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Chapter 4. Introduction to the Internal Organs

Zangfu: The Internal Organs and Their Correspondences

Zangfu is the general term for all internal organs. The Zang organs are the Yin organs. As a category, they are the more solid organs, and their shared main physiological functions are the manufacture and storage of essential substances, including vital essences (Jing), Qi, Blood, and body fluids. The Zang organs include the Heart, Pericardium, Lungs, Spleen, Liver, and Kidneys.

The Fu organs are the Yang organs. As a category, they are more hollow, and their shared main physiological functions are the receiving and processing (digesting) of food and other nutrients and transmitting and excreting wastes. The Fu organs include the Small Intestine, Large Intestine, Stomach, Gall Bladder, Urinary Bladder, and Sanjiao/Triple Burner.

Additionally, there are Six Extraordinary Fu organs. They are the Gall Bladder (which is also a regular Fu organ), Brain, Marrow, Bones, Vessels, and Uterus.

Almost all of the Western medical understanding of the internal organs is contained within the Chinese view. When there are significant divergences, they will be pointed out. We’ll primarily be looking at the organs from the expanded perspective of Chinese medicine, using the concepts of Qi, meridians, and Yin and Yang as have been previously discussed.

When practitioners of Chinese medicine refer to the Heart, for example, they are referring to the Heart Qi, the functions of its associated Heart meridian, various Heart Yin and Yang qualities and attributes, and the physical organ itself. This is more accurately an Organ System or Organ Network, encompassing the total functionality of the Heart system in that context rather than just the physical heart organ.

Because of Chinese medicine’s emphasis on functionality, some glands are not considered separate entities. The functions of those glands are subsumed by the function of a related organ, even though the physical structure is known to exist. So adrenal gland function is considered part of Kidney function, and pancreatic function is considered part of Spleen function. Some Chinese medical subsystems refer to the Spleen as the Spleen/Pancreas for this reason.


In the discussion of Organ Systems, commonly used descriptive phrases need some explanation. These indicate the holistic nature of this type of medicine, as some phrases refer to things that do not at first seem to relate to the organ at all. They include the wider scope of influence each organ has on the body and a subtler range of functional interrelationship than is considered in allopathic medicine.

In this context, these words or phrases have a specific, consistent meaning, although there are differences in translation and interpretation and some translators and authors may use them interchangeably. The written Chinese language is character-based, and many characters have no absolute, universally agreed-upon interpretation. The interpretations presented below are very common and will be used here for the sake of a standard, uniform presentation.

The word “govern” indicates an association with the organ’s main physiological function, and usually most closely correlates with the Western understanding of at least a part of the organ’s function. “The Lungs govern respiration” is a very clear example. “Rule” and “dominate” are translations sometimes used instead of “govern.”

The word “dominates” means “exerts a strong influence on,” usually in terms of generating or maintaining the healthy functioning of a particular body tissue. Sometimes the word “control” is used interchangeably, but that can be confusing, as an organ can control many things but has only one affinity to a body tissue that it dominates. “The Spleen dominates the muscles” is an example.

Every internal organ has a functional relationship with a particular sense organ. The phrase used to indicate that relationship is “opens to,” as in “The Liver opens to the eyes.” Most of the sense organs literally are openings to the outer world. The eyes have pupils, the ears have the auditory canal, the nose has nostrils, and the mouth is an opening. In the absence of trauma or contact-related irritation, a problem with a sense organ, such as blurred vision or reduced hearing, almost always indicates a problem with its associated organ and figures into the diagnosis. This includes age-related sensory declines, as they are caused by a decline in the related organ function.

Although the word “control” can be used as a gentler-sounding alternative to “dominate” it is typically a more generic word, meaning one of the many functions of the organ being discussed. Very often, “control” is used after another descriptive word or phrase to amplify its meaning. In this example, it follows the phrase “opens to”: “The Liver opens to the eyes, controls vision, and controls tears.” Of primary concern is the Liver opening to the eyes. The control of vision and tears relates to the functions of the eyes, still mediated by the Liver.

All of the phrases or descriptive words explained to this point fall under the province of the physical and energetic aspects of the organs. Analysis of these aspects presented in the next chapter is headed “Physical and Energetic Aspects of (the related Organ).”

Every organ has a particular affinity for an emotion or a few related emotions. In Chinese medicine, the stated emotional correspondences reflect the pathological manifestation that occurs when the related organ is not functioning properly. Conversely, when an emotion lingers long beyond what would otherwise be a normal, healthy response to a life situation, it becomes a pathological factor and will damage the related organ, functionally or materially. This “two-way street” feature is an aspect of holism that pervades all of Chinese medicine—Qi and Blood influence each other, Yin and Yang influence each other, and so on—but nowhere is that more obvious for Westerners than it is regarding emotions.

There are also normal, healthy emotional attributes associated with an organ that is functioning well and in concert with all the other organs. While some of these attributes are things we might not ordinarily think of as emotions, they all have emotional connections and require a healthy emotional balance in order to manifest. They can be diminished by a predominance of their unhealthy emotional counterpart. For example, the Liver’s positive attribute of fortitude, defined as possessing physical and emotional strength, can be diminished by prolonged depression. Other positive attributes, like the Heart’s healthy expressions of compassion and empathy, are more easily seen as qualities associated with the emotion love, another of its positive attributes. Accordingly, we’ll refer to all of these as the healthy emotions associated with each organ.

Somewhat paradoxically, the healthy expression of emotions is seldom discussed in Chinese medical texts, which are most concerned with what happens when things go wrong. The healthy emotional correspondences are presented here for you as well, under the heading “Emotional Aspect of the (Organ).”

From a Confucian perspective, the virtues are similar to positive emotions. Each organ has a related virtue, which can help to heal any problem associated with that organ, and will otherwise strengthen and nourish that organ. You will find the Confucian virtues presented after each organ’s healthy emotional correspondence.

The word “houses” refers to an organ’s association with a nonphysical, intangible attribute. “The Heart houses the mind” and “The Kidneys house willpower” are examples. Sometimes the word “stores” is used interchangeably with “houses.” Most often, “stores” is used to refer to a physical essence that is stored in a Yin organ, as opposed to the intangible attribute indicated by “houses.”

For the reader who might prefer to keep spirituality out of the discussion of medicine, these qualities can be easily and accurately thought of as addressing a psychological aspect of health. Accordingly, they are discussed under the heading “Psychospiritual Aspects of the (Organ)” and follow the discussion of emotional aspects so those correspondences may be readily noted. Those discussions are intentionally brief, since while they are of interest and relevance, they may be best explored in books devoted to Chinese spiritual philosophy.

Every organ has an associated external environmental factor by which it is most affected. Conversely, when an organ is out of balance, it often generates an internal analogue of its environmental factor. This can be a very useful observation when establishing a diagnosis. Those factors are introduced here and will be examined in more detail in Chapter 7, “Pathogenesis.” Since each environmental factor is more prominent in a particular season, the seasonal associations with each organ are included. The interface between specific seasonal environmental energies and related organs is a unique feature of the holism of Chinese medicine.

Every organ has an ascendant time of day called its “open” time, when the Qi of the organ is at its peak within any twenty-four hour period. If a pathology obviously affects primarily one organ, it may be best to treat that organ at its ascendant time. For example, Lung time is 3 a.m. to 5 a.m. If a patient suffers from asthma, bronchitis, chronic cough, tuberculosis, or any other breathing disorder, their symptoms will usually be worst at that time. Historically, an acupuncturist who followed the principle of chronoacupuncture might sleep at their patient’s house and wake at 3 a.m. to treat them. Alternatively, the patient might be prescribed a Qigong practice that strengthens the Lungs, told to practice between 3 a.m. and 5 a.m., and given an herbal formula to drink during those hours.

The organs’ ascendant times may serve as an aid to diagnosis. Shortness of breath is usually thought of as a Lung problem, but if a person regularly suffers from breathing difficulties between 11 a.m. and 1 p.m., the Heart’s ascendant time, it could indicate that the breathing difficulty stems from a Heart weakness. The organs’ affinity for the cycle of diurnal energies is another unique feature of the holism of Chinese medicine.