The internal organ network is at the highest level of function in the body. They are like the headquarters in our bodies. They supply vital instructions to our entire body to allow us to function. Without properly functioning viscera, the qi, blood, shen, and jing would become pathogenic. In TCM, one of the most crucial concepts to grasp is this organ system. A practitioner would be performing treatment blindly if they didn’t understand this concept. All of TCM diagnostics is based on how these organs are functioning. So, proper knowledge of the organs is a necessity for successful treatments in TCM. This section will explore all the functional aspects of the internal organ network. It is important to note the term network. This term denotes it connection between all organs and there pathways. It also shows how one organ and associated pathway can affect another, either positively or negatively when it becomes diseased. In practice it is rare that only one organ is involved. Not only is a solid background in organ functions and physiology needed, but their connection to each other as well. The Wu Xing – Five Element Theory wonderfully shows how everything is connected, as you can see on the Five Element page.
The lungs are considered the most vulnerable internal organ because they come in direct contact with the external environment. The Lungs are usually the first internal organ to be attacked by the six pernicious influences – wind, heat, cold, dampness, dryness, and fire. It is considered the barrier from the exterior. The functions of the Lungs include – Control Breathing, Governs Qi
Control Channels and Blood Vessels, The Regulation of Water Passages, Regulate the Descending and Dispersing Actions in the Body, Control t he Skin and Hair, Open to the Nose, and Control the Emotions of Grief and Sadness.
Control Breathing – The function of breathing greatly parallels that of the western model. In TCM the lungs control the inhalation of clean, pure air (Qi) and exhales the dirty air (Qi). The role of extracting pure from impure make the lungs the most susceptible to contact with the external world.
Governs Qi – As we have established before in the discussion of Qi, the lungs extract clean, pure Qi from the air we breath and combine it with refined food Qi to make true Zen Qi – the Qi that flows in the meridians and resides in the internal organs. After the formation of Qi, the Lungs spread the Qi all over the body, nourishing all the organs and tissues, thus promoting all physiological functions. Therefore, it is said that the Lungs govern Qi.
Control Channels and Blood Vessels – As we have just established, the Lung controls the Qi, which, in turn allows the flow of Blood. Therefore, the Lungs play a crucial role in the circulation of Blood in the blood vessels. Any pathology in the Lungs, such as a deficiency, can eventually lead to stagnation of Blood.
In the discussion of Qi and the vital substances, we established the formation of Qi is a product of Gu Qi From the Spleen and Zong Qi from the Lungs. Therefore the Lungs are said to govern the Qi in the entire body.
When the Lung Zang is strong and the Qi is abundant, Qi and Blood circulate evenly throughout the body and the limbs will be warm. However, when the Lung Qi is weak, it will not be able to push the Blood and will result in cold limbs and especially hands.
The Regulation of Water Passages – The Lungs are said to control the water passages and assure bodily fluids are dispersed evenly throughout the body. When the Lungs receive the refined fluids from the Spleen, they transform the fluids into a fine mist and then proceed to spread them throughout the body. When the Lungs are healthy this process runs smoothly. When there is impairment of Lung Qi, fluids will tend to accumulate giving rise to edema.
Regulate the Descending and Dispersing Actions in the Body – The Lungs are responsible for the dispersing of the Wei Qi (Defensive Qi) and body fluids throughout the body, especially the superficial body. When the Lungs are healthy, they assure the body from the external pernicious influences – wind, cold, heat, dampness, dryness, and fire by dispersing Wei Qi to the body. When the Lung Qi is weak, the Wei Qi will not be able to reach the skin and our protective barrier is broken and a cold can follow. If the external pathogen is Wind-Cold, it obstructs the skin and you feel blocked. This can lead to symptoms such as headache, stuffed nose, and sneezing.
The lungs are the outer most Zang and therefore have a natural descending nature. The Lungs direct the Qi downward to the lower most Zang, the Kidneys. This connection is important because between the two viscera our respiration is determined. The Lungs are responsible for the exhalation, and the Kidneys are responsible for the inhalation. When the descending nature of the Lungs are impaired, there will be symptoms such as coughing, chest congestion, and asthma.
Control the Skin and Hair – We can now appreciate the vital role of ensuring the flow of Qi and fluids through the body. When the Lungs are healthy, they receive fluids from the Spleen and then spread them throughout the body and the skin. This allows the skin and hair the nourishment it needs to be moist and healthy. When the Lung Qi is impaired, the skin and hair can become rough and dry. It is important to note that the head hair is mostly related to the Kidney Zang and general, body hair is that of the Lung Zang.
Open to the Nose – All internal visceral organs are said to open in a particular orifice. The Lungs are said to open into the nose. Therefore any condition of the nose and nasal passages are directly linked to the Lungs.
Control the Emotions of Grief and Sadness – The emotions play a key role in the diagnosis and treatment on TCM. Each internal organ is believed to control and manifest a particular emotion. The emotion that the Lungs govern is grief and sadness.
Zang Viscera Emotion
Lung Grief and Sadness
Spleen Worry and Pensiveness
Kidneys Fear and Shock
Liver Anger and Resentment
The Spleen is located in the middle jiao. Its associated Fu organ is the Stomach. Out of all the internal organs, the Spleen has the most different role to the western counterpart. In the western standpoint, the Spleen is viewed as large lymph node, filtering the blood. It also plays an important role in the production and storage of blood. In TCM, the Spleen plays the crucial role in the health and vitality of the body. The Spleen is solely responsible for the digestion, assimilation, and the separation of nutrients. The separation of nutrients is the basis of Qi and Blood for the body. This is the primary function of the Spleen. Here are the functions of the Spleen – Governs the Transportation and Transformation, Contains the Blood, Dominate the Muscles and Four Limbs, Open in the Mouth, Manifests in the Lips, Controls the Raising of Qi, Houses the Thought, and Controls the Emotion of Worry and Pensiveness.
Governs the Transportation and Transformation – The Spleen is the primary internal organ for digestion. When the food is ingested it is transported to the Stomach. The Spleen then transforms the stored food into nutrients and waste, or refined (Gu –Qi) and dirty. The refined Qi is then directed to the Lungs (Zong – Qi) and Heart to produce True Qi (Zen Qi) and Blood (Xue).
The Spleen also transports and transforms body fluids. When there is Spleen impairment, accumulation of fluids will follow leading to internal Dampness. This leads to body edema, obesity, and phlegm diseases.
When the Spleen Zang is healthy, there is good appetite, digestion, energy, and muscle function. When it is impaired, it will soon lead to fatigue, diarrhea, and lack of appetite, poor digestion, and abdominal distension.
Contains the Blood – The Spleen is said to hold or control the Blood in the blood vessels so that it can circulate throughout the body. When the Spleen is healthy, there will be ample Blood flow as well as the production of Blood will be strong. If the Spleen is weakened, it will fail to control the blood and the loss of holding function will lead to forms of hemorrhaging, such as uterine bleeding, blood in the stool, and bloody nose.
Dominate the Muscles and Four Limbs - When the Spleen is optimal, its transformation and transportation of food and water nourishes all the muscles and four limbs. However, when there is impaired Spleen Qi there will be inadequate nourishment and the muscles will be weak and without form. The four limbs of the body will also be weak and lack full strength.
Open in the Mouth - The mouth is the beginning journey for the transformation and transportation of food into Qi. The mouth has a very important role the preparation and digestion of food. This function is the sole responsibility of the Spleen. It is said that the Spleen vital functions start at the mouth. The Spleen opens at the mouth. When the Spleen is healthy there will be a good appetite and taste of foods will be normal. If the Spleen is impaired the sense of taste will be malfunctioning. There will be a sweetish taste in the mouth do to the dampness that is brought by the impaired Spleen.
Manifests in the Lips - The lips are said to be the reflection of the condition of the Spleen. The condition of the lips expresses the Spleen’s function of transportation and transforming of water and food. When the Spleen is healthy, there will be fully flowing flow of Qi and Blood and the lips will be red and moist. When there is impairment of the Spleen, there will be pale and dry lips.
Controls the Raising of Qi – It is said that the Spleen has a general raising quality of Qi. The Spleen is located in the middle jiao and therefore has a lifting function on the Qi from the midline. Therefore, the Spleen has a holding function that holds all the internal organs in place. In ancient classics, the Chinese refer the Spleen as the Center (Zhong) organ. When there is impairment of Spleen Qi, there will be possible prolapse of internal structures such as hemorrhoids, prolapsed anus, and prolapsed uterus.
Houses the Thought – Because of the raising function of the Spleen, Qi and blood nourishes the head and brain, thus yielding clear thought and a sense of well being. When the Spleen is impaired, it will lead to mental and psychological blockage and the thought process is cloudy.
Controls the Emotion of Worry and Pensiveness – The emotion associated with the Spleen is worry and pensiveness. When there is excess worry in ones life it can have a damaging effect on the Spleen. The Spleen will become weak and dampness will sure to follow. Pensiveness is another emotion that the Spleen harbors. Too much obsessive behavior such as studying to intensely will also damage the Spleen.
The heart is located in the upper jiao and is paired with Small Intestine. The Heart is known as the ruler of all internal organs. Its functions parallel that of the west, which is pumping Blood through the blood vessels nourishing the internal organs and body. However, in TCM the Heart has more function. It has the important function of controlling the mind and the spirit (Shen). Here are some of the functions of the Heart – Governs Blood, Controls Blood Vessels, Houses the Shen, Manifests in the Complexion, Opens to the Tongue, Controls Sweat, and the Emotion that it Controls is that of Joy.
Governs Blood – This parallels the function in the west. The Heart regulates the blood flow in the blood vessels. This is very important function that is crucial for the health and well being of ones constitution. When there is optimal and balanced blood flow all the internal organs are nourished and the body is warmed comfortably and evenly. When there is impairment of Heart Qi, the body’s temperature will be cold and the extremities will be chilled. In very serious weaknesses, there can be Heart related chest pains.
Controls Blood Vessels – In TCM the blood vessels are an extension of the Heart itself. Any impairment of the Heart is an impairment in the blood vessels. Optimal functioning Heart Qi leads to proper circulation, and impaired Heart Qi leads to pathology of the blood vessels, such as arteriosclerosis.
Houses the Shen – As we have established earlier the concept of Shen is complex and vast. Shen is viewed as the mental, psychological, and spiritual properties of the body that builds the foundation of our constitution. It is safe to state that the Shen precipitates our personalities that make use unique. The heart houses the Shen and is also under the direct control of the Heart (Xin Cang Mai). When our Heart is optimally functioning our spirits are high and the constitution is strong. When the Heart is impaired, the Shen can be disturbed and this can lead to a range of mental and psychological imbalances.
Manifests in the Complexion – The function of the smooth flow of Blood throughout the body and blood vessels assures the outward appearance. It is said that the Heart can be assessed by the outward complexion of the body. A healthy Heart will lead to nicely rosy and moist appearance. When there is impairment, the complexion will be dull and almost lifeless. In extreme conditions of Heart impairment, there will be stagnation of blood and the complexion will appear purple or bluish.
Opens to the Tongue – In ancient classics, it is said that the tongue is a reflection of the Heart (Xin Kai Qiao Yu She). As we will explore in TCM diagnosis, the tongue is a diagnostic map of the internal organs. The heart reflects the overall tongue appearance and specifically is expressed in the tip of the tongue. If the Heart is impaired, the overall tongue will appear pale and if there is stagnation of blood the tongue will appear purple.
Controls Sweat – Blood (Xue) and Body Fluids (Jin Ye) have a common origin according to TCM theory. The sweat is one of the bodily fluids that originate between the muscles and skin. There is a continuous interchange between the two fluids. When the Heart Blood is too thick, the bodily fluids will enter the blood vessels and balance the Blood. Therefore, it is known that Heart governs Blood and this mutual communication with body fluids leads to the fact that the Heart pertains to sweat. A weakness in Heart Qi can lead to spontaneous sweating. A Heart Yin deficiency can lead to night sweats. Heavy loss of body fluids can also deplete Heart Blood and produce Heart Blood deficiency.
Emotion that it Controls is that of Joy – The emotion associated with the Heart is that of joy and happiness. A happy and joyous attitude in life is a direct reflection of Heart Zang. However, over joyous emotions can have a damaging effect. It is important to remember that in TCM a healthy balance it key to ones constitution and health. Even too much joy can be inappropriate, believe it or not. Disharmony of Heart Qi can reflect in depression and an overall negative or pessimistic view on life.
Physically the Liver is positioned in the right hypochondriac region and is located in the middle jiao. Its paired Fu organ is the Gall Bladder. In TCM the liver plays a very vital in physiology. It is said that the Liver is the controls the interior and the entire body (Gan Zhu Yi Shen Zhi Li). The Liver had the important function of assuring the smooth flow of Qi throughout the entire body. The functions of the Liver include – Storage of Blood, Control of Qi Throughout the Body, Controls the Tendons, Manifests in the Nails, Opens into the Eyes, and the Emotion of Anger.
Storage of Blood – The Liver is considered the storage site for Blood when it is not in use. The Liver regulates the amount of Blood in the Blood in circulation. The need for Blood varies according to the physical activity. When body is active, the Liver will assure the demand for more Blood in circulation. In healthy individuals, the body will receive an ample Blood supply and all functions will be healthy and strong. If there is an impairment of Liver Qi weakness and stiffness will follow. In women, the Liver is commonly treated because of the menstrual cycle and the releasing and storing of Blood.
Control of Qi Throughout the Body – The Liver is the master controller of the Qi throughout the body. In the Nei Jing it states that the Liver is the General of the Army, coordinating the movements of the troops. The Liver controls not only it’s own Qi, but the Qi in all the Jing Luo. When the Liver Qi is functioning optimally, all the physical and emotional activities operate smoothly. When the Liver is impaired, the Qi tends to stagnate or become hyperactive, leading to whole myriad of symptoms both physically and emotionally.
Controls the Tendons – In TCM the concept of tendons include the ligaments as well and are referred to as the sinews. They are seen in light of the association of the muscles. Therefore the Liver has a vital role in the in the flexibility and movement of the body. The tendons ability of elasticity is dependent on the nourishment of Liver Blood, which is dependent on the smooth flow of the Liver Qi.
Manifests in the Nails – The nails are the reflection of the Liver. When the Liver Qi and Blood are healthy, the nails will be strong and moist. If the Liver is impaired, the nails are likely to be in poor shape, such as brittle, thin, and weak.
Opens into the Eyes – The eyes are said to be the reflection of our spirits and constitution. Even though all the internal organs have a connection to the eyes, the Liver is responsible for the proper nourishment of the eyes to moisten and provide clarity. If there is impairment of the Liver, the eyes will become chronic eye problems.
Emotion of Anger – The emotion associated with the Liver is that of anger and resentment. Impairment of Liver Qi can lead to outbursts of anger and irrational emotional tendencies. Resentment is also controlled by the Liver and held in resentment can impair the Liver Qi.
The Kidneys are located in the lower back on both sides of the spine. It is considered as part of the lower jiao. Its paired Fu is the Urinary Bladder. The Kidneys are the storage sight of the Jing. They are also considered the source of all Yin and Yang of the body and hold the fire of the gate of life (Shen Zhu Ming Men Zhi Huo). The functions of the Kidneys include:
Store Jing and Dominate the Growth and Development
The Jing is the essence of life and the Kidneys store this vital substance. The Jing determines the constitution and is essential in all aspects of the physiology of the body. Since the Jing is responsible for the growth and development of the individual, the Kidney are looked at when there is problems concerning this aspect.
Production of Marrow and Fill the Brain and Dominate the Bones
The Kidney Jing is responsible for the production of marrow, which is an essential component of bones, spinal cord, and brain. Therefore, the Kidneys are responsible for the strength of the bones and teeth and assure quality and efficient brain function. If there is impairment of the Kidney and the production of marrow, there will be a variety of problems including ringing in the ear, blurred vision, lack of focus and concentration, and spinal back pain, especially low back. As we established earlier, Jing has a role in the production of Blood. Thus, Impairment of Kidney Qi may lead to blood deficiency.
Maintain the Gate of Fire
The source of all heat generated in the body is housed in the Kidneys. In TCM this is referred to as the Ming Men. The Ming Men is physically between the two Kidneys. The maintenance of this Fire is represents the Yang functions of the Kidneys. When there is impairment in the Kidney Yang, all Yang or heat related problem arise such as decreased body temperature, impotence, and lack of energy.
Control of Water Metabolism
Water metabolism is a reflection of the healthy balance of the Kidney Yin and Yang. When the Kidneys are optimally functioning, they send any clear fluids back to the Lungs to produce even more Qi and Blood and any dirty fluids to the Urinary Bladder for excretion. Impairment of Kidney Qi will lead to improper water management and symptoms such as excess urination and edema. If the Qi rebels upward it can lead to difficulty in breathing, and extreme cases, chronic asthma.
Control Reception of Qi
The reception of Qi is the representation of the relationship between the Kidneys and Lungs. The Lungs receive air and proceeds to descend its Qi to nourish the body. The Kidneys receive the Lung Qi and then has a remarkable holding or grasping function, which is needed in full respiration. When the Kidneys are impaired, or more specific Kidney Yang is impaired, there will be difficulty in inhalation, such as that of asthma.
Open to the Ear
The Kidney are said to open to the ears (Shen Kai Qiao Yu Er Yin). The Kidneys rely on the Jing to nourish them for proper function. If the Kidney Jing is impaired, it can lead to symptoms of ringing in the ear and possible deafness.
Manifests in Head Hair
The head hair relies on the Jing to nurture them. In optimal Kidneys, the hair will be rich, thick, and moist reflecting healthy and abundant Jing. Impairment of the Kidneys leads to dull, lifeless, and brittle hair. Premature graying and thinning can also reflect Kidney impairment.
Emotion of Fear and Shock
The Kidneys are said to control fear and shock. When there is excess fear in life, it can lead to impairment of Kidney Qi and visa versa.
House the Will
The Kidneys is the resident of ones will power (Shen Cang Zhi). If the Kidneys are optimally functioning, the will power will be strong and the mind sound in judgment. If the Kidney Qi is impaired, will power is lacking and the mind is easily discouraged. This is an important point when treating depression and addictions – smoking, drugs, and alcohol.
The Large Intestine is paired with the Lungs. The Large Intestine continues the process of digestion from the Small Intestine. Common symptoms of impaired Large Intestine include constipation, diarrhea, and abdominal pain. Functions of the Large Intestine include
Absorption of Pure Qi and Excretion of Impure Qi
The Large Intestine receives the impure Qi from the Small Intestine and further extracts any pure Qi and excretes the impure.
Control of Bodily Fluids
The final stages of water metabolism, is performed by the Large Intestines.
The Stomach is paired with the Spleen. The Stomach is considered the start of the digestive process. The Spleen grabs the food from its Yang counterpart to start the transformation Qi and Blood. Impairment of Stomach Qi can lead to decreased appetite, nausea, mouth sores, and vomiting. Some of the functions include:
Reception and Storage of Food
The primary function of the Stomach is the reception of the food we eat and then storage of food. The Spleen then receives the food and starts the transformation and transporting functions.
Descending of Qi
The natural movement of the Stomach is downward to the Spleen. If the Stomach is impaired, the Qi can flow in the opposite direction causing nausea, heartburn, and acid reflux. This is called rebellious Qi.
The Small Intestine is paired with the Heart. Symptoms of impaired Small Intestines include abdominal pain, indigestion, gas, diarrhea, and dark urine. The functions of the Small intestine include:
Separation of Pure from Impure
The Small Intestine receives the impure food from the spleen and further separates the pure from impure.
The Gall Bladder is paired with the Liver. Common patterns of Gall Bladder impairment include intercostals pain, headaches, digestive problems, anger, and other emotional disturbances. The functions of the Gall Bladder include:
1. Storage and Secretion of Bile
The Liver stores the body’s bile and the Gall Bladder stores and secretes it. This process aids in the proper digestion of fatty foods. Impairment of Gall Bladder Qi can lead to digestive problems.
2. Rules Decision
The Gall Bladder is said to rule the decision process. If the Gall Bladder is impaired, the capacity to make decisions is tough.
The urinary Bladder is paired with the Kidneys. Symptoms of impaired Urinary Bladder include difficulty urinating, burning urination, bleeding urination, and urgency to urinate. The function of the Urinary Bladder include:
Receives and Secretes Urine
Once the Lungs, Small Intestines, Large Intestine, and Kidneys extract the pure from the impure, the Urinary Bladder finally excretes the impure as urine.
The San Jiao is paired with the Pericardium. The San Jiao is not a organ, but rather a grouping of organs by their location and function. They are grouped into three groups, or burners:
This consists of the Heart and Lungs. The upper burner is known as the, “mist”.
This consists of the Spleen, Liver and Stomach. The middle burner is known as the, “foam”.
This consists of Kidneys and Intestines. The lower burner is considered the, “swamp”.