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Chapter 5. Zang: The Yin Organs

The Heart

Main Functions of the Heart

• Governs the Blood and dominates the Blood Vessels

Other Functions and Attributes

• Opens to the tongue and controls taste and speech

• Houses the mind (consciousness) and Shen (“spirit”). In a medical context, any of these four words may be used interchangeably. (See Appendix 2Note 5.1.)

• Manifests on the facial complexion

• Controls sweat

Additional Correspondences

• Its associated emotion is joy. Joy slows and scatters Qi.

• Its healthy emotional expressions are compassion, empathy, and love.

• The Heart’s virtue is Li, or “Order.”

• In Five Element theory, its elemental representation is Fire. Accordingly, its seasonal correspondence is summer, and it is most affected by the environmental factor of Heat.

• Its influencing taste is Bitter. The significance of taste is discussed in Chapter 8 and Chapter 15.

• Its ascendant time of day is 11 a.m. to 1 p.m.

Analysis of Physical and Energetic Aspects of the Heart

The primary function of the Heart, governing the Blood and dominating the Vessels, is almost identical to the Western view of the heart, even if the language is different. This means that the Heart, specifically the Heart Qi, is the motive force driving blood circulation, and the Blood Vessels are the physical structures through which Blood is circulated. When the Heart Qi is strong and the Heart Blood is abundant, blood circulates well throughout the entire body, nourishing all body tissues. Another meaning is that the condition of the Heart is reflected in the quality of the pulse, as assessed through the Vessels. When the Heart Qi and Blood are strong and abundant, the pulse will be even, strong, and regular. If they are deficient, the pulse will feel weak and very thin (thready, in Chinese medical terminology) and may be irregular.

A distinctly non-Western aspect of Heart function is unique to Chinese medicine. The Heart is responsible for converting the Qi acquired from food, drink, and air into Blood. Other organs, the Lungs and Spleen, are involved in this process, but the actual transformation occurs in the Heart.

The Heart opens to the tongue. The tongue is considered “a sprout of the Heart,” so, as with all organs and their related sense organs, there exists a close physiological, structural relationship between the two. The Heart meridian also connects with the tongue internally, and this connection is primarily responsible for the Heart’s control of taste and speech. If the Heart is functioning normally, the tongue will appear moist and light red, it will move freely and easily, and the sense of taste will be normal.

Various pathologies alter the tongue’s color, moisture, size, and shape. For example, Heart Blood Stagnation will cause the tongue color to become purplish, while Heat will turn it red. Heart Blood or Yin Deficiency may make it dry and thinner in shape. A fuller range of possible changes in the tongue is covered in Chapter 10, “Diagnosis.”

A freely moveable tongue is required for the basic function of speech, but the quality and content of speech—coherence—relates more to the Heart housing the mind. This concept is both broad and complex, as it involves philosophy and spirituality, which are integral to classical Chinese medicine, as much as it does clinical medicine. For our purposes, we’ll stick to the basics, which are more straightforward and easier to apply practically.

We’ve learned that the Heart governs Blood and Blood Vessels throughout the body. Because there are many blood vessels in the face and head, the quality of the Blood can be readily assessed there, so the Heart manifests on the complexion. This is in part due to the heart’s physiological function of pumping blood. Whether standing or sitting, the heart has to pump blood upward, against gravity, to get to the face and head. This is an aspect of Heart Qi. If the Blood is healthy and abundant, and the Qi is strong, the facial complexion will have a light red glow and a luster. If there are Heart problems, the complexion can appear sallow, white or gray, and dull.

All body fluids are on the Yin side of the Yin-Yang continuum and share a common source. In Western as well as Chinese medicine, there are well-known correlations between blood, heart function, and body fluids. The Western biomedical condition of edema is caused by blood vessels becoming excessively permeable from various factors, allowing the fluid portion of the blood to leak into surrounding tissue and cause swelling. Two examples include an obstruction of blood flow by blood clots in the deep veins, causing leg edema, and congestive heart failure, which can cause leg edema and pulmonary edema (a fluid buildup in the lungs). In Chinese medical terms, clot obstruction is an example of a failure of the Heart to adequately govern the Blood, while Heart Qi Deficiency can cause the consequences of congestive heart failure. Both involve the failure of the Heart to adequately govern the Blood Vessels, allowing leakage.

Sweat is another body fluid that shares a common source with Blood, and because there can be an immediately observable correlation between sweat and Heart function, the Heart is said to control sweat. When the Heart is functioning normally, its control of sweat contributes to the healthy luster of the complexion. In the case of Heart pathologies, Heart Yin Deficiency causes night sweats, and more severe Heart problems can cause profuse, cool, and usually clammy sweat. Conversely, conditions that may cause profuse sweating, including excessive exercise and prolonged exposure to high heat or dryness, can deplete Heart Blood and cause such things as heat exhaustion or stroke. Some classic texts observe that “the Heart loathes Heat” for this reason. In these cases, it is notable that speech may also become incoherent.

Analysis of Emotional Aspects of the Heart

The Heart’s associated emotion is joy. It may be difficult at first to understand how joy can be considered a pathological manifestation. In this case, the joy is excessive, approaching mania. A common example used to explain this is a person who may become so excitedly overjoyed at winning a fortune in the lottery that he has a heart attack. This may be an extreme example, but it does illustrate how excessive joy can be detrimental to heart health, scattering the Qi to the point where there is none to provide heart functionality. There are less obvious ways in which joy can be problematic, but remember that it’s only when joy is excessive or prolonged that it will be destabilizing. Since the Heart houses the mind, prolonged and excited joy can lead to mania, delirium, or a loss of the ability to perceive or function in the world that everyone else experiences.

The Heart’s healthy emotional expressions are compassion, empathy, and love. These emotions can engender a more balanced, healthy experience of joy.

Analysis of Psychospiritual Aspects of the Heart

The Heart houses the mind. The Chinese word Shen is translated as “mind,” “consciousness,” and “spirit.” Here, “spirit” relates most to aspects of consciousness, and is similar to the idiomatic English usage in the phrases “having a spirited conversation,” or “being in high (or low) spirits.” It encompasses all mental activity, thinking, and emotional experience, involves memory, and is associated with sleep. So when the Shen is strong, supported by healthy Heart Qi and abundant Heart Blood, the mind is peaceful, clear, lively, and aware of and responsive to the environment, emotions are balanced, and sleep is sound and restful. Speech is orderly and coherent, as it will be directed by a healthy Shen. If the Shen is housed insecurely by an impaired Heart, a person may experience poor sleep, excessive and often disturbing dreams, depression, sluggish thinking, and poor memory. In extreme cases, the result can be delirium, mania, or loss of consciousness. In those instances, speech will be less organized, possibly incoherent, or absent.

Beyond the standard concerns of Chinese medicine, clear Heart consciousness influences a person’s ability to make supportive, beneficial choices about various life issues over the long-term arc of one’s life. When we consider the time component involved in those types of decisions, it becomes easier to understand how the Heart plays a role in the long-term aspects of memory. This becomes more important as a person advances to old age, since short-term memory may decline under the dominion of the Kidneys, but long-term memory will remain intact for as long as the Heart is functioning reasonably well.

The Pericardium

The pericardium is the protective membrane that surrounds the heart. Its name is its description and is practically identical in English and Chinese. The English word is derived from Latin: “peri-” means around or surrounding, and “cardium” means heart. The Chinese word is XinbaoXin means “heart.” Bao means “wrap” or “a wrapping.” Both mean “surrounding the heart” or “the heart wrapping.”

Its main function is to protect the Heart. Accordingly, almost anything external to the Heart that may harm it will first affect the Pericardium. Its secondary functions are largely identical to those of the Heart. This means that clinically, while the Pericardium has some unique qualities and functions, it is almost never treated as a separate organ but more as an appendage of the Heart. This is alluded to in its Five Element correspondence, where its element is designated as Supplemental Fire.

The Pericardium does have its own meridian, which is needled independently from the Heart. Some schools of acupuncture almost never needle the Heart meridian directly, preferring to treat it through the Pericardium whenever possible. In many styles of Qigong, the Pericardium meridian is of extreme importance. The eighth point of the Pericardium meridian, Laogong, is located at the center of the palm and is one of the most energetically sensitive points on the body. It is used to tactilely sense Qi for medical and other purposes as well as to emit and absorb Qi.

The Pericardium has an internal/external relationship with its paired intangible Yang organ, the Sanjiao (or Triple Burner), discussed later.

The Lungs

Main Functions of the Lungs

• Govern the Qi and respiration

• Control the channels and blood vessels

• Control dispersing and descending

• Regulate water passageways

• Dominate and manifest on the skin and body hair

Other Functions and Attributes

• Open to the nose, control smell, and control mucus

• House the corporeal soul (Po)

Additional Correspondences

• Its associated emotions are grief and sadness. Grief and sadness constrict Qi.

• Its healthy emotional expressions are exuberance, zest, and vitality.

• The Lung’s virtue is Yi, or “Integrity.”

• In Five Element theory, its elemental representation is Metal. Its seasonal correspondence is autumn, and it is most affected by the environmental factor of Dryness.

• Its influencing taste is Spicy.

• Its ascendant time of day is 3 a.m. to 5 a.m.

Analysis of Physical and Energetic Aspects of the Lungs

One of the primary functions of the Lungs, governing respiration, is almost identical to their Western function. That is, pure air is drawn into the lungs through inhalation, oxygen and other gasses are exchanged in the blood, and carbon dioxide and other wastes are expelled through exhalation. When we take into account that one translation of the word “Qi” is “air,” that explains half of what is meant by the Lungs’ function of governing Qi. (When used in the context of Chinese medicine and Qigong, the translation “air” is a limited, partial meaning of the word “Qi”.) On the inhalation, clear Qi (Qingqi, atmospheric or celestial Qi) is drawn in, and on the exhalation, waste Qi is expelled. This is the main point of the Lungs’ function of governing the Qi of respiration. But the Lungs also govern the Qi of the whole body, the second meaning in its governance of Qi, and this relates to many of their other functions.

As the Lungs draw in atmospheric Qi, that Qi combines with the Qi extracted from food by the Spleen, to form Zongqi (Zong Qi), most simply translatable as “chest Qi.” (Other traditional translations include “gathering Qi” or “ancestral Qi,” but the meanings of those translations are more complex and obscure—less suitable for practical use here.) That is a form of Qi more useable by the entire body. The Lungs’ “control of descending and dispersing” function circulates this Qi throughout the body, nourishing all its tissues and promoting healthy physiological functioning. Because it’s formed in the chest, it directly aids in strengthening Heart function, especially in regard to circulating Blood, and a portion of Zongqi is combined with Heart Qi to help form Blood.

The Lungs’ function of controlling the channels and blood vessels can be partially understood by its role in aiding the Heart in its circulation of Blood. However, Zongqi forms nutritive Qi, which circulates internally both with the Blood in the blood vessels, and within the meridians. Since the Lungs control the Qi of the entire body and help form and power the circulation of nutritive Qi, it is said to control the channels and Blood vessels.

The Lungs are the uppermost of the Zangfu organs, known traditionally as “the canopy” of the organs, and because they interface directly with the atmosphere, they are also the most external of the Yin organs. These qualities play a role in the following Lung attributes.

As the uppermost Yin organ, its Qi must descend. We’ve seen how it descends Qi to nourish the body and improve functionality, providing nutritive Qi throughout the vessels and meridians. Another portion of Zongqi helps create Weiqi (defensive Qi) which circulates just under the surface of the skin and serves as the first line of defense against pathogenic invasion. This is nearly equivalent to the general immune system of Western medicine. This also relates to the Lungs being the most external of Yin organs, since it directs Qi to the most external parts of the body.

The Lungs descend and disperse body fluids as well as Qi. As it dominates and manifests on the skin and body hair, including the sweat glands, the Qi and fluids warm the skin and provide nourishment and moisture, keeping the skin supple and lustrous. Dominating the skin also means control of the opening and closing of the pores. When the Lung Qi is strong, the surface of the body is consolidated and strengthened against colds, flus, and other external pathogens, and sweat is normal. If the Lung Qi is weak, the pores of the skin may become more flaccid and open. This provides an entrance for disease, and sweat can be spontaneous, profuse, and often cool or clammy.

The Lungs descend body fluids to the Kidneys and Urinary Bladder. Some of that fluid is “steamed” by the Kidneys, which rises as a vapor to moisten the Lungs. The rest is converted into urine to be excreted by the Urinary Bladder. In this way, the Lungs’ function of regulating water passageways plays a role in the elimination of waste fluids through sweat and urine. Lung Qi Deficiency affecting the water passageways can cause various urinary disturbances and edema.

The nose is the direct opening to the Lungs. Air and clear Qi enter the Lungs through the nose. When Lung Qi is normal and healthy, the nasal passages remain open, respiration is full and easy, and the sense of smell is normal. When the Lungs are invaded by pathogens that cause a cold or sinus infection, breathing becomes obstructed, excess mucus is produced and causes either a stuffy or runny nose, and a person may sneeze and have a reduced sense of smell. Excess Heat in the Lungs can cause the nose to bleed and also reduce the sense of smell.

Analysis of Emotional Aspects of the Lungs

Grief and sadness are the emotions associated with the Lungs. Any emotion can be situationally appropriate. It’s only when an emotion becomes prolonged or habitual that it can cause health problems. So any period of protracted grief can depress Lung function and cause a person to breathe more shallowly, drawing in less clear Qi and thus lowering energy overall. Conversely, when the Lungs are out of balance with the rest of the body (possibly affected by Damp through phlegm accumulation from poor Spleen functioning, for example), or suffering a deficiency of Qi or Yin from other causes, a person may experience a lingering sadness or grief for no apparent reason. When grief constricts Qi, there is a sense of being shut down, withdrawn, and disengaged from life.

The emotional expression of healthy Lungs is exuberance and a zest for life. A natural antidote for sadness and grief, this is the outcome of strong Lungs effectively bringing in more Qingqi, which energizes the entire body and makes a person feel full of life. This is one reason why regulated breathing is an important part of all Qigong practices and makes a person healthier and more vital.

Analysis of Psychospiritual Aspects of the Lungs

The Lungs house the Po, the corporeal soul. While this has more to do with Chinese spiritual philosophy than with practical Chinese medicine, it does have some contemporary clinical relevance. The Po is the densest, most Yin part of the human soul. It has a particular sensitivity to the emotions associated with the Lungs, sadness and grief. Sometimes grief can be so profound that even in English it is referred to as being “soul sick.” In that case, the quality and depth of breath is usually affected, becoming short, shallow, and restricted, an indication of its association with the Lungs. In those cases, treating the Lungs can strongly rectify emotional disturbances and restore balance. There is even a point on the Urinary Bladder meridian called Po Hu that tonifies the Lungs for just such conditions.

Being the densest, most Yin part of the soul, at death the Po descends and is absorbed back into the earth.

The Liver

Main Functions of the Liver

• Governs the smooth flow of Qi

• Stores Blood

• Dominates the Sinews (tendons and ligaments)

Other Functions and Attributes

• Opens to the eyes, controls sight, and controls tears

• Manifests on Nails

• Houses the ethereal soul (Hun)

Additional Correspondences

• Its associated emotions are anger and depression. Anger makes Qi rise.

• Its healthy emotional expressions are fortitude, the ability to get things done, a creative drive, and the ability to make life plans. This latter can be thought of as a quality of “having vision,” a metaphorical association with the eyes.

• The Liver’s virtue is Ren, or “Kindness.”

• Its Five Element representation is Wood. Its seasonal correspondence is spring, and it is most affected by the environmental factor of Wind.

• Its influencing taste is Sour.

• Its ascendant time of day is 1 a.m. to 3 a.m.

Analysis of Physical and Energetic Aspects of the Liver

The Liver’s nature is typified by the qualities associated with the first of its functions, governing the smooth flow of Qi. The Liver likes to grow in a healthy, lush, vigorous way, thriving in a favorable environment while similarly supporting such a favorable environment throughout the body. That is best accomplished through its governance of the smooth flow of Qi, which creates a sense of relaxation, a free looseness (contrasting tension and a feeling of being bound up), and a functional ease in every Organ System. The Liver dislikes depression. It will both be adversely affected by prolonged periods of depression and will generate feelings of depression when it is functionally compromised, primarily from various types of deficiency.

The smooth flow of Qi can be subdivided into three distinct yet interrelated aspects: its relationship to emotions, its role in digestion, and its relationship with Qi and Blood.

There is a traditional herbal formula designed to support and promote the smooth flow of Liver Qi. Its name, Xiao Yao Tang, means “Free and Easy Wanderer” formula, conjuring the image of an enlightened, peaceful, and carefree Daoist monk roaming the countryside unencumbered and untroubled by conflict yet able to help resolve conflicts between others and restore neighborly harmony. This is a useful image to keep in mind, since that is exactly the Liver’s role in this context.

The Liver and Emotions

When a healthy Liver ensures the smooth flow of Qi, a person experiences emotional balance and is able to enjoy the full range of emotions while rarely being prone to emotional excess or fixation. While every organ has a particular emotional affinity, the Liver’s larger role is in allowing all the emotions a harmonious expression. We’ve seen how the Heart houses consciousness and therefore encompasses all mental and emotional experience, yet the free, smooth flow of Qi is required for the free and strong flow of Blood, allowing Qi and Blood to be harmonized and the mind to be peaceful and at ease.

Any strong or prolonged emotional experience can disrupt the flow of Liver Qi, and any Liver imbalance can be responsible for a variety of emotional upsets. Some of those upsets can be directly associated with the emotional state of another organ, since Liver Qi is responsible for the free flow of Qi in every organ. For example, if Lung Qi is not flowing freely due to Liver Qi Stagnation, a person may experience grief or sadness, the emotions that are most closely linked with the Lungs.

More commonly, those upsets first affect the Liver’s primary associated emotions. In the case of Liver excess or hyperfunction, Liver Qi Stagnation or Obstruction, those emotions include anger and the related emotions of frustration and irritability. In the case of a Liver deficiency or hypofunction, depression is most common. Depression can easily coexist with frustration, irritability, and anger, so those emotions cannot be used as the sole determinant of the exact type of Liver dysfunction.

The Liver and Digestion

The smooth flow of Liver Qi is very influential in the proper functioning of the Stomach and Spleen. The Stomach’s main function is the breakdown of foods into useful nutrition. The Spleen is responsible for extracting food Qi, transforming the nutrition into a more bioavailable form, and transporting it throughout the body. The normal direction of Stomach Qi is downward, since the Stomach sends processed food material down to the Small Intestine, while the normal direction of Spleen Qi is upward, since the Spleen sends part of the food Qi up to the Lungs and Heart for conversion to Blood. The Liver supports those normal digestive activities of the Stomach and Spleen. If the Liver function is disturbed and its Qi does not move freely, there can be abdominal discomfort and distention, and the accompanying disruption can cause the normally descending Stomach Qi to reverse, causing belching, hiccups, nausea, and vomiting. A disruption of the normally ascending flow of Spleen Qi can lead to diarrhea. This type of digestive disturbance is from a local excess of Liver Qi, which, in an attempt to disperse, moves laterally to the Stomach and Spleen. This is called “Liver Invading the Stomach and Spleen.”

The Liver also secretes bile, another aspect of its role in digestion. The free flow of Liver Qi is necessary for proper bile flow. Bile is necessary for the digestion of dietary fats. A disruption in bile flow can cause belching and jaundice, a yellowing of the skin and eyes.

The Liver’s Relationship with Qi and Blood

“The Qi is the commander of the Blood,” a saying in Chinese medicine, means that all blood flow relies on the functional energy of Qi. While the Heart and Lungs play the largest role in blood circulation, the Liver ensures that the Heart Qi and Lung Qi are smooth and unobstructed, so they can perform their role as efficiently as possible. Additionally, Qi flow throughout the body must be smooth and unobstructed if Blood is to freely circulate to all body tissues. A disruption in Liver Qi can cause Qi stagnation or Blood Stasis anywhere in the body. This can cause minor, dull aches to severe, sharp pain, abdominal distention, loss of appetite, a sense of pressure in the chest, various menstrual disorders, and even the formation of cysts, tumors, or other masses.

While these three aspects of governing the smooth flow of Qi have been presented separately, keep in mind that they are entirely interrelated, and each aspect is a part of the others.

The Liver stores Blood based on physiological need. When the body is active, the Liver releases more Blood so that it can moisten and nourish the muscles, as well as other tissues. This helps supply the body with needed energy. We learned that “the Qi is the commander of the Blood,” and the corollary to that is “the Blood is the mother of the Qi.” This means that Qi requires a material substrate out of which to grow, and the Blood is that substrate. Healthy, abundant Blood brings abundant Qi with it.

When a person is at rest, as during sleep at night, more of the Blood returns to the Liver, since the circulating Blood volume requirements are less. The Liver can then assist in restoring a person’s energy during sleep. Following the principles of Chinese medicine, being soundly asleep by 11 p.m. each night is considered especially important. The Gall Bladder’s ascendant time is from 11 p.m. to 1 a.m. The Gall Bladder is the Yang partner to the Liver. Both are Wood-element organs, and 11 p.m. begins Wood time and influences the functionality of the Gall Bladder and Liver.

If there are problems with Liver Blood, the body is not as well nourished, and a person may become easily fatigued. Since the Liver opens to the eyes, there can be blurred vision or other visual disturbances. Since it dominates the tendons and ligaments, the muscles and limbs can become tight, achy, or numb. Because of the Liver’s strong relationship with Blood and Qi, most gynecological complaints are directly attributable to the Liver during a woman’s menstrual years, including headaches, cramps, breast tenderness, irregular cycles, scanty menstrual blood, and clots in the menstrual blood, among other possibilities.

The tendons and ligaments, collectively referred to as “the Sinews” in most Chinese medical texts, are what connect muscle to bone (tendons), allowing for all body movement, and what connects bone to bone at the joints (ligaments). We’ve seen how Liver Blood nourishes and moistens all body tissues and how Liver Qi influences smooth movement and all functionality in the body. A healthy Liver provides for free, open, relaxed, and easy movement in the four limbs and the joints. If the Liver is compromised, the Sinews will not be nourished properly and can cause stiffness and tight, painful muscles and joints. In more severe cases, where there may be strong pathological Heat affecting the Liver, there can be tremors, spasms, and opisthotonos, a type of whole-body rigidity primarily affecting the muscles of the back.

The fingernails and toenails are considered to be extensions of the tendons. When the Liver Blood is healthy and abundant, the tendons and nails are strong, moist, and healthy. When the Blood is deficient, the nails will appear dry, brittle, and with indentations or cracks.

The eyes are the sense organs most closely associated with the Liver. Liver Blood nourishes the eyes, allowing for clarity of vision. The Liver meridian also connects internally with and brings Qi to the eyes. A healthy Liver produces bright, lively eyes that shine and move quickly and easily. If Liver Blood is deficient and fails to nourish the eyes, they may become dry, red, or itchy, and there can be visual disturbances like nearsightedness, floaters (spots in front of the eyes), or poor night vision. I’ve explained that some Liver diseases affecting bile flow can cause jaundice, a yellowing of the eyes and skin. There are even idiomatic English language references to the Liver’s association with the eyes. If a person is angry (the emotion associated with the Liver), he is said to be “seeing red,” a visual connection to that emotion. If the Liver has been compromised by too much alcohol consumption, a person is said to be “seeing double” or “blind drunk.”

Analysis of Emotional Aspects of the Liver

Since the Liver has a relationship with all of the emotions as part of its governance of the smooth flow of Qi, we introduced some of the emotions that are specific to the Liver above. Let’s examine the Liver’s emotions more closely now.

The emotions commonly associated with the Liver are anger and depression. Anger is most often seen in excess conditions, such as Liver Qi Stagnation, in which there is an undesirable buildup of Liver Qi due to some type of obstruction. When anger causes Qi to rise, anger can become more intense, flaring up unpredictably like a blazing fire, out of control. Lesser manifestations of the same condition include frustration and irritability. These are unhealthy counterparts to emotions that are generated by a normal, healthy Liver. Those include fortitude and the abilities to get things done, to accomplish something, and to have vision in a conceptual way that allows for effective life plans. If someone does not have vision—does not feel they are able to accomplish life goals—they will become frustrated and irritable, may appear hyperactive and volatile, may use anger as a pathological substitute to get people around them to do the things they want, and may attempt to destroy anything they perceive as an obstacle in their path.

Depression is most often seen in some type of deficient condition, such as Liver Blood Deficiency, for example. In this person, the same feeling of not being able to accomplish positive life goals will generate feelings of hopelessness, like there is no point in even trying to make one’s life better. This is a mild to moderate depression, as opposed to the bleak despair of clinical depression, which comes from the Kidneys.

Analysis of Psychospiritual Aspects of the Liver

The Liver houses the Hun, or the “ethereal soul,” which is the counterpart to the Po, or the corporeal soul housed by the Lungs. While the Hun is not of great importance relative to the contemporary practice of Chinese medicine, there is a notable correspondence with an aspect of the Liver’s emotional health. The Hun is influential in giving a person the ability to create a life plan and find a sense of direction, or life trajectory. This can be thought of as a type of practical physics, since the Hun must be aligned with and firmly rooted in space and time in order to fulfill this purpose. Without such a root, possible in Liver Blood or Liver Yin Deficiency, a person may suffer from mental confusion and a sense of aimlessly wandering through their own life.

The Hun is the more active, Yang aspect of the soul, relative to the Po. Without the stability of adequate Liver Blood or Liver Yin, the Hun is inclined to roam. This can cause spontaneous astral projection, the sense of floating above the body just before sleep or of entirely leaving the body during sleep. At death, while the Po descends into the earth, the Hun unites with the subtle energies of the nonmaterial world.

The Spleen

Main Functions of the Spleen

• Governs transformation and transportation

• Controls blood

• Dominates muscles and the four limbs

Other Functions and Attributes

• Opens to mouth, controls taste, and controls saliva

• Controls the raising of Qi

• Manifests on lips

• Houses thought

Additional Correspondences

• Its associated emotions are worry and pensiveness. Worry knots the Qi.

• Its healthy emotional expressions are centeredness, groundedness, calm focus, and presence.

• From a Confucian perspective, the Spleen’s virtue is Xin, or “Trust.”

• In Five Element theory, its elemental representation is Earth. Its seasonal correspondence is late summer, and it is most affected by the environmental factor of Damp.

• Its influencing taste is Sweet.

• Its ascendant time of day is 9 a.m. to 11 a.m.

Analysis of Physical and Energetic Aspects of the Spleen

The Spleen’s main functions of transformation and transportation have to do with its role in the digestive process. Specifically, it separates and extracts pure, useable nutrients, the “clear” or “clean” portions of the Guqi (Gu Qi, “grain” Qi or food Qi) from food and drink held in the stomach (its paired Yang organ), transforms those nutrients into useable substances as part of their becoming Qi and Blood, and then transports those nutrients both for further processing and to disseminate them throughout the body for nourishment. The impure parts of food are left in the Stomach, which sends it down into the intestines either for further processing or for elimination.

The initial transportation of Guqi is upward, part of the Spleen’s ability to control the raising of Qi, to the Lungs for transformation into Zongqi (chest Qi), and to the Heart to be transformed into Blood. These aspects of the Spleen’s function have earned it the distinction of being considered the primary Yin organ for the generation of Qi and Blood and the foundational source of postnatal Qi. Postnatal Qi—that is, all the Qi acquired after birth until the time of death—is important to all of Chinese medicine, but perhaps most important to the practice of Qigong, whose sole purpose is the acquisition, preservation, and utilization of Qi for numerous specific objectives.

The Spleen also transforms and transports water and other body fluids. As with food, it first separates the useable portions (the “clear” or “clean” portions) from any liquid that has been consumed. The clean portions are transported to the Lungs, which distribute moisture to the skin, and are further used to moisten all the tissues of the body. The impure parts of the fluids are sent down into the intestines either for further processing or for elimination. The Spleen also transports excess fluids from meridians, tissues, and organs for elimination from the body. So the Spleen’s role in water metabolism includes transportation of clean fluids to ensure proper moistening of all body tissues and the elimination of excess or unclean fluids to prevent the accumulation of Damp. Damp is a pathological manifestation of moisture and can be produced by Spleen Qi Deficiency.

Looking at just this part of Spleen function, a healthy Spleen is responsible for good appetite and nutrient absorption, normal digestion and elimination, the production of energy, and the generation of Blood and other body fluids. A poorly functioning Spleen can cause poor appetite, abdominal distention, low energy, loose stool, or diarrhea (from poor nutrient absorption with an accumulation of Damp), as well as swelling, edema, and phlegm (from an accumulation of Damp). (See Appendix 2Note 5.2)

The Spleen’s control of Blood has two main parts. We’ve looked at one part already, the Spleen’s role in generating Blood. The second part is that the Spleen is responsible for holding the Blood within the blood vessels. When the Spleen is healthy and working properly, there is no obvious indication of it performing this function, since the body is simply functioning normally. However, a deficiency of Spleen Qi can cause a variety of bleeding disorders if the Blood extravasates, or leaves the blood vessels inappropriately. This can include the tendency to bruise easily, having frequent nose bleeds or bleeding gums, bloody stool, excessive uterine bleeding or bleeding at various time throughout the menstrual cycle, and frank hemorrhaging with a poor ability of the blood to clot normally.

The Spleen’s domination of the muscles and four limbs is related to functions already discussed. As the Spleen transforms nutrients into Qi, Blood, and body fluids and transports them to all the body’s tissues, it nourishes the muscles, providing for good muscle development and strength, and it lubricates muscle tissue, providing for suppleness and proper functionality. While the Spleen dominates all muscles, it has a special affinity for the muscles of the arms and legs. If the Spleen Qi is weak, a person will tire easily, and the muscles will be weak, stiff, dry, and less flexible and may even atrophy.

The Spleen’s opening to the mouth and controlling taste and saliva is the very first step in its bringing nutrients into the body for transformation and transportation. A healthy Spleen creates a healthy appetite, and the mouth is able to enjoy the full spectrum of tastes to support that appetite. (In any illness, one of the main indicators of a good prognosis is the maintenance or return of a good appetite.) Spleen deficiencies may cause a poor appetite and dull the sense of taste or may cause an unpleasant, abnormal sweet taste in the mouth.

The production of adequate saliva is necessary to break down starches and lubricate other food for better mastication, the beginning of good digestion. The Spleen’s manifestation on the lips is a reflection of the quality of its transformation and transportation. A healthy Spleen produces ample Qi and Blood, and so the lips will appear pink, moist, and lustrous. Various Spleen pathologies will make the lips appear pale, dry, or cracked.

The Spleen controls the raising of the Qi. We’ve seen how the Spleen sends nutrients upward to the Lungs and Heart to produce Qi and Blood, one aspect associated with the raising of Qi. (This quality is counterbalanced by its paired Yang organ, the Stomach, which descends Qi.) Another raising function involves holding the internal organs in their proper place, to prevent organ prolapse. While many internal organs such as the stomach, kidneys, or urinary bladder are subject to prolapse, in prolonged Spleen weakness, the uterus or anus may abnormally lower to the point of protruding from the body. The final aspect of raising Qi is that the Spleen causes clear Yang Qi to rise to the head, aiding in the function of all the sense organs and in clear thinking. If the ascent of the Qi is blocked, as can be the case in an accumulation of Damp, there can be dizziness, blurry vision, a sense of heaviness in the head, and fuzzy thinking.

Analysis of Emotional Aspects of the Spleen

The Spleen’s associated emotions are worry and pensiveness. Since it houses thought, some sources say thinking or meditation is an associated emotion. Keeping in mind that from a medical perspective the primary emotions of an organ are its pathological manifestations (an aid to diagnosis), for this association to hold, the quality of that thinking has to be interpreted as obsessive or at least excessive, bringing it into the realm of worry or pensiveness (brooding). Pensiveness in this case means overthinking or excessive mental work. All of these things can damage the Spleen functionally, in all of the ways discussed previously. When worry causes Qi to knot, a person will become stuck fretting over a troubling thought or stuck in a nonproductive, circular thought pattern. This is very similar to the obsessive portion of an obsessive-compulsive disorder.

If a person has a constitutional Spleen weakness, one common manifestation is being flighty or ungrounded, with an inability to stay focused or present—the stereotypical “space cadet.” A person with a healthy Spleen will have exactly the opposite presentation and will be grounded, solid, focused, and present. Their thoughts are clear and organized, and they may be able to engage in prolonged mental work with relatively little detrimental effect.

Analysis of Psychospiritual Aspects of the Spleen

The Spleen houses thought, but this is a different function from the Heart housing the mind or consciousness. There is some relationship between the two, as illustrated by the function of the first acupuncture point on the Spleen meridian, which is said to clear the Heart and stabilize the spirit. The Kidneys play yet another role in thinking and memory as we will soon see.

Housing thought primarily has to do with clear thinking, having the ability to concentrate and memorize easily, absorbing information in the context of schoolwork, any type of extended study, or related mental tasks. This absorption can be seen as yet another aspect of the Spleen’s governing of transformation and transportation. Just as the Spleen absorbs nutrition from the outside world and makes it useable within the body, it grasps or apprehends concepts and ideas, absorbing and transforming them through thought to make them useable and accessible for many purposes by the person who has assimilated them.

As in its emotional correspondence, overthinking and excessive studying can weaken the Spleen. This is a relatively common concern for high-achieving students. Strengthening the Spleen can minimize this, and there is even one point on the Spleen meridian that is used for students who think too much.

The Kidneys

Main Functions of the Kidneys

• Govern birth, growth, reproduction, and development and govern Water

• Store Jing (essence)

• Dominate bones, produce Marrow, and fill the Brain

Other Functions and Attributes

• Control the reception of Qi

• Open to ears and control hearing

• Control the two lower orifices and control urine

• Manifest on the head hair

• House willpower

Additional Correspondences

• Its associated emotions are fear and fright. Fear and fright make Qi drop.

• Its healthy emotional expressions are self-understanding and clear perception, leading to true wisdom.

• The Kidneys’ virtue is Zhi, or “Wisdom.”

• Its Five Element representation is Water. Its seasonal correspondence is winter, and it is most affected by the environmental factor of Cold.

• Its influencing taste is Salty.

• Its ascendant time of day is 5 p.m. to 7 p.m.

Introduction to the Kidneys

The Kidneys are perhaps the most complex organ in all of Chinese medicine. They have more functional interrelationships with every organ than any other individual organ. Being the origin of both Fire and Water in the body, the Kidneys have many unique and seemingly paradoxical attributes. Although there are two kidneys, some sources include a third, nonphysical (although functionally very apparent) structure called the Mingmen as an integral part of the Kidneys, while others consider it to be separate from but functionally related to the Kidneys.

The Kidneys occupy a unique place among all Yin organs in that they store “prenatal essence,” or Yuan Jing (also translated as original, preheaven, or congenital essence), which is inherited from one’s parents and is loosely equatable with being the repository of all our genetic information. While other types of Jing are found throughout the body, the Kidneys are the only place where Yuan Jing is stored. Combined with “acquired essence,” it composes Kidney Jing. Kidney Yin, Yang, and Qi are separate things and are included as part of Kidney Jing. Since so many of the Kidneys’ functions rely upon it storing Jing, some consideration is warranted.

General Characteristics of Jing

In simplest terms, Jing is a Yin fluid with a high-energy functional Yang Qi aspect. Present in many places throughout the body, Jing is most often thought of as exclusively residing in the Kidneys, since Kidney Jing is a one-of-a-kind essence that underlies the health of the entire body.

Most organs store or generate their own type of Jing essence. Every organ has a Yin substantive nurturing aspect, and a Yang energetic functional aspect. These are mutually supportive qualities that are typically separate, although some part of an organ’s Yin fluid can be imbued with an energizing Yang quality, which makes it a Jing essence. This Jing is manufactured or otherwise acquired through various physiological processes after birth and throughout the course of one’s life, so it is an acquired essence, a postnatal Jing.

For example, we’ve seen how saliva is a fluid controlled by and associated with the Spleen. Saliva is not commonly thought of as Spleen essence, but if we examine its role, we see how it fits the criteria. It is a Yin fluid substance that moistens the mouth and lips, which are associated with the Spleen. It moistens food for easier mastication, another part of its Yin attribute. But beyond moistening food, it also breaks down some components of food, beginning the process of digestion, under the Spleen’s governance of transformation. This is a functional Yang attribute of saliva, due to saliva containing Yang Qi, energy blended with the Yin fluid. From Western medical science, we know that saliva contains salivary amylase, an enzyme that breaks down carbohydrates. The salivary amylase is the most Yang part of saliva—an example of the Yang within the Yin as illustrated by the Taiji symbol—and is what makes saliva a Jing and not just a moistening Yin fluid.

Using this example as a model, we can define Jing as any Yin fluid that contains a functionally Yang quality, an energy that initiates, mediates, or maintains any functional activity in the body. This analysis is supported by the definition of Jing from the Beijing Medical College Dictionary of Traditional Chinese Medicine found in the following section. With this understanding, we can draw correlations between Jing and Western medically defined substances such as enzymes (which catalyze all biological chemical reactions), hormones, and other secretions of most endocrine and exocrine glands.

Jing and Qi

Jing has a unique relationship with Qi, in part because Jing may be thought of as Qi in the form of a fluid substance. In his book The Foundations of Chinese Medicine, Giovanni Maciocia states, “[Original Qi] is closely related to Essence. Indeed, Original Qi is nothing but Essence in the form of Qi, rather than fluid. It can be described as Essence transformed into Qi.” 8 While describing Jing (essence) as Qi, the clear implication is that original Qi is contained in and transformed from the fluid essence.

Some Chinese medical references inseparably link Jing with Qi, calling it Jingqi. In the Beijing Medical College Dictionary of Traditional Chinese Medicine, Jingqi is considered both a “vital substance, chiefly referring to that derived from food essence,” and as “vital essence and vital energy as material basis for visceral functioning. The vital essence and energy stored in the kidney are closely related to sexual activity and reproduction.” 9 From these statements we begin to see how Qi and Jing have an interdependent relationship of mutual influence. We also see that when Jing or essence is referred to by itself, it is almost always Kidney Jing being discussed.

Jing is a highly refined substance, the quality and quantity of which influences every aspect of our health and life. In The Web That Has No Weaver, Ted Kaptchuk explains,

Jing, best translated as Essence, is the Substance that underlies all organic life. … [It is] the source of organic change. Generally thought of as fluid-like, Jing is supportive and nutritive, and is the basis of reproduction and development.

Jing has two sources. … Prenatal Jing … is inherited from the parents. In fact, the fusion of this prenatal Jing is conception. … The quantity and quality of prenatal Jing is fixed at birth and, together with Original Qi, determines a person’s basic makeup and constitution.

Postnatal Jing is the second source and aspect of Jing. It is derived from the purified parts of ingested food. The Postnatal Jing constantly adds vitality to the Prenatal Jing. Together, they comprise the overall Jing of the body.10

This passage provides a workable definition of Jing, primarily focusing on Kidney Jing, and introduces its two sources, prenatal Yuan Jing and postnatal acquired Jing.

Kidney Jing

There is a lot to be explored in the expanded understanding of Yuan Jing (prenatal Jing) and acquired Jing. Throughout the rest of this book, we’ll focus primarily on Kidney Jing and its role in general and medical health.

Kidney Jing is what’s most often meant in discussions of Jing. While every organ has its essence, the Kidneys are unique in that they also store the arguably finite Yuan Jing from one’s parents and a significant quantity of acquired Jing, more readily available from food and other sources. This blend of Yuan and acquired Jing is typically identified simply as “Jing,” most physically manifesting as sperm and ova. Kidney Jing contains both inherited Yuan Jing and acquired Jing, and by extension Kidney Yin, Yang, and Qi.

Kidney Jing has at its root the energy of sex, which in many people’s experience embodies the strongest concentration of the energy of life. That sexual association is also responsible for much of the Kidneys’ role in governing birth, growth, reproduction, and development, and, later in life, inevitable decline.

Sexual essence, specifically Kidney Jing, is not only the root of sexual vitality and reproduction but of all vitality, not just sexual activity. Many people take up the practice of Qigong or Taiji in their later years for the expressed purpose of conserving or restoring their sexual vitality and consequently their overall health and longevity.

Qigong and Jing

Qigong can be practiced as a part of Chinese medicine, as is taught in this book. When Qigong is cited as the only practice that can restore Jing, it is almost always taken to mean sexual Jing essence, Kidney Jing. Since Yuan Jing is stored in the Kidneys and makes up a part of Kidney Jing, some contend that Qigong may also restore Yuan Jing. Many practitioners consider Qigong to be the best way, possibly the only way, to replenish Yuan Jing. Some highly cultivated contemporary Qigong masters have stated that the practice of Qigong allows one to access and alter the genetic code itself. This clearly addresses Yuan Jing, and at an advanced level of practice, it may in fact be possible to replenish or otherwise positively alter Yuan Jing. More commonly, scholars, teachers, doctors, and other authorities agree that Kidney Jing, since it is largely composed of acquired Jing, can be replenished and nourished, and its Yuan Jing component can be conserved or spared.

Conservation is no small thing. As people age and experience the associated decline and degenerations that typically accompany aging, it is the depletion of Kidney Jing (the Kidney Yin and Yang Qi components separately as well as the totality of essence as their material foundation) that is the primary cause of that decline. While sensible, healthy lifestyle choices help slow that decline, the skillful practice of Qigong can stop or reverse many of those changes. When that occurs, it is evidence that the Kidney Jing, including Yuan Jing, is being restored, and this is what is meant by most who state that Qigong can replenish Jing.

Mingmen

Some of the oldest Chinese medical texts (notably the Classic of Difficulties, Chapter 36, produced circa 100 CE) consider that the left Kidney is the “true” Kidney, the source of true Yin. This makes it the origin of Water. At that time, the right Kidney was not thought of as a true Kidney at all, but instead as the seat of the “Gate of Vitality,” a common translation of Mingmen, which contains Kidney Yang. That makes the right Kidney, or Mingmen, the origin of Fire. When referred to in this context, its full name is Mingmen Hou, meaning “Life Gate Fire.”

Two herbal formulas from that time, still in use today, are named to neatly capture that thought. Zuo Gui Wan, or “Restore the Left” pill, nourishes Kidney Yin. You Gui Wan, “Restore the Right” pill, tonifies Kidney Yang.

Physicians from later periods revised this thought and considered Mingmen a separate energy center located between the Kidneys. That perspective is prevalent today and is in keeping with what most cultivated Qigong practitioners assert from direct experience. While the Mingmen is still called the Gate of Vitality, or the Gate of Life, it is also colloquially referred to as “the rear Dantian,” since it is located behind and slightly above the Dantian, can be perceived as a discrete energetic entity, and serves functions similar to the Dantian while maintaining its role as the origin of Fire.

For our purposes, we will consider the right and left Kidneys and the Mingmen as one functional unit unless otherwise stated for a specific purpose or clarification. In contemporary clinical settings, the right and left Kidneys are seldom treated separately (although Kidney Yin and Yang are frequently addressed separately), and except in advanced Qigong practices, the Mingmen is almost never directly addressed separately. (See Appendix 2Note 5.3.)

Analysis of Physical and Energetic Aspects of the Kidneys

The Kidneys’ function of governing growth, reproduction, birth, and development is related to its storing of Jing essence. The union of parental Kidney Jing creates a new life and is the clearest indication of Kidneys governing reproduction. Equally important, each parent must have enough sexual vitality to have the health and sexual desire to initiate conception, another aspect of reproduction.

Original essence along with its original Qi governs the growth and development of the fetus inside the womb. After birth, that essence is stored within the Kidneys of the newborn as part of its original essence, along with the Kidney Yin and Yang that makes the baby a unique individual. Original essence is responsible for the baby’s constitution and vitality and governs its continued growth through all the stages of life, including puberty/reproduction, maturation, menopause/andropause, and the decline that precedes the finality of death.

Acquired essence, the refined essences extracted from food and transformed by the Stomach and Spleen, is added to Kidney Jing after birth. It replenishes and adds vitality to original essence, and together they form the totality of Kidney Jing.

Kidney Jing is the material base for Kidney Yin, Yang, and Qi, all of which can be transformed from Kidney Jing and exist simultaneously with it. Some medical texts say it is the essential Kidney Qi that governs the phases of birth, growth, development, and reproduction, which are all functional activities and so naturally rely on Qi, but since even in that case it’s derived from Kidney Jing, essence is its ultimate source. Accordingly, Kidney Yin and Yang also have Jing as their foundation.

Kidney Yin is the foundation for all the Yin fluids of the body, which moisten and nourish all the organs and body tissues. Kidney Yang is the foundation for all the Yang Qi of the body, which warms and promotes the functional activities of all the organs and body tissues. This is how the Kidneys are the origin of Water (Yin) and Fire (Yang), an important aspect in their government of all the developmental stages of a person’s life.

The Kidneys’ relationship with Bones and Marrow is again dependent on their storage of Jing. Essence generates Marrow. This Marrow has two aspects, one that is similar to Western medicine, bone marrow, and one that is very different, Marrow as the substance that makes up the spinal cord and Brain.

Marrow is produced in the core matrix of bone cavities. The strength and density of bone is dependent upon its nourishment by Marrow. If the Kidneys are strong and Marrow is abundant, bones will be firm and hard, with a suppleness that makes them difficult to break. If the Kidneys are deficient and Marrow is insufficient or of poor quality, there can be bony malformation in children and weak, achy back, knees, and feet in adults. Bones will be brittle and prone to break more easily. (See Appendix 2Note 5.4.) The teeth are an extension of bone and are therefore subject to the same considerations. Healthy, abundant Marrow creates teeth that are strong, dense, resistant to cavities, and rooted firmly in the gums and jaw. Weak Kidneys cause teeth to be softer, prone to chipping and cavities, and liable to become loose or to fall out.

Marrow generates the spinal cord and Brain, a perspective unique to Chinese medicine. Marrow is said to fill up the Brain, so the Brain is referred to as “the sea of Marrow.” If the Kidney Jing is strong, it will nourish the Brain and produce clear thinking with good memory and concentration. If the Jing is weak, there will be forgetfulness, poor concentration, and fuzzy or dull thinking. The Kidneys’ involvement with memory and concentration is primarily related to short-term memory. The loss of short-term memory can be distracting and disruptive to a person’s ability to follow an immediate sequence of events, reducing concentration. This is most often seen in the elderly, who have a marked decline in Kidney Jing. Milder versions of this can happen at any age, whenever Jing is sufficiently depleted. We’ve seen that the Heart houses consciousness, and the Spleen houses thought. This function of the Kidneys completes the picture of the organs’ roles in consciousness, thought, and other mental processes.

The Kidneys receive Qi from the Lungs. They are said to “grasp” the Qi, assisting the Lungs in their descending function. This is what is meant by controlling the reception of Qi. Working in concert with the Lungs, when Kidney Qi is strong, respiration is smooth, even, and full. If Kidney Qi is weak and fails to grasp the Qi, Lung Qi can stagnate in the chest, causing shortness of breath and difficult inhalation, especially after any type of exertion. This is a common cause of asthma.

We’ve seen that the left Kidney is the origin of Water, and the Kidneys’ Five Element representation is Water. The Kidneys’ governance of Water is yet another water correlation, and relates to its function of controlling the lower orifices. The Kidneys are very involved with every aspect of water metabolism and play an important role in the regulation and distribution of all body fluids.

Fluids are first received by the Stomach and then transported by the Spleen up to the Lungs. The Lungs’ function of descending and dispersing sends fluids down to the Kidneys. Here, the Kidney Yin Qi and Yang Qi come into play and separate the clear, pure fluids from the waste fluids. The pure fluids are sent back up to the Lungs by the “steaming” function of Kidney Yang Qi, for distribution to all of the organs and tissues in the body. The waste fluids are sent to the Urinary Bladder to be converted to urine and excreted.

Kidney Qi is also responsible for the Kidneys’ opening and closing function, in which it acts as a sort of sluice gate. This function is most commonly thought of in its connection to urination, but since the Kidneys regulate all aspects of water metabolism, it is equally important in their receiving fluids from the Lungs. When the Kidneys’ Yin and Yang Qi are balanced and normal, the Kidneys will receive, separate, and transmit fluids normally. Urination will be normal, and the body will be hydrated and nourished by ample amounts of pure fluids. If Kidney Yang Qi is deficient, the sluice gate will be too open, there will be less efficient separation of the pure fluids from the waste fluids, and urination will be profuse and pale. If prolonged, dehydration may occur. If Yin Qi is deficient, the gate will be too closed, urination will be scanty and dark yellow, and there may be an abnormal accumulation of fluids, causing edema.

The lower orifices include the anterior orifice (urethra and sex organs), involved in urination and reproduction, and the posterior orifice (the anus), functioning to excrete feces. While it is the Urinary Bladder that discharges urine, Kidney Qi powers that function and similarly powers the anus in its excretory function. In addition to the urinary considerations addressed above, weak Kidney Qi can cause incontinence or enuresis (the inability to control urination). It can also cause diarrhea and anorectal prolapse. Semen is the external manifestation of Jing, so a deficiency in either Kidney Qi or essence can cause spermatorrhea (leakage of sperm), nocturnal emission, premature ejaculation, or impotence. It can cause infertility in both sexes. There can be other less common presentations, but primarily, healthy functioning lower orifices will prevent any type of leakage, while compromised functioning will allow leakage of sperm, urine, and feces.

The Kidneys open to the ears and control hearing. This is a less obvious connection than many organs have with their related sense organ, yet the Huangdi Neijing (The Yellow Emperor’s Inner Cannon, a classic Chinese medical text produced circa 100 BCE) states, “The Kidney Qi goes through the ear. If the Kidney is harmonized, the ears can hear the five tones.” 11 The ears rely on nourishment from Kidney Jing and Qi for healthy functioning. With such nourishment, hearing is acute. If the Kidneys are weak, hearing can become reduced even to the point of deafness, or there can be other hearing abnormalities, such as tinnitus (a persistent ringing in the ears). This connection becomes more apparent in the presence of pathology, since many hearing problems are resolved by treating the Kidneys, and in the aging process.

The Kidneys manifest on the hair. The hair relies on Kidney Jing to grow. Jing supports the production of Blood, and hair is called a “surplus of Blood” in some texts. In any case, Blood is required to nourish hair and give it luster. When the Jing is abundant and able to promote healthy Blood, the Kidneys create hair that is full, thick, lustrous, and with good color. If the Kidneys are weak and Jing is deficient, the hair will be dull or brittle, will lose color and become gray or white, and will fall out easily. Hair is considered a secondary sex characteristic in most cultures and can be a subliminal cue in assessing a person’s sexual (and overall) vitality, since both depend on Kidney health. Accordingly, during reproductive years hair appearance may be a factor in selecting a potential mate.

As people age, it’s natural that Kidney Jing, Yin, Yang, and Qi will decline, causing all of the symptoms of aging. Taking into account what we’ve learned about the Kidneys, we can easily see that correspondence. In aging people, sexual vitality diminishes until in menopause women can no longer conceive and bear children, and at some point most men will have too low a sperm count or too weak an erection to be able to father children. Bones become brittle, become osteoporotic, and tend to fracture easily. They may change in other ways, causing various spinal curvatures or arthritic deformities. Teeth become loose and fall out, hair becomes dull, brittle, thin, and white; and hearing diminishes. Short-term memory becomes poor. Incontinence and breathing difficulties are common. Many elderly people become fearful and sensitive to cold. When the Kidneys become too weak to provide the ultimate support that other organs rely on, those organs become functionally impaired.

Analysis of Emotional Aspects of the Kidneys

The emotions associated with the Kidneys are fear and fright. These can arise from various Kidney deficiencies, although Qi deficiency is most usually involved. Fear is typically a more prolonged, pervasive state of being. Fright has the quality of an immediate shock, a sudden fear from a perceived real-life danger, or the feeling some might seek out in an amusement park fun house or at a horror movie. Since fright has a rapid onset, its effects manifest rapidly and obviously, so we’ll discuss that first.

Fear and fright cause Qi to drop. When frightened, that drop can happen suddenly and strongly and can make a person lose control of the lower orifices, the anus and urethra. Most people have encountered instances, either in real life or in the movies, of someone getting so frightened that they wet themselves. This is also the origin of the descriptive if somewhat crude phrase of being “scared shitless.” The sudden drop also causes a loss of Qi, so the Kidneys must convert and release some Jing to make up for that loss, which can be temporarily stimulating and energizing. That’s why fright is used as entertainment in amusement parks, movies, public haunted houses, and other similar diversions. They are especially popular with young people and those with abundant Jing, who are less likely to notice the depleting effects in the short term. People who are addicted to extreme sports (also known as “adrenaline junkies”), transform fear into excitement and get their high from the same source, Kidney Jing. If prolonged, this expenditure of Jing will eventually lead to adrenal fatigue or adrenal burnout, one Western correlation with Kidney deficiency.

Fear produces many of the same consequences as fright. A person may be fearful because of a constitutional Kidney deficiency, but if it’s situational, it may be more insidious because it can grow slowly, linger, and be interpreted as a person’s nature. In children, lingering fear can be caused by insecurity about family matters, for example, which is often a significant factor in bed-wetting. In adults, fear is caused by a perception of danger, a feeling that their life is threatened. This can take the form of chronic anxiety from concerns about job security or other financial matters, an unsettling or hostile work or home environment, or the more immediate danger of occupations that put a person in emergency situations on a regular basis. The loss of Jing may happen more slowly, and includes a depletion of Kidney Yin, producing Dryness and Heat. In this case, symptoms of Kidney Yin Deficiency can include heart palpitations, night sweats, dry mouth, and insomnia.

If fear with its concomitant depletions is prolonged, it can lead to a bleak, hopeless depression, much more debilitating than the depression caused by Liver Blood Deficiency or Qi Stagnation.

The Kidneys’ healthy emotional expressions of self-understanding and clear perception can thwart the manifestations of fear or can be the natural antidote to fear, especially if the fear is not well-grounded in reality. With some work, the bed-wetting child can be reassured that her family is stable, loving, and supportive. The adult who feels fearful about job security, finances, family, or other daily life situations can learn either how to change his circumstances or how to change his perception of those circumstances, whichever may be most appropriate. In these examples the clarity and understanding empowers the person and dispels the fear at the root of the problem.

Analysis of Psychospiritual Aspects of the Kidneys

The Kidneys house willpower. This is an aspect of the mind that allows a person to focus on a goal and pursue it to completion. It’s related to the healthy emotional expressions of clarity and self-understanding, since those qualities provide a person with the ability to see which goals are in their ultimate best interest and with the motivation with which to direct the drive of will. With strong Kidneys, a person can work purposefully for extended periods of time with focus and concentration and can effectively store and retrieve information in short-term memory.

When the Kidneys are suffering an imbalance, the motivation to work can become excessive and cause the compulsive working habits of the workaholic. If the Kidneys are weak, then concentration is poor, the mind can be easily distracted from primary goals, determination wavers, and the person can become discouraged.

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8. Giovanni Maciocia, The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists (London: Churchill Livingstone, 1989), 41.

9 . Xie Zhufan, Huang Xiaokai, Dictionary of Traditional Chinese Medicine (Hong Kong: The Commercial Press, Ltd., 1984), 34.

10. Ted Kaptchuk, The Web That Has No Weaver: Understanding Chinese Medicine (Chicago: Congdon and Weed, 1983), 43.

11. Giovanni Maciocia, The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists (London: Churchill Livingstone, 1989), 97.