling Shu, Xie Ke).

Physiological Characteristics of the Heart: The heart is a yang organ and governs clarity. The heart is the sun among the yang organs, utilizing yang qi. The yang heat of the heart not only maintains the physiological functions of the heart itself but also nourishes the entire body.

Relationship of the Heart with Form, Orifices, Will, Fluids, and Seasons:

The heart is connected to the vessels, and its manifestation is on the face.

The heart is associated with the tongue.

The heart is associated with joy.

The heart is associated with sweat.

The heart corresponds to summer qi.

The heart externally corresponds to the chest. “The heart is the official of the ruler, where the spirit emerges.”

2. The Lung (Fei)

The lungs are located in the chest, one on each side, lobed and loose in texture. They reside above the diaphragm, connect to the trachea, open to the nose, and directly communicate with the atmosphere.

Physiological Functions of the Lung:

The lung governs qi, controls respiration, governs water, and regulates the hundred vessels.

1. The lung governs qi:

The lung governs the qi of the entire body. This means the lung has the role of presiding over and regulating the qi of all organs and tissues, participating in the generation of qi through respiration and regulating the qi mechanism. 2. The lung governs respiratory qi. The lung is the site of gas exchange between the internal and external environments, meaning the lung, through the act of breathing, inhales clear qi from the environment and exhales turbid qi from the body, achieving the function of gas exchange.

2. The lung governs water: This refers to the lung’s role in the distribution, movement, and excretion of body fluids through its dispersing and descending functions. As the highest organ, the lung participates in regulating the body’s fluid metabolism, hence it is said that “the lung is the source of water” (Xue Zheng Lun, ‘Swelling’).

3. The lung governs the hundred vessels: All blood vessels converge and flow through the lung, undergoing gas exchange during respiration, thus the lung governs the hundred vessels.

Physiological Characteristics of the Lung: 1. The lung is the canopy: The canopy refers to an umbrella. The canopy originally referred to the cover of ancient emperors’ carriages. The lung is the canopy, meaning it is the highest organ in the body cavity, protecting the other organs and resisting external pathogens. The lung is located in the chest, occupying the highest position among the five organs, covering the other organs, and is the external defense of the organs, hence it is called the canopy. 2. The lung is a delicate organ: The lung is delicate, meaning it is clear, empty, and tender, making it susceptible to external pathogens. The lung is a clear and empty organ, and being in a high position, it is the canopy of the organs, the convergence of the hundred vessels, and it opens to the skin and hair, connecting directly to the weather. External pathogens can invade the body through the mouth and nose or through the skin, easily affecting the lung and causing disease. Changes in the cold and heat of other organs often affect the lung, as it is intolerant to cold and heat, hence it is called a delicate organ.

Relationship of the Lung with Form, Orifices, Will, Fluids, and Seasons:

The lung is connected to the skin, and its manifestation is on the hair.

The lung is associated with the nose, and the throat is the portal of the lung.

The lung is associated with grief and worry.

The lung is associated with mucus.

The lung corresponds to autumn qi.

The lung externally corresponds to the abdomen. “The lung is the official of the assistant, governing regulation.”

3. The Spleen (Pi)

The spleen is located in the upper part of the abdominal cavity, below the diaphragm, connected to the stomach by a membrane, “shaped like a dog’s tongue, resembling a chicken comb,” forming a system with the stomach, flesh, lips, and mouth.

Physiological Functions of the Spleen:

The spleen governs transportation and transformation, and it governs blood.

1. The spleen governs transportation and transformation: Transportation refers to the transfer and delivery, while transformation refers to digestion and absorption. The spleen’s function of transportation and transformation means it can convert food and drink into essence and transport the essence to all organs and tissues in the body. In essence, the spleen is responsible for the digestion, absorption, and transportation of nutrients. This includes the transportation of food and the transformation of fluids.

(1) Transportation of food: Food refers to all kinds of food and drink. The spleen’s transportation of food means its role in digesting and absorbing food. The process of the spleen’s transportation of food is as follows: First, the food that has been initially digested by the stomach is further processed by the small intestine, and through the spleen’s grinding and digestion, it is transformed into essence (also known as food essence); Second, it absorbs the food essence and transports it throughout the body; Third, it sends the food essence to the heart and lungs to transform it into vital substances such as qi and blood. In summary, the spleen governs the transportation of food, which includes the digestion of food, absorption of essence, and transformation of essence into qi and blood.

(2) Transportation of fluids: The transportation of fluids refers to the spleen’s role in absorbing and transporting fluids, regulating the body’s fluid metabolism, meaning the spleen works with the lungs, kidneys, triple burner, and bladder to regulate and maintain the balance of fluid metabolism in the body. The spleen’s function of transporting fluids is a key link in regulating the body’s fluid metabolism. In the process of fluid metabolism, while the spleen transports food essence, it also delivers the necessary fluids (body fluids) to all tissues through the heart and lungs to nourish and moisten them, and it promptly transports the fluids used by the organs back to the kidneys, where they are transformed into urine and expelled, thus maintaining the balance of fluid metabolism in the body. The spleen is located in the middle burner, serving as the hub for the body’s qi mechanism’s rise and fall, thus playing an important role in fluid metabolism. Therefore, when the spleen’s function of transporting fluids is strong, it can ensure that all tissues receive adequate moisture without causing excessive fluid retention. Conversely, if the spleen’s function of transporting fluids is impaired, it will lead to stagnation of fluids in the body, resulting in pathological products such as dampness and phlegm, and even edema.

Physiological Characteristics of the Spleen: 1. The spleen qi is primarily ascending. The spleen’s nature is to ascend, meaning the movement of the spleen’s qi is primarily upward; when the spleen ascends, its qi is strong. The spleen qi maintains the relative position of the organs. 2. The spleen prefers dryness and dislikes dampness. The spleen governs dampness and dislikes dampness because dampness harms the spleen, causing it to lose its healthy function, leading to dampness in the patient, referred to as “dampness obstructing the spleen’s earth.”

Relationship of the Spleen with Form, Orifices, Will, Fluids, and Seasons:

The spleen is connected to the flesh and governs the limbs. Its manifestation is on the lips.

The spleen is associated with the mouth.

The spleen is associated with thought.

The spleen is associated with saliva.

The spleen corresponds to late summer.

The spleen externally corresponds to the lower abdomen. “The spleen is the official of admonition, knowing the surroundings.”

4. The Liver (Gan)

The liver is located in the abdomen, below the diaphragm, on the right side, slightly to the left. It forms a system with the gallbladder, eyes, tendons, and nails. It governs smooth flow, stores joy, and dislikes depression, being yin in nature and yang in function. In the Five Elements, it belongs to wood, corresponding to spring among the four seasons.

Physiological Functions of the Liver:

The liver governs smooth flow and stores blood.

1. The liver governs smooth flow: This means the liver has the role of ensuring smoothness, comfort, and unobstructed flow to maintain the smooth flow of qi throughout the body. The liver’s function of smooth flow is crucial in physiological activities, as it relates to the smooth flow of qi throughout the body. Qi movement refers to the rise and fall of qi, which is the basic form of qi transformation. The human body is a system that continuously undergoes the rise and fall of qi transformation. The process of qi transformation is achieved through the functions of the organs. The organs, meridians, qi, blood, body fluids, and yin-yang all rely on the rise and fall of qi to interconnect and maintain their normal physiological functions. The liver’s smooth flow function plays an important role in balancing and coordinating the rise and fall of qi between all organs and tissues. “All qi transformations of the twelve organs must rely on the liver and gallbladder’s qi transformation to be able to flow smoothly without illness” (Du Yi Sui Bi, Volume Four). Therefore, when the liver’s smooth flow function is normal, the qi flows smoothly, the blood is harmonized, the meridians are unobstructed, and the activities of the organs and tissues are coordinated normally.

2. Regulating emotional states: Emotions refer to feelings and moods, which are a type of psychological process primarily reflecting emotional changes in human mental activities. In TCM, emotions fall under the narrow sense of spirit, including joy, anger, worry, thought, sadness, fear, and shock, collectively known as the seven emotions. The liver can regulate emotional activities through its smooth flow function and the smooth flow of qi.

3. Promoting digestion and absorption: The spleen and stomach are the main digestive organs in the body. The stomach governs reception, while the spleen governs transportation. The liver’s smooth flow is an important condition for maintaining the normal digestion and absorption of the spleen and stomach. The liver promotes the spleen and stomach’s digestive and absorptive functions by coordinating the rise and fall of qi in the spleen and stomach and secreting and excreting bile.

4. Maintaining blood circulation: The liver’s smooth flow can directly affect the smooth flow of qi. Only when the qi flows smoothly can the heart govern blood vessels, the lungs assist the heart in circulating blood, and the spleen govern blood, thus ensuring the normal circulation of qi and blood.

5. Regulating fluid metabolism: The regulation of fluid metabolism is mainly completed by the lungs, spleen, kidneys, and other organs, but it is also closely related to the liver. Since the liver governs smooth flow, it can regulate the qi of the three burners, promoting the functions of the lungs, spleen, and kidneys in regulating fluid metabolism, namely by promoting the spleen’s transportation of fluids, the lungs’ distribution of body fluids, and the kidneys’ transformation of fluids to regulate fluid metabolism. The three burners serve as the channels for fluid metabolism. “If the upper burner is not treated, water will invade the high source; if the middle burner is not treated, water will remain in the middle; if the lower burner is not treated, water will disrupt the two excretions. When the qi of the three burners is treated, the vessels will be unobstructed, and the water channels will be smooth” (Liu Jing, Zang Xiang Lei). The function of the three burners in regulating fluid metabolism is essentially a comprehensive function of the lungs, spleen, and kidneys in regulating fluids. The liver’s smooth flow is normal, and the qi flows smoothly, thus the fluid metabolism is also smooth, which is the theoretical basis for regulating water through qi.

6. Regulating reproductive functions: (1) Regulating the Chong and Ren channels: Women’s physiological activities such as menstruation, pregnancy, and childbirth involve the functions of many organs, among which the liver plays a very important role, hence the saying “women rely on the liver for their innate constitution.” (2) Regulating the essence chamber: The essence chamber is where men store their essence. As men’s kidney qi becomes abundant, the essence matures (the substance that promotes sexual maturity and maintains reproductive function), leading to the overflow of essence and the ability to reproduce. The opening and closing of the male essence chamber and the storage and release of semen are related to the functions of the liver and kidneys. “The one who governs closure and storage is the kidney, while the one who governs smooth flow is the liver” (Ge Zhi Yu Lun, Theory of Yang Excess and Yin Deficiency).

2. The liver stores blood: The liver’s storage of blood refers to its ability to store blood, prevent bleeding, and regulate blood volume. Hence, it is known as the “sea of blood.”

(1) Storing blood: Blood originates from the essence of food and is transformed by the spleen and stored in the liver. The liver stores a certain amount of blood, which can nourish itself, restrain the liver’s yang, and maintain the balance of yin and yang in the liver, as well as harmonize qi and blood. Therefore, if the liver does not store blood, it can lead to insufficient liver blood and excessive rising of yang qi, which can also result in bleeding.

(2) Regulating blood volume: Under normal physiological conditions, the blood volume in various parts of the body is relatively constant. However, the blood volume in different parts of the body often changes with different physiological conditions. When the body is under intense activity or emotional excitement, the blood demand in various parts of the body increases, and the blood stored in the liver is distributed to the periphery to meet the body’s activity needs. When people are at rest and their emotions are stable, the activity level of various parts of the body decreases, and the blood demand in the periphery also decreases, leading to some blood returning to the liver. The saying goes, “When a person moves, blood flows through the meridians; when a person is still, blood returns to the liver.” Therefore, the liver’s ability to store blood and regulate blood volume is why it is called the “sea of blood.”

Physiological Characteristics of the Liver:

1. The liver prefers smooth flow: Smooth flow means to stretch, be unobstructed, and be clear. Depression means to be restrained and obstructed. The liver is the organ of wind and wood, and its qi rises, preferring smooth flow and disliking depression. The liver qi should remain gentle and smooth to maintain its normal physiological functions.

2. The liver is a strong organ.

Relationship of the Liver with Form, Orifices, Will, Fluids, and Seasons:

The liver is connected to the tendons, and its manifestation is on the nails.

The liver is associated with the eyes.

The liver is associated with anger.

The liver is associated with tears.

The liver corresponds to spring qi.

The liver externally corresponds to the two sides of the body. “The liver is the official of the general, where strategies emerge.”

5. The Kidney (Shen)

Physiological Functions of the Kidney:

The kidney stores essence, governs the reception of qi, and governs water.

1. The kidney stores essence: The kidney’s storage of essence refers to its role in storing and sealing the essence of the human body. The physiological functions of essence include: The essence in the kidneys not only promotes the growth, development, and reproduction of the body but also participates in blood production and enhances the body’s resistance to disease. (1) Promoting reproduction: Kidney essence is the original substance for embryonic development and can promote the maturation of reproductive functions. The generation, storage, and release of kidney essence play an important role in reproduction. The development of the reproductive organs and their reproductive capabilities depend on the abundance of kidney essence. In summary, the development and maturation of male and female reproductive organs and their reproductive capabilities rely on the abundance of kidney essence, and the generation, storage, and release of essence are all governed by the kidneys, hence the saying “the kidneys govern reproduction.” Based on this theory, tonifying the kidneys and preserving essence has become one of the important methods for treating reproductive and sexual function abnormalities.

(2) Promoting growth and development: Life follows the natural laws of birth, growth, maturity, aging, and death. The time from birth to development, growth, maturity, aging, and death is called lifespan, usually measured by age. (3) Participating in blood production: The kidneys store essence, and essence can transform into marrow, which can then be transformed into blood. “Blood is a product of essence, but essence is stored in the kidneys, and while it is not abundant, blood is rich in the channels, and wherever it goes, it is present” (Jing Yue Quan Shu, Blood Evidence). “Blood is the essence of food and drink, transformed by the true fire of the Mingmen” (Du Yi Sui Bi, Theory of Qi, Blood, and Spirit). Therefore, it is said that the source of blood is in the kidneys. Thus, in clinical practice, methods to tonify essence and marrow are often used to treat blood deficiency. (4) Resisting external pathogens: Kidney essence has the role of resisting external pathogens, preventing diseases. “Those with abundant essence do not fall ill; those with depleted essence are prone to all diseases” (Feng’s Secret Record). When essence is abundant, vitality is strong, defenses are firm, and adaptability is high, making it difficult for pathogens to invade. Conversely, when essence is depleted, vitality weakens, defenses are loose, and adaptability is low, making it easy for pathogens to invade and cause illness. Hence, it is said that “those who store essence do not fall ill in spring” (Su Wen, Jin Gui Zhen Yan Lun). If essence is not stored in winter, one will surely fall ill in spring; the kidney essence’s ability to resist external pathogens belongs to the category of righteous qi, which is similar to the meaning of “when righteous qi is present, evil cannot invade” and “wherever evil gathers, its qi must be weak.”

2. The kidney governs water and fluids: Fluids refer to the normal liquids in the body. The kidney governs water and fluids, broadly speaking, meaning the kidney is the water organ, referring to its role in storing essence and regulating fluids. In a narrow sense, it refers to the kidney’s function of hosting and regulating the body’s fluid metabolism.

3. The kidney governs the reception of qi: Reception means to capture and accept. The kidney’s role in receiving qi refers to its ability to capture the qi inhaled by the lungs and regulate breathing. Although the lungs govern breathing, the qi inhaled must descend to the kidneys, where the kidney qi captures it, allowing for smooth and regulated breathing. “Qi roots in the kidneys and also returns to the kidneys, hence it is said that the kidneys receive qi, and their breath is deep” (Yi Yan, Qi). “The lungs govern qi, while the kidneys govern the root of qi; the lungs govern exhalation, while the kidneys govern inhalation; when yin and yang intersect, breathing is harmonious” (Liu Zheng Zhi Cai, Volume Two).

Physiological Characteristics of the Kidney: The kidney governs closure and storage: Closure, also known as sealing and storage, refers to the ability to securely store and seal the essence of the five organs and six bowels. Sealing and storage is an important physiological characteristic of the kidneys. The kidneys are the source of innate essence, the root of life, storing true yin and housing original yang, being the organ of water and fire. The kidneys store essence, which should be preserved and not leaked; the kidneys govern the life fire, which should be hidden and not exposed; the source of life comes from the kidneys, growth and development depend on the kidneys, and life activities rely on the kidneys. The kidneys are where the body’s yin essence gathers; when kidney essence is abundant, the source of transformation is sufficient.

Relationship of the Kidney with Form, Orifices, Will, Fluids, and Seasons:

The kidneys are connected to the bones and produce marrow, and their manifestation is in the hair.

The kidneys are associated with the ears and the two yin.

The kidneys are associated with fear.

The kidneys are associated with saliva.

The kidneys correspond to winter qi.

The kidneys externally correspond to the lower back. “The kidneys are the official of strength, where skills emerge.”

6. The Six Bowels (Liu Fu)

The six bowels refer to the gallbladder, stomach, large intestine, small intestine, triple burner, and bladder. The term “fu” originally referred to a storehouse. The main physiological function of the six bowels is to receive, digest food, separate clear from turbid, transform essence, and expel waste without allowing it to remain. Therefore, the six bowels should be harmonious and unobstructed. The specific physiological functions of the six bowels are: Food enters the stomach, is digested in the stomach, moves down to the small intestine for further digestion, separates clear from turbid, absorbs the essence, and the large intestine receives the food residue from the small intestine, absorbs excess water, and the remaining waste is expelled as feces through drying and conducting. During the digestion and absorption of food, the gallbladder secretes bile into the small intestine to assist in digestion. The triple burner is not only a channel for transformation but also plays a crucial role in hosting various qi, promoting the normal functioning of the transformation process.

7. The Gallbladder (Dan)

The gallbladder is attached to the short lobe of the liver, connected to the liver, and is a hollow sac-like organ. The gallbladder is one of the six bowels and also one of the extraordinary organs.

Its main functions are:

1. Storing and excreting bile, which is bitter and yellow-green, and has the function of promoting the digestion and absorption of food. Bile is transformed from the essence of the liver and stored in the gallbladder, hence it is called the “storehouse of essence” and “the house of purity.” The excretion of bile relies on the regulation and control of the liver’s smooth flow function. When the liver’s smooth flow function is normal, bile excretion is smooth, and the spleen and stomach’s transformation function is strong. If the liver qi is stagnant, bile excretion is hindered, affecting the spleen and stomach’s digestive function, leading to symptoms such as fullness in the chest and sides, loss of appetite, or irregular bowel movements; if the liver’s smooth flow is excessive, bile qi may reverse, leading to symptoms such as bitterness in the mouth and vomiting of yellow-green bile; if damp-heat accumulates in the liver and gallbladder, bile may overflow to the skin, resulting in jaundice; if bile excretion is obstructed for a long time, it can lead to the accumulation of stones.

2. Governing decision-making: Decision-making belongs to the realm of thought. The gallbladder governs decision-making, meaning it has the role of judging matters and making decisions. This function is important for defending against and eliminating the adverse effects of certain mental stimuli, maintaining and controlling the normal flow of qi and blood, and ensuring the coordination between various organs. Since the liver and gallbladder are mutually dependent and interrelated, with the liver governing strategies and the gallbladder governing decisions, their mutual coordination regulates the normal progression of mental activities. Clinically, individuals with insufficient gallbladder qi are often easily startled, fearful, and indecisive.

8. The Stomach (Wei)

The stomach is located below the diaphragm, connecting to the esophagus above and the small intestine below. The upper opening of the stomach is the cardia, and the lower opening is the pylorus; the stomach is divided into three parts: upper, middle, and lower, hence it is also called the stomach cavity.

Its main functions are:

1. Governing the reception and digestion of food. Reception means to accept and contain; digestion refers to the process by which the stomach initially digests food into chyme. The stomach’s function of receiving and digesting food means it can accommodate food transmitted from the esophagus and initially digest it before passing it to the small intestine, hence the stomach is known as the “sea of food and drink” and “the granary.” The stomach’s reception and digestion provide the material basis for the spleen’s transportation function. Therefore, the spleen and stomach are often referred to as the “foundation of postnatal life, the source of qi and blood transformation,” and the functions of the spleen and stomach are summarized as “stomach qi.” The source of postnatal nutrition is closely related to the strength of “stomach qi,” and in clinical practice, the strength of “stomach qi” is often used as an important basis for judging the severity of diseases and prognosis, emphasizing the importance of “preserving stomach qi.” If the stomach’s reception and digestion functions are abnormal, it can lead to symptoms such as stomach distension, nausea, loss of appetite, acid regurgitation, and hunger; if the stomach qi is severely damaged, it can lead to difficulty in eating, poor prognosis, and even life-threatening conditions, hence the saying, “A person lives with stomach qi; without stomach qi, one dies.”

2. Governing the downward movement of food: The downward movement refers to the stomach qi’s smooth descent. Food enters the stomach, is digested, and then moves down to the small intestine for further digestion and absorption; the clear substances are transported by the spleen, while the turbid substances are passed to the large intestine to be transformed into waste and expelled. The entire process is completed through the stomach qi’s “downward movement.” Therefore, the stomach’s governing of downward movement means it can pass the chyme down to the small and large intestines and expel waste.

The stomach’s governing of downward movement is essential for the reception of food. Therefore, if the stomach fails to move downward, it not only decreases appetite but also causes the turbid qi to rise, leading to symptoms such as bad breath, abdominal distension and pain, or acid reflux, nausea, vomiting, etc.

9. The Small Intestine (Xiao Chang)

The small intestine is located in the abdomen, connecting to the stomach above through the pylorus and to the large intestine below through the ileocecal valve, forming a hollow tubular organ that is convoluted and coiled. Its main functions are:

1. Governing reception and transformation. Reception means to accept and contain. The small intestine receives food that has been initially digested by the stomach, serving as a container; it also allows the food to remain in the small intestine for a period to facilitate further digestion and absorption. Transformation refers to the digestion and absorption of the chyme, converting food into essence. If the small intestine’s functions of reception and transformation are impaired, symptoms such as abdominal distension, abdominal pain, diarrhea, or loose stools may occur.

2. Separating clear from turbid: Separation refers to the function of secretion and differentiation. The small intestine separates the clear essence from the turbid waste.

10. The Large Intestine (Da Chang)

The large intestine is located in the abdominal cavity, connecting to the small intestine above through the ileocecal valve and to the anus below, forming a tubular organ that is convoluted and coiled. The main function of the large intestine is to transmit and transform waste. Transmission refers to the conduction and transformation of waste. The large intestine receives the food residue passed down from the small intestine, absorbs excess water, and forms feces, which are expelled through the anus, hence the large intestine is known as the “transmission organ.” The large intestine’s transmission and transformation functions extend the stomach’s downward movement and are closely related to the spleen’s upward movement, the lung’s dispersing function, and the kidney’s qi transformation function. If the large intestine’s transmission is obstructed, it can lead to abnormal bowel movements, such as damp-heat in the large intestine, qi stagnation, resulting in abdominal pain and diarrhea, or if the large intestine is excessively hot, it can lead to dry stools and constipation; if the large intestine is cold and deficient, it can lead to loose stools and diarrhea.

11. The Bladder (Pang Guang)

The bladder is located in the lower abdomen, a hollow sac-like organ that connects to the kidneys above through the ureters and opens to the front yin through the urethra. The main function of the bladder is to store and excrete urine. Urine is transformed from body fluids, and its formation relies on the kidney’s qi transformation, which descends to the bladder and regulates its opening and closing, ultimately being expelled. Therefore, the bladder’s qi transformation function is based on the physiological foundation of the kidneys’ qi transformation. If the kidney and bladder’s qi transformation functions are abnormal, it can lead to urinary difficulties, such as frequent urination, urinary retention, urinary pain, or incontinence.

12. The Triple Burner (San Jiao)

The triple burner refers to the upper, middle, and lower burners, and is one of the six bowels. Among the organs, the triple burner is the largest, having a name but no physical form, hence it is called the “lonely bowel.” From a positional perspective, the area above the diaphragm is the upper burner, including the heart and lungs; the area below the diaphragm and above the navel is the middle burner, including the liver, gallbladder, spleen, and stomach; the area below the navel is the lower burner, including the large and small intestines, bladder, and kidneys. The triple burner is exteriorly related to the pericardium.

Its specific functions are:

1. Hosting various qi, governing the qi transformation activities of the body. The triple burner is the pathway for the body’s original qi. The original qi originates from the kidneys and must pass through the triple burner to be distributed throughout the body, stimulating and promoting the functional activities of various organs and tissues, thus maintaining the normal life activities of the body. The original qi is the driving force for the qi transformation activities of the organs, and the triple burner’s smooth flow of original qi is related to the normal functioning of the body’s qi transformation. Therefore, the triple burner “hosts various qi and governs the qi transformation activities of the body.”

2. Serving as the pathway for the body’s fluid movement. This means the triple burner has the role of unblocking the water pathways and facilitating the movement of fluids. Although the metabolism of body fluids relies on the cooperation of various organs, it must also depend on the smooth flow of the triple burner’s water pathways to proceed normally. If the triple burner’s water pathways are obstructed, the functions of the lungs, spleen, and kidneys in regulating fluid metabolism will be difficult to perform. Therefore, the triple burner plays an important role in fluid metabolism.

13. The Five Elements Theory

The relationships between the five organs:

The Five Elements generate one another:

For example, wood generates fire, meaning the liver (wood) assists the heart (fire); the liver stores blood, and the heart governs blood vessels. The liver’s blood storage function helps the heart’s blood vessel function. Fire generates earth, meaning the heart (fire) warms the spleen (earth); the heart governs blood vessels and spirit, while the spleen governs transportation and blood production. The heart’s blood vessel function is normal, allowing blood to nourish the spleen; thus, the spleen can perform its functions of transportation, blood production, and blood regulation. Earth generates metal, meaning the spleen (earth) benefits the lungs (metal); the spleen can enhance qi, transform qi and blood, and transport essence to nourish the lungs, promoting the lung’s function of governing qi. Metal generates water, meaning the lungs (metal) nourish the kidneys (water); the lungs govern clarity, while the kidneys govern essence storage. The lung’s qi dispersal assists the kidney’s essence storage, reception, and water regulation. Water generates wood, meaning the kidneys (water) nourish the liver (wood); the kidneys store essence, and the liver stores blood, while kidney essence can transform into liver blood, assisting the liver’s normal function. This interdependent relationship among the five organs is explained using the theory of the Five Elements.

14. The Relationships Between Organs

1. Heart and Lung: The heart governs blood, while the lungs govern qi. The maintenance of the functional activities of the body’s organs relies on the circulation of qi and blood to deliver nutrients. Although the normal flow of blood is governed by the heart, it must rely on the lung’s qi to promote it, and the ancestral qi stored in the lungs must be infused into the heart’s vessels to reach the entire body.

2. Heart and Liver: The heart is the driving force of blood circulation, while the liver is an important organ for storing blood. Therefore, when the heart’s blood is abundant, the liver’s blood storage is also full, which can nourish the tendons and promote the normal activities of the body’s limbs and bones. If the heart’s blood is deficient, it can lead to insufficient liver blood, resulting in symptoms such as muscle pain, hand and foot cramps, and convulsions. Conversely, if liver qi stagnates and transforms into fire, it can disturb the heart, leading to symptoms such as irritability and insomnia.

3. Heart and Spleen: The essence transformed by the spleen must rely on the flow of blood to be distributed throughout the body. The heart’s blood must also depend on the water and food essence absorbed and transported by the spleen. On the other hand, the heart governs blood, while the spleen regulates blood; the spleen’s normal function is essential for regulating blood. If the spleen qi is weak, it can lead to blood not circulating properly.

4. Heart and Kidney: The heart and kidneys interact and constrain each other to maintain a relative balance in physiological functions. Under physiological conditions, the heart’s yang continuously descends, while the kidney’s yin continuously ascends, intersecting and harmonizing, known as “the heart and kidney intersecting.” In pathological conditions, if kidney yin is insufficient and cannot ascend to the heart, it can lead to excessive heart yang, resulting in a loss of balance, known as “heart and kidney not intersecting.”

5. Liver and Spleen: The liver stores blood, while the spleen governs the transportation of food essence and blood production. If the spleen is deficient and affects blood production, it can lead to liver blood deficiency, resulting in symptoms such as dizziness, blurred vision, and unclear sight. The liver prefers smooth flow and dislikes stagnation; if liver qi stagnates and obstructs the spleen, it can lead to abdominal pain and diarrhea.

6. Liver and Lung: The liver’s meridians connect to the lungs, establishing a certain relationship. The liver’s qi rises, while the lung’s qi descends, affecting the rise and fall of qi in the body. If liver qi rises excessively, it can hinder the lung’s descent, leading to symptoms such as chest tightness and shortness of breath. If liver fire invades the lungs, it can lead to symptoms such as chest pain and coughing up blood.

7. Liver and Kidney: The kidneys store essence, while the liver stores blood. The liver blood relies on the nourishment of kidney essence, and kidney essence also requires continuous supplementation from the liver, making them interdependent and mutually nourishing. If kidney essence is insufficient, it can lead to liver blood deficiency. Conversely, if liver blood is deficient, it can affect the generation of kidney essence. If kidney yin is insufficient, it can lead to liver deficiency, resulting in symptoms such as dizziness, tinnitus, tremors, numbness, and convulsions.

8. Lung and Spleen: The spleen transports the essence of food and sends it to the lungs, combining with the qi inhaled by the lungs to form ancestral qi (also known as lung qi). The strength of lung qi is related to the spleen’s ability to transform essence, so when the spleen qi is strong, the lung qi is abundant. If the spleen is deficient and affects the lungs, symptoms such as pale complexion, lack of speech, poor appetite, cough, and loose stools may occur. In clinical practice, the method of “tonifying the spleen and benefiting the lungs” is often used for treatment. For example, in cases of chronic cough with abundant thin white phlegm, easy to expectorate, fatigue, and poor appetite, although the disease is in the lungs, the root cause lies in the spleen, thus the method of “strengthening the spleen and drying dampness to resolve phlegm” must be employed for effectiveness. The saying goes, “The lungs are the container for phlegm, while the spleen is the source of phlegm,” which reflects the relationship between the spleen and lungs.

9. Spleen and Kidney: The spleen yang relies on the kidney yang’s warmth to function properly. If kidney yang is insufficient, it can lead to spleen yang deficiency, resulting in symptoms such as morning diarrhea, undigested food, and edema. Conversely, if spleen yang is weak, it can also lead to kidney yang deficiency, resulting in symptoms such as coldness in the lower back, water retention, and abdominal swelling.

10. Lung and Kidney: (1) From the perspective of fluid metabolism, the kidney’s meridians connect to the lungs, managing the three burners. The upper burner relies on the lung’s regulation, the lower burner relies on the kidney’s opening and closing, and the middle burner relies on the spleen’s transformation, thus the lungs, spleen, and kidneys are closely related in fluid metabolism. If one organ’s function is impaired, it can lead to fluid retention and edema. (2) From the perspective of qi, the lungs govern respiration while the kidneys govern the reception of qi; both organs work together to maintain the rise and fall of qi in the body.

11. Heart and Kidney: The heart and kidneys interact and constrain each other to maintain a relative balance in physiological functions, known as “the heart and kidney intersecting.” If kidney yin is insufficient and heart fire is excessive, it can lead to symptoms such as forgetfulness, insomnia, palpitations, and nocturnal emissions.

The heart and kidneys also have another physiological and pathological relationship, which is the interaction of heart yang and kidney yang, promoting each other. When the heart’s yang is sufficient, it indicates smooth blood circulation; if the kidney’s original yang is weak (the fire of life is weak), it can lead to heart deficiency; conversely, heart deficiency can also affect kidney yang deficiency.

12. Heart and Liver: The heart is the center of blood circulation, while the liver is an important organ for storing blood. Therefore, when the heart’s blood is abundant, the liver’s blood is also stored adequately, which can nourish the tendons and promote the normal activities of the body and limbs. If blood is insufficient and excessively consumed, leading to blood deficiency in the liver, it can result in symptoms such as muscle cramps, hand and foot spasms, and convulsions, indicating pathological changes caused by excessive consumption of heart blood and insufficient nourishment of the liver.

13. Heart and Spleen: The spleen’s transportation function requires the promotion of heart yang, while the generation of heart blood must rely on the water and food essence absorbed and transported by the spleen. On the other hand, the heart governs blood while the spleen regulates blood; the spleen’s normal function is essential for regulating blood. If spleen yang is weak, it can lead to blood not circulating properly.

14. Liver and Spleen: The liver stores blood, while the spleen governs the transportation of food essence and blood production. If the spleen is deficient and affects blood production, it can lead to liver blood deficiency, resulting in symptoms such as dizziness, blurred vision, and unclear sight.

15. Spleen and Lung: The lung qi’s strength relies on the supply of food essence from the spleen, and the qi of food and drink is closely related to the spleen’s transformation. Therefore, when the spleen is deficient and affects the lungs, symptoms such as pale complexion, lack of speech, poor appetite, cough, and loose stools may occur. In clinical practice, the method of “tonifying the spleen and benefiting the lungs” is often used for treatment. For example, in cases of chronic cough with abundant thin white phlegm, easy to expectorate, fatigue, and poor appetite, although the disease is in the lungs, the root cause lies in the spleen, thus the method of “strengthening the spleen and drying dampness to resolve phlegm” must be employed for effectiveness. The saying goes, “The lungs are the container for phlegm, while the spleen is the source of phlegm,” which reflects the relationship between the spleen and lungs.

16. Spleen and Kidney: The spleen yang relies on the kidney yang’s warmth to function properly. If kidney yang is insufficient, it can lead to spleen yang deficiency, resulting in symptoms such as abdominal cold pain, diarrhea, and water retention. Conversely, if spleen yang is weak, it can also lead to kidney yang deficiency, resulting in symptoms such as coldness in the lower back, water retention, and abdominal swelling.

17. Lung and Liver: When liver fire is excessive, it can scorch the lungs, leading to symptoms such as dry cough or blood-streaked phlegm, chest pain, and irritability; if liver qi rises excessively, it can also affect the lung’s descent, leading to symptoms such as chest tightness and shortness of breath.

18. Kidney and Liver: The kidneys store essence, while the liver relies on kidney essence for nourishment to maintain its normal function. If kidney yin is insufficient, it can lead to liver deficiency, resulting in symptoms such as dizziness, tinnitus, tremors, numbness, and convulsions. Often, both the liver and kidneys are treated together using methods to nourish the kidneys and liver for effective results.

19. Kidney and Lung: (1) From the perspective of fluid metabolism, the kidney’s meridians connect to the lungs, managing the three burners. The upper burner relies on the lung’s regulation, the lower burner relies on the kidney’s opening and closing, and the middle burner relies on the spleen’s transformation, thus the lungs, spleen, and kidneys are closely related in fluid metabolism. If one organ’s function is impaired, it can lead to fluid retention and edema. (2) From the perspective of qi, the lungs govern respiration while the kidneys govern the reception of qi; both organs work together to maintain the rise and fall of qi in the body.

13. The Relationships Between the Six Bowels

The six bowels are the organs that conduct food and drink; they both have distinct functions and cooperate to complete the processes of receiving, digesting, absorbing, conducting, and excreting food.

14. The Relationship Between Organs and Bowels

1. Heart and Small Intestine: The meridians connect, and they are mutually interdependent. If the heart has heat, it can lead to mouth and tongue ulcers. If the heart’s heat transfers to the small intestine, it can lead to symptoms such as short, red urine and painful urination.

2. Liver and Gallbladder: The gallbladder is attached to the liver, and the organs are interconnected, forming a mutual relationship. Bile originates from the liver; if the liver’s smooth flow is abnormal, it will affect the normal excretion of bile. Conversely, if bile excretion is abnormal, it will also affect the liver. Therefore, liver and gallbladder symptoms often occur simultaneously, such as jaundice, side pain, bitterness in the mouth, and dizziness.

3. Spleen and Stomach: In terms of characteristics, the spleen prefers dryness and dislikes dampness, while the stomach prefers moisture and dislikes dryness. The spleen governs upward movement, while the stomach governs downward movement. In terms of physiological functions, the stomach is the sea of food and drink, governing digestion; the spleen governs the transportation of fluids and essence. The two work together to complete the transformation of food and drink. If the spleen qi does not rise, the stomach qi will not descend, leading to symptoms such as poor appetite, nausea, abdominal distension, and constipation; if the diet is irregular, causing the stomach to lose its harmony, it will affect the spleen’s upward movement, leading to symptoms such as abdominal distension and diarrhea.

15. The Practical Significance

The theory of the interrelationship between organs and bowels also has practical significance in acupuncture treatment: For example, asthma related to the hand taiyin lung meridian is often treated with the hand yangming meridian’s Hegu point, while the foot yangming stomach meridian is often treated with the foot taiyin spleen meridian’s Yinlingquan point, achieving satisfactory results. These treatments are based on the theory of the interconnection of the organs and bowels through meridians.

16. The Importance of the Spleen and Stomach

The human body is an organic whole composed of organs, meridians, skin, muscles, tendons, bones, essence, and qi and blood. The theory of organs studies the physiological functions and pathological changes of the body’s organs and their interrelationships. The organs include the heart, liver, spleen, lungs, and kidneys, known as the five organs. Additionally, the pericardium is located around the heart, containing meridians, serving as a pathway for qi and blood, and protecting the heart, thus it is also referred to as an organ. The bowels include the gallbladder, stomach, small intestine, large intestine, bladder, and triple burner, known as the six bowels.

The organs are the main organs for generating essence, blood, and body fluids, promoting metabolism, and maintaining the body’s functional activities. Specifically, the five organs are responsible for storing essence (essence refers to blood and body fluids), while the six bowels are responsible for receiving, digesting, absorbing, conducting, and excreting food. Thus, the organs primarily focus on storage, while the bowels focus on conduction.

The relationships between the organs and bowels, whether between organs or between bowels, or between organs and bowels, are all interconnected. The five organs are also closely related to the five body structures and the five senses and seven orifices. The relationship between the five organs and the five body structures is as follows: the heart governs the vessels, the liver governs the tendons, the spleen governs the muscles, the lungs govern the skin, and the kidneys govern the bones. The relationship between the five organs and the five senses and seven orifices is that the heart opens to the tongue, the liver opens to the eyes, the spleen opens to the mouth, the lungs open to the nose, and the kidneys open to the ears and the two yin (the nose, eyes, and ears each have two openings, along with the front and back yin, making a total of nine openings). Because the five organs are related to the five body structures and the five senses and seven orifices, changes in the five organs often reflect on the corresponding body structures and orifices.

TCM’s understanding of organ functions and diseases has been somewhat rough due to historical limitations. In TCM, the concept of “organs” is not only anatomical but also a physiological and pathological concept, so the concept of “organs” in traditional Chinese medicine differs from the concept of “organs” in modern medicine. For example, in TCM, the “heart” does not completely equate to the modern medical heart; it represents not only the anatomical heart but also includes the functions of some organs in the circulatory and nervous systems in physiology. When studying traditional Chinese medicine, we should adopt a dialectical materialist perspective, combine it with modern medicine, grasp its essence for analysis and research, and contribute to the creation of a unified new medicine in our country.

17. Yin: The triple burner

The interconnections between the organs through meridians and the infusion of qi and blood form an organic whole. In physiological states, they work both independently and cooperatively, constituting complex physiological activities. In pathological states, they also influence each other. Therefore, their relationships can be reflected in physiological and pathological changes. Mastering these theories of organ relationships has certain guiding significance for clinical diagnosis and treatment.

Reference: “Traditional Chinese Medicine Dictionary”

Appendix: Diagram of the Eight Major Systems:

1. Digestive System

The digestive system includes the mouth, throat, esophagus, stomach, intestines, and digestive glands.

Reason: The first major barrier to digestion is the stomach, followed by the intestines. If the stomach and intestines are damaged, it will affect the absorption of nutrients from food, preventing various organs from receiving sufficient nutrients, leading to the decline and disease of other systems. Common diseases include stomach distension, disordered gastric acid secretion, gastric ulcers, chronic gastritis, duodenal ulcers, intestinal inflammation, hemorrhoids, etc.

2. Immune System

The immune system includes tears, mucous membranes, lymph nodes, liver, spleen, etc.

Reason: Due to prolonged nutritional deficiencies, zinc, iron, selenium, etc., cannot be absorbed normally, leading to damage to the immune system. Common diseases include frequent colds, shoulder pain, low back pain, lymph node pain, swollen lymph nodes, skin dark spots, and weak constitution.

3. Respiratory System

The respiratory system includes the nose, throat, trachea, bronchi, lungs, pleura, and mediastinum.

Reason: When the immune system is damaged, the respiratory tract becomes blocked, and a large amount of toxins cannot be effectively expelled through the respiratory tract, accumulating in weak areas of the respiratory tract. This system begins to show signs of lung function decline, bronchitis, and accumulation of waste in the lungs. Common diseases include asthma, pneumonia, lung deficiency, tuberculosis, upper respiratory infections, and lower respiratory infections.

4. Nervous System

The nervous system includes the brainstem, diencephalon, cerebellum, cerebrum, spinal cord, cranial nerves, autonomic nerves, and spinal nerves.

Reason: When the immune system and respiratory system cannot guarantee nutrition, the protective ability of the nervous system weakens, leading to damage and decline of the nervous system. Common diseases include excessive stress, irritability, anger, insomnia, negativity, neurasthenia, depression, and neuropathic pain.

5. Circulatory System

The circulatory system includes the heart, arteries, veins, blood, and lymphatic system.

Reason: When the nervous system is disordered, the response to nutritional needs is slow, and the circulatory system’s ability to detoxify weakens, leading to damage and destruction of the circulatory system. Common diseases include microcirculation disorders, low blood pressure, high blood lipids, anemia, stroke, arrhythmia, and heart disease.

6. Endocrine System

The endocrine system includes the pituitary gland, thyroid, parathyroid, adrenal glands, pancreas, gonads, and thymus.

Reason: When the circulatory system is disordered, the balance of the endocrine system decreases, leading to disturbances in blood sugar, impaired insulin function, and hormonal imbalances. Common diseases include acne, hormonal disorders, hyperthyroidism, kidney deficiency, uterine fibroids, insulin dysfunction, and diabetes.

7. Urinary and Reproductive System

The urinary and reproductive system includes the kidneys, ureters, bladder, urethra, and male and female reproductive systems.

Reason: When the urinary system is damaged, its balance decreases, leading to kidney function decline and prostate disorders. Common diseases include kidney deficiency, frequent urination, urinary stones, cystitis, and prostate diseases.

8. Skeletal System

The skeletal system includes bones, joints, and skeletal structures.

Reason: When the above systems and the urinary system are damaged, the skeletal system’s balance decreases, and diseases can invade the deep bone tissues, leading to increased bone cell proliferation, excessive calcium loss, and damage to collagen in the joints, resulting in osteoporosis and hyperplasia. Common diseases include osteoporosis, calcium deficiency, bone hyperplasia, lumbar hyperplasia, arthritis, and periostitis.

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