The Relationships Between the Zang-Viscera and Fu-Viscera
1. The Heart and the Small Intestine
The Heart Meridian pertains to the heart and connects with the small intestine,
while the Small Intestine Meridian pertains to the small intestine and connects with the heart, thus forming their interior-exterior relationship. This connection is obvious pathologically. For example, excessive fire of the heart may transmit to the small intestine,leading to a burning sensation during urination, oliguria, deep yellow urine, or even dysuria. Such a condition is termed "excessive heart-fire transmitting to the small intestine. " Conversely, excessive heat in the small intestine may also go upward along the meridian to affect the Heart Meridian, giving rise to flaring up of heart-fire, and resulting in manifestations as mental restlessness, erosion and lesions in the oral cavity and tongue,etc. In treating these conditions, the method of clearing up heart-fire and promoting diureses is usually applied.
2. The Lung and the Large Intestine
The exterior-interior relationship between the lung and large intestine is formed by inter-connection of their meridians. They cooperate in their physiological functions. The lung is located in the upper-jiao and has the function of depurative descending. When the lung keeps its qi flowing downward, the function of the large intestine in transmission will be normal, and the movement of the fu-viscera will be free. The large intestine is 10cated in the lower-jiao, and the patency of the large intestine qi benefits depurative descending of lung-qi and maintains an even and smooth respiration.
The lung and large intestine work in coordination in physiology and inter-influencing in pathology. For example, when the lung is diseased, the depurative descending function will be abnormal, and the functional activities of qi will also become abnormal. This causes a failure to send body fluids downwards, and causes the large intestine to be lacking in moisture and to fail to perform its transmission, thus producing constipation, and difficult bowel movement. Conversely, dysfunction of the large intestine in transmission may affect the function of the lung in depurative descending, and cause lung-qi to fail to deseend, or even to rush up, leading to fullness in the chest, cough, asthma, and breathing with difficulty. In treating these conditions, consideration must be given to both the lung and large intestine. In the treatment of lung disease, free movement of the large intestine-qi is often taken into consideration. In treating disorders of the large intestine, the dispersion and descent of the lung-qi should be examined. This may enhance the therapeutic effect in clinical practice.
3. The Spleen and the Stomach
Both the spleen and stomach are located in the middle-jiao and are inter-connected by meridians, forming an exterior-interior relationship. Physiologically, they share the work and coordinate to maintain the normal digestive function, the relationship between the spleen and stomach is manifested in the following:
1) Coordination of Ingestion and Transportation and Transformation
The stomach has the function of taking in and digesting food into chyme, and thus provides the material basis for transportation and transformation of the spleen. The spleen transports, transforms, and distributes the essential substance to the entire body,and this function adapts to the stomach's continuing capacity for food intake. As both organs function in close cooperation in performing digestive activity, they affect each other in pathology. For example, if the stomach's digestive function is impaired, the spleen is left with fewer raw materials from which to form qi and blood, giving rise to poor appetite and an unpleasant and hungry sensation in the stomach. Dysfunction of the spleen in transportation and transformation may attack the digestive function of the stomach,leading to abdominal distension after eating, loss of appetite, belching and loose stools,and so on.
2) Complementary of Ascending and Descending
The spleen dominates ascending, while the stomach dominates descending. The former distributes clear-yang and the essential substance of drink and food up to the heart and lung. The latter sends digesting food down to the small intestine, and in a broader sense, to down-flow throughout the whole of the digestive tract. Hence, the two organs work in harmony to guarantee a normal digestive function. The spleen is in charge of sending up the clear, while the stomach is in charge of sending the turbid downwards,which are opposing, yet complementing functions. Failure of the clear qi to send upward may impair the sending downward of the turbid qi. Similarly, failure of the turbid qi to send downward may affect the sending up of clear qi. Failure of the spleen in sending up the clear can lead to the fall of the middle-qi, characterized by abdominal distension, diarrhea, and prolapse of rectum. In this case, the stomach-qi goes upwards instead of downwards, and there may be nausea, vomiting, hiccups, and abdominal distension. Therapeutic efforts should aim at strengthening the spleen and harmonizing the stomach.
3) Adjustment of Dryness and Dampness
The spleen likes dryness and dislikes dampness. The stomach likes moistness and
dislikes dryness. The spleen belongs to the yin organs, and transports and transforms
water and dampness, which is particularly susceptible to invasion by the damp evil. When dampevil invades the spleen, it may impair the function of transportation and transformation, and in turn, it may easily produce phlegm-dampness, in which case the spleen is said to be encumbered by damp. The stomach, on the other hand, pertains to yang and has the function of ingestion and decomposition, which is vulnerable to dryness-heat evil.When dryness:heat evil invades the stomach, it consumes fluids in the stomach. Only when the spleen-dryness and the stomach-dampness are in coordination with each other can yin and yang of the spleen and stomach be kept in balance, ensuring a flourishing state of the digestive function. In summary, the spleen and the stomach are closely related, and the coordination of the stomach's reception and the spleen's transportation, the complementary nature of the spleen's ascending and the stomach's descending, and the adjustment of dryness and dampness all are of particular importance in the digestive process. Disruption of this balance constitutes a primary cause of digestive disturbances, and its restoration figures frequently in the treatment of spleen and stomach disorders.
4. The Liver and the Gallbladder
The liver is located on the right side beneath the diaphragm, and the gallbladder is attached to the undersurface of the right hepatic lobe. They are externally-internally related through the meridians. The bile originates from the liver, the liver dominates the conducting and dispersing functions, and generates the surplus liver-qi that collects in the gallbladder to form bile. The gallbladder is in charge of the storage and excretion of bile.Thus the liver is closely related to the gallbladder in secretion, storage, and excretion of bile, all of which relates to the digestive function. The two organs not only act in coordination with each other physiologically, but also affect each other in pathology. For example, failure of the liver in conducting and dispersing may lead to the dysfunction of the gallbladder tract and affect the excretion of bile. On the other hand, impairment of the gallbladder may cause obstruction of bile discharge, and affect the functional activity of liver-qi, leading to pain in the chest and hypochondrium, bitter taste in the mouth, and so on. In clinical practice, syndrome differentiation of the liver and gallbladder cannot be completely separated, because their clinical manifestations usually appear simultaneously. Taking damp-heat syndrome of the liver and gallbladder as an example, there may be jaundice and a bitter taste in the mouth, among other symptoms.
In addition, the liver dominates stratagem, the gallbladder dominates decision-making. Only when both are in coordination can the physiological function of mental activity and judgment be normal.
5. The Kidney and the Bladder
The kidney is located in the lumbar region, while the bladder is located in the lower abdomen. They are connected by their meridians to form the exterior-interior relationship. The kidney is a zang-viscus that dominates the water metabolism running through its entire process. The bladder is a fu-viscus that serves to store and excrete urine. However, the bladder's function of opening and closing relies on the transformative function of kidney-qi When the kidney essential qi is sufficient, the retentive power of kidney qi will be normal, and the bladder will open and close regularly to maintain the normal function of excreting urine. When kidney essential qi is deficient, the dysfunction of the transformative function of kidney-qi will lead to an irregular opening and closing of the bladder, resulting in disturbance of water metabolism, dysuria, incontinence of urine, and enuresis.
According to clinical practice, pathological changes of the kidney and bladder often affect each other. In dealing with these conditions, consideration must be given to both of them. Generally, syndromes of excess are mostly attributable to the bladder, and the treatment of the bladder is taken as a main approach. Syndromes of deficiency are mostly attributable to the kidney, and treatment often focuses on reinforcing the kidney.
