Chapter 4 Section 2 Understanding of Human Physiology and Pathology in Traditional Chinese Medicine
The word "Zang Xiang" first appeared in the "Nei Jing", "Zang" refers to the five internal organs that reside in the body; "Xiang" refers to the signs of life activities that appear outside.Its research content is centered on the five zang-organs (heart, liver, spleen, lung, and kidney), and expounds the physiological functions of the zang-fu organs, as well as the relationship between the zang-fu organs (stomach, small intestine, large intestine, triple burner, bladder, gallbladder, etc.) The external organization, the relationship between the five sense organs and the nine orifices, and the organic connection between man and nature, part and whole.For example, the "Neijing" believes that: the heart is the official of the monarch, and it is the master of the gods, and the master of the gods will be at ease.Its flowers are on the face, it fills the blood vessels, opens to the tongue, and the small intestine is the exterior and interior of each other, and the pericardium (also known as the pericardium) is its periphery.It means that the heart is the most important of the viscera, equivalent to the king of a country.God, in a broad sense, refers to the external manifestation of the life activities of the entire human body; in a narrow sense, God refers to human spirit and thinking activities.The heart governs the gods, which means that the heart is what the spirit meets, so "those who let things be called the heart".Vessels are the home of blood and the tunnel through which blood passes.The heart has the function of promoting the movement of blood in the vessels, so it is said that "the heart governs the blood vessels".The rich blood vessels on the face can best reflect the ups and downs of heart energy; the rich facial expressions can best reflect the changes of emotion and spirit, so it is said that "the beauty is on the face".The heart meridian Bieluo (the Bieluo is the collateral of the other meridian that goes to the adjacent meridian) ascends the tongue, so the physiological changes and pathological changes of the heart can be reflected in the tongue body.The function of the heart (gods, blood vessels) is so important, so it is said that "the master (the meaning of dominance, referring to the heart) is clear, and the rest is safe; For example, the lung is the official of Xiangfu, which is used to control festivals; the liver is the official of the general, which is used to plan and worry." The above uses the heart as an example to illustrate the interpretation of the theory of Zangxiang to the function of the original viscera (fu).
The formation of the Zangxiang theory is inseparable from the long-term observation, repeated medical practice, and simple anatomical knowledge of ancient doctors. It gradually rose from perceptual knowledge to rational knowledge, and then turned back to guide medical practice.For example, when people are angry, anxious, and get angry, their eyes will become red and painful, and the mood changes of "anger" are related to the liver. After treatment with drugs that relieve liver fire, they will improve, so it is deduced that "the liver opens up to the eyes".Another example is that patients with weak spleen and stomach often suffer from loss of appetite, diarrhea, edema of limbs, fatigue and emaciation. It is also concluded that "spleen governs movement and transformation", "stomach governs reception", and "spleen governs promotion of clearness (enhancing the qi of clear yang, It is beneficial to the physiological functions such as water and grain essence for the body to use)".Limited to the level of anatomy in ancient times, Chinese medicine mainly focuses on the overall and dynamic observation of the living and moving human body.Thousands of years of clinical practice have proved that this research method is different from the anatomy-based research method. It has a holistic concept, and it is also one of the important reasons why Chinese medicine and Western medicine form two completely different theoretical systems.
Since the "Nei Jing", doctors of successive dynasties have continuously enriched and improved the theory of Zangxiang.On the one hand, it deepened the new understanding of anatomy; on the other hand, with the rise of medical schools in the Jin, Yuan and Ming and Qing Dynasties, various doctors deepened the content of the Zangxiang theory from different angles, and formed a series of theoretical and clinical Effective prescriptions are still widely used clinically.For example, Li Dongyuan’s elaboration on the spleen and stomach in the Jin and Yuan dynasties; Zhang Jingyue’s discussion on kidney yin and kidney yang in the Ming Dynasty; Li Shizhen’s understanding of brain function;
Zangxiang also uses the cognition method of five elements to explain the connection between viscera, fu organs, various tissues and organs, and the natural world.Take wood, fire, earth, metal, and water as five systems, and there are relationships between them such as life, restraint, multiplication, and insult, and each system is centered on the liver, heart, spleen, lung, and kidney, and each has its own .
If you can understand what the Zangxiang theory is, you will also know that the names of organs used in Chinese medicine and Western medicine are sometimes the same, but the two refer to and their physiological functions are fundamentally different, and must not be confused.For example, someone has a problem with their eyes, and Chinese medicine says "the disease is in the liver", so the patient is burdened and feels that he needs to draw blood to check the condition of liver function.In fact, it is the liver that does not understand the theory of Tibetan phenomena in traditional Chinese medicine, which is different from the liver in Western medicine.This misunderstanding is all too common today.
The theory of spirit, energy and spirit originated from the Taoist school.The Taoist school was founded in the late Spring and Autumn Period and flourished in the middle and late Warring States Period.At the beginning of the Western Han Dynasty, the completion of the compilation of the main propaganda of Taoism made the theory of spirit, energy and spirit tend to be perfect. "Huainanzi" expounds the relationship between shape, energy and spirit, and integrates the theory of essence, energy and spirit, the theory of yin and yang, and the theory of five elements, and discusses the origin and evolution process of all things in nature, as well as the relationship between spirit and matter.
Traditional Chinese medicine uses essence, qi, and spirit to explain the transformation law of the unity of form and spirit in human life activities.Essence is the foundation of the human body and the material basis of life activities, which can be divided into innate and acquired.The innate essence is inherited from parents and is born with; the acquired essence comes from the subtle substances metabolized by diet.There are two meanings of qi: one refers to the flowing subtle and hard-to-see subtle substances, such as vitality, health, nutrition, meridians, etc.; the other refers to the physiological functions of viscera, such as spleen and stomach qi, heart qi, bladder qi, etc. .
Spirit is the external manifestation of essence and qi, that is, the sign of life manifested externally. "Su Wen·Yi Jing Chang Qi Lun" said: "Those who gain the spirit prosper, and those who lose the spirit die." Therefore, the most important content of inspection in diagnosis is the spirit.Broadly speaking, not only inspection, but also the pulse condition obtained by checking the clinic, the physiological signs obtained by asking the clinic, and the sound of hearing the clinic can all reflect the patient's mental state.Human spiritual activities such as gods (gods in the narrow sense), souls, souls, wills, and wills also belong to the category of gods.The spirit has a regulating effect on qi, thereby affecting the storage, release, gathering, and dispersion of essence.The regulating effect of spirit on qi and essence can be said to be the main theoretical basis of qigong movement.
The relationship among Jing, Qi, and Shen can be summed up as follows: Jing is the foundation, Qi is the function, and God is the expression. Life and death share, mutual influence, endless transformation, and life maintenance.Therefore, the theory of essence, qi and spirit embodies the "constant view of human body" in traditional Chinese medicine.It reflects the dialectical relationship between spirit and matter, and this theory is applied to various aspects of TCM diagnosis, treatment, disease prevention, and health care.
The meridian theory is a theory that studies the physiological functions, pathological changes of the meridian system of the human body, and its relationship with viscera.Meridians are the pathways through which Qi and blood run in the human body. It is a unique system that communicates the inside and outside of the human body, up and down, and connects viscera and organs.
The theory of meridians includes two parts: meridians and collaterals.Meridians are divided into regular and extra meridians; collaterals are divided into Bieluo and Sunluo.Although the internal organs, six internal organs, limbs, five sense organs and nine orifices of the human body have various physiological functions, they can carry out organic overall activities together, mainly relying on the connection of meridians.The occurrence and transmission of diseases, from the outside to the inside, also take the meridian as the way.Therefore, changes in the meridian circulation position can also be used as the basis for diagnosing diseases.
The most important trunk lines in the meridians are the twelve meridians, namely the Lung Meridian of Hand Taiyin, the Large Intestine Meridian of Hand Yangming, the Stomach Meridian of Foot Yangming, the Spleen Meridian of Foot Taiyin, the Heart Meridian of Hand Shaoyin, the Small Intestine Meridian of Hand Taiyin, the Bladder Meridian of Foot Taiyang, the The Kidney Meridian of Shaoyin, the Pericardium Meridian of Hand Jueyin, the Sanjiao Meridian of Hand Shaoyang, the Gallbladder Meridian of Foot Shaoyang, and the Liver Meridian of Foot Jueyin, the meridians of Qi circulate in order, like a circle without reason.It can be seen that the meridian theory and the theory of Zangxiang are closely related and inseparable.
More than two thousand years ago, the meridian theory was quite mature.As for when it was discovered, and how it was discovered, this huge and complex network system with precise acupoints [shushu], it can be said that no one has yet given a satisfactory explanation.At present, a lot of research has been done on the essence of meridians at home and abroad. Most of the reported routes of sensation transmission along the meridians are basically consistent with the meridian routes recorded in ancient medical books, but they are not consistent with the anatomical distribution of nerves, blood vessels, and lymph. .It is worth noting that although the meridian theory cannot be fully explained by western medical theory and modern science, acupuncture treatment of diseases has spread all over the world and has been highly valued. It can be seen that the meridian theory can stand the test of time and clinical practice.It can also be said that the meridian theory must have its material basis.
In the Spring and Autumn Period, our ancestors had a systematic understanding of the pathogenic factors.In the "Internal Classics", there is a complete discussion on the theory of six exogenous emotions, seven emotions, diet, and diseases caused by overwork.Although later generations have developed some etiology, in terms of its scope, it has not deviated from the generalization of these aspects for more than two thousand years.
The six evils refer to wind, cold, heat, dampness, dryness, and fire, which are the pathogenic factors of human beings.In traditional Chinese medicine, it is called exogenous pathogenic factors.
The seven emotions refer to the seven emotional changes of joy, anger, worry, thought, sadness, fear, and shock. Excessive changes can also make people sick.
Diet and overwork-induced diseases are due to eating disorders, impermanence in daily life, excessive fatigue, and irregular sexual intercourse.
Pathogenesis is the pathological mechanism, which refers to the principle of disease occurrence and the law reflecting the location, nature and development of the disease.For the systematic exposition of pathogenesis, "Nei Jing" is still the most recommended.In a nutshell, Chinese medicine believes that when righteousness cannot resist evil, the disease will develop; when the righteousness overcomes the evil and retreats, the disease tends to improve; when the evil overcomes the positive and declines, the disease tends to worsen; and the transmission of the disease is various.As for the results of the analysis of the etiology and pathogenesis, the natural syndromes can also be identified.Of course, the analysis of etiology and pathogenesis is based on the theory of Tibetan phenomena and meridians.
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