The Basic of Visceral Manifestation Theory
1. Ancient Anatomical Knowledge
Anatomy is the elemental knowledge of traditional Chinese medicine. The Yellow
Emperor's Internal Classic contains numerous records regarding the dissection of the human body especially the blood circulation system. It not only describes the formation, nature and function of the blood, but also explains the source which provides the blood ability to circulate and the hearts ability to pump that blood. Discussed are the organs to which the blood travels, and the rate at which it is pumped. In addition, the size,length, volume, and weight, as well as the shape, and linear measurements of some of the viscera are also recorded in the Classic on Medical Problems. During the Qing dynasty, Dr. Wang Qingren wrote the Correction of Medical Classic. It was through the observation of human cadavers, and of their internal organs that Dr. Wang Qingren verified existing anatomical records of his predecessors, including more than 20 picture illustrations. Despite a few errors, Dr. Wang's scientific attitude is highly commendable.
Owing to the limitation of the historical condition, as well as the level of science, ancient doctors acquired only a superficial knowledge of the structure of the body. Because they were limited to naked eye observation, doctors were confined to knowledge of only macro-structures, far less than the anatomical composition known today. Moreover, the influence of feudal ethics hindered the further development of the science of anatomy. Despite this, anatomical knowledge did play an integral role in the formation of the visceral manifestation theory, and laid a scientific foundation in morphology.
2. A Long-term Observation of Physiological and Pathological Phenomena
In accordance with the theory of the "understanding interior change from the exterior phenomena" from the Internal Classic, ancient medical practitioners were engaged in a lengthy and careful observation of the external manifestations of the physiological and pathological phenomena of the human body. Gradually, the laws of the physiology and pathology were realized. For example, it was discovered that people with weak constitutions and with an aversion to wind and cold, perspire more, and are more susceptible to illness caused by the exogenous evils in daily life. Through long-term observation, analysis and synthesis, it was concluded that a type of "defence-qi" is disseminated along the exterior of the body and performs the role of muscular protection, guarding against exogenous evils. Generally, it is not easy to be attacked by exogenous evils when awake or moving about. On the contrary, one may catch a cold while sleeping. Thus, it is clear that the circulation of defense-qi is closely related to the awake or sleep state, and therefore defense-qi circulates at night and is the yin aspect, while during the day it is the yang aspect. Another example is that anxiety often produces poor appetite, dyspepsia, abdominal distention, fullness, etc. Long-term observation of this correlation led ancient Chinese to connect "pensiveness", mental stress, to the digestive function of the spleen.Hence, the viewpoints of "The spleen dominates pensiveness", and "Excessive pensiveness injures the spleen", were held.
3. The Accumulation of Clinical Experiences
During the long period of fight against disease, it was observed that certain pathological phenomena are related to the dysfunction of viscera. This recognition had been tested and verified through clinical practice, and further deduced by physiological functions of certain organs and their pathological changes. Thus, the visceral manifestation theory was gradually established through repeated practice, synthesis and analysis. One example is that lung disease often manifests itself through a stuffed nose, and nasal discharge,which can be successfully treated from the Lung Meridian. Eventually ancient medical practitioners concluded that the lung has a connection with the nose. As a final example,many herbs for reinforcing the kidney can also accelerate the healing of bone fractures.This derived the saying that "The kidney dominates the bone", and it was further deduced that the kidney has a physiological role in promoting the growth and development of bones.
It is necessary to further explain that TCM pays a great deal more attention to the observation of living bodies from the philosophy of holism. It also holds that anatomy can not completely reflect functional changes of the living body, for it is only through the study of dead viscera and tissues that anatomical science is formed. Therefore, the formation of the visceral manifestation theory is established on the premises of the three aspects stated above, but "physiological changes" and "pathological phenomena" can better reflect the essence of the viscera and provide the basis of the theory.
