Transcript VISCERAL PICTURE THEORY******

1
THE TCM VIEW OF HUMAN BODY
• Different views of
structure and
function of the
human body from
Western medicine.
• The visceral organs
are seen as
comprehensive
systems of
physiological
function than as
anatomical entities.
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VISCERAL PICTURE
• It is a theory expounding the
physiological functions and
pathological changes of the internal
organs of the body and
• The relationships among the organs
through inspection of physiological
and pathological signs outside.
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VISCERAL PICTURE
• Guided under the ancient
philosophical thinking in China.
• The viscera are not simply the
organs in anatomy but also
mean the physiological
functions.
• The names are generally the
same as those of internal
organs in Western medicine .
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VISCERAL PICTURE
• Through inspection of the
corresponding external signs one can
determine the functional status.
• Eg through inspecting the complexion,
tongue color, pulse picture and
sensation of the chest one can know
the function of the heart in governing
the blood and vessels is normal.
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THE FIVE ZANG-VISCERA五脏
Lung
Liver
Heart
Spleen
Kidney
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FUNCTIONS AND CHARACTERISTICS OF
THE FIVE ZANG-VISCERA
• To produce and store essence-qi
（化生和储存精气）
• They can be full of essence-qi
instead of containing the
foodstuff. （满而不实）
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THE FU-VISCERA六腑
Gall
Bladder
Bladder
Small
Intestine
Stomach
San-jiao
(Triper
Warmer)
Large
Intestine
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FUNCTIONS AND CHARACTERISTICS OF
THE SIX FU-VISCERA
•To receive, digest and
transmit the foodstaff （受盛
和传化水谷）
•They can be full of foodstuff
instead of storing essence-qi
（实而不满）
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EXTRAORDINARY FU-VISCERA奇恒之腑
•
Brain
Marrow
Bone
Vessel
Gallbladder
Uterus
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MAJOR FUNCTIONS OF THE HEART
(1) Governing Blood: includes two respects of circulating
and producing blood:
1.1 The heart circulates blood: continuous flow of blood
in the vessels depends upon the action of heart-qi.
- If heart-qi is sufficient and the function of the heart in
governing blood is normal, the complexion will be
rosy and lustrous, comfortable thorax, even,
moderate and forceful pulse.
- Unsmooth blood flow, forceless or intermittent and
hasty pulse, dark and gray complexion, cyanoses of
the lips and tongue will be manifested if heart-qi is
insufficient and the function of heart governing is
disordered.
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MAJOR FUNCTIONS OF THE HEART
1.2 The heart produces blood: Blood is mainly
composed of nutritive qi and body fluid, but
the movement of heart yang is essential for
nutritive qi and body fluid to compose
blood,
- The heart produces and circulates blood to
ensure adequate nourishment of blood for
all tissues of the body.
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MAJOR FUNCTIONS OF THE HEART
(2) Housing spirit:
- The heart has the function of dominating the body’s
mental activities and life activities of the whole
body.
- Man’s psychological and emotional activities are
closely related with the effective coordination of
the five Zang-viscera and dominated by the heart.
- When the heart is able to house the spirit, there will
be high spirit, clear consciousness, quick thinking
and swift response.
- If the function is abnormal, insomnia, restlessness,
delirium and madness or even coma will occur.
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MAJOR FUNCTIONS OF THE HEART
• The function of housing spirit and the function of
governing blood of heart are closely related.
• The function of housing spirit of the heart can regulate
the heart qi in its driving blood to circulate within the
vessels.
• The heart’s governing blood function provides material
basis for mental activities, also beneficial to the heart in
its housing spirit.
• Therefore the dysfunction of the heart in governing
blood will inevitably lead to disorder of the heart-spirit; in
the contrary, the dysfunction of the heart in housing spirit
may also result in anomaly of blood flow.
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HEART
• The heart circulates and produces
blood so as to guarantee sufficient
nourishment of blood for all tissues of
the whole body.
• The heart also has the function of
dominating the mental activities such
as in psychology and emotions, and
life activities of the whole body.
(housing spirit)
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THE HEART
• The heart and small intestine form an
internal-external relationship through
mutual connection and affiliation of
their meridians,
• The heart is associated with vessel in
constituent, reflects its brilliance in the
face, is associated with joy in emotion,
with tongue in orifice and with sweat in
secretion.
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with joy in emotion
brilliance in the face
heart
tongue in orifice
with sweat in secretio
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THE LUNG
• The major functions of it are governing
respiratory qi and qi of the whole
body, smoothing water passage and
connecting with vessels.
• The lungs and large intestine form an
exterior-interior relationship through
connection and affiliation of their
meridians.
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MAJOR FUNCTIONS OF THE LUNG
1. The lung governs respiratory qi:
- The lung is the embodiment of diffusion and purificationdescent of the lung-qi in the process of gas exchange
between the interior and exterior of the body.
- Diffusion of lung-1i exhales turbid gases; and descent of
lung-qi inhales clear air to ensure normality of the lung in
governing respiratory qi.
- If the lung-qi fails in diffusion, or descent, it will definitely
influence the respiratory movement of the lung and
manifested as chest distress, cough, panting etc.
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MAJOR FUNCTIONS OF THE LUNG
2. The lung governs qi of the whole body:
- The whole body’s qi is mainly composed of pectoral
qi and primordial qi.
- The pectoral qi is mainly produced by combination
of the clear air inhaled by the lung and the essential
qi of foodstuffs transformed and transported by the
spleen and stomach.
- The pectoral qi forms in the thorax and
accumulates in the thorax.
- The inhalation and exhalation by the lung plays an
important role for the motion of qi of the whole
body in ascending, descending, exiting and
entering.
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THE LUNGS
• The lung is associated with the
skin in constituent, reflects its
brilliance in the fine hair, and is
associated with sorrow in
emotion, with nose in orifice,
and with snivel in secretion.
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lung
with nose in orifice
Governing qi of
the whole body
smoothing water
passage and
connecting with
vessels.
skin in constituent
brilliance in the fine ha
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THE SPLEEN
• Its main functions are to govern
transformation and transportation,
send up the clear and control
blood.
• The spleen and stomach form an
exterior-interior relationship
through mutual affiliation and
connection of their meridians.
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MAJOR FUNCTIONS OF THE SPLEEN
1. The spleen governs transformation and transportation
of foodstuff.
- The digestion of the food takes place in the
gastrointestinal tract, but it must depend on the
transformation of the spleen to turn the food into
essence;
- The essence again depend upon the spleen to absorb
and sent up to the lung and spread to the whole body.
- When the spleen functions soundly, it provides sufficient
nutrient for the production of essence, qi, blood and
fluid to nourish the viscera, meridians, four limbs,
tendons, muscles or in short, the whole body will function
normally.
- Diarrhea, poor appetite, lassitude and emaciation are
manifestations of the spleen’s weak ability in transporting
the foodstuff.
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MAJOR FUNCTIONS OF THE SPLEEN
1.1 Transforming and transporting water: the spleen
transport body fluid to regulate water metabolism.
-Normal spleen qi will transport the body fluid to moisten
and nourish the body.
-It will also o the surplus water to the lung and kidney,
where the water will be transformed into sweat and urine
and discharged out of the body.
-When the spleen fails in its transforming and transporting
functions, it will lead to water stagnation in the body and
thus the pathological products such as water-dampness
and phlegm-stagnant-fluid will develop.
-Hence, to ensure sufficient qi and blood and the body will
be free from pathogenic invasions.
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MAJOR FUNCTIONS OF THE SPLEEN
(2) The spleen is in charge of sending up the clear:
this denotes that the spleen qi goes upward and
thus transport the nourishment of foodstuff essence
by its transformation up to the heart, lung, head
and eye.
The foodstuff essence then transformed into qi-blood
by the functions of the heart and lung so as to
nourish the whole body.
Only when the ascending of the spleen qi
coordinates well with the descending of stomach
qi, the body’s digestion will be in order.
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MAJOR FUNCTIONS OF THE SPLEEN
• If the spleen qi is incapable to ascend and sinks
down, chronic diarrhea with proctoptosis, or
ptopses of some body organs.
(3) The spleen controls blood: this signifies that the
spleen is able to keep the blood circulating within
the vessels and preventing it from extravasation.
- When qi-blood is abundant, blood will remain in the
vessel.
- Spleen’s weak power in controlling blood often
manifested as bleeding in the lower part of the
body such as hemafecia, hematuria and etc.
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THE SPLEEN
• The spleen is associated with
the muscles in constituent,
dominates the four limbs,
reflects its brilliance in the lips,
is associated with thinking in
emotion, with mouth in orifice
and with saliva in secretion.
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with mouth in orifice
spleen
brilliance in the lips
govern transformation and transportation
with the muscles in
constituent
control blood
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THE KIDNEY
• The major functions of kidney are
storing essence, governing water and
governing reception of qi.
• The kidney and bladder form an
exterior-interior relationship through
mutual connection and affiliation of
their meridians.
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MAJOR FUNCTIONS OF THE KIDNEY
(1) The kidney stores essence: the essence stored in the
kidney includes “ innate essence” and “essence.”,
- The innate essence cines from birth and the acquired
essence comes from the foodstuff, both work together
to form the kidney essence,
- The whole process of human life is influenced by the
kidney-essence-qi.
- The development of human’s reproduction organs and
its reproductive power are influenced by the
abundance of the kidney-essence-qi,
- The reproductive power is called Tianggui (sex
promoters), We age when Tiangui is exhausted.
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MAJOR FUNCTIONS OF THE KIDNEY
1.2 the kidney essence can transform into kidney qi,
and the kidney qi can present with physiological
effects of two respects of kidney yin and kidney
yang.
The kidney yin plays moistening, calming and
inhibiting roles; kidney yang plays warming,
propelling and exciting roles.
The kidney yin and yang are the root of yin and yang
for every viscus, they restrict and depend on each
other to maintain the balance of yin and yang of
every viscus,
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MAJOR FUNCTIONS OF THE KIDNEY
• deficient kidney yang will manifest in listlessness,
lassitude, cold limbs, clear urine of increased
volume, low sexual desire and edema.
• Deficient kidney yin will manifest internal heat,
dizziness, tinnitus, sore and weak feeling in the waist
and knees, red tongue.
• The kidney yin and yang are very important to
human life, so the kidney yin is called “genuine
yin”and “original yin” and the kidney yang is called
“genuine yang” and “original yang”.
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MAJOR FUNCTIONS OF THE KIDNEY
(2) The Kidney governs water: this function signifies that
kidney is responsible for controlling and regulating the
distribution and excretion of water in the body to keep
water metabolism in order.
-the spleen and stomach work together to transform and
transport the foodstuff, diffusion and descending by the
lung, steaming and qi transformation by the kidney, and
taking the San-jiao as the passage ways, water is
transported throughout the whole body;
-the water being metabolized can be transformed into
sweat and urine to be discharged out of the body,
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MAJOR FUNCTIONS OF THE KIDNEY
• The whole process involves many viscera and the
kidney-essence-qi plays controlling and regulating
role.
(2) The kidney governs reception of qi: this function
means the kidney possesses the function of
receiving the fresh air inhaled by the lung so as to
keep the depth of inspiration.
- The respiratory function of the body is governed by
the lung, but it must be through the reception and
storage by the kidney qi to keep a certain depth.
Hence the lung and kidney work together to
perform our normal breathing activities.
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MAJOR FUNCTIONS OF THE KIDNEY
• If the essence-qi in the kidney gets deficient and
with little power to receive qi, there will appear
gasping by a little exertion, or dyspnea with
prolonged expiration.
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THE KIDNEY
• The kidney is associated with the
bone in constituent, reflects its
brilliance in the hair, is associated
with fear in emotions, with ear and
two yin organs( urinary tract and
anus) in orifice, and with spittle in
secretion.
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with ear and two yin
organs in orifice
storing essence
bone in constituent
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THE LIVER
• Its major functions are to govern free flow of
qi and store blood.
• The liver and gallbladder form an exteriorinterior relationship through affiliation and
connection of their meridians,
• The liver is associated with tendons in
constituent , reflects its brilliance in the nails,
and is associated with anger in emotion,
with the eye in orifice, and with tear in
secretion.
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liver
to govern free flow of qi
store blood
with tendons in constituent
brilliance in the nails
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MAJOR FUNCTIONS OF THE LIVER
(1) The liver governs free flow of qi: the liver is
responsible for the dynamic of the body qi.
- It plays an important role in ensuring the free flowing
of the body qi so as to promote proper circulation
and distribution of essence, blood and body fluid,
transformation and transportation by the spleen
and stomach, secretion and excretion of bile,
steady emotions, ejaculation in men and
menstruation in women.
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MAJOR FUNCTIONS OF THE LIVER
1.1 free flow of qi dynamic:
- When the liver fails in governing the free flow of qi, it
may manifest in distending pain in the chest, pain
around hypochondria, two breasts, or lateral parts
of the lower abdomen;
- The reverse rising of liver qi will manifest as
headache and red eyes, red face, irritability, or
hematemesis and hemoptysis.
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MAJOR FUNCTION OF THE LIVER
1.2 circulation of blood and body fluid:
- When the liver qi gets stagnated, qi-blood
circulation will be stagnated.
- The adverse rising of qi will force blood to go
upward and lead to bleeding like hematemesis.
- Besides, the abnormal flow of qi will also cause
pathological changes of water, dampness, phlegm
and fluid retention.
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MAJOR FUNCTION OF THE LIVER
1.3 promote transformation and transportation of the
spleen and stomach:
- When the liver functions normally, qi flows freely and
smoothly and the spleen’s ascending and
stomach’s descending function will be normal.
- Spleen will fail to send up the clear and manifested
as dizziness and vertigo in the upper part of the
body and diarrhea in the lower part; stomach qi will
not descend and will manifest as hiccup and
eructation in the distention and fullness in meddle,
and constipation in the lower.
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MAJOR FUNCTION OF THE LIVER
1.3 help secretion and excretion of bile:
- The bile is produced by the surplus liver qi, so its
secretion and excretion are controlled by the liver’s
function of governing free flow of qi;
- If the liver qi gets depressed, it will affect the
secretion and excretion of bile, resulting in
pathological changes of distension, fullness and
pain in the hypochondria, bitter taste in the mouth,
indigestion, and even jaundice.
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MAJOR FUNCTION OF THE LIVER
1.4. being conducive to ejaculation in men and
menstruation in women:
- If the liver’s function in governing free flow of qi gets
abnormal, the ejaculation in men will become unsmooth, and the menstrual cycle in women will
become disturbed with obstructed menstruation,
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MAJOR FUNCTION OF THE LIVER
(2) The liver stores blood:
This function signifies that the liver stores blood, regulates blood
volume and prevents bleeding,
The liver can store a certain amount of blood so as to check the
yang qi of liver to prevent its over-rise, and thus to maintain
the normal process of liver’s function of governing free flow of
qi;
With adequate blood being stored and assisted by the free flow
of qi, the liver can effectively regulate the amount of blood
demanded by every tissue according to the needs of the
body.
When a person is moving, blood will circulate throughout the
body and as he is in rest, his blood will return to the liver. In
addition, storage of blood by the liver is also conducive to
keeping the blood within the vessels to prevent unduly
bleeding.
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MAJOR FUNCTION OF THE LIVER
• liver is in charge of storing blood, and its body is yin,
but the governing free flow of qi functions belongs
to yang, so it is said “ the liver pertains to yin in
substance and yang in function.”
• The two functions of storing blood and governing
free flow of qi are dependent upon each other.
• As the liver governs free flow of qi, qi dynamic will
be unimpeded, then blood can normally
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GALL BLADDER
• The gallbladder connects with the
liver.
• The bile stored in the gallbladder ,
under the control and regulation by
the function of the liver in governing
free flow of qi, is excreted into the
intestine to help to digest and absorb
the foodstuff.
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GALL BLADDER
• The gallbladder connects with the
liver.
• The bile stored in the gallbladder ,
under the control and regulation by
the function of the liver in governing
free flow of qi, is excreted into the
intestine to help to digest and absorb
the foodstuff.
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GALL BLADDER
• If the liver functions abnormally in governing
free flow of qi, the excretion of bile is
obstructed, thus it will affect the digestion
and absorption of the foodstuff, there may
appear distending pain in the
hypochondrium, poor appetite and
abdominal distention.
• If the bile goes adversely upward, there may
occur bitter taste in the mouth or vomiting
with bitter liquid yellowish and green in color
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GALL BLADDER
• If the bile spreads out from the bile
tract, there may appear jaundice.
• The gallbladder also has the
function to judge and govern
decisions.
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Gallbladder
jaundice
the function to
judge and govern
decisions
bitter taste in the mouth or
vomiting with bitter liquid
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THE STOMACH
• The major functions of the
stomach are to receive and
decompose the foodstuff.
• Decomposing the foodstuff
indicates the stomach has the
action to primarily digest the
foodstuff to make it become the
chyme糜.
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THE STOMACH
• If the stomach’s functions of receiving and
decomposing the foodstuff get disordered,
there will be symptoms such as poor
appetite, eructation with fetid odor, etc
• If the stomach qi fails to descend, and
further it develops into adverse rise of
stomach qi, there will be symptoms such as
belching, nausea, vomiting, hicup,etc
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to receive and
decompose
qi fails to descend
belching, nausea,
vomitting
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THE LARGE INTESTINE
• The major function of the large intestine is to
transform and convey the waste.
• The large intestine accepts the foodstuff
residue from the small intestine by its
separation, and reabsorbs the redundant
water in the waste so as to make the waste
become stool;
• then conveys the stool down and
discharges via the anus out of the body.
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THE STOMACH
• The major functions of the
stomach are to receive and
decompose the foodstuff.
• Decomposing the foodstuff
indicates the stomach has the
action to primarily digest the
foodstuff to make it become the
chyme糜.
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THE STOMACH
• If the stomach’s functions of receiving and
decomposing the foodstuff get disordered,
there will be symptoms such as poor
appetite, eructation with fetid odor, etc
• If the stomach qi fails to descend, and
further it develops into adverse rise of
stomach qi, there will be symptoms such as
belching, nausea, vomiting, hicup,etc
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to receive and
decompose
qi fails to descend
belching, nausea,
vomitting
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THE LARGE INTESTINE
• The major function of the large intestine is to
transform and convey the waste.
• The large intestine accepts the foodstuff
residue from the small intestine by its
separation, and reabsorbs the redundant
water in the waste so as to make the waste
become stool;
• then conveys the stool down and
discharges via the anus out of the body.
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transform and convey the waste
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THE SMALL INTESTINE
• The major physiological functions of the small intestine
are to dominate reception and digest the chyme,
(accepts the chyme sent down by the stomach and
holds it for a longer time so as to facilitate further digest
on of it into the essence) and
• to separate the clear from the turbid (separates its
digested foodstuff into two parts of foodstuff essence
and waste, and absorbs the essence and sends the
waste down into the large intestine.）
• Must coordinate with the transformation and
transportation of the spleen qi so the work can be
smoothly accomplished.
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further digests food decomposed initially by
the stomach
turbid is sent downwards to the large
intestine
separation of the clear from the turbid
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URINARY BLADDER
• The major function of the urinary bladder is
to store and discharge urine.
• The urine is produced from the water under
the qi transformation of the kidney, then
poured into the bladder for storage.
• When the urine in the bladder gets to a
certain amount, it will be discharged out of
the body.
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URINARY BLADDER
• If the kidney qi fails in control,
there will appear enuresis, or even
incontinence of urine.
• If the qi transformation of the
kidney gets disordered, there will
appear dysuria（排尿困难）, or
even anuria（尿闭）.
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dysuria, or even anuria
to store and discharge urine
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TRI-JIAO
• The tri-Jiao is a collective term for the upper,
middle and lower-jiao.
• The meaning of the tri-jiao is of two:
- the passageways formed by the mutual
communication of the spaces among the
viscera and within the interior of the viscera.
-a concept of simple regions, the part
above diaphragm as the upper-Jiao, the
part form below the diaphragm to the
umbilicus as the middle-Jiao and the part
below the umbilicus as the lower-Jiao.
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TRI-JIAO
• The major functions of the tri-jiao are to pas
primordial qi and transmit water.
• The primordial qi originates from the kidney and it
flows into the five Zang and six Fu-viscera and
spreads through the whole body via tri-jiao.
• The water metabolism of the whole body requires
the tri-jia to act as its passages to ascend, descent,
exit and enter normally.
• If the water passageways of the tri-Jiao get
obstructed, the lung, spleen and kidney will hardly
perform their physiological effects in distributing and
regulating water metabolism.
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WOMB
• The major function of the womb is to control
menstruation and culture the fetus.
• The production of menstruation and formation and
cultivation of the fetus are the outcome that the
viscera, Tiangui, meridians and qi-blood act on the
womb.
• When the womb functions normally, the
menstruation and development of the fetus will be
normal.
• Otherwise disturbance of menstruation, pregnancy
and problem development of the fetus may
appear.
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BRAIN
• The major functions of the brain are to dominate life
activity, mentality and consciousness and sensible
movements.
• When the brain functions normally, the human body
will be full of vitality with clear consciousness, acute
senses and agile movements.
• If the brain functions abnormally, the body will be
disordered in vital activity with listlessness,
unconsciousness, dull senses and slow movements.
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TCM NOTION OF HUMAN LIFE CYCLE
• Every cycle is 10 years.
• Male’s cycle is 8 years, based on the body’s key
organs’ prosperity and the descending and decline
of qi and blood.
• Female’s cycle is 7 years, based on the prosperity
and decline rate of the kidney ‘s qi and tian kui , 天
癸 a unique substance responsible for maintaining
the sexual functions.
• Man’s key organs fully grown at the age of 10. Qi
and blood flow actively and manifested in
preference to move and run.
• “人生十岁，五脏始定，血气已通，其气在下，故好走。”
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TCM NOTION OF HUMAN LIFE CYCLE
• At 20 years old, muscle and tendons fully grown
and manifested in sheer vitality. “二十岁，血气始盛，
肌肉方长，故好趋。
• At 30 years, the human body’s physical growth
reached its peak and are swift in movement. “三十
岁，五脏大定，肌肉坚固，血脉盛满，故好步。”
• At 40, the human body’s growth optimized and is a
watershed period. Aging soon started and hence
tend to dislike moving excessively. “四十岁，五脏六
腑，十二经脉，皆大盛以平定，腠理始疏，荣华颓落，发
颇斑白，平盛不摇，故好坐。”
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TCM NOTION OF HUMAN LIFE CYCLE
• At 50, the liver energy started to decline and so the
gall bladder’s secretion. Vision also began to blur.
“五十岁，肝气始衰，肝叶始薄，胆汁始灭，目始不明。”
• At 60, the heart energy started to turn weak and
man tended to worry more. Flow of qi and blood
slowed and hence preferred to rest the body by
lying down. “六十岁，心气始衰，苦忧悲，血气懈惰，故
好卧。”
• At 70, spleen energy became deficient and dry skin
manifested. “七十岁，脾气虚，皮肤枯。”
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TCM NOTION OF HUMAN LIFE CYCLE
• At 80, lung energy weakened and unable to
express eloquently. “八十岁，肺气衰，魄离，故言善
误。”
• At 90, kidney’s energy burnout and visible
weakening and emptiness of spleen, liver, lung and
heart. “九十岁，肾气焦，四脏经脉空虚”
• At 100, all organs ‘ energy became deficient and
only the skeleton remained. “百岁，五脏皆虚，神气皆
去，形骸独居而终矣。”
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