Unit 3 Theory of Visceral ManifestationWhile you listen（Watch）1) internal 2) disharmony3) system 4) specific 5) performs6) energetic7) fundamental8) nourishes9) sweat10) insightsAfter you listen（Watch）1)What is oriental medicine? Is it the same as Chinese medicine?Oriental medicine can mean Traditional Chinese medicine, Traditional Korean medicine or Kampo (Japanese medicine). So it is not the same as Chinese medicine. In the United States, oriental medicine refers to a master's degree program of Acupuncture and Chinese Herbal Medicine, with Tuina, Qigong and associated modalities.2) Why are the Chinese organs vastly different from the western organs?The Chinese organs, i.e. the internal organs or zang fu, are vastly distinct from the Western organs, even though they share the same names. They overlap only in certain instances. In Western medicine an organ is a collection of various tissues integrated into a distinct structural unit to perform specific functions. For example, the kidney is either of a pair of small organs in the body which takes away waste matter from the blood to produce urine. Compared with Chinese medicine, the zang fu organs are energy transformers or transformers in a complex bioenergetic system. And what they do relates to their qi transformation functions. For example, one of the main functions of the kidney is to promote growth and development of the body and play an important role in reproduction.3) How can physical problems be prevented from occurring?We can trace the source of the imbalance, predict potential problems, successfully treat them, and prevent them from occurring, not just eliminate them with the expectation that they'll return. Physical problems only manifest when the energetic source is out of balance. For example, a cough tells us that the lungs are transforming clean air qi improperly.4) Can you describe shen in your own words?Shen is one of the basic substances that according to Chinese medicine are present in every part of the body. It is another very special form of qi, usually translated as spirit or mind. If the brain is the computer, then shen is the user or operator. It's the decision maker and resides in the heart.Script:Zang Fu, The Organs Part 1 IntroductionWelcome to American Dragon Presents: Chinese Medicine in America. My name is Joel Penner. I'm a doctor of oriental medicine, a California state licensed acupuncturist and herbalist, and a professor of oriental medicine. I'm also the co-author of the textbook Zang Fu Syndromes:Differential Diagnosis and Treatment. In this episode, we begin our discussion of the internal organs or zang fu. Z ang fu is the heart and soul of Chinese medicine. Knowing what the organ systems do give us the ability to understand the human body, discover the imbalances that result in disharmony, predict the progression of imbalance, correct the problems, and prevent recurrence. This is called zang fu diagnosis and treatment. It's very important at this point for you to understand that even though they share the same names, the Chinese organs are vastly different from the Western organs. If you try to impose your Western understanding on the Chinese organs, you will get completely confused. Only in certain instances do they overlap. The zang fu are energy transformers or qi transformers in a complex bioenergetic system. And what they do relates to their qi transformation functions.Please look at this chart to my right. This is a schematic drawing of the major qi relationships in the body. As you can see, it's quite complex. We won't go into detail with this chart. However, we will look at parts of it as we discuss the organs.Qi is the fundamental substance of the universe. It is the vital energetic force that gives life to all things. Everything is composed of qi. There are three sources of qi used by the human body. These sources are similar, let's say, to a computer. Electricity is its source of energy. This raw electricity, however, needs to be transformed in order to be usable by the computer. The original stepdown transformation is done by the power supply. It turns the raw electricity into energy that is compatible for use by the computer. In the same way the human body has external sources of energy or qi.Let's look at this chart. It's called the qi axis. The first source of qi is what we call congenital qi. It comes from our parents, from the sperm and the egg. It contains our DNA and is the map of our physical and bioenergetic potentials. This qi is stored in the kidneys. The kidneys then transform this qi so that it can perform specific functions within the body. We'll go into detail about this when we discuss kidney functions. The next source of qi is called clean air qi. It is received by the lungs and transformed into qi that performs different specific functions from kidney qi. And the last source of qi is food and drink, which is received by the stomach, processed and sent to the spleen and pancreas for transformation and the qi that again performs different specific functions from kidney or lung qi.We can relate this to our computers. The sound card in the video card in our computers transforms energy into physical forms like music which can be heard, or videos which can be seen. There is even a printer now that takes electrical impulses and transforms them into a car that can be driven, or a plane that can be flown. The organs also transform energetic or qi patterns into physical manifestations, such as organs for blood or cells. The beauty of the Chinese medical system is that by understanding these two relationships, as I said before, we know what is supposed to happen. We can trace the source of the imbalance, predict potential problems, successfully treat them, and prevent them from occurring, not just eliminate them with the expectation that they'll return. Physical problems only manifest when the energetic source is out of balance, just like static in our computers. The sound system tells us that the sound card isn't transforming the electricity properly. So a cough tells us that the lungs are transforming clean air qi improperly. In the next several videos, we will be discussing how the organs relate to and transform the various different types of qi.I recommend reviewing our video of the five substances. The five substances are also known as the five treasures. These are all types of qi which perform specific functions and include qi,jing, blood, shen and body fluids. A quick review reminds us that qi is the fundamental substance in theuniverse. Everything is a manifestation of qi. Jing is a specialized form of qi that contains the blueprint for our life on earth. It comes from our parents and contains our DNA. Blood is another specialized type of qi that nourishes and moistens the cells. Shen is another very special form of qi which is translated as spirit or mind. If the brain is the computer, then shen is the user or operator. It's the decision maker and resides in the heart.Body Fluids are another specific form of qi which cool, moisten and lubricate the body. Here is a schematic body fluid metabolism. We will be using this chart when we discuss the organs relationships to body fluids. There are thin fluids called jin, such as tears and sweat, which moisten and cool. And there are thick fluids, like spinal or synovial fluid called ye, which lubricate.In our next video, we will be discussing the kidneys and how they transform congenital qi. I'm really excited about this series. My hope is that by understanding this system, you will have new insights about how the human body functions and how you can live a healthy, happy life. See you then.BEFORE CLASS1. Quest for Definition1)visceral manifestation: also called “zang xiang”, first appeared in the Huangdi Neijing. Zang,sharing the same pronunciation with viscera in Chinese, refers to internal organs inside the body;xiang means image or phenomenon. When used together, zang xiang, or visceral manifestations, as analyzed above, simply refers to internal organs and the external manifestations of their physiological and pathological states.2)extraordinary fu-organs: refer to a group of tissues and organs, including the brain, the bonemarrow, the bones, the vessels, the gallbladder and the uterus. Extraordinary fu-organs are characterized by hollowness, and have a similar function to the five zang-organs in storing essence.3)organic holism: TCM believes that the human body is composed of various tissues and organs,including the viscera, the meridians, the five sensory organs, the nine orifices, the four limbs and all the skeletal parts. These different tissues and organs are united into an organic whole because they are closely related to each other in structure, physiology and pathology.4)“The liver opens into the eyes”: The eyes have a close relationship with the liver; becausethey are connected to the liver meridian. The ability to see depends on the nourishment of the eyes from blood stored in the liver, and many liver disorders are reflected in the eyes.5)fullness and solidity (of the zang-fu organs): The five zang-organs only store essence but notexcrete it; that is the reason why they can be full but not solid. The six fu-organs are in charge of transporting and transforming food, so they can be solid but not full.6)“Viscera inside the body must manifest themselves externally”: The internal organs insidethe body are connected to external organs, tissues and corresponding portions. Therefore, the functional condition of the internal organs will inevitably manifest externally. Judging from specific external physiological and pathological signs, doctors can detect the condition of aninternal organ.2. Text-based Activities1) How can the phrase “zang xiang” be interpreted?According to the explanation in some Chinese medical classics, “zang” refers to interior organs which are stored inside the body, and “xiang” refers to exterior manifestations of physiological functions and pathological changes of internal organs. The viscera are stored inside the body and the image is manifested outwardly. For this reason, it is also called “visceral manifestation”.2)What are the physiological functions and functional characteristics of zang-organs and fu-organs respectively?The common physiological function of five zang-organs is to transform and store essence; while that of six fu-organs is to receive, transport and transform water and food. The functional characteristic of zang-organs is to be solid but not full as they only store essence but not excrete it; while that of fu-organs is to be full but not solid as they are in charge of transporting and transforming food.3)What is an extraordinary fu-organ?The extraordinary fu-organs, as a type of fu-organs, differing from the six fu-organs in shape and physiological function, are relatively hermetic organs and do not contact with water and food directly.4)What is the significance to differentiate zang-organs from fu-organs in clinical practice?The differentiation between zang-fu organs helps to identify the type of pattern and establish corresponding therapeutic principles. For instance, the disorders of zang-organs are mostly of deficiency type ; while the disorders of fu-organs are mainly of excess type . The related fu-organ can be purged for the treatment of the excess type of zang-organ disorders, and the related zang-organ can be nourished for the treatment of the deficiency type of fu-organ disorders.5)On what basis has the theory of visceral manifestation been developed?The theory of visceral manifestation has been advanced on the basis of the following development: the knowledge of anatomy accumulated in ancient times, the long-term observation of the human physiological functions and pathological changes, and the repeated medical practice in which certain physiological functions were disproved and analyzed in the light of pathological phenomena and curative effect.FOLLOW-UP ACTIVITIESTask one Comprehension Check1.Questions for Discussion1)How do the zang-fu organs in the theory of visceral manifestation differ from those inWestern medicine? Can you give an example?In the zang-fu theory, the organs are defined not only from their structural level, but much more from their functional level. In another word, the concept of the viscera or organs in TCMweighs much more on the meaning of physiology and pathology instead of anatomy. One organ’s functions in TCM could appear in that of several organs in Western medicine, while one organ’s functions in Western medicine could be distributed into that of several organs in TCM. For instance, the heart in TCM possesses both the functions of controlling blood circulation and mental activities, which are controlled by the heart and brain in Western medicine.2)How do you underst and the “harmony between the heart and kidney”?The harmony between the heart and kidney emphasizes the harmonious coordination between the heart and kidney achieved through the dynamic descending and ascending movement of yin and yang in the heart and kidney. As the heart is located in the upper part of the body, the heart yang qi should descend to strengthen the kidney yang qi’s function of warming the kidney yin fluid, so as to prevent excessive coldness in the kidney. The kidney is situated in the lower part of the body, hence the kidney yin fluid should ascend to help the heart yin fluid to control the heart yang qi, preventing hyperactive heart yang qi from transforming into fire. In summary, the heart-kidney harmonious communication is based on the dynamic balance between the ascending of kidney yin and descending of heart yang.3)Can you explain how the zang-fu organs are involved in the water/fluid transmissionand excretion according to TCM theory?Fluids are received by the stomach, which begins a process of separation, by which the unusable portions of food are sent to the intestines as waste and the pure water is extracted. This process is continued by the spleen, which then sends the pure fluids in a vaporized state upward to the lung. The lung circulates the clear part of the fluids throughout the body, but liquefies whatever has become impure through use and send it downward to the kidney. In the kidney, the impure part is further separated into relatively “clean” and “turbid” parts. The clean part is transformed into mist and sent upward to the lung where it rejoins the cycle. The final impure portion goes into the bladder, where it is stored and subsequently excreted.4)In TCM theory, the spleen could be damaged by emotional factors like over-thinking. Isthere any evidence of the causal relationship between emotional disorder and gastrointestinal diseases in Western medicine?Both the spleen and over-thinking belong to the earth, giving rise to a TCM theory stating that “over-thinking impairs the spleen”. According to TCM theory, over-thinking on one subject will lead to anxiety, with resultant dysfunction in the transport of water and nutrients around the body and the stagnation of qi, indicative of a poorly functioning of the spleen. In Western medicine, recent academic studies support such a correlation between emotional disorder and gastrointestinal diseases. For instance, it was found that Irritable Bowel Syndrome (IBS), which is a collection of patterns of altered bowel movement in the absence of any damage in GI tract, was closely associated with anxiety. This may be explained by the over-stimulation or under-stimulation of the digestive system by the SNS, leading to contradicting IBS symptoms such as constipation and diarrhea. A study also shows that stressors can disrupt the function of GI microbiota by inducing a neural response, which increases the risk of mucosal infection and inflammation. Stress on theGI mucosal immune system can lead to the translocation of pathogenic microbes from the GI tract to the interior of the body, with the resultant infection and the associated inflammatory response. Severe and sustained anxiety can induce peptic ulceration. Symptoms of peptic ulcer, including digestive discomfort and bleeding along the digestive tract, can be related to spleen dysfunction, in which the spleen fails to sustain the function of the digestive system and regulate the circulation of blood.2. Chart Completion1)interior organs;2)exterior manifestations;3)physiology and pathology;4)clinical practice;5)the heart, liver, spleen, lung and kidney;6)the gallbladder, stomach, small intestine, large intestine, bladder and triple energizer;7)the brain, marrow, bone, vessel, gallbladder and uterus;8)transform and store;9)receive, transport and transform;10)full but not solid;11)solid but not full;12)shape and physiological function;13)deficiency;14)nourishing;15)excess;16)purging;17)knowledge of anatomy;18)physiological functions and pathological changes;19)pathological phenomena and curative effect;20)organic holism;21)the interconnection between meridians;22)mental and emotional activities;23)generalizesTask Two Vocabulary1. Directions: Complete the following phrases respectively according to its corresponding meaning or equivalent in Chinese within the brackets.1) exterior2) dissect3) physiological4) holistic5) excess6) mental7) clinical8) emotional9) organic10)consciousness 11) visceral12) anatomical13)deficiency14)morphological 15) anatomy16) purge17) therapeutic18) nourish19) internal20) maintenance 21)interconnection 22)differentiate23)foundation24) texture25) disprove 26) artery27) curative28)transforming29) essence30) deduce2. Match the following words with their proper meanings.1) e2) h 3) m4) b5) i6) o7) d8) g9) f10) l11) a12) j 13) n 14) k15) c3.Fill in the blanks with the words from the box and change the form when necessary.1) holism 2) capacity3) maintenance4)physiological5) mental6) nourishing7)pathological8) manifestation 9) expounded10)generalized 11) disproved12) hermetic13) therapeutics14) collective15)correspondingTask Three Translation1 Translate the following medical expressions into English.1)theory of visceral manifestation2)five zang-organs and six fu-organs3)extraordinary fu-organs4)stuffy nose and running nose5)transport and transform water and food6)store essence7)internal and external relations8)curative effect9)clinical practice10)only store essence but not excrete it11)receive food but not to store essence12)be full but not solid13)be solid but not full14)mental and emotional activities15)physiological function16)pathological change17)The five zang-organs pertain to yin.18)The six fu-organs pertain to yang.19)anatomical concept20)holism/ concept of holism2 Translate the following sentences into Chinese or English.1)藏象学说是研究人体各个脏腑的生理功能、病理变化及其相互关系的学说。
