Five Organs

From the Daoist classic, Contemplations by the Huainan Masters (Huainanzi) , ca. 110 B.C.:
The heart is the ruler of the five organ networks. It commands the movements of the four
extremities, it circulates the qi and the blood, it roams the realms of the material and the
immaterial, and it is in tune with the gateways of every action. Therefore, coveting to
govern the flow of energy on earth without possessing a heart would be like aspiring to
tune gongs and drums without ears, or like trying to read a piece of fancy literature
without eyes.
From the Daoist classic, Guanzi, prior to 200 B.C.:
The heart is the emperor of the human body. Its subordinate officers are in charge of the
nine orifices and their related functions. As long as the heart remains on its rightful path,
the nine orifices will follow along and function properly. If the heart's desires become
abundant, however, the eyes will lose their sense of color, and the ears will lose their
sense of sound. Thus it is said: 'Keep your heart empty-this is the art of the heart through
which the orifices can be mastered.'
Deviation above will necessarily cause malfunction below. Do not race your heart like a
horse, or you will exhaust its energy. Do not fly your heart like a bird, or you will injure
its wings. Never frantically move things around just for the sake of seeing what will
happen. If you move things around you dislocate them from their proper place. If you
will be calm and patient, everything will come to you by itself.
The Dao is never far away, yet it may be hard to reach. It is within every one of us, yet it
may be hard to grasp. If we stay clear of desires, the shen will enter its home. If we sweep
away all impurities, the shen will stay with us. Human beings all crave intelligence and
wisdom, but rarely do we try to understand what the source of their existence is. Alas,
intelligence, intelligence-even if you jump over the ocean, it will not just sit there waiting
for you! The seeker will be limping behind the one who is without desires. The sage does
not seek anything, and thus naturally achieves the state of vacuous understanding
[ultimate knowledge apart from fixed concepts].
From Li Ting, A Primer of Medicine (Yixue Rumen) , 1575:
The heart is the master of the body and the emperor of the organ networks. There is the
structural heart made from blood and flesh: it has the shape of a closed lotus flower and is
situated underneath the lung and above the liver. And there is the luminous heart of spiritshen-which
generates qi and blood and thus is the root of life. It is the source of all our
bodily parts and functions, yet it does not manifest in obvious signs and colors. Just when

you want to define it and say 'here it is,' it is gone; whenever you forget about it, however,
it comes closer to you than ever. This is why it is called the 'vacuous spirit.' Despite its
elusive nature, shen commands our body's every action and every part. Material form and
luminous shen must therefore be looked upon as an interdependent pair, and we have to
understand that diseases of the structural heart are always caused by unbalanced emotions
such as depression, anxiety, obsession, or sadness, which open up a pathway through
which noxious pathogens can enter.
From Li Yuheng, Unfolding the Mat with Enlightening Words (Tuipeng Wuyu) , Ming dynasty,
1570:
The ancient book of definitions [Neijing] refers to the heart as the ruler of the human
body, the seat of consciousness and intelligence. If we decide to nourish this crucial
element in our daily practice, then our lives will be long, healthy, and secure. If the ruler's
vision becomes distracted and unclear, however, the path will become congested, and
severe harm to the material body will result. If we lead lives that are centered around
distracting thoughts and activities, harmful consequences will result.
The sage regards his/her body like a country: the heart is the ruler, and the jing and the qi
are the citizens. If the heart does not abuse its superior position, if it remains centered and
focused on the essential matters, the jing will flourish and the qi will be steady, noxious
intruders will always be fought off, the dantian will be full with treasures, and every part
of the body landscape will be light and at piece.
From Shen Jin'ao, Dr. Shen''s Compendium of Honoring Life (Shen Shi Zunsheng Shu) , 1773:
All of the twelve channel networks obey the orders of the heart. The heart, therefore, is
the ruler of the organ networks. Its position is south, its season is summer, and its nature
is fire. The heart thus represents the principle that is referred to as the body's imperial fire
(jun huo). Its relationship to the other organs is hierarchical; not only do the twelve
channel networks attune their respective qi [functions] to the directives of the heart, but
they offer their entire jing [material essences] as tribute to nourish the heart.
The heart, therefore, is the root of life, the seat of shen, the master of blood, and the
commander of the vessels. This elevated position is due to the omnipresence of shen:
shen resides within qi, and qi resides within jing. Only the heart's jing is always
abundant, enabling it to dispatch subordinate shens to the other four zang organs. Only
the heart's qi is always abundant, enabling it to draw the jing of the body into the six fu
organs. These are the major functions of the heart.
The heart is connected to the kidney. The classic [Neijing] states: 'The heart resides in
the vessels. It rules the kidney network, not via a controlling position in the restraining
circle of relationship between the organ networks [where the kidney actually restrains the
heart], but simply because it is the general master of all organ networks. Before the heart
fire can harmoniously blend with the kidney water, however, the kidney water must be
sufficient. Otherwise the heart fire will flare out of control, and all kinds of heart and
kidney ailments will arise.'
Due to this interdependent relationship between the heart and the kidney, there are two
methods of nourishing and protecting the heart: First of all, there is the method of
nourishing the heart qi directly, that is, via its own channel network. This means: do not
burden yourself with depressing thoughts, do not get anxious about future events that
may never happen, do not dwell on things that are well in the past-all of these emotions
dissipate the brightness of shen. If we overextend our heart we will harm its qi. If this
happens, the heart jing will also suffer damage, and the shen, consequently, will lose its
abode. If we take a look at the doctrines of Confucius-do not will, do not strive, do not be
inflexible, do not be egotistical-and his student Mencius-do not be self-righteous, do not
expect things, do not force things-we see that the art of nourishing the heart had already
been fully understood during the ancient times of Confucius and Mencius. Even though
both masters never said much about medicine, they certainly understood how to nourish
the heart.
Secondly, there is the option to foster the heart by nourishing its jing via the kidney
network. This means: moderate your sex life and do not lust after women, otherwise your
ministerial fire (xiang huo) will flare up and become unstable. If there is no protective
maintenance of the kidney, the kidney jing will be harmed. If the kidney jing is harmed,

then its qi will also suffer detrimental influences. Water, then, will be unable to restrain
fire, yin will be unable to provide shelter to yang, and pathological water qi will enshroud
the heart.
This is precisely what Master Xiangchuan meant when he said: 'Jing can generate qi, and
qi can generate shen; there is nothing greater than a healthy body brimming with ying
[jing] and wei [qi]! A practitioner seeking to nourish life must first of all treasure his jing.
If the jing is plentiful, there will be abundant qi; if qi is abundant, there will be abundant
shen; and if shen is abundant, the body will be strong. Finally, if the body is strong, there
will be no disease.' The master physician Zhu Danxi (1282-1358), moreover, wrote once:
'The kidney is in charge of bracing and storing, the liver is in charge of harmonizing the
flow. Both organ systems contain ministerial fire, and at their upper end they are linked to
the heart. The heart emperor represents fire-once aroused, it flares up. If the heart's
imperial fire flares up, the ministerial fire will also flare and the jing will naturally
wander astray. This shows us that jing is braced by the kidney and activated by the liver,
and that leakage of jing is usually initiated by the heart. If one of these networks loses its
equilibrium, the other parts will be affected, too.' What Xiangchuan and Danxi express so
lucidly here represents the collective warning that the ancient masters of heart
nourishment have issued since times immemorial. In sum, if the heart is not properly
nourished, it will fall ill; if the kidney is not properly nourished, the heart will also fall ill.
The heart, moreover, is said to be in charge of blood; and blood is jing. Under normal
circumstances there is a natural surplus of heart qi, but in the event that jing is harmed
and blood is lost, the heart will become deficient. If blood is plentiful, therefore, our shen
will be bright, but if the blood becomes exhausted our will power will become weak and
muddled. Any situation of excess fire in the body involves a deficiency of blood; and
blood deficiency, in turn, diminishes the beneficial functions of fire.
Is it then that these internal excess and deficiency conditions of the heart bear similarities
to external imbalances such as fire stagnation or fire pathogens that saturate the
atmosphere during certain times of the sixty year cycle of cosmic circulation? Indeed,
both external and internal imbalances of this nature have to be counteracted by
restraining one's jing to sustain the qi, and by nourishing one's yin to solidify the shen.
The term "shen," frequently translated today as "spirit," encompasses some of the most complex
concepts of traditional Chinese medicine. In the Neijing, shen is mentioned about 240 times.
Traditionally, the term refers to the mechanism of change, the mystery of sudden and profound
transformation, and the expression in a person's face, particularly the eyes. When applied to the
human body, the term describes a major part of what would be called physical vitality, mental
activity, and spirit.
Three main functions are attributed to shen:
1. mental activity (consciousness) as a manifestation of the central, albeit hidden,
movement of shen. The ancient character shows a close affinity to the Big Dipper, which
the Chinese viewed as the center of the universe. Shen, therefore, appears to be at the
heart of all mental and physical activities, just as the Dipper appears to be the central
pivot of the stars. As the Neijing puts it: "The heart is the emperor of the five zang and
the six fu networks...; if the heart flares, then all of them will get out of line." The heart,
via the flame of shen that it harbors within, is therefore like a lantern in charge of
illuminating the outside world; it is seen as the source of thought processes. Any thought
or idea, the will to carry it out, mental focus, planning, and intelligence can thus be
considered to be manifestations of shen;
2. the seven emotional reactions (joy, anger, sadness, grief, fright, apprehension, worry)
and their involuntary expressions (facial expressions, body movements, gestures,
sighing, moaning, giggling, sobbing) are manifestations of shen; and
3. the controlling and regulating effect of the heart over mental and physical properties that
are classified as the five modes of operation (wushen): hun, po, yi, zhi, and shen (this
latter being the same term). Each of the modes is attributed to one of the five organ
networks:
hun refers to the self-awareness and self-control mechanism; associated with the liver;

po refers to the body's basic reactive instincts associated; with the lung;
yi refers to the ability of thinking and remembering; associated with the spleen;
zhi refers to the function of memory; associated with the kidney;
shen refers to the function of processing all incoming sensory and intuitive information
and supervising the body/mind reaction to it; associated with the heart.
When trying to comprehend the central aspects of Chinese medicine, it is extremely important
to understand the dominant effect of the "immaterial shen" over the physical structure of the body.
"If shen is strong," one of the Neijing''s classic definitions reads, "the body will be strong; if we
lose shen, the body will perish." Just like the Dipper in the sky appears to regulate the movement of
sun (yang) and moon (yin), shen commands the basic movement of bodily yin (blood) and yang
(qi).
It can be said that shen operates beyond the realm of physical form; it always relies, however,
on the continuous supply of the more dense and less refined qi and jing which constitute the
material foundation of the body. The inter-relationship is as follows: the workings of shen rely on
both pre- and postnatal jing-qi, while the movement and transformation of physical jing and qi, in
turn, are controlled by shen.
Blood is a type of "jing"-the latter being a term that always refers to sticky refined body
substances which comprise the fundamental yin essence of the body (bone marrow, sperm, vaginal
fluids, blood, saliva, etc.). Blood is regarded as a particularly important element of the material
basis for shen activity. Further, the blood vessels are an important extension of the heart. In Neijing
terms: "The heart network includes the blood vessels, and the blood vessels house shen." Extensive
blood loss has a devastating affect: the afflicted person will be without shen-unconscious.
As long as the heart is in motion, blood circulates through the vessels; and as long as this is the
case, a person is alive. The blood vessels constitute one of the structural aspects of the heart
network. From an evolutionary point of view, the physical heart is actually a local elaboration of
the blood vessels. In a human embryo, it is a network of primitive blood vessels that appears first.
Only later are parts of this network modified to form the physical heart.
From a Chinese perspective, blood is primarily produced in the process of extracting food
essence in the middle burner. The definitive section in the Neijing states:
The middle burner is located underneath the upper burner and is closely associated with
the stomach. It is in charge of extracting qi from food, of discarding the dregs, of
assimilating the vital fluids, of transforming them into the body's own jing, and then
transporting this final product up to the lung and eventually transforming it into blood
which nourishes the entire body; there is no substance within the body that is more
precious than this.
In other words, fluids and nutritive qi derived from food enter the blood vessels where they are
further transformed and refined. This process is usually referred to as "turning [the fluids into] red
[blood]." Other organs involved in the process of manufacturing blood are the kidney (transforms
jing into blood) and the spleen/stomach (produce food essence). The liver regulates blood flow and
blood storage (amount retained in the body) and is considered to be the other major blood organ.
The heart circulates the blood.
Blood moves through the body in an open-ended circle, providing the material basis for all
aspects of mental activity and all organ networks and their associated body layers (skin, muscles,
tendons, and bones). In the original terms of the Neijing : "If the liver is supplied with blood, we
can see; if the feet are supplied with blood, we can walk; if the hands are supplied with blood, we
can grasp." The pumping action behind this central cycle of life giving movement is governed by
the heart.
If the quality of heart blood is unblemished, the myriad of fine vessels in the face will be well
supplied, and the person will present with a rosy and lustrous complexion. Chinese medicine,
therefore, has traditionally regarded the face as a mirror of the condition of the heart. Again, the
Neijing points out: "If the qi of the shaoyin hand (heart) network becomes obstructed, the blood
vessels will cease to function. If the vessels cease to function, the blood will not move. If the blood

does not move, the skin and body hair will lack nourishment. Thus the face will turn grey like
lacquer and the blood will perish."
The essential "looking" aspect of the four-fold system of Chinese diagnosis refers primarily to
the observation of the face. Since the conditions of both blood and shen reflect here, the face can
tell much about the general state of a person's physical and emotional state. The Neijing''s "superior
doctor"-also called shen (different character)-thus knows about the condition of a patient by
looking at the face alone.
In general, it can be said that the occurrence of sweat is controlled by the opening of pores that are
managed by the body's protective qi (wei qi). Sweat production, however, relies on the process of
distilling pale fluid from the blood by "steaming" transformation. As is observed in the Neijing: "A
person who has lost large quantities of blood does not sweat anymore, and the one that has lost
large quantities of sweat does not have any blood anymore."
Comprising a transformed blood material, sweat is therefore considered to be quite a precious
substance in the Chinese tradition, while it is generally ignored, or simply considered a bothersome
part of life, in the Western cultures. Oriental physicians usually shake their heads when told about
Western health rituals that entail the frequent and deliberate secretion of sweat, such as weekly
saunas or intense daily exercise schedules. On the other hand, it could be argued that people living
in industrial societies tend to have a much richer diet than those living in traditional rural societies;
for them, failing to sweat enough could lead to accumulation.
The organs, classified as zang and fu, are paired. While the zang organ serves as a residence (the
shen resides in the heart) and a major transporter (the heart moves the blood) the fu organ serves
only as a transfer station, temporarily storing material that is to be discharged. The heart is paired
with the small intestine, interconnected by the luo vessels. The small intestine receives partially
digested food residue from the stomach and proceeds with the process of digestion by separating it
into "pure" and "impure" substances, thus providing its transfer functions. Pure essence is being
recirculated to the spleen, which is in charge of transporting it to the five organ networks where it
can be stored. Fluids reabsorbed from the dregs are being passed on to the bladder, which stores
and expels surplus liquid from the body. Solid waste matter is transmitted to and expelled via the
large intestine.
Some cases of burning urination (particularly if accompanied by symptoms of dark or red
urine) are treated by clearing heat in the heart: this heat, transferred from zang to fu (heart to small
intestine) is then carried to the bladder with the fluid wastes.
An internal branch of the heart channel connects with the tongue. The Neijing states: "The heart qi
communicates with the tongue. If the heart is in a state of harmony, the tongue can distinguish the
five essential flavors."
The color of the tongue body reflects the condition of heart blood. A deep red or scarlet
tongue, for instance, usually indicates the presence of toxic heat in the blood. At a severe stage,
toxic heat may adversely affect shen and eventually cause loss of consciousness (as in the case of
encephalitis or other febrile diseases). A pale tongue usually indicates blood deficiency.
Just as important in the context of heart-tongue relation is the second meaning of the Chinese
term "xin" (heart), namely, center. In Chinese medical terminology, "xin" often refers to or at least
implicates the stomach, since the epigastric region constitutes the structural center of the torso. We
know that diseases of the structural heart often manifest as symptoms of stomach pain. Vice versa,
stomach problems, such as ulcers, can both cause and be exacerbated by mental symptoms that in
Chinese terms would be classified as a heart disorder. In clinical diagnosis, the physical tongue
body serves as an indicator of the condition of the organs (especially the circulation through the
organs), while the tongue coating serves as an indicator of the situation of the digestive system.
Clinicians primarily seek information about the heart's condition from the tip of the tongue where
imbalances of the upper burner organs, lung and heart, may reflect.

The pericardium or "heart protector" is said to be a shielding layer enveloping the heart. Just as an
emperor is surrounded by a dense circle of intermediaries, the pericardium forms a network of
finely meshed pathways around the heart through which both the heart's qi and blood have to pass
on their way to and from the far reaches of the body landscape. The pericardium is categorized as a
separate organ, yet, as the heart's last line of defense against invading pathogens, it clearly is an
integral part of the extended heart network. The Neijing emphasizes: "If we talk about pathogens
[evil] entering the heart, we always mean that the pathogens have advanced to the pericardium." If
pathogens would indeed advance to the actual innermost, where all mental and physical functions
are conceived and coordinated, the result would be like that of foreign rebels advancing to the
throne room of the imperial palace: demise of the country results.
Obstruction of the Heart Orifice: At an advanced stage of pathology, heat pathogens may
obstruct the pericardium and thus cause the orifice to the heart-the crucial opening through which
the flame of consciousness illuminates the outside world-to become blocked. Typical symptoms are
unrelenting high fever, loss of consciousness, and delirious talk. If the orifice of the heart becomes
obscured by phlegm fire, epileptic seizures or outbreaks of madness may occur. It is important to
note that the term "obstructed heart orifice" is not a label for common emotional disorders, but
indicates an acute situation where all mental faculties are seriously impeded.
Lack of Nourishment to the Heart Shen: If heart yin, that is the basic material substance of the
heart (heart blood), is deficient, a person's shen will become deprived of the nourishment it requires
and will be unable to rest. Symptoms of insomnia, confusion, memory loss, and other mental
symptoms are possible results of this condition.
Obstruction by Phlegm-Rheum: If the heart yang, the flame of life, is deficient, water
accumulates in the upper part of the torso and gives rise to a frequently occurring symptom
complex that is referred to as "water qi intimidating the heart" (shui qi ling xin). Palpitations,
edema, asthmatic breathing, pulmonary heart disease, and related conditions are typical
manifestations of this situation.
Frenetic Blood Movement Due to Blood Heat: Exuberant heat in the internal "blood layer" can
cause the blood to deviate from its proper course in the vessels, resulting in various kinds of
hemorrhaging. If the yang vessels are harmed, bleeding occurs in the upper part of the body
(nosebleed, vomiting of blood, expectoration of blood); if the yin vessels are harmed, bleeding
occurs in the lower part of the body (blood in stool, urine, metrorrhagia). This type of pathology
(heat, hyperactivity, affecting the blood) is also associated with the other blood network: the liver.
Blood Stasis: If blood stasis occurs in the vessels for prolonged periods of time, pathological or
"dead" blood will form and severely impact both mental and physical aspects of the heart network.
Prolonged or recurrent bleeding is also a major cause of blood stasis, which in turn may bring about
further hemorrhaging. Blood stasis is also associated with the other blood network, namely the
liver: inhibited flow of liver qi is most often responsible for blood stasis.
Blood stasis in the pericardium is a common cause of angina pectoris. Ancient texts frequently
describe a heart attack (sudden chest pain, loss of voice, lips and face turn blue, hands and feet turn
cold and blue) as a syndrome of "polluted blood attacking the heart."
Heart Heat Manifesting in the Small Intestine: Imbalances of zang organs frequently manifest
as symptoms in their associated fu network. Thus, heart heat may manifest as burning diarrhea with
intestinal cramping or burning urination (often with dark or red urine) that represents transfer of
heat from small intestine to bladder. Conversely, small intestine heat can result in heart symptoms
such as restlessness or mouth ulcers.
Heart Disorder Affecting the Tongue: Deficiency of heart blood usually causes the tongue to
take on a pale color. Mouth ulcers frequently arise from heart or small intestine heat. Stasis of heart
blood often reflects in the form of purple spots in the tongue body or in the
discoloration/malformation of the veins underneath the tongue. If heat toxins have invaded the
pericardium, or if phlegm obscures the orifice to the heart, patients may lose control over their
tongue. Stroke victims, for instance, often experience stiffness of the tongue resulting in the
common post-stroke phenomenon of slurred speech.
Deficiency of Heart Yin (Blood): Besides the mental symptoms indicating a malnourished shen,
there may be physical symptoms such as palpitations, dizziness, a pale face, dry skin and body hair,
and a fine, weak, and often rapid pulse. Since the liver network is in charge of storing the blood,

lood deficiency most commonly involves the liver.
Excessive Joy Injuring the Heart: Under normal circumstances, joy can relieve tension, stimulate
the flow of qi and blood, and harmonize the (nutritive) ying and (protective) wei layers. If this
particular emotion is exaggerated, however, the qi will disperse and shen will scatter. Intense and
prolonged emphasis on joy, in other words, can impair a person's focus and concentration. A person
who has been giggling/laughing for a long time and now has a hard time stopping and regaining
control, is, at least during this particular moment, without shen (that is unable to focus). In cases
where the shen becomes so severely dispersed that it cannot find its way back to its physical
"home," madness may result. Shock causes the heart shen to become dispersed and all subordinated
shen to deteriorate into a state of disarray. Typical manifestations of this problem are loss of
consciousness, epilepsy, or dementia that have been induced by a shock (a frightful experience).
Vice versa, a deficiency of heart qi can cause a person to be easily startled.
Nourish blood (bu xue): tang-kuei (danggui), salvia (danshen), rehmannia (dihuang), millettia
(jixueteng).
Nourish the heart and pacify shen (yang xin an shen yang ): fushen (fushen), zizyphus
(suanzaoren), biota (baiziren), succinum (hupo).
Tonify qi (bu xin yi qi): ginseng (renshen), polygala (yuanzhi), longan (longyanrou), baked
licorice (zhi gancao).
Warm yang (wen yang yi qi): cinnamon bark (rougui), cinnamon twig (guizhi), aconite (fuzi),
alpinia (yizhiren), (zishiying).
Astringe and tonify yin (lian yin): schizandra (wuweizi), cornus (shanzhuyu), peony (baishao),
mume (wumei).
Purge fire (xie huo): coptis (huanglian), gardenia (zhizi).
Clear heart heat (qing xin): rhino horn (xijiao) or water buffalo horn (shuiniujiao), forsythia
(lianqiao), and the "heart" portions of bamboo leaves (zhuye) and lotus (lianzi xin; lotus embryo).
Sedate the heart and settle shen (zhen xin an shen): cinnabar (zhusha), dragon bone (longgu),
oyster shell (muli), magnetite (cishi), rust (sheng tieluo).
Open the orifice of the heart (kai qiao): borneol (bingpian), musk (shexiang), acorus
(shichangpu), styrax (suhexiang).
Open the orifice by dispelling heat phlegm (huo tan): bamboo sap (zhuli), ox gallstone
(niuhuang), bamboo resin (tianzhuhuang), bile treated arisaema (dan nanxing), fritillaria (beimu),
pinellia (banxia).
Transform water rheum to calm the heart (hua yin ning xin): hoelen (fuling), atractylodes
(baizhu), cinnamon twig (guizhi), akebia (mutong).
Move the blood (huo xue): persica (taoren), carthamus (honghua), cnidium (chuanxiong),
achyranthes (niuxi).
Drive out blood stasis (zhu yu): leech (shuizhi), tabanus (mengchong), eupolyphaga
(tubiechong), pteropus (wulingzhi).
Soften and dissipate masses (ruan jian): zedoaria (ezhu), sparganium (sanleng), anteater scales
(chuanshanjia), turtle shell (biejia).
Stop bleeding (zhi xue): notoginseng (sanqi), bulrush (puhuang), bletilla (baiji), sanguisorba
(diyu), cephanoplos (xiaoji), lotus nodes (oujie).
Cool the blood: red peony (chishao), raw rehmannia (sheng dihuang), moutan (mudanpi),
lithospermum (zicao).
Although many blood disorders are treated via the liver, it is the heart that is officially considered to
be the master of the vessels and their content. Blood disorders, therefore, are often associated with
the heart. If blood heat causes eruptions or bleeding, the blood needs to be cooled. If blood cold
causes stagnation and pain, the channels need to be warmed. In cases of bleeding, additional

hemostatic measures can be applied, but it is imperative to first clearly differentiate the cause for
the condition; blood heat, spleen qi deficiency, and blood stasis can all be potential causes.
Since the heart stores the shen, the label "heart disorder" often stands for situations where the
shen cannot be properly stored. This primarily manifests in symptoms of mental agitation, such as
insomnia, vivid dreaming, irritability, or hysteria. If the shen is agitated due to the presence of
excess pathogens, the removal of the pathogens (heat, phlegm, stagnant blood) is often sufficient to
settle an agitated shen. Often, however, it is a deficiency of heart blood-the material (yin) pool that
keeps the volatile (yang) shen grounded-which is at the root of this condition. In this case, the
blood must be nourished to restore the material basis of shen and give it a residence that it feels
enticed to return to. To achieve a more immediate effect, it is advisable in both cases to include
herbs that have a sedative action on the heart and thus directly settle the shen. Usually, substances
with a settling affect are heavy in nature, such as cinnabar (zhusha), magnetite (cishi), oyster shell
(muli), or dragon bone (longgu). A subdued heart can also cause a dispersal of shen focus, and a
slow beating pulse can cause the blood to stagnate in the vessels; in such cases, it is necessary to
invigorate the heart and vitalize the blood circulation.
Just like a bright fire burns pure and is not obscured by smoke, the heart and its light of
consciousness remain pure unless pathogenic influences, such as impure qi or phlegm, block the
heart orifice. If impure qi veils the flame of consciousness, herbs that expel impurity and open the
orifice should be used. If blood stasis clogs the heart collaterals (vessels), then measures that drive
out stasis and unblock the collaterals should be employed.
If the material basis of the heart, the heart yin and heart blood, are deficient, nourishing of yin
and/or blood is indicated. If the force of the heart-the heart yang and heart qi-are deficient, yang
should be warmed and qi should be tonified. In case that a heart yang deficiency has already caused
pathological water and phlegm to accumulate, measures that support heart yang need to be
accompanied by herbs that drive out water rheum and phlegm.
In case there are obvious signs of dispersed heart qi (palpitations, shortness of breath),
deficient heart yin (sweating), or disturbed heart shen (inability to concentrate), sour flavors can be
used to astringe the various substances of the heart. The famous turn of the century physician
Zhang Xichun, for instance, often decocted large amounts of the sour fruit cornus (shanzhuyu) and
gave it to patients in emergency situations to keep their shen qi from leaving the body. Most
commonly, today, schizandra is used to astringe both heart yin and heart qi.
Bitter is the flavor with a direct affinity to the heart network, and thus should be used, but
sparingly, in patients with heart problems. Bitter flavors have a drying effect, and, when used in
large amounts, can have a potentially damaging affect on heart yin.
In a situation where the heart has transferred pathological heat to the small intestine, treatment
should clear heart heat, descend fire, and guide out the heat via the lower burner.
In the treatment of all heart disorders, the network's relationship to other systems needs to be
taken into consideration. In deficiency situations, for instance, the "tonify the mother" rule applies;
heart yin/blood deficiencies are thus primarily addressed by tonifying the liver yin/blood. Also of
particular importance is the heart's relationship to its upper burner neighbor, the lung. Since the
heart is the lung's controlling organ, heart pathology occasionally manifests in bloody (heart
colored) phlegm. On the other hand, prolonged phlegm accumulation in the lung will eventually
affect the heart, causing palpitations, chest pain, and pulmonary heart disease. In this situation, it is
primarily the pathological water in the lung that needs to be addressed. Furthermore, the heart
forms the shaoyin network along with the kidney. Since the heart is above and the kidney below, it
is one of the critical physiological tasks to connect and mingle the energies of the heart and the
kidney despite the natural tendency of water to flow down and fire to flare up. If the body's polar
water and fire networks fail to link up properly, symptoms of restlessness, insomnia, and other
signs of the water organ failing to control the fire organ occur. In this case, the heart and the kidney
need to be "reconnected" by clearing heart fire (descending heart fire) and steaming kidney water
(ascending kidney water); an example is using a small amount of bitter coptis to reduce the heart
fire with a small amount of hot spicy cinnamon to steam the kidney water.
HEART BLOOD DEFICIENCY (xin xue xu): primary symptoms are palpitations; pale and
lusterless complexion. Secondary symptoms include insomnia; vivid dreaming; forgetfulness;

tendency to easily get startled; dizziness; pale lips and nails. The tongue is typically pale; the pulse
tends to be fine.
Representative Herbs: tang-kuei (danggui), cooked rehmannia (shu dihuang), salvia (danshen),
peony (baishao), gelatin (ejiao), longan (longyanrou), zizyphus (suanzaoren), biota (baiziren),
fushen (fushen), millettia (jixueteng).
Representative Formula: Tang-kuei Four Combination (Siwu Tang).
HEART YIN DEFICIENCY (xin yin xu): primary symptoms are palpitations; panic sensations;
insomnia; vivid dreaming; dry mouth and throat; heat sensation in palms and soles. Secondary
symptoms include forgetfulness; restlessness; tendency to easily get startled; flushed cheeks; dark
urination; dry stools; tidal heat sensations; night sweats. The tongue is typically red with little
coating; the pulse tends to be fine and rapid.
Representative Herbs: raw rehmannia (sheng dihuang), tang-kuei (danggui), ophiopogon
(maimendong), salvia (danshen), lily (baihe), zizyphus (suanzaoren), biota (baiziren), polygonatum
(yuzhu), polygonatum root (huangjing), (hehuanpi), fushen (fushen).
Representative Formulas: Ginseng and Zizyphus Combination (Tianwang Buxin Dan); Cinnabar
Sedative Pills (Zhusha Anshen Wan).
UPFLARING HEART FIRE (xin huo shang yan): primary symptoms are restlessness; mouth
ulcers; palpitations; insomnia. Secondary symptoms include heat sensation in the chest; flushed
face; thirst; dark or red urine; constipation; and in serious cases, outbreaks of madness. The tongue
typically presents with a red body or a bright red tip; the pulse tends to be forceful and rapid.
Representative Herbs: gardenia (zhizi), coptis (huanglian), ox gallstone (niuhuang), rhinoceros
horn (xijiao), antelope horn (lingyangjiao), (lianzixin), scrophularia (xuanshen), raw rehmannia
(sheng dihuang), forsythia (lianqiao), ophiopogon (maimendong), phragmites (lugen),
lithospermum (zicao).
Representative Formulas: Purge the Heart Decoction (Xiexin Tang); Rehmannia and Akebia
Formula (Daochi San).
HEART QI DEFICIENCY (xin qi xu): primary symptoms are palpitations accompanied by
shortness of breath that get aggravated by physical activity; mental and physical fatigue; sensitivity
to wind and drafts; spontaneous sweating. Secondary symptoms include stuffy sensation or dull
pain in the chest; pale face color; shallow breathing; low voice and disinclination to talk. The
tongue is typically pale; the pulse tends to be fine and weak or irregular.
Representative Herbs: ginseng (renshen), codonopsis (dangshen), astragalus (huangqi), cinnamon
twig (guizhi), fushen (fushen), polygala (yuanzhi), baked licorice (zhi gancao).
Representative Formula: Nourish the Heart Decoction; Astragalus and Zizyphus Combination
(Yangxin Tang).
HEART YANG DEFICIENCY (xin yang xu): primary symptoms are palpitations; shortness of
breath that gets aggravated by physical activity; cold extremities; and general sensation of physical
coldness. Secondary symptoms include sensation of stuffiness or pain in the chest; pale or ashen
face color; shallow breathing; disinclination to talk; aversion to wind and drafts; spontaneous
sweating; colorless urination; loose stools. The tongue typically presents with a pale body and a
thin, white and moist coating; the pulse tends to be deep, forceless and slow, or fine and weak, or
irregular.
Representative Herbs: cinnamon twig (guizhi), aconite (fuzi), dry ginger (ganjiang), polygala
(yuanzhi), bakeri (xiebai), fushen (fushen), astragalus (huangqi), baked licorice (zhi gancao).
Representative Formulas: Cinnamon and Licorice Combination (Guizhi Gancao Tang); Protect
the Source Decoction (Baoyuan Tang).
HEART QI AND BLOOD DEFICIENCY (xin qi xue liang xu): primary symptoms are
palpitations; shortness of breath; insomnia; vivid dreaming; dizziness; pale or ashen face color.
Secondary symptoms include mental and physical fatigue; spontaneous sweating; shallow
breathing; disinclination to talk; pale lips and nails; dry and brittle hair. The tongue is typically pale
and tender; the pulse tends to be fine and weak.
Representative Herbs: astragalus (huangqi), ginseng (renshen), codonopsis (dangshen), cinnamon
twig (guizhi), fushen (fushen), baked licorice (zhi gancao), tang-kuei (danggui), cooked rehmannia

(shu dihuang), peony (baishao), gelatin (ejiao), salvia (danshen), longan (longyanrou), millettia
(jixueteng).
Representative Formulas: Tang-kuei and Ginseng Eight Combination (Bazhen Tang); Ginseng
and Longan Combination (Guipi Tang).
HEART QI AND YIN DEFICIENCY (xin qi yin liang xu): primary symptoms are palpitations
and shortness of breath that get aggravated by physical activity; insomnia; vivid dreaming; mental
and physical fatigue; heat sensations in the palms and soles; pale face with flushed cheeks.
Secondary symptoms include forgetfulness; spontaneous sweating or night sweats; low voice; dry
mouth and throat; low-grade fever or heat sensation. The tongue typically presents with a red and
tender body with little moisture and a thin white coating or little coating; the pulse tends to be fine
or fine and rapid.
Representative Herbs: ginseng (renshen), pseudostellaria (taizishen), glehnia (bei shashen),
polygonatum root (huangjing), astragalus (huangqi), baked licorice (zhi gancao), fushen (fushen),
ophiopogon (maimendong), raw rehmannia (sheng dihuang), dendrobium (shihu), schizandra
(wuweizi).
Representative Formulas: Baked Licorice Combination (Zhi Gancao Tang); Generate the Pulse
Powder; Ginseng and Ophiopogon Formula (Shengmai San).
HEART BLOOD STAGNATION (xin xue yu zu): primary symptoms are palpitations and
sensations of stuffiness and pain in the chest (pain is piercing or stabbing, comes and goes, or
comes on suddenly; it may reflect into the left arm, shoulder, or upper back); in serious cases this
condition may cause loss of consciousness, as may happen during a heart attack. Secondary
symptoms include purplish discolorations on the face, lips, or nails; cold extremities; spontaneous
sweating. The tongue typically presents with a purplish body or with purple spots on the sides or on
top, the pulse tends to be hesitating or irregular, or in acute emergency cases may seem to be "on its
way out."
Representative Herbs: persica (taoren), carthamus (honghua), salvia (danshen), tang-kuei
(danggui), cnidium (chuanxiong), red peony (chishao), curcuma (yujin), pteropus (wulingzhi),
bulrush (puhuang), cinnamon twig (guizhi), chih-shih (zhishi), bakeri (xiebai), trichosanthes fruit
(gualou), aquilaria (jiangxiang).
Representative Formulas: Persica and Achyranthes Combination (Xuefu Zhuyu Tang); Coronary
Number II (Guanxin Er Hao); Pteropus and Bulrush Formula (Shixiao San) plus Chih-shih, Bakeri,
and Cinnamon Combination (Zhishi Xiebai Guizhi Tang); for loss of consciousness, may have to
include Ginseng and Aconite Combination (Shen Fu Tang).
WATER QI ENCROACHING ON THE HEART (shui qi ling xin): primary symptoms are
palpitations; shortness of breath; coughing or asthmatic panting with clear phlegm; pale or ashen
complexion; puffiness or edema. Secondary symptoms include dizziness; sensation of fullness in
the epigastric region; panicky disposition; aversion to cold; cold extremities; mental and physical
fatigue; sensation of upwards rushing qi; small amounts of clear urination. The tongue typically
presents with a fat and pale body, toothmarks, and a slippery white coating. The pulse tends to be
deep and fine, but often soft or slippery in the first (cun) positions.
Representative Herbs: cinnamon twig (guizhi), hoelen (fuling), atractylodes (baizhu), aconite
(fuzi), dry ginger (ganjiang), alisma (zexie), polyporus (zhuling), akebia (mutong), astragalus
(huangqi), codonopsis (dangshen).
Representative Formulas: Atractylodes and Hoelen Combination (Ling Gui Zhu Gan Tang);
Vitality Combination (Zhenwu Tang); Hoelen Five Herb Formula (Wuling San).
ACUTE COLLAPSE OF HEART YANG (xin yang xu tuo): primary symptoms are acutely
compromised mental faculties, and sudden onset of cold sweats and ice cold extremities. Secondary
symptoms include palpitations; stuffy sensation in chest; blue lips; ashen face color; barely
detectable voice; weak and shallow breathing. The tongue is typically pale or purplish; the pulse
tends to feel as if being "on its way out."
Representative Herbs: ginseng (renshen), aconite (fuzi), dry ginger (ganjiang), baked licorice (zhi
gancao), bakeri (xiebai), cinnamon twig (guizhi).
Representative Formulas: Ginseng and Aconite Combination (Shen Fu Tang); Ginseng, Aconite,
Dragon Bone, and Oyster Shell Combination (Shen Fu Long Mu Tang).

PHLEGM FIRE DISTURBING THE HEART (tan huo rao xin): primary symptoms are
palpitations; restlessness; disturbed mental faculties; insomnia; vivid dreaming; red face; heavy
breathing. Secondary symptoms include constipation; dark urination; mad or violent behavior;
uncontrolled movements; hysterical crying or laughter; incoherent screaming or swearing. The
tongue typically presents with a red body and a thick yellow and greasy coating; the pulse tends to
be wiry, slippery, and rapid.
Representative Herbs: bamboo skin (zhuru), rhubarb (dahuang), coptis (huanglian), gardenia
(zhizi), bile treated arisaema (dan nanxing), trichosanthes (gualou), ox gallstone (niuhuang), acorus
(shichangpu), curcuma (yujin).
Representative Formulas: for less serious conditions, use Harmonize the Gallbladder Decoction
with Coptis (Huanglian Wendan Tang); for more serious conditions, use Lapis Drive Out the
Phlegm Pill; Lapis and Scute Formula (Mengshi Guntan Wan); for violent conditions, use Rusty
Iron Shavings Formula (Sheng Tieluo Yin).
PHLEGM OBSCURING THE ORIFICE OF THE HEART (tan meng xin qiao): primary
symptoms are acutely disturbed mental faculties or loss of consciousness. Secondary symptoms
include fever; inability to speak; seizures; stuffy sensation in chest; body pain; sudden deafness;
sounds of rattling phlegm or drooling sputum; thirst but no desire to drink. The tongue usually
presents with a thick yellow and greasy coating; the pulse tends to be soft or slippery and rapid.
Representative Herbs: curcuma (yujin), acorus (shichangpu), polygala (yuanzhi), bamboo sap
(zhuli), fritillaria (beimu), rhino horn (xijiao), gardenia (zhizi), coptis (huanglian), forsythia
(lianqiao), bamboo leaf (zhuye), moutan (mudanpi), talc (huashi).
Representative Formulas: Acorus and Curcuma Decoction (Changpu Yujin Tang); Guide Out the
Phlegm Decoction (Daotan Tang) plus orifice opening substances (acorus, curcuma, polygala);
Great Treasure Pill; Rhinoceros and Amber Formula (Zhibao Dan).
HEAT INVADING THE PERICARDIUM (re xian xinbao): primary symptoms are high fever;
clouded consciousness; delirious talk. Secondary symptoms include cold extremities; restlessness;
fever blisters; eruption of macules; seizures; nausea. The tongue is typically scarlet red with a dry
surface or a yellow coating; the pulse tends to be rapid or slippery and rapid.
Representative Herbs: ox gallstone (niuhuang), rhino horn (xijiao), curcuma (yujin), acorus
(shichangpu), bamboo leaf (zhuye), (lianzixin), scrophularia (xuanshen), ophiopogon
(maimendong).
Representative Formulas: Clear Heat in the Ying Layer Decoction (Qing Ying Tang); Ox
Gallstone Pacify the Palace Pill; Bezoar and Curcuma Formula (Angong Niuhuang Wan); Purple
Snow Pellet (Zi Xue Dan); Ox Gallstone Rectify the Qi Pill (Niuhuang Chengqi Wan).
HEART AND KIDNEY FAILING TO LINK (xin shen bu jiao): primary symptoms are
restlessness; insomnia; vivid dreaming; palpitations; forgetfulness; spermatorrhea or premature
ejaculation. Secondary symptoms include dizziness; tendency to easily get startled; ringing in the
ears; tidal heat sensations; night sweats; sore and weak lower back and knees; dry throat; flushed
cheeks; dark and scanty urination or nocturia; constipation. The tongue typically presents with a red
body and little or no coating; the pulse tends to be fine and rapid.
Representative Herbs: raw rehmannia (sheng dihuang), asparagus root (tianmendong),
ophiopogon (maimendong), scrophularia (xuanshen), salvia (danshen), schizandra (wuweizi),
fushen (fushen), lotus seed (lianzi), anemarrhena (zhimu), coptis (huanglian), phellodendron
(huangbai), cinnamon bark (rougui).
Representative Formulas: Coptis and Gelatin Combination (Huanglian Ejiao Tang); Connecting
Pill (Jiaotai Wan).

From Li Zhongzi, A Primer of Medical Objectives (Yizong Bidu), 1637:
The Classic states: 'Whenever we treat a disease, we must approach it at the base.' Base here
means root or source. Every stream on earth has a source, and every plant has a root. If all
murky sediments settle at the source, the downstream waters will naturally be clear and fresh,
and if we water a root, it will grow and branches will sprout; these are the laws of nature. The
experienced physician, therefore, will always consider the source.
However, the body's source is differentiated into a prenatal and a postnatal aspect. The
prenatal source is the kidney; the kidney is associated with the direction north and the phase
element water-water being the first offspring, in Taoism, of heavenly Oneness. The postnatal
source of the body is the spleen; the spleen is known as the Central Palace and associated
with the phase element earth-earth being the mother of every living thing.
From Zhuang Yuanchen, Shujuzi: Inner Chapters ( Shujuzi Neipian), Ming Dynasty:
The kidney is the ocean of the human body. Since oceans are situated on a lower level than
the earth's streams and rivers, they draw every one of them to form one large body of water.
Oceans may appear vast and inexhaustible, yet they still drain off some of their seemingly
unlimited supply. One way of drainage is called 'going to ruins,' meaning the water drains
down into the earth from where it will not return. The other way of drainage is called
'dwelling with the stars,' meaning the water steams toward the sky and later rains down to
earth again, where it dissipates into rivers and streams and eventually returns to the ocean.
This is the water that circulates between heaven and earth, always striving to keep an
equilibrium between the extreme states of drought and flooding.
In the context of the human body only the kidney can be compared to the workings of this
natural cycle. All the essences and fluids of the body's various pathways pour into the kidney.
After the kidney has assembled the essential fluids of the body's vessels, it also experiences
two ways of drainage: one way is through the sexual urge which draws the essence
downward to the sexual centers; once it exits from here it cannot come back into the system,
so this is just like the ocean "going to ruins." The other way is the upward dispersal by way
of the suctioning affect of true qi, which draws the body's combined essences all the way up
to the flower pond (mouth); from here it moves down through the throat into the stomach,
lubricating the five organ networks, nourishing all of the body's pathways, and finally
returning to the kidney. This is the microcosmic process of ascending and descending that can
be compared to the ocean 'dwelling with the stars.'
Those who are knowledgeable in the art of nourishing life take care to shut off the lower exit
[of jing via ejaculation] while striving to keep the upper pathway [of jing, nourishing the
organs and brain] open and unobstructed. In this fashion, there will be a nourishing cycle that
is free of leaks. Physical vitality (jing) and mental clarity (shen) will be abundant, nutritive qi

(ying) and protective qi (wei) will be strong, inside (water essence) will be sufficient to
control fire, and outside (qi) will be sufficient to ward off noxious influences. This is what the
art of expelling disease and the art of longevity is all about.
From Zhang Huang, A Compendium of Illustrated Texts (Tushu Bian), Ming Dynasty:
In relation to the other organ networks, the kidney is situated in the lowest position. It is
associated with the phase element water, and it is in charge of storing essence (jing). Just like
water was the first substance to emerge from heavenly oneness, the kidney is the source of
the human body, the initial sprout of physical life.
Everything between heaven and earth that is made from qi and blood has the urge to mate.
Once fire and water separate and desire finds a match, the essence leaves the source, and
what creates the body will turn into what kills the body. If you are a student of the Book of
Change (Yijing) and align your desires by fooling around with the lofty hexagram 41
[Sacrifice, Decrease], then this is like being worried about floods at one moment and about
water leakage the next-you 'sacrifice' again and again, thus using yourself up until there is
nothing left to spare. Therefore, if you want to protect your source of longevity, there is no
better way than to guard yourself against sexual desires.
From Sun Yikuei, Contemplations On Unexplored Medical Topics (Yizhi Xuyu), 1584:
In the Simple Questions (Suwen) section of the Neijing it is stated: 'The kidney stores the
qi of the bones and the marrow.' At another place it says: 'The black color associated with the
direction north corresponds directly with the kidney; its corresponding orifices in the body
are the two yin (the genitals and the anus), and its essence is stored in the kidney.' The
Nanjing (Classic of Difficulties) further explains: 'This is where males store their essence.'
This line does not mean that all of the essence is stored right there; the brain is also called the
sea of marrow, and the kidney connects with the brain via the spine.
Master Shengsheng once said: 'Chapter 36 of the Nanjing states that there are really two
kidneys, namely the left one being the actual kidney, while the right one is mingmen, the gate
of life. It is this mingmen that is the seat of all physical (jing) and mental (shen) essences, and
it is here that essence is stored in males, and from where the uterus branches off in females.
Thus, we speak of two kidneys. Just as is said in chapter 39 of the Nanjing: 'The fact that six
fu organs are paired with five zang organs means that the kidney really represents two organ
systems, namely the left one being the kidney, and the right one being mingmen. And
mingmen, that is the abode of jing and shen. This is where male essence is stored and where
the female uterus is attached; its qi is on the same wavelength with the kidney.''
A detailed examination of both sections of the Neijing does not yield any references to a
differentiation of the kidney network into two distinct parts. It was the author of the Nanjing
who first made this distinction. Does this mean that the entity which the Nanjing author calls
mingmen-the abode of jing and shen, the seat of the original qi, the place where males store
essence and females have their uterus-is nothing but idle talk? I say we have to take this
theory seriously, since it appropriately places extra weight on the kidney network by
emphasizing that the original qi which lodges in the kidney is the source of our life force.
The Central Junction Classic ( Huangting Jing) states: 'The kidney qi regulates the upper
burner, nourishes the middle burner, and protects the lower burner.' The Collection of
Central Harmony (Zhonghe Ji) states: 'Breathing through the process of opening and
closing-that is what happens at the gorge of mystery (mingmen), the root of heaven and
earth.' Opening and closing here does not refer to the regular action of inhaling and exhaling
through the nose or mouth, but to what is called the true breath. The author of the Nanjing
also said: 'The igniting spark between the kidneys (shenjian dongqi) is the origin of the
various processes of human life, the base of the body's five zang and six fu organs, the root of
the twelve channel pathways, the door of breath, and the source of the triple burner.'
Precisely this is what the concept of mingmen is all about. It is what the Confucians refer to
with their Taiji image, and what the Taoists call the gorge of mysterious origination. If we
take a close look at a bronze acupuncture statue we can easily find out that the point
mingmen is not located on top of the right kidney, but right between both kidneys. This
certainly proves my point.
From Chen Shiduo, A Secret Manual from the Stone Chamber (Shishi Milu), ca. 1690:
As has already laid out in detail in the Nanjing, mingmen is the master of the twelve channel
networks. But even though many texts have since been written about this subject, the
quintessence of mingmen still remains in the dark. Therefore I chose to bring up this topic
one more time.

It is always said that mingmen is the master of the twelve channel networks. Now, what kind
of master is it exactly and what does it master? Let me put it this way: if there is no fire inside
us, we cannot exist. This fire must be there first so that the twelve channel networks can be
imbued with the igniting spark of transformation. mingmen, therefore, is a type of prenatal
fire. This fire is immaterial and dwells in water. On earth, material fire is being quenched by
water. Immaterial water, on the contrary, has the ability to generate fire. Therefore, when we
say that "fire is being quenched by water" we refer to material water; when we say that "fire
is being fueled by water" we refer to immaterial water. And it so happens that immaterial fire
can generate immaterial water, meaning that fire is not contained within fire, but within
water.
Mingmen fire, is yang fire-a yang that is embedded within two yin. In the microcosmic
context of the human body, mingmen is generated first, and only then the heart. Does this fact
not illuminate the importance of mingmen? When the heart procures the power of mingmen,
consciousness is in command, and we can relate to the outside world. When the liver
procures the power of mingmen, it can plan. When the gallbladder procures the power of
mingmen, it can make decisions. When the stomach procures the power of mingmen, it can
absorb food. When the spleen procures the power of mingmen, it can transport. When the
lung procures the power of mingmen, it can fulfill its administrating and regulating functions.
When the large intestine procures the power of mingmen, it can pass on the waste. When the
small intestine procures the power of mingmen, it can disseminate. When the kidney procures
the power of mingmen, it can bring about physical vigor. When the triple burner procures the
power of mingmen, it can keep the body's water pathways unobstructed. When the bladder
procures the power of mingmen, it can store. In other words, there is not a single one among
the organ networks that does not rely on the mingmen fire for warmth and nourishment.
This type of fire should be tonified rather than purged. This is done by tonifying fire within
water, and especially by tonifying water within fire. In this fashion, fire can be fueled by
water and at the same time be stored within water. If we just use cold or cool herbs to attack
the mingmen fire, it will become weak, and how could it then nourish the twelve channel
networks? This is what is really meant by the Neijing statement 'when the master is dim, the
twelve officials are all in a state of crisis.' Doesn't that strongly emphasize the importance of
mingmen?
From Tang Zonghai, A Refined Interpretation of the Medical Classics (Yijing Jingyi), Qing
Dynasty:
The root of the triple burner is in the kidney, more precisely right between the two anatomical
kidneys. Right there is a greasy membrane that is connected with the spine. It is called
mingmen, and constitutes the source of the three burners.
From Zhang Shanlei, A Revised Edition of Master Zhang''s Treatise on the Organ Networks
(Zhang Shi Zangfu Yaoshi Buzheng), ca. 1918:
The triple burner is really a name for the function of the body's ministerial fire. It is the
process of disseminating original qi from mingmen, which is in charge of ascending and
descending, and absorbing and excreting. It roams in between the heaven and earth of the
body's landscape, and commands all bodily qi-the qi of the five zang and the six fu organs,
the protective qi (wei) and the nutritive qi (ying), the qi in the channels and collaterals, and
the qi on the top, the bottom, the left, and the right. Its unofficial name is therefore the central
store house of clear qi. The upper part is in charge of absorbing, the middle part is in charge
of transforming, and the lower part is in charge of excreting.
From Sun Yikui, Mysterious Pearls of Wisdom (Chi Shui Xuan Zhu), 1584:
The so called triple burner is embedded in the greasy membrane of the diaphragm, that is the
hollow space between the five zang/six fu organs and the connective pathway through which
food and grain must pass. The qi of the triple burner is contained and active within this space,
steaming the diaphragm, reaching out to the skin, differentiating the flesh, and setting
everything around it in motion. The regions that it reaches are labeled according to their
location, that is why we speak of the upper burner, the middle burner, and the lower burner.
Although the triple burner does not have any structural reality to it, it has a distinct location
that is determined by the structural entities surrounding it.
From Shen Jin'ao, Illuminating Lantern on the Origins of Complex Diseases (Zabing Yuanliu
Xizhu), 18th century:

What we call the triple burner is actually the corridor above and below the stomach. The
triple burner and its associated regions thus entirely belong to the stomach, and what it
oversees is primarily the functioning of the stomach. The triple burner qi is utilized to
ferment and cook the food. Together with the stomach, the triple burner is located in front of
the taiyin spleen network-a place that the roaming ministerial fire calls home. The term
"burner," therefore, refers to the triple burner's function of cooking everything.
From Li Dongyuan, Illuminating the Science of Medicine (Yixue Faming), 13th century:
The triple burner is an entity that has a name but no structural form. It is in charge of all
bodily qi, and it is a functional manifestation of the three treasures [jing, qi, shen]. All of the
body's physiological movements, its unobstructed ins and outs and ups and downs, therefore,
rely on the triple burner-the process of breathing in and breathing out, the ascending and
descending motion of qi, and the absorption and excretion of food and water. The upper
burner is located underneath the heart; it is in charge of storing without draining. The middle
burner is in the center of the epigastric region; it is in charge of fermenting and cooking food
and water. The lower burner is beneath the umbilicus; it is in charge of differentiating the
clear from the turbid, and it drains without storing. The driving source behind all three of
these functions, however, is the middle burner.
From Chen Nianzu, The Three Character Classic of Medicine (Yixue Sanzi Jing), Qing
Dynasty:
The term triple burner refers to the qi that circulates in the upper, middle, and lower burners.
Burner means heat. Only when the entire body cavity is permeated with hot qi can the body's
water ways be open and regulated. The triple burner is the fu organ that forms a zang/fu pair
with the pericardium, and thus belongs to the phase element fire. In other words, if the
heating qualities of the upper burner are out of control, water will assault the upper plains of
the body. If the middle burner is out of control, water will stagnate in the epigastric region. If
the lower burner is out of control, water will disturb bowel movements and urination. On the
other hand, if the triple burner qi is healthy and in control, the body's channels and collaterals
will be open and its water ways will be disinhibited. It is for this reason that the triple burner
is called the official in charge of uninhibited water flow.
Jing is the Chinese designation for the essential fluid of our physical body. The archaic Chinese
character for jing denoted the most refined essence obtained from rice (which is the main staple of the
Oriental diet, so this means the refined essence from food). The basic yin (matter) from which all yang
(physical action) springs is jing. In classical Chinese medical texts, jing is sometimes referred to as the
body's "original water" with water representing the ultimate yin ("original fire" being the ultimate
yang).
Water has a tendency to drain downward. The kidney, the lowest of the organ networks, is where
the body's water assembles and goes into storage until needed elsewhere. If the kidney function is weak,
its storage capability will become inhibited and jing will leak from the body. Due to the Daoist belief
that the jing is lost when a man excretes semen (of particular concern, when an elderly man, who
already had deficiency of jing through aging, excretes semen), virtually all of the ancient medical texts
mention spermatorrhea (a code for release during the disallowed practice of masturbation, wet dreams,
and ejaculation during intercourse when the attempt is being made to prevent it) as a condition to be
treated, since it indicates a breach of the kidney's function of safeguarding and storing jing. According
to the Daoist ideal, except during early adulthood, men should refrain from releasing semen, or, at the
very least, experience this infrequently.
Therefore, excessive sexual indulgence by males is considered to be a major health hazard in all
genres of traditional Chinese writing. Since most men cannot control their urge to ejaculate, every
intercourse means an irrevocable giving away of jing. Although Chinese medical texts consent that this
may be affordable for young men (who have a rich supply of jing and who can easily replenish jing
through post-natal sources), they generally warn that the health of elderly males will suffer serious
consequences from frequent ejaculations. "What gives life will take life" is therefore a common
admonition that spans two thousand years of Chinese medical literature.
While most Daoist and medical writings take up both the general topic and the detailed techniques
of safeguarding jing, it is the realm of literature which best reflects the Chinese fear of continuous jing

loss by way of sexual indulgence. The epic Ming Dynasty novel, Flower In the Golden Vase ( Jin
Ping Mei), narrates the story of the erotomaniac Ximen Qing who peddles his money and political
influence to assemble a harem of six women, then resorts to tonic drugs to bolster his flagging virility,
and finally comes to a horrid end after a final ejaculation of "mercury-like fluid, followed by blood and
a gust of cold air." A Daoist physician who is called to the deathbed comments: "The candle flickers
once the oil is used up." Both mercury and lamp oil are often used metaphors for the kidney jing. To
avoid such a gruesome death, the handsome protagonist of the second moralist novel of the Ming
dynasty, Prayer Mat of Flesh (Rou Putuan), decided to become a Buddhist hermit, cut off his
surgically amplified penis, and utilize his jing for spiritual cultivation.
Although the word jing is synonymous with the Chinese word semen, the seminal fluid represents
only one form of jing. Other dense fluid essences such as saliva (particularly the kind that gets
spontaneously excreted during meditation), vaginal fluids, breast milk, or blood are all regarded to be
different transformations of one and the same jing; these are refined essences. Female "leakage"
problems, such as metrorrhagia or leukorrhea occurring in older women, are therefore taken seriously
for the same reasons as loss of semen in men. Daoist body science even features a special category
called female alchemy (nu dan), wherein adepts are instructed in the conservation of (menstrual) blood
and its transformation into physical and spiritual energy.
The jing stored in the kidney can be differentiated into prenatal jing and postnatal jing. Prenatal
jing contains the information that is given to us before birth (we would today describe it as genetic
information) that is intimately linked to the growth and maturation of an individual, which differs for
men and women. The defining passage in the Neijing for women reads: "At the age of seven, the
kidney qi [the physical action generated by the material basis of kidney jing] in females is strong, and
the teeth come in. At the age of two times seven, the tiangui (stage of hormonal and reproductive
maturity) arrives, the conception vessel opens, the penetrating vessel flourishes, menstruation is regular,
and pregnancy becomes possible." With regard to male physiology: "At the age of eight, the kidney qi
solidifies in males and teeth develop. At the age of two times eight, the kidney qi flourishes, the tiangui
arrives, ejaculation occurs, and it becomes possible to have intercourse with females and beget
children...; at the age of seven times eight, the liver qi is exhausted, the tendons are unable to facilitate
smooth movement, the tiangu is dried up, jing is sparse, the kidney system is exhausted, and symptoms
of physical aging are plentiful."
Postnatal jing is the nutritive essence distilled from food by the spleen/stomach, and used to
provide a constant flow of nourishing dew to the other organ networks. If all the networks are
plentifully supplied, the surplus of the body's vital fluid transformation is stored in the kidney. The
Neijing states: "The kidney is in charge of water, and it receives the essences of the other zang and fu
organ networks and stores it." Before birth, prenatal jing forms the material basis for the development
of postnatal jing. Once born, postnatal jing continuously boosts the body's limited supply of prenatal
jing. Both forms of essence compose an indivisible entity.
Kidney jing encompasses both kidney yin and kidney yang, often referred to as the body's original
yin and original yang. Kidney qi is produced by the dynamic interaction between the two, specifically
the action of functional/warming kidney yang steaming the material kidney yin. Kidney yin is the
source of all material body fluids, in charge of nourishing and moistening all organ networks. Kidney
yang, sometimes also called true yang, is the source of all types of yang qi. It is the driving force behind
all processes of warming, generation, and transformation. The yin and yang aspects of the kidney both
rely on each other and control each other. The proper balance between kidney yin and kidney yang is an
important precondition for health.
Will, determination, and power of memory are attributed to the kidney. The ability to keep a secret is
attributed to the kidney's power of retention and safeguarding against leakage. The Neijing defined that
"the kidney stores jing, and jing houses will power." In turn, if kidney jing becomes exhausted, a weak
will and poor memory will result.
Fluids reach the kidney after they have been absorbed by the stomach, raised upwards by the spleen,
and sprinkled downwards by the lung. At this point they become differentiated into clear and turbid
aspects by virtue of the transformative powers of kidney yang. The clear part of fluid essence returns to
the lung, from where it moistens each one of the zang organs. From the lung, it turns into nasal
discharge, or sweat, or saliva, or tears; and it differentiates into jing, blood, jin (liquids, that is the
thinner fluids moistening the muscles), and ye (the denser fluids lubricating the joints and bone
marrow). The turbid part feeds into the bladder, where it is being transformed into urine, and excreted.

Bone marrow is considered to be a transformation of kidney jing that has the specific task of nourishing
the bones. It is differentiated into bone marrow, spinal marrow, and brain marrow. Spinal marrow feeds
into the brain, where the densest concentration of "marrow" can be observed. The brain is therefore also
called the sea of marrow.
If kidney jing is plentiful, both the bone (supporting the body) and the brain (supporting the mind)
will be at a level of ideal strength. On the other hand, a deficiency of kidney jing will bring about brittle
bones and a listless spirit. As the Neijing puts it: "The kidney is the master of physical strength; it
produces exquisite movements/actions."
Since the teeth are considered to be the "surplus of the bones," they also rely on the nourishment of
the kidney. If the jing is plentiful, the teeth are firm; if not, they come loose or fall out.
The hair's growth process is governed by the waxing and waning of kidney qi. Again the crucial
Neijing quote: "At the age of seven, a female's kidney qi is in high gear, the second teeth come in and
the hair grows." Ancient texts often consider the head's hair to be a direct outgrowth of the brain, which
would relate it to the kidney. The growth pattern and general luster of the hair is an important indication
for the condition of prenatal jing.
Although the process of breathing is governed by the lung, the containment of incoming qi within the
lower burner is governed by kidney qi. Only if kidney qi is plentiful and its grasping power sufficient
can the qi passages of the lung be unobstructed and the breathing be harmonious. If the kidney is weak
and the breath cannot "root" in the kidney, disease will eventually arise. Shallow breathing, particularly
in patients suffering from chronic asthma, is therefore often associated with a kidney qi deficiency. In
this situation, the breath gets stuck above the diaphragm and cannot descend into its rightful abode, the
lower dantian. This aspect of the kidney is one reason why there is such an intent focus on abdominal
breathing in Oriental cultures.
The kidney and bladder form a zang-fu pair: "The kidney is connected with the bladder," states the
Neijing; "the bladder is the store house of the liquids and humors." This statement reminds us that the
bladder, similar to the gallbladder and the small intestine, not only excretes unwanted waste materials,
but comprises a temporary station along the body's complex highway of vital fluid transformation.
Bladder function, particular its function of "opening and closing," is largely dependent on the power of
kidney qi. If kidney qi is strong, normal water metabolism will take place. The storage and excretion
process of water through the bladder is thus intimately related to the general functioning of the kidney.
The ears, which faintly resemble the kidneys in shape, are thought to reflect the condition of kidney
jing. Large ears and sharp hearing indicate an excellent condition of kidney jing. As people grow older,
they not only become more forgetful, but their power of hearing decreases (and sometimes their ears
shrivel up) as their jing depletes. As the original statement of the Neijing goes: "The kidney qi
communicates with the ears; if the kidney functions properly, the ears can distinguish the five essential
sounds."
Kidney qi, due to its mother organ's close proximity to the openings in the lower burner, governs
the opening and closing function of the "two private parts," including sexual functions like erection,
ejaculation, and lubrication of the vaginal tract, and maintenance of fecal continence (as well as urinary
continence via the control of the bladder).
The concept of mingmen, the vital gate of life, is an integral part of the kidney system. The Nanjing
(Classic of Difficulties) elaborated on basic Neijing theory by figuratively differentiating these two
aspects of the kidney in structural terms, thereby initiating a medical theory that was later referred to as
the mingmen school: "There are two kidney parts. Actually, not both of them are kidneys. The left one
is the kidney, the right one is mingmen." The classic then goes on to elaborate that mingmen is the place
"where the entirety of bodily jing and shen is at home, and where the original qi is generated." "It is the
root of all zang-fu networks, the foundation of the twelve channels, the gate of breath, and the source of

all three burning spaces." Later medical scholars argued that mingmen is an immaterial force that could
not be physically located in the right kidney. Rather, its location is the central point on the spine
between the two anatomical kidneys and opposite the umbilicus, thus forming a "posterior dantian." The
Chinese name for the acupuncture point located there is mingmen (GV-4).
The fire lodged within kidney water is often referred to as the body's ministerial fire (xiang huo),
as opposed to the imperial fire (jun huo) of the heart. In its role of the "minister" serving the higher
centers, it warms the spleen, ripens food, grasps lung qi, and gives volume to a person's voice.
The triple burner, a fu organ that is said to pass through and connect all of the body's three burning
spaces, stimulates qi transformation with a specific focus on water metabolism. It keeps the body's
water ways unobstructed and smoothly operating. These functions of the triple burner are intimately
tied to the kidney and bladder. The Neijing says: "The upper burner is like a mist, the middle burner is
like a swamp, and the lower burner is like a ditch," referring to the essence misting activity of the lung
on top, the fermenting action of the spleen/stomach at the center, and the canalization of water in the
lowest part of the torso.
Injury to Kidney (Yin) and Mingmen (Yang) Fire: if the kidney's ability to store jing becomes
disturbed, a person's growth patterns and reproductive ability will be affected; infertility, hair and tooth
loss, slow physical development, or softness and malformation of the bones may result.
If within the kidney jing the crucial controlling/generating balance between kidney yin and kidney
yang becomes disturbed, different symptom patterns may arise. Typical manifestations of hyperactivity
of yang due to kidney yin deficiency are burning sensation in the palms and soles, tidal heat sensations,
night sweats, spermatorrhea, or sexual dreams. When the kidney yang is exhausted and thus unable to
execute its ministerial warming function, symptoms of listless spirit may result: sore lower back and
knees; cold sensations in the body and its extremities; inhibited urination or frequent and profuse
urination; early morning diarrhea; asthmatic panting upon slight physical exertion; difficult breathing;
impotence and premature ejaculation; or infertility due to a "cold uterus." If there is evidence of kidney
deficiency without obvious cold or heat symptoms, this symptom complex is usually referred to as
kidney qi (or kidney jing) deficiency.
It is important to understand the intimate relationship of kidney yin and kidney yang, and that
prolonged kidney yin deficiency will eventually influence kidney yang and vice versa. This
phenomenon is usually called a deficiency of kidney yin implicating kidney yang, or a deficiency of
kidney yang implicating kidney yin.
Changes in Water Metabolism: since the kidney is said to be in charge of water, all pathological
changes involving water are in some way associated with the kidney. If there is a lack of kidney yang,
the body's general process of qi transformation will suffer, and consequently water metabolism will be
inhibited. As the Treatise on Blood Diseases ( Xuezheng Lun) explains: "If there is not enough yang
qi, pathological water accumulations will turn into phlegm and distress the heart or attack the lung, or
cause symptoms of edema, abdominal pain accompanied by a sensation of qi rushing upwards, or
diarrhea and intense cold."
Most cases of phlegm or edema occur when the yang fire is unable to transform yin water.
Figuratively speaking, the kidney is the general commanding the two water fu organs which are mainly
involved in the transportation and transformation of water, namely the triple burner and the bladder. As
the Neijing says: "The shaoyang [triple burner] belongs to the kidney; above, the kidney connects with
the lung, and thus has two fu organs under its command [triple burner and bladder]."
Therefore, if there is not enough kidney yang, the upper burner cannot properly distribute fluids,
the middle burner cannot properly steam and ripen food and separate the clear from the turbid, and the
lower burner cannot properly transform qi, thus influencing the opening and closing ability of the
bladder (causing excessive or inhibited urination, as in bed wetting, frequent urination, nocturia, etc.).
Moreover, since urine is manufactured from body fluids which are in part produced by the kidney,
a deficiency of kidney water will always involve a deficiency of fluids, causing inhibited urination.
Along the same lines, too much urination will eventually harm the body's fluid supply.
Emotional Influences on Proper Kidney Function: the kidney is said to house the force of will
power and determination. Will power, therefore, relies on nourishment by kidney jing. If jing is weak,

then will power and its sustained expression (memory) will also be weak.
Intense or prolonged fear, the emotion associated with the kidney, will cause injury to the kidney
qi, resulting in impotence, spermatorrhea, or the gradual development of cowardly behavior. The other
way around, a physical deficiency of kidney jing can cause a disposition for panicky and fearful
behavior.
Kidney Disorders Causing Pathological Changes in the Bones,, the Marrow,, the Hair,, and the
Ears: if kidney jing is sufficient, the continuous production of high quality marrow is assured, resulting
in properly nourished and, thus, firm and strong bones. Otherwise the skeletal structure will be weak, or
structural changes such as osteoporosis might occur.
If the kidney is harmed by pernicious qi affecting the kidney jing and consequently the marrow and
bones, there will be symptoms of weak and sore waist and legs, or even atrophy of the legs causing
severely limited mobility. As the Neijing states: "If kidney qi is pathologically hot, the lumbar spine
will be inhibited, the bones will become brittle and the marrow scorched, and atrophy of the bones will
result."
For the same reasons, symptoms of loosening and deteriorating teeth, or the drying, greying, and
gradual falling out of hair are related to the state of the kidney's jing qi. Since the ears and the
associated sense of hearing also depend on nourishment by the kidney's jing qi, ringing in the ears, loss
of hearing, or deafness are typical symptoms for various aspects of kidney deficiency.
Moisten the kidney (tonify kidney yin) (zi yin; bu shen yin): rehmannia (dihuang), tortoise shell
(guiban), asparagus root (tianmendong), lycium fruit (gouqizi), morus fruit (sangshenzi), ligustrum
(nuzhenzi).
Warm the kidney (strengthen yang; tonify the vital flame of life) (wen shen; zhuang yang; bu
ming huo): aconite (fuzi), cinnamon bark (rougui), sulphur (liuhuang), morinda (bajitian), deer antler
(lurong), cnidium fruit (shechuangzi), cistanche (roucongrong).
Complement jing and tonify the marrow (tian jing bu sui): animal bone marrow (dongwu jisui),
animal brain (naosui), placenta (ziheche), deer antler (lurong), antler gelatin (lujiaojiao), tortoise plaster
gelatin (guijiao), cordyceps (dongchong xiacao).
Restore the storing action of the kidney (astringe jing; stop vaginal discharge; curb frequent and
profuse urination) (gu shen; se jing; zhi dai; shou se xiao bian): schizandra (wuweizi), cornus
(shanzhuyu), alpinia (yizhiren), rubia (fupenzi), mantis egg case (sangpiaoxiao), rose hips (jinyingzi).
Restore the kidney''s function of grasping and retaining qi (na qi gui shen): schizandra (wuweizi),
psoralea (buguzhi), gecko (gejie), cornus (shanzhuyu), aquilaria (chenxiang).
Aid the transformation of bladder qi (hua pangguang qi): cinnamon twig (guizhi) and hoelen
(fuling), cinnamon bark (rougui), lindera (wuyao), fennel (xiao huixiang), saussurea (muxiang), citrus
seed (juhe), litchi seed (lizhihe).
Open and disinhibit the water passages of the bladder and the triple burner (tongli pangguang,,
sanjiao): alisma (zexie), hoelen (fuling), polyporus (zhuling), talc (huashi), akebia (mutong),
tetrapanax (tongcao), tokoro (pixie), polygonum (bianxu), lygodium (haijinsha).
Clear kidney heat (moisten yin and descend deficiency fire) (qing shen re; zi yin jiang huo):
anemarrhena (zhimu), phellodendron (huangbai), morus bark (digupi), eclipta (hanliancao).
Discharge kidney fire (purge fire with salty and cold materials) (xie shen huo; xian han xie huo):
salt (qingyan), halite (qingyan), urine (tongbian), calcitum (hanshuishi).
Since the kidney is the representative lower burner organ, it generally needs to be addressed with high
amounts of heavy and sticky substances. The 18th century fever school authority Wu Jutong once
described this characteristic in graphic terms: "Lower burner therapy is like a weight-if it is not heavy
enough, it does not reach the bottom."
Kidney disorders are generally of a cold and deficient nature. Kidney therapy, therefore, needs to
focus primarily on the tonification of deficiency; purging of excess is a definite taboo. If kidney water is
deficient, the kidney needs to be tonified by moistening yin. If kidney jing is deficient, it needs to be

eplenished by supplementing jing and tonifying the bone marrow. If kidney yang is deficient, the
kidney needs to be tonified by using modalities that strengthen yang. In the more advanced scenario of
mingmen fire exhaustion, materials that warm and tonify the vital flame of life need to be employed.
Since the kidney has both yin and yang aspects, pathological situations may arise from an
imbalance in the ratio of kidney yin and kidney yang. The most typical example is the upflaring of
deficiency fire due to a deficiency in kidney water, which calls for a descending action that re-anchors
the floating fire in the yin waters of the kidney. This is primarily achieved by the use of yin tonics
which will bring the diminished yin level back to full capacity and thus naturally extinguish the
deficiency type of pathological heat. If yang deficiency has begun to implicate yin, both jing and
marrow should be supplemented and the vital flame of life be warmed and tonified. If both kidney yin
and yang are deficient, both the various aspects of the kidney and the vital flame of life should be
tonified.
In the common scenario of spleen and kidney deficiency, both spleen and kidney yang need to be
tonified. In case of lung and kidney deficiency, both lung and kidney yin need to be moistened. In
chronic asthma patients where kidney deficiency results in an inability of the kidney to grasp the
descending qi from the lung, the kidney needs to be warmed with substances that specifically assist with
the action of grasping and retaining qi, such as gecko (gejie) and schizandra (wuweizi). If lung metal
fails to properly generate kidney water, kidney yin needs to be moistened indirectly by nourishing the
yin of its mother system, the lung. If kidney water fails to nourish its son, liver wood, the liver needs to
be supported by moistening kidney yin and/or kidney jing. In the case that kidney deficiency has caused
an exhaustion of the earth network, the lower burner's vital flame of life needs to be rekindled with
warming substances in order to provide the transformative forces of the middle burner above with the
activating heat they require.
If the extended water network (including the kidney, the bladder, and the triple burner) is
compromised by a damp heat condition, the dampness should be disinhibited with materials of a
cooling nature that have a specific affinity to the lower burner, such as alisma (zexie), polyporus
(zhuling), and talc (huashi). If the transformative powers of the bladder and the triple burner fail due to
an exhaustion of the kidney's vital flame of life, then this type of pathological water accumulation needs
to be transformed by primarily warming kidney qi, and secondarily by adding several herbs that directly
move out the pathological water. If phlegm, dampness, or water rheum stagnate internally, phlegm
damp needs to be disinhibited, and water rheum driven out.
If the kidney has been damaged due to chronic illness, exaggerated emotions, or excessive sexual
activity, a change of the situation or life style that has originally caused the condition is imperative.
Simultaneously, the recovery of the kidney system can be supported by prescribing a selection of tonic
agents that moisten yin, strengthen yang, or nourish jing and marrow.
As the water network, the kidney has an aversion to dry influences. It would be particularly
detrimental to exclusively employ bitter and drying substances in a situation where the kidney yin is
deficient. Perhaps unexpectedly, the Neijing recommends pungent flavors to counteract dryness in the
kidney; these pungent flavors aid the lung in distributing moisture to the kidney. In clinical reality, herbs
like cuscuta (tusizi) and cnidium fruit (shechuangzi) fit this category. The kidney strives for a state of
guarded firmness and tight solidity. If the storage fortress of the kidney is properly buttressed, precious
essence will not leak out. Many bitter materials, although they should be used cautiously for the reasons
just mentioned, have a stabilizing affect on kidney yin. Anemarrhena (zhimu), an herb that is both bitter
and moistening, and phellodendron (huangbai) are the prime substances used in situations of continuous
jing leakage, particularly lower burner deficiency fire fueling obsessive sexual urges, excessive
masturbation, recurrent sexual dreams, spermatorrhea, or certain types of leukorrhea.
Salty flavors have a direct affinity to the kidney network, and are generally beneficial when used in
moderation. "Salty flavors generate the kidney," comments the Neijing. Increased dietary intake of salt,
usually obtained from stored foods with salt as the preserving element, taken during the water season
(winter) contributes to preserving the kidney against the cold. On the other hand, salt has a percolating
and leakage-promoting affect that is overall unsuitable for an organ system that is in charge of storing
and metabolizing physiological jing, humors, and fluids. Therefore, excessive consumption of salty
foods is discouraged, as it will harm the kidney and its affiliated body layer. "If the disease is in the
bone layer," the Neijing points out elsewhere, "do not eat salty foods."
If the kidney root is damaged, many of the body's stem and branch organs have already entered a
pathological state first. If kidney yin-that is the base substance from which liver yin, stomach yin, heart
yin, lung yin, and the body's humors and fluids are formed-is deficient, it usually means that the
condition is preceded by a yin deficiency in other organs. Similarly, the essential flame of the lower
burner only flickers after the light in the upper levels has grown dim. This situation has given rise to a

school of medicine that favors kidney tonification in most deficiency situations. Tonifying kidney yin
and kidney yang, proponents have argued since the 13th century, means to moisten and strengthen the
body's source yin/yang and thereby the yin/yang of all organ networks. However, the root status of the
kidney also implies that kidney deficiency is often accompanied by inadequate spleen/stomach function.
This poses a problem in light of the fact that herbal kidney therapy requires heavy amounts of sticky
substances that are generally hard to digest. One attempt to remedy this situation was the addition of
herbal "digestive aids" to kidney formulas such as Rehmannia Six Formula (Liuwei Dihuang Wan).
Pharmacists at the renowned Beijing herb emporium Tongren Tang, for instance, used to automatically
add small amounts of the aromatic cardamon (sharen) if the patient's prescription called for large
amounts of the greasy kidney tonic rehmannia (dihuang). Proponents of the spleen/stomach school, on
the other hand, have argued that kidney deficiency is often the result of a deficiency of its controlling
network, namely spleen earth. Spleen tonification advocates have said for more than half a millennium
that this should be the primary modality to regenerate the kidney system. In any case, caution needs to
be exercised regarding the prescription of heavy "water" substances to patients who show signs of
digestive weakness, such as poor appetite, bloating, and tendency to experience diarrhea or loose stool.
A safe method for the direct tonification of lower burner source qi has been developed by the ancestors
of Chinese medicine, namely Daoist practitioners of "inner alchemy." The term inner alchemy refers to
Qigong exercises of the quiet, meditative kind that focus on generating warmth and fullness in the lower
dantian.
KIDNEY YIN DEFICIENCY (shen yin xu): primary symptoms are dizziness; blurry vision; ringing
in the ears; sore and weak lower back or knees; burning in palms and soles; tidal heat sensations; night
sweats. Secondary symptoms include dry mouth and throat; flushed face; emaciated features; premature
graying of hair; low sperm count in males; decreased menstrual flow and infertility in females;
forgetfulness; insomnia; spermatorrhea; premature ejaculation; heel pain; yellow urination; dry stool.
The tongue typically presents with a red body and little or no coating; the pulse tends to be fine and
rapid.
Representative Herbs: rehmannia (dihuang), cornus (shanzhuyu), asparagus root (tianmendong),
ho-shou-wu (heshouwu), lycium fruit (gouqizi), ligustrum (nuzhenzi), tortoise shell (guiban), turtle
shell (biejia), scrophularia (xuanshen), eclipta (hanliancao), anemarrhena (zhimu).
Representative Formulas: Return the Left Decoction; Achyranthes and Rehmannia Formula (Zuogui
Yin); Rehmannia Six Formula (Liuwei Dihuang Wan).
KIDNEY YANG DEFICIENCY (shen yang xu): primary symptoms are pale or dark complexion;
listless spirit; obvious aversion to cold; cold extremities; low sex drive; weak or cold and painful lower
back and knees; early morning diarrhea; frequent urination or clear and profuse urination. Secondary
symptoms include impotence; premature ejaculation; infertility; clear vaginal discharge; inhibited
urination and edema; dizziness; ringing in the ears. The tongue typically presents with a pale, tender,
and often toothmarked body, and a white and slippery coating; the pulse tends to be deep, slow, and
forceless.
Representative Herbs: aconite (fuzi), cinnamon bark (rougui), epimedium (yinyanghuo), morinda
(bajitian), psoralea (buguzhi), deer antler (lurong), curculigo (xianmao), fenugreek (huluba), cistanche
(roucongrong), cynomorium (suoyang).
Representative Formulas: Return the Right Pill (Yougui Wan).
KIDNEY QI DEFICIENCY (shen qi xu): primary symptoms are dizziness; ringing in the ears; weak
or sore lower back and knees; physical and mental fatigue; shortness of breath. Secondary symptoms
include pale complexion; spontaneous sweating; decreased mental and physical growth rate in children;
frequent urination; nocturia; spermatorrhea; premature ejaculation; asthmatic panting upon exertion.
The tongue typically presents with a pale body and a white coating; the pulse tends to be fine and weak.
Representative Herbs: walnut (hutaorou), dioscorea (shanyao), eucommia (duzhong), cuscuta (tusizi),
schizandra (wuweizi), cornus (shanzhuyu), morinda (bajitian).
Representative Formula: Rehmannia Eight Formula (Shenqi Wan).
KIDNEY JING DEPLETION (shen jing bu zu): primary symptoms are dizziness; ringing in the ears;
weak or sore lower back and knees; low sperm count in males; amenorrhea and infertility in females;
delayed mental and physical development in children. Secondary symptoms include decreased memory;
slow and clumsy body movements; dull facial expressions; emaciated body structure; hair loss; loose
teeth; late closing of fontanella in babies; muscular atrophy.
Representative Herbs: placenta (ziheche), deer antler (lurong), tortoise shell gelatin (guijiaojiao),
cordyceps (dongchong xiacao), cooked rehmannia (shu dihuang), lycium fruit (gouqizi), cornus

(shanzhuyu), eucommia (duzhong), cistanche (roucongrong).
Representative Formula: Placenta Restorative Pills (Heche Dazao Wan).
BILATERAL DEFICIENCY OF KIDNEY YIN AND YANG (shen yin yang liang xu): primary
symptoms are dizziness; ringing in the ears; weak, sore, or painful lower back and knees; cold fingers
and toes and/or burning sensations in palms and soles; night sweats or spontaneous sweating. Secondary
symptoms include pale complexion and/or flushed face; poor memory; insomnia; vivid dreaming;
listless spirit; loose teeth; dry and split hair; unsteady walk; swollen feet; asthmatic panting upon
physical exertion. The tongue typically presents with a red body and little or no coating, or with a pale
body and white coating; the pulse tends to be fine and rapid, or deep, slow, and weak.
Representative Herbs: cooked rehmannia (shu dihuang), ho-shou-wu (heshouwu), lycium fruit
(gouqizi), ligustrum (nuzhenzi), cornus (shanzhuyu), cuscuta (tusizi), schizandra (wuweizi).
Representative Formulas: Rehmannia Eight Formula (Shenqi Wan); Five Seed Fertilize the Ancestral
Force Pill (Wuzi Yanzong Wan).
THE KIDNEY QI FAILS TO EXECUTE ITS STORING ACTION (shen qi bu gu): primary
symptoms include clear, frequent, and dribbling urination; enuresis; bedwetting; spermatorrhea;
premature ejaculation; tendency to miscarry; clear vaginal discharge. Secondary symptoms include pale
complexion; mental and physical fatigue; weak or sore back; loss of hearing; spontaneous sweating.
The tongue typically presents with a pale body and a white coating; the pulse tends to be fine and weak.
Representative Herbs: schizandra (wuweizi), euryale (qianshi), rose hips (jinyingzi), mantis egg cases
(sangpiaoxiao), dioscorea (shanyao), alpinia (yizhiren), dragon bone (longgu), oyster shell (muli),
cuscuta (tusizi).
Representative Formulas: Golden Lock Shore Up the Jing Pill (Jinsuo Gujing Wan); Mantis Formula
(Sangpiaoxiao San); Retract the Source Pill (Suoquan Wan).
THE KIDNEY FAILS TO GRASP AND RETAIN QI (shen bu na qi): primary symptoms are
shortness of breath or asthmatic panting (brief inhale, longer exhale), especially following physical
exertion. Secondary symptoms include pale complexion; puffy face; blue lips; emission of small
amounts of urine when coughing; spontaneous sweating; general aversion to cold; cold extremities;
weak or sore lower back and knees; mental and physical fatigue. The tongue typically presents with a
pale body and a white coating; the pulse tends to be fine and weak, or floating and uprooted.
Representative Herbs: walnut (hutaorou), gecko (gejie), psoralea (buguzhi), schizandra (wuweizi),
cooked rehmannia (shu dihuang), ginseng (renshen), codonopsis (dangshen), aquilaria (chenxiang),
amethystum (zishiying).
Representative Formulas: Ginseng and Walnut Decoction (Renshen Hutao Tang); Ginseng and Gecko
Powder (Shen Jie San); All Encompassing Qi Pill (Du Qi Wan).
YIN DEFICIENCY CAUSING FIRE EFFULGENCE (yin xu huo wang): primary symptoms are
flushed face and red lips; restlessness; difficulty falling asleep; dry mouth and throat; burning sensation
in palms and soles; tidal heat sensations; night sweats. Secondary symptoms include obsessive sexual
fantasies; excessive urge to masturbate; frequent sexual dreams; dark urination; constipation. The
tongue typically presents with a red body and little or no coating; the pulse tends to be fine and rapid.
Representative Herbs: anemarrhena (zhimu), phellodendron (huangbai), coptis (huanglian), raw
rehmannia ( sheng dihuang), peony (baishao), cynanchum (baiwei), eclipta (hanliancao), lycium bark
(digupi).
Representative Formulas: Anemarrhena, Phellodendron, and Rehmannia Formula (Zhi Bai Dihuang
Wan); Lock in the Marrow Pellet (Fengsui Dan).
KIDNEY YANG DEFICIENCY CAUSING WATER EFFUSION (shen yang xu shui fan):
primary symptoms are puffiness and edema (especially prominent in lower extremities). Secondary
symptoms include ashen or waxen face color; inhibited urination; obvious aversion to cold; cold
extremities; palpitations; stuffy sensation in chest; shortness of breath; cough or asthmatic panting
accompanied by expectoration of runny and clear phlegm; heavy and painful waist; abdominal fullness;
scrotal edema. The tongue typically presents with a fat, pale, and toothmarked body, and a white and
slippery coating; the pulse tends to be deep and wiry; or deep and fine.
Representative Herbs: aconite (fuzi), cinnamon twig (guizhi), hoelen (fuling), curculigo (xianmao),
alisma (zexie), plantago seed (cheqianzi), polyporus (zhuling).
Representative Formula: Vitality Combination (Zhenwu Tang).

From Zhou Xuehai, Reflections Upon Reading the Medical Classics (Du Yi Suibi), ca. 1895:
The physician who knows how to harmonize the liver knows how to treat the hundred
diseases.
From Tang Rongchuan, A Treatise on Blood Disorders (Xuezheng Lun), 1884:
Spreading is the nature of wood. The transformation of food qi relies entirely on the
spreading and dredging function of liver wood once the food enters the stomach. If the
liver's pure yang does not rise, it cannot spread and dredge the grain and fluids, and
distention and discomfort in the middle region will inevitably result.
The liver is associated with wood. Wood qi is characterized by its upward momentum
and its innate desire to be straight. As long as the flow of liver qi is not impeded, the
blood vessels will remain open and unobstructed.
The liver is the organ that is in charge of storing blood. It also commands the ministerial
fire (xiang huo). If there is sufficient blood, this fire will be warm but not fierce. As a
result, the blood can circulate smoothly through the body's three burning spaces; it will
reach the pores, and every single place in the body will benefit from its warming and
nourishing function.
From Zhang Xichun, Chinese at Heart But Western Where Appropriate: Essays Investigating
an Integrated Form of Medicine (Yixue Zhong Zhong Can Xi Lu), 1933:
Liver and spleen function together by assisting each other. However, people are always
quick to point out that an excess of liver wood can injure the spleen earth, and thus have
a detrimental affect on the proper digestion of food. But nobody seems to pay attention to
the fact that a weak liver cannot circulate the spleen qi and thereby also cause
maldigestion. Below, the liver connects to the Sea of Qi [lower dantian, associated with
the kidney], which means that the liver is closely associated with the body's ministerial
fire. It can utilize the power of this fire to produce earth. The food which enters the
spleen and stomach relies on this power to be 'cooked.' This is what is meant by saying
that the liver and the spleen function by assisting each other.
From Ye Tianshi, A Handbook of Clinical Case Histories (Linzheng Zhinan Yian), 1746:
The liver is known as both the wood organ and the wind organ. Because it houses the
ministerial fire within, we can say that the structure of the liver is yin while its function is
yang. Its nature is firm and resolute, and it is in charge of moving and ascending. The

liver relies entirely on kidney water to sustain it, on blood to moisten it, on lung metal's
clear nature and descending function to keep it in check, and on the generosity of the
middle palace's earth qi to nourish it. In this way, a firm and unrelenting character is
being fitted with a soft and harmonious body, resulting in the liver's balancing and free
flowing nature.
From Zhang Huang, A Compendium of Illustrated Texts (Tushu Bian), Ming Dynasty:
The liver is associated with wood. It stores the blood and is the home of the hun spirits.
Among the seven human emotions, only anger is of an intense nature. It dries up the
blood and dissipates the hun spirits. The person who understands the way of nourishing
the liver, therefore, never throws fits of anger.
From Yu Bian, Medical Teachings Continued (Xu Yishuo), 1522:
The Classic of Sagely Benefits states: 'The seasonal cycle of transformation begins
with the wood phase. In the body, therefore, the process of germinating and nurturing the
twelve channel systems is initiated by the liver. During the first month of pregnancy, for
instance, a woman's fetus is nourished by her jueyin liver network.' The liver, therefore,
marks the beginning of cyclical action, the stirring of spring yang which all living things
rely upon as a catalyst for their growth. By avoiding outbursts of anger and by fostering
this particular type of yang energy, your prenatal qi will keep generating forever. The
liver is also in charge of color; if its qi is in harmony, the body will exhibit a healthy
luster. If its qi is injured, the body will appear dry and brittle. Nourishing the liver,
therefore, first of all means to refrain from anger. This is the key for the maintenance of
good health.
From Yang Jizhou, The Great Compendium of Acupuncture and Moxibustion (Zhenjiu
Dacheng), ca. 1590:
The eyes represent the orifices of the liver. When a person closes his/her eyes and falls
asleep, the blood returns to the liver. From there it is transmitted to the eyes, and the
ability to see results from this. When a person sleeps, now, the nameless fire within
grows dim in order to revitalize. Although it may be impossible to refrain from sleeping
altogether, it is advisable not to just let this energy dissipate for the mere sake of falling
into a slumber.
Insomnia caused by a cold deficiency pattern of the gallbladder is accompanied by
symptoms of restless thought and a sensation of extreme mental weariness. Excess heat
in the liver will typically cause a person to sleep too much, resulting in the mirror of
intelligence gathering dust and a deterioration of the root of good health. None of these
conditions, obviously, are the result of proper nourishing of the liver and gallbladder nor
an appropriate way of subduing the sleep demons.
This is what you should do: do not get angry, do not lay down during the day, and always
retire your body but not your shen. The essence of sleep, after all, is the soul of the body.
If you can manage to sleep little, then the master mind will be bright and alert. Not only
will your shen qi be flowing freely and purely, but you will also not be disturbed by
dreams. Every time you are overcome by a craving for sleep, blood rushes to the heart
and the original shen is forced to leave its abode. The clouds then cast a gloomy shadow
over the heavenly realm of spirit, and the shen itself will grow dim and unconscious just
like its domicile.
The Daoist master Zhang Sanfeng once said: 'Grasp the dream in the dream; behold the
darkness within the darkness. Since I saw the face of the girl, I can happily view the
paradise, Penglai, right in front of my eyes. This is precisely what I mean! The Neijing ,
furthermore, states: 'The three months of spring are the period of commencement; heaven
and earth are born, and all living things are flourishing. Get up early in the morning, walk
around in the courtyard, loosen your hair and relax your body. By doing so you will
generate mental strength and act in harmony with the qi of spring, thus following the way
of nourishing life. If you live contrary to this principle, you will harm your liver.'
Everybody should be aware of this basic principle.
From Cai Luxian, Chinese Medicine and Pharmacology: A Collection (Zhongguo Yiyao
Huihai), 1936:
The gallbladder stores the essential fluids. It is thus called the 'chief of staff' and the 'store

house of essence.' All the organs are of a murky nature, only the gallbladder is clear. All
the other fu organs are called "bowels in charge of transporting" or something like this;
only the gallbladder is not labeled as a transporter, but stands out as a 'store house.' It is a
fu (transport) network, but has the characteristics of a zang (storage) network.
Blood flow varies according to the time of day, the season of the year, a person's constitution, and
the state of physical and mental quietude or agitation. The blood flows at a reduced rate when
sleeping, and at an increased rate when physically working. Thirteen centuries ago, the influential
Tang dynasty scholar Wang Bing described this function of the liver in the following manner: "The
liver stores the blood, and the heart moves it. If a person moves about in a waking state, then the
blood is distributed throughout all channels; if a person rests, the blood returns to the liver."
Emotions such as anger, embarrassment, or unexpected joy can also increase blood flow,
causing the ears and face to turn red. In situations when less blood is needed, it is "stored in the
liver," which thus assumes a warehouse-like function. The actual storage of blood is done in the
penetrating vessel, one of the eight extraordinary vessels that extends from the lower dantian to the
head; this vessel is often considered to be part of the liver network. The liver is best compared to a
managing clerk, who moves goods in and out of the warehouse as they are needed.
Just as important is the liver's function of maintaining a smooth and uninterrupted flow of virtually
all body substances (including qi, blood, jing, and liquids and humors). The term shu (sometimes
translated as coursing or smoothing) is used to refer to the action of maintaining a mode of
operation in the body that is not stagnating, not overly agitated, and continuously flowing. The
term xie (sometimes translated as draining) is used to refer to the liver's action of purging
stagnation in the spleen/stomach. Proper coursing and draining, or lack thereof, is mostly reflected
in the relation of emotions to qi and blood circulation and to the influence of the liver on digestive
system functions:
Emotional aspect: the ancient Chinese observed that human emotions are largely governed by the
heart network. However, they also concluded that mental well-being or various shades of
depression have an association with the coursing and draining function of the liver. Only if the liver
carries this task out properly can the body's qi and blood flow unobstructed, and thus facilitate a
feeling of ease, harmony, and peace. If for some reason the liver fails to maintain this state,
depression (of liver qi) or pathological rising (of liver yang) may result. As the Qing Dynasty
classic, A Treatise on Blood Disorders (Xue Zheng Lun), states: "The liver is classified as
wood; wood qi is characterized by its determination to go straight to where it wants to go to; if it is
not blocked or suppressed, the movement in the vessels will be smooth."
Digestive aspect: since this moving function of the liver regulates the qi flow in the entire body, it
influences the dynamics of the other organ networks, particularly the neighboring digestive
systems. It assists the upward and downward flows of the spleen/stomach system (the stomach is to
move the food mass downward, the spleen is to move the extracted qi upward), passes bile into the
intestines, helps to transport food essence, and aids the unobstructed movement and metabolism of
water. The Treatise on Blood Disorders says "Coursing and draining is an integral part of liver
nature. Once food qi enters the stomach, it is entirely up to the liver wood to course and drain it.
Only if this process is intact will grain and water transform properly."
Hun is originally an ancient astronomical term, describing the light of the moon (as opposed to its
material body). Just like moonlight is a reflection of sunlight, hun stands for a particular type of
consciousness that is reflecting waking consciousness (shen) on another plane. The Neijing
comments in its typical terse code: "Hun is that what follows shen going in and out."
Hun can be interpreted as the realm of the subconscious that is particularly active during sleep
time. Therefore, all Chinese words that include the character hun describe states of dreaming or
trance. As Zhang Jingyue, master physician of the Ming dynasty, put it: "This dim state of
consciousness during dreaming, or the elusive visions we see meandering during nocturnal sleep,
all fall under the category of hun." Hun, in other words, can be understood as an ethereal type of
consciousness which can separate from the body during sleep and interact with other "souls" (as

hun is often translated) during this time.
Different from po (see the chapter on lung for more information), the vital instinctive spirit
that is tied closely to the material body, hun is what is believed to leave the body after death and
what can be called upon in prayers. The wandering ghosts (that usually cause trouble) described in
Chinese stories are actually hun that roam about aimlessly, because they have nobody to perform
the pacifying sacrificial rites for them.
According to traditional concepts, male physiology is mostly based on qi (yang), while female
physiology is primarily based on blood (yin). Males tend to have an abundance of qi that they can
afford to spend freely, while females have an abundance of blood that they can give away freely (as
becomes evident from the menstrual bleeding). Liver function, therefore, has great influence over
an important part of female physiology-menstruation.
The penetrating vessel and the conception vessel, are two pathways linked to the liver that are
intimately involved with the transportation of blood. The penetrating vessel, above compared to a
warehouse, is also called the Sea of Blood; and the conception vessel, as the name indicates, is
credited with the function of nourishing the uterus and the fetus. Both the conception vessel and the
penetrating vessel belong to the category of the eight extraordinary vessels. Both these vessels are
involved in the liver's ability to store blood; they set out from the uterus, and are also closely linked
with the kidney channel.
The Neijing says: "In females, the tiangui (ability to conceive) arrives at the age of two times
seven; at this point, the conception vessel will be open, the penetrating vessel will be exuberant,
and therefore menstruation arrives in regular intervals and pregnancy becomes possible....At the
age of seven times seven, the conception vessel becomes deficient, the penetrating vessel is
exhausted, the tiangui dries up, and menstruation stops; aging is taking place and there will be no
more pregnancies."
The tendons connect the muscles to the bones. In accordance with the characteristics of the liver,
they facilitate smooth and continuous movement. Because of this basic concept, some scholars
have recently included the nerves (which do not have a separate designation in classical Chinese
theory) under the category "tendons" (jin). The proper functioning of the tendons relies entirely on
their nourishment by liver blood.
The nails are considered the surplus of the tendons: as such, they are an exterior manifestation
of the general quality of the tendons, and thus, liver blood within. Dry and brittle or extremely pale
nail beds always indicate a poor quality of liver blood, while pink nailbeds and firm nails indicate a
healthy state of liver blood.
Hair is also associated with the liver blood: it is called the "surplus of the blood" (xue yu). The
rich liver blood of females is expressed in lush, long, and fast growing hair on the head; males have
more facial and body hair, which is governed by the qi organ, lung. Dry and brittle hair can be an
indication of liver blood deficiency, while hair that suddenly falls out (alopecia) is usually because
of both deficiency of blood and impeded flow of liver blood to the head, usually due to sudden
emotional trauma.
The eyes are nourished by the essence of all five organ networks, and thus differentiated into five
organ specific zones which may reveal important diagnostic information. The eyes as a whole,
however, represent the opening of the liver, and are thus considered to be more closely linked to
the liver than to any of the other organ networks. "Liver qi communicates with the eyes," states the
Neijing, "and if the liver functions harmoniously, the eyes can differentiate the five essential
colors....If the liver receives blood, we can see. The liver channel branches out to the eyes. Both
liver qi and liver blood flood the eyes to maintain proper eyesight. A person's eyesight may
therefore also serve as an indicator for liver function.

Just as trees (wood) tend to unrelentingly pursue their upward quest for the light, the liver
represents the innate will of the body/mind to spread outward. Just like qi and blood have to spread
within the body to ensure physical survival, human shen needs to spread freely through the social
environment to guarantee an uninhibited passage through life. Individuals with strong liver qi and
blood are usually excellent strategic planners and decision makers: they know how to spread
themselves into the world. Due to these qualities, they often make outstanding business managers.
If, however, this tough and determined spreading nature of the liver is not in a state of harmonious
balance with the softer side of liver wood-ease, smoothness, flexibility-the wood-endangering state
of rigidity arises.
The Liver Is Unable to Store the Blood: if the liver fails to be properly nourished by the qi
derived from food via the spleen/stomach, or if for some reason the function of storing and
regulating the blood becomes affected, symptoms of blurred vision, cramping, inhibited joint
movement, dry eyes, night blindness, trembling hands and feet, numb extremities, dry, brittle,
malformed, or grey nails, dry and split hair, scanty menstruation, or amenorrhea may occur.
The Liver Loses Its Ability to Course and Drain: if qi gets stuck, the inhibited coursing action
of liver qi immediately manifests in the form of mental and emotional symptoms; depression,
sensation of emotional pain, or crying are typical examples. If liver qi flares up and upsets the
harmonious interplay between body and mind, outbursts of anger, or pain and distention in the
sides of the chest may result.
This condition has also immediate consequences to the functioning of the spleen/stomach,
specifically the actions of absorbing, transforming, and transporting grain qi (postnatal essence).
Typical signs of a liver qi disorder implicating the neighboring spleen/stomach system are
belching, regurgitation of stomach acid, vomiting, and diarrhea.
If the liver is not coursing the qi, body fluids (which also rely on liver qi to be moved) may
stagnate, with a potential development of edema or ascites. And very importantly, if liver qi
stagnates for a long time the proper circulation of blood will be impaired. Therefore, people with
chronic diseases that involve liver qi stagnation often present with symptoms of both qi and blood
stagnation, such as piercing pain in the chest, tumors and growths, and irregular menstruation.
Liver Disharmony Reflecting on the Emotions and Mental Activities: a deficiency of liver qi
typically causes a person to be indecisive and adrift, with a marked inability to plan ahead
effectively. If gallbladder qi is deficient, the person will be fearful, have a panicky disposition, and
have difficulty making decisions.
Certain emotional states can result from, or cause, liver qi disorders. For example, a state of
depression brought on by an unexpected event can eventually cause physical symptoms attributed
to liver qi stagnation; liver qi stagnation, in turn, can cause mental depression. An intense outbreak
of anger can induce sudden headaches, dizziness, chest pain, and other signs of liver-qi flare up (as
the Neijing points out: "When a person is angry, the qi moves up); liver qi flaring up can cause one
to feel anger. Sometimes a person will suffer a stroke ("qi and blood rushing to the brain") during
or shortly after an outburst of anger. Anger is a physiologically normal emotion and will usually
not cause disease. The constant suppression of anger or putting oneself always in a situation that
generates anger, on the other hand, can be the cause of long ranging problems, since it promotes a
chronic state of internal qi stagnation.
Excess Pathogens in the Liver Channel: wind-heat (external heat) entering the liver channel
causes red, swollen, or painful eyes. Upflaring liver fire from internal causes may also produce red
eyes, or a white film on the eye. Hyperactivity of liver yang manifests in upwardly mobile
symptoms, especially hypertension and dizziness. Liver-wind (internal wind) may produce
seizures, uncontrollable eye movements, lock jaw, or tetanic cramping. The Neijing points out
that: "All wind and dizziness disorders belong to the liver."
Cold pathogens have a coagulating affect on the liver channel causing abdominal pain
radiating to the genitals, testicular pain, or vaginal atrophy.

Course the liver and regulate qi (shu gan li qi): cyperus (xiangfuzi), bupleurum (chaihu), blue
citrus (qingpi), curcuma (yujin), melia (chuanlianzi).
Move blood and expel stasis (huo xue xing yu): persica (taoren), carthamus (honghua),
tang-kuei (danggui), red peony (chishao), leech (shuizhi), tabanus (mengchong), corydalis
(yanhusuo), notoginseng (sanqi), achyranthes (niuxi), leonurus fruit (chongweizi).
Smooth the liver and nourish blood (rou gan): tang-kuei (danggui), peony (baishao), lycium
fruit (gouqizi), gelatin (ejiao), zizyphus (suanzaoren).
Moisten the liver and tonify yin (zi yin): rehmannia (dihuang), ho-shou-wu (heshouwu),
ligustrum (nuzhenzi), astragalus seed (shawanjili).
Astringe the liver (lian gan): chaenomeles (mugua), mume (wumei), schizandra (wuweizi),
peony (baishao).
Clear liver heat (qing gan): scute (huangqin), gardenia (zhizi), prunella (xiakucao), celosia
(qingshuangzi).
Purge liver heat (xie gan): gentiana (longdancao), indigo (qingdai), isatis (daqingye), aloe
(luhui).
Cool liver blood (liang gan): moutan (mudanpi), lithospermum (zicao), sanguisorba (diyu), biota
tops (cebaiye).
Course wind heat in the liver channel (shu feng): chrysanthemum (juhua), mentha (bohe),
tribulus (baijili), vitex (manjingzi), siler (fangfeng).
Open the collaterals and sweep out the wind (huo luo sou feng): silkworm (jiangchan),
typhonium (baifuzi), scorpion (quanxie), tribulus (baijili), equisetum (muze), agkistrodon
(baihuashe), zaocys (wuxiaoshe).
Warm the liver (wen gan): evodia (wuzhuyu), artemisia (aiye), fennel (huixiang), zanthoxylum
(chuanjiao), cinnamon twig (guizhi), tang-kuei (danggui).
Calm the liver (ping gan): peony (baishao), uncaria (gouteng).
Sedate the liver (zhen gan): oyster shell (muli), haliotis (shijueming), tortoise shell (guiban),
turtle shell (biejia).
Extinguish internal wind (xi feng): gastrodia (tianma), antelope horn (lingyangjiao), centipede
(wugong), scorpion (quanxie), silkworm (jiangchan).
If the liver fails to store the blood, it needs to be nourished and smoothed with blood tonic
substances such as tang-kuei (danggui) and peony (baishao). If liver yin-the liver's basic
physiological substance that gets refined into liver blood-has already been damaged, the liver needs
to be moistened with yin tonic substances such as rehmannia (dihuang) or ho-shou-wu (heshouwu).
If liver qi is depressed, the liver needs to be treated with substances that restore its coursing
function, such as bupleurum (chaihu) or cyperus (xiangfuzi). If prolonged qi stagnation has
affected the blood by causing blood stasis, the liver blood needs to moved and the stasis expelled
by using substances like persica (taoren) and carthamus (honghua).
In a situation where an outbreak of rage has triggered a rampant and, usually, upwardly
mobile qi flow, the liver needs to be calmed with gently descending substances such as peony
(baishao) or uncaria (gouteng). If liver qi surges upwards and draws blood along with it, calming
and descending substances need to be combined with herbs that cool liver blood, such as moutan
(mudanpi); achyranthes (niuxi) will also guide blood downward. If a fit of anger sets liver fire
ablaze, liver heat needs to be cleared with herbs like scute (huangqin), or in more serious situations
also be addressed with materials that strongly purge liver heat such as gentiana (longdancao).
If wood fails to course and drain earth, the symptoms of stuckness, fullness, and distress in the
middle burner need to be alleviated by coursing the liver (e.g., with bupleurum; chaihu) and
harmonizing the spleen/stomach (e.g., with white atractylodes; baizhu).

In the case that wind-heat pathogens have invaded the liver channel network, the wind has to
be expelled by using substances that course liver wind, such as mentha (bohe) or chrysanthemum
(juhua). If the coagulating influence of cold pathogens are obstructing the proper flow of blood in
the liver channels, the liver needs to be warmed and the cold dissipated with herbs like artemisia
(aiye) or evodia (wuzhuyu).
If upflaring liver fire causes symptoms of heat in the upper burner, liver heat has to be cleared.
If a constitutional yin deficiency causes fire and develops into the serious condition of rebelliously
upflaring liver yang, the rampant liver yang needs to be subdued by employing a combination of
calming (gently descending) and purging (strongly descending) medicinals. The physician Zhang
Xichun, however, has cautioned against pushing down and thereby humiliating the liver-the "proud
general" of the organ systems-too intensely; small amounts of substances that promote its
physiologically upward qi flow, such as germinated barley (maiya) and melia (chuanlianzi), should
be included in formulas that sedate the liver.
If there is liver wind stirring internally, the liver should be calmed and the wind extinguished.
If wind-phlegm pathogens block the collaterals causing surface numbness and pain, then
substances that can both sweep the wind from the collaterals and clear phlegm obstruction of the
collaterals, such as silkworm (jiangchan) or typhonium (baifuzi), should be used.
As an upwardly mobile yang organ, the liver easily suffers from symptoms of hyperactivity.
As an emergency measure, the Neijing suggests the ingestion of sweet flavors to moderate
symptoms of pain, cramping, and other signs of acute liver aggravation.
Furthermore, as with the wood network that is energetically akin to proliferating spring
foliage, the liver has the innate desire to spread and disperse. If this spreading aspect of liver
physiology is disturbed, various levels of stagnation manifest and dispersing measures need to be
employed. Since pungent flavors can directly disperse stagnation, they can generally be
recommended for a condition characterized by stagnant qi. Pungent flavors, however, are generally
warming in nature and the liver, particularly when its flow is suppressed, tends to heat up easily.
Different from the often exclusive use of pungent substances in lung treatment, it is thus important
in liver therapy to include along with the pungent herbs bitter, cold materials. Bitter materials such
as scute (huangqin) or gentiana (longdancao) are usually classified as having a heat clearing or heat
purging affect. Sour, moreover, is the flavor with a direct affinity to the liver network. If used
appropriately, sour foods or herbs can be of benefit to the liver. As the Neijing points out: "Sour
generates the liver," but also warns against the excessive use of sour flavors, since this would
actually cause damage to the liver system: "If the disease is in the tendon layer, do not eat sour
flavors."
Damp heat in the gallbladder needs to be addressed not only by clearing liver heat, but also by
disinhibiting gallbladder damp (e.g., with capillaris; yinchen). In situations where gallbladder qi
deficiency impacts the smooth circulation of liver qi, general qi tonification needs to be supported
by herbs that pacify the shen and nourish kidney yin.
The liver's mother organ and lower burner neighbor, the kidney, when weakened, can have a
detrimental affect on the liver's qi, yin, and blood. Thus, liver tonification often indicates the use of
herbs like rehmannia (dihuang) and lycium fruit (gouqizi) that also have a tonic affect on the
kidney.
LIVER QI STAGNATION (gan qi yu jue): primary symptoms are tendency to get depressed;
frequent sighing; impatient disposition and temper outbreaks; sensations of stuffiness; fullness or
congestion in the chest, intercostal, or subcostal regions. Secondary symptoms include obstructed
bowel movements; dry and distended eyes; feeling of something being stuck in the throat;
self-doubts and crying; pain (especially intercostal and abdominal) that is characterized by moving,
pulling, or penetrating sensations; in females; premenstrual breast distention; menstrual cramping
and irregular menstruation. The tongue typically presents with a reddish body (especially at the
sides) and a thin coating; the pulse tends to be wiry.
Representative Herbs: bupleurum (chaihu) with peony (baishao), cyperus (xiangfuzi), curcuma
(yujin), cnidium (chuanxiong), blue citrus (qingpi), chih-shih (zhishi), corydalis (yanhusuo), melia
(chuanlianzi).
Representative Formulas: Bupleurum and Chih-shih Formula (Sini San); Bupleurum and

Cyperus Formula (Chaihu Shugan San).
LIVER BLOOD DEFICIENCY (gan xue xu): primary symptoms are pale face color; dizziness;
dry eyes or, at a more advanced stage, blurry vision (especially at night); numbness in the
extremities (including arms easily "falling asleep" while sleeping); limited flexibility of tendons
and muscles. Secondary symptoms include pale lips and nails; dry, split, atrophied, or malformed
nails; muscle twitching; spasms or cramping in the extremities; trembling hands or feet; occasional
intercostal pain; ringing in the ears; in females: decreased and pale menstrual flow. The tongue is
typically pale or pink; the pulse tends to be fine, or wiry and forceless.
Representative Herbs: tang-kuei (danggui), peony (baishao), gelatin (ejiao), ligustrum (nuzhenzi),
cornus (shanzhuyu), cnidium (chuanxiong), zizyphus (suanzaoren), millettia (jixueteng).
Representative Formulas: Tang-kuei Four Combination (Siwu Tang); Tonify the Liver Decoction
(Bugan Tang); Linking Decoction (Yiguan Jian) minus melia (chuanlianzi) plus peony (baishao).
LIVER YIN DEFICIENCY (gan yin xu): primary symptoms are dizziness; blurry vision; dry
eyes; dull intercostal pain; dry mouth and throat; heat sensations in palms and soles. Secondary
symptoms include numbness in extremities; limited tendon flexibility; lusterless nails; impatient
disposition and temper outbreaks; flushed cheeks; dark urination; constipation; low grade fever;
restlessness and insomnia; tidal heat sensations; night sweats. The tongue typically presents with
redness and little or no coating; the pulse tends to be wiry and fine, or wiry, fine, and rapid.
Representative Herbs: peony (baishao), lycium fruit (gouqizi), ligustrum (nuzhenzi), gelatin
(ejiao), tang-kuei (danggui), rehmannia (dihuang), cornus (shanzhuyu), ho-shou-wu (heshouwu),
turtle shell (biejia), zizyphus (suanzaoren), biota (baiziren).
Representative Formulas: Linking Decoction (Yiguan Jian); Ligustrum and Eclipta Formula
(Erzhi Wan).
LIVER FIRE BLAZING (gan huo shang yan): primary symptoms are pain and distention in the
head; dizziness; ringing in the ears or sudden deafness; red face; red, swollen, or painful eyes; dry
and bitter sensation in the mouth; marked impatience and tendency to throw fits of anger.
Secondary symptoms include insomnia; vivid dreaming; throbbing or burning pain along sides of
chest; dark urination; constipation. The tongue typically presents with a red body and a yellow
coating; the pulse tends to be wiry and rapid.
Representative Herbs: gentiana (longdancao), prunella (xiakucao), gardenia (zhizi),
chrysanthemum (juhua), aloe (luhui), antelope horn (lingyangjiao), bupleurum (chaihu), ch'ing-hao
(qinghao), moutan (mudanpi), eriocaulum (gujingcao), celosia (qingxiangzi).
Representative Formulas: Gentiana Combination (Longdan Xiegan Tang); Tang-kuei and Aloe
Pill (Danggui Luhui Wan); Purge the Green Pill (Xieqing Wan).
REBELLIOUS UPFLARING OF LIVER YANG (gan yang shang kang): primary symptoms
are dizziness; distention and pain in the head; ringing in the ears; redness and heat sensation in the
face and upper part of the body. Secondary symptoms include insomnia; vivid dreaming;
impatience; angry disposition; heavy head and "light feet" (easily stumbles); weak and sore lower
back and knees; dry mouth and throat. The tongue is typically red; the pulse tends to be wiry and
forceful, or wiry, fine, and rapid.
Representative Herbs: uncaria (gouteng), haliotis (shijueming), dragon bone (longgu), oyster
shell (muli), gastrodia (tianma), tribulus (baijili), silkworm (jiangchan), peony (baishao), tortoise
shell (guiban), turtle shell (biejia), rehmannia (dihuang).
Representative Formula: Gastrodia and Uncaria Combination (Tianma Gouteng Yin).
LIVER WIND STIRRING INTERNALLY (gan feng nei dong): primary symptoms are
cramping; seizures; trembling; shaking; dizziness; and numbness. This category is usually divided
into three subcategories:
1. Extreme Heat Generating Wind (re ji sheng feng): primary symptoms are high fever,
restlessness, thirst, flushed face, red eyes, seizures or cramping. Secondary symptoms
include dark urination; constipation; upwardly turned eyes; unconsciousness; delirious
talk. The tongue typically presents with a red body and a yellow coating; the pulse tends
to be wiry and rapid.
Representative Herbs: rhino horn (xijiao), antelope horn (lingyangjiao), ox gallstone
(niuhuang), uncaria (gouteng), gastrodia (tianma), anemarrhena (zhimu), raw rehmannia

(sheng dihuang), chrysanthemum (juhua), scute (huangqin).
Representative Formulas: Antelope and Uncaria Decoction (Lingyang Gouteng Tang
); Ox Gallstone Pacify the Palace Pill; Bezoar and Curcuma Formula (Angong
Niuhuang Wan).
2. Hyperactive Liver Yang Producing Wind (gan yang hua feng): primary symptoms
are cramping; seizures; numbness in the extremities; paralysis (especially of the
hemiplegic type); slurred speech; mouth and eyes going off to one side. Secondary
symptoms include sudden loss of consciousness or severely impacted mental faculties;
splitting headache; severe dizziness; weakness or soreness in lower back and knees; dry
mouth; flushed face. The tongue is typically bright red; the pulse tends to be wiry.
Representative Herbs: uncaria (gouteng), gastrodia (tianma), achyranthes (niuxi),
hematite (daizheshi), silkworm (jiangchan), cicada (chantui), centipede (wugong),
peony (baishao), rhino horn (xijiao), ox gallstone (niuhuang), antelope horn
(lingyangjiao).
Representative Formulas: Sedate the Liver and Extinguish the Wind Decoction
(Zhengan Xifeng Tang); Downward Momentum Decoction (Jianling Tang).
3. Blood Deficiency Generating Wind (xue xu sheng feng): primary symptoms are
dizziness; headache; blurry vision; numbness in the extremities or, in more severe cases,
symptoms of cramping, trembling, or twitching. Secondary symptoms include dry and
itching skin; fainting spells; and general blood deficiency symptoms such as pale
complexion, pale lips and nails, brittle or malformed nails, and dull intercostal pain. The
tongue typically presents with a pale body and little coating; the pulse tends to be fine
and wiry.
Representative Herbs: cooked rehmannia (shu dihuang), peony (baishao), tang-kuei
(danggui), millettia (jixueteng), earthworm (dilong), uncaria (gouteng).
Representative Formulas: Tang-kuei Four Combination (Siwu Tang); Settle Tremor
Pill (Dingzhen Wan).
COLD PATHOGENS HAVING A COAGULATING AFFECT ON THE PROPER FLOW IN
THE LIVER CHANNELS (han chi gan mai): primary symptoms are lower abdominal distention
and pain. In females, these may include symptoms of menstrual cramping or pain due to abdominal
masses; in males, radiating pain to or from the testicles, or general aversion to cold and preference
for warm temperatures are indications. Secondary symptoms include testicular cold sensation or
undescended testicle; atrophy of scrotum; cold extremities; little desire to drink fluids; clear and
profuse amounts of urination. The tongue is typically moist and presents with a slippery white
coating; the pulse tends to be deep and slow, or deep and wiry.
Representative Herbs: tang-kuei (danggui), cinnamon twig (guizhi), evodia (wuzhuyu), artemisia
(aiye), lindera (wuyao), fennel (huixiang).
Representative Formulas: Tang-kuei, Evodia, and Ginger Combination (Danggui Sini Jia
Wuzhuyu Shengjiang Tang); Warm the Liver Decoction (Nuangan Jian); Tiantai Mountain Lindera
Powder (Tiantai Wuyao San); Fennel and Citrus Seed Pill (Huixiang Juhe Wan).
DAMP HEAT IN THE LIVER/GALLBLADDER (gan dan shi re): primary symptoms are
discomfort, stuffiness, or pain in chest, epigastric, or subcostal region; abdominal distention;
nausea; bitter or unpleasant taste in mouth; no appetite; restlessness; easily angered; dark urination.
Secondary symptoms include alternating heat/cold sensations; thick and colored vaginal discharge;
itching or swollen genitalia; obstructed bowel movements; jaundice and yellow eyes. The tongue
typically presents with a reddish body and a greasy yellow coating; the pulse tends to be wiry and
rapid.
Representative Herbs: gentiana (longdancao), capillaris (yinchen), gardenia (zhizi), scute
(huangqin), rhubarb (dahuang), indigo (qingdai), akebia (mutong), alisma (zexie), plantago leaves
(cheqiancao), hoelen (fuling), coix (yiyiren), talc (huashi), bupleurum (chaihu), curcuma (yujin).
Representative Formulas: Bupleurum and Chih-shih Formula (Sini San) plus capillaris
(yinchenhao); Gentiana Combination (Longdan Xiegan Tang); Capillaris Combination
(Yinchenhao Tang).

From Shen Jin'ao, Docttor Shen''s Compendiium of Honoriing Liife (Shen Shii Zunsheng Shu), 1773:
The lung is the master of qi. Above, it connects to the throat; below, it connects to the orifices of the
heart and the liver. It is in charge of inhalation and exhalation, and, in more general terms, the flux of
coming in and going out.
It is situated atop the other organs, so that it can keep them in check and push the body's waste materials
downward, all the way into the large intestine. In other words, it takes in clear qi and gives off murky
refuse; it absorbs the yin within taiyang to sustain the body's yang qi [it absorbs the material essence of
universal qi to sustain the body's functions], and it commands the yang within taiyin to propel the
body's yin substances [it commands the descending force to move out the waste]. In cooperation with
the foot taiyin spleen network, it transports qi and provides it to all the other organs; it is for this reason
that both the lung and the spleen are both called taiyin.
The lung is associated with the phase element metal, the direction west, and the season of autumn. In
autumn, the seasonal qi turns crisp and clear, and all living things rely on its force to become ripe and
complete. Metal is the mother of water. Lung qi, therefore, generally moves downwards. When our
bodies rest, it descends into the kidney palace and combines with water, a process the Neiijjiing refers to
as 'the mother concealing herself inside the newly conceived offspring.'
Only the kidney is 'true water,' conceived in the heavenly spheres where the state of oneness prevails. It
is thus only appropriate that the kidney's mother, the lung, resides at the very top of the dome that is
formed by the body's main cavity. In a cosmic context, this would be like being situated at the upper
source of the stream of heavenly energy, flowing downwards through the head, and finally entering the
[kidney's] Dragon Gate below to combine [with true water] to form the ocean [of bodily qi]. Since the
lung thus functions by transporting essence to the other organs, its main action could also be compared
to the climatic process of sprinkling morning dew, a heavenly substance which is dispensed generously
every morning to nourish all living creatures [below] on earth.
Typically, the lung is sensitive to dryness as well as to cold and heat. This means that the lung's function
of lubricating the other organs with essence has a tendency to deviate from its mode of smooth
operation by providing either not enough or too much lubrication. Or, if invaded by evil qi, it will be
unable to assume its commanding role among the organ networks, and will instead produce diseases of
a dry or a hot or a cold nature. This is the reason why the ancient books all refer to the lung as 'the
delicate organ.'
From Ye Tianshi, A Handbook of Clliiniicall Case Hiisttoriies (Liinzheng Zhiinan Yiian) , 1746:
The lung is the main pump behind the action of inhalation and exhalation. It is located at the highest
point of the body, and thus is in a position to receive the clear qi that ascends from the other organ
networks. Its nature is to be clear and aloft, and its functional quality is to expand downwards-be in
charge of all descending movement within the body. Also, the lung is known as the delicate organ,
which is extremely sensitive to the influence of evil qi. Each of the six influences [liuyin], therefore,
can easily cause a state of imbalance in the lung. The lung has an innate aversion to cold, to heat, to
dryness, to dampness, and most of all, to fire and wind. In the presence of these kinds of pernicious
influences the lung easily loses its clear and crisp equilibrium; it will be inhibited in its function to
descend and command, and as a result of this, normally free flowing qi will become obstructed and
stagnate.
From Yu Chang, The Sttattuttes of Mediiciine (Yiimen Fallü) , 1658:
All bodily qi has its physical origin in the lung. If the lung's qi is clear and straightforward, then there is

not a single type of qi in the body that will not obey and flow along smoothly. However, if the lung qi
becomes obstructed and turns murky, then the qi dynamics of the entire body will start to go against
their natural flow and start to move upwards instead of downwards.
From Yang Jizhou, The Greatt Compendiium of Acupunctture and Moxiibusttiion (Zhenjjiiu Dacheng) , ca.
1590. This paragraph appears in the chapter on the lung channel, and is marked as a quote from an older Daoist
source, The Oriigiinall Cllassiic of Guiidiing tthe Breatth (Daoyiin Benjjiing) :
The lung is the lid of the five organ networks. It produces the voice, and it provides proper
moisturization to the skin. As soon as there is either internal damage due to the seven harmful emotions,
or external injury due to the six climatic influences, the rhythmical process of inhaling and exhaling and
the general qi flow between the body's inside and outside are disturbed; the lung metal then loses its
clear quality. If we want to restore purity in the metal, we must first strive to regulate the breath. Once
the breath is regulated, erratic movement will not occur and the heart fire will calm down all by itself.
The process is as follows: first, we must concentrate on the dantian, this will quiet the heart; then, we
must relax and broaden the center of our torso; and finally, we must visualize that the qi comes and goes
freely through every single pore of our body. Soon, there will be no obstruction, and if we focus
diligently enough our actual breath will become very fine and subtle. This, then, can be called the true
breath [as achieved during meditation]. The breath, therefore, has its origin in the heart. When the heart
is at peace, the qi is in a state of harmony and can return to its root in the lower abdomen with every
breath we take. In this fashion, the lung and its breath can truly fulfill their assigned role as the mother
of the [lower] dantian.
From The Hiidden Tao:: A Collllecttiion (Daozang) ; Ming Dynasty compilation of esoteric Taoist texts (ca.
1600), some of them dating back to 600 B.C.:
Qi disorders of the lung manifest as coughing. The secretion [ye] associated with the lung is nasal
discharge. The lung qi connects with the brain above and the spleen below. In general, all types of
bodily qi are governed by the lung. Laying down for too long harms the lung. The lung is the source of
inhaling and exhaling. It is the officer in charge of qi. If noxious kidney qi enters the lung, there will be
lots of nasal discharge.
The large intestine is the bowel associated with the lung. If it is in harmony with the lung, the hair of the
body and head will be lustrous. If the hair becomes dry and falls off, the lung is exhausted.
The Centtrall Junctture Cllassiic (Huangttiing Jiing) states: 'The lung palace can be compared to a lid. In
its innermost part reside the seven lads in charge of regulating the qi. In the outside world, it
corresponds to Mt. Song [the highest of China's Five Holy Mountains]. The nose is its surface site.
'Shang' is its sound, pungent is its flavor, tart is its smell. If noxious heart qi enters the lung, the person
will experience an aversion to tart, putrid smells. Its disposition is righteousness, its humor is anger, its
fluid [jin] is saliva. If a patient suffers from lung consumption, there will be lots of saliva. During the
three months of autumn, the Metal King carries out his chore of termination, and everything withers.
The wise person who wants to put his po spirits to rest and thus preserve his material body, must
restrain his seed [avoid ejaculation of sperm], nourish things, be merciful, and not be too exuberant in
his expressions.'
The lung makes a pair with the large intestine. On the body surface, it assumes form in the nose. If lung
wind is present, the nose will be congested. If the face appears withered, the lung is dry. If the nose
itches, there is a worm in the lung. If a person is panicky and constantly frightened, the po spirits are
leaving the lung. If white and black spots appear all over the body, the lung is weak. If somebody has a
powerful voice, the lung is strong. If somebody cannot bear exposure to cold, the lung is in shambles. If
somebody craves pungent food, the lung is deficient. If somebody experiences constipation, the lung is
obstructed. If somebody has a glossy white face color, the lungs are healthy.
If the lung is diseased, there will be frequent coughing, symptoms of upward qi movement, a puffy face,
an excessive desire to lay down, blemishes in the face, a yellow-white face color, a cold nose, a
headache, pain and distention in chest and back, restless extremities, itching of the skin, obstruction in
the throat, dreams of beautiful ladies clad in silken fabrics and fancy jewelry-oneself wearing scaled
armor-or of speckled banners and lofty heroes. We can remove these conditions by working with the
mantra "ssssssssssssssssssss" and by clicking our teeth at sunrise nine times: first, pull in fresh air
through your nostrils, then gently "sssssssssss" thirty-six times to expel lung heat and all other kinds of
noxious qi which may lodge there.
According to the traditional Chinese world view, every process and every thing represents a transformation of one
and the same qi. Yin (matter) and yang (function) are the two most basic differentiations of this-ONE-universal Qi.
According to various references in the Neiijjiing, the term qi, when used in the context of the human body, has
essentially two meanings:
1. material building blocks that are essential for the maintenance of physical life, as in yuan qi (original
qi), da qi (breath), or gu qi (food qi);
2. functional aspects of specific organ networks, such as stomach qi, liver qi, taiyang channel qi, etc.

Qi in the body is produced and maintained by two basic sources: prenatal jing qi (essence) of the kidney and
postnatal air and food qi that is processed in the lung and spleen/stomach systems.
Qi, by definition, moves. It is the uninhibited movement of bodily qi which facilitates health. The basic
movements of qi are ascending (sheng), descending (jiang), going out (chu), and coming in (ru).
The basic functions of bodily qi are:
1. Moving and circulating structural body substances (blood circulation, distribution of fluids, growth
process, function of organ/channel networks).
2. Warming the various layers of the body (if skin and muscles are not warmed due to qi deficiency, there
will be aversion to cold, cold hands and feet, etc.).
3. Creating a protective shield effect against external pathogens such as wind or cold as well as, in modern
terms, viruses and bacteria.
4. Stabilizing and holding the structural parts of the body in place (otherwise bleeding, sweating, enuresis,
prolapse of organs may occur).
5. Driving metabolism (e.g., in the process of blood production, or in the functioning of certain organs,
such as qi transformation facilitating water metabolism in the bladder).
There are many different layers of bodily qi which are referred to by the following terms:
Yuan Qii (original qi), also called jing qi (essence qi) or shenjian dong qi (qi that spirals out from between the
kidneys). It is created by the interaction of the body's yuan yang (original yang) and yuan yin (original yin). It is
considered to be the most fundamental qi of the human body, the root source of metabolism. The Qing dynasty
medical scholar Xu Lingtai states in his influential treatise, Diiscussiing tthe Oriigiins and tthe Devellopmentt of
Mediiciine (Yiixue Yuanlliiu Lun, 1757): "And where, then, is this so called original qi located? All five organ
networks possess their own true jing which is their piece of the original qi. However, the true home of this
substance is what the Daoist classics call the dantian, or what the Nanjjiing (Cllassiic of Diiffiicullttiies) calls mingmen
(gate of life), and what the Neiijjiing calls 'the little heart next to the seventh vertebrae.'"
Da Qii (great qi), also called tian qi (heavenly qi): the breath.
Gu Qii (grain qi), also called di qi (earthly qi): qi distilled from food.
Zhen Qii (true qi): the body's total energy, being the combination of prenatal original qi and postnatal air/food qi.
Zong Qii (ancestral qi): combination of the two aspects of postnatal qi, the breath, and distilled food essence. It
gathers in the middle dantian that is located between the nipples, and surfaces in the throat to support the breath and
the voice. It also enters the heart channel to promote circulation of qi and blood.
Yiing Qii (nutritive qi): manufactured from the denser portion of food essence; circulates inside the blood vessels;
can combine with fluids to produce blood; helps blood to circulate. Ying (nutritive qi) and xue (blood) can
therefore be differentiated only theoretically-in physical form they are always one.
Weii Qii (protective qi): made from the more ethereal portion of food essence; circulates outside the vessels; warms
the muscles, moistens the skin, is in charge of opening and closing the pores. This is why it can protect the body
against the invasion of pernicious qi invading from the outside.
Zheng Qii (righteous qi), Xiie Qii (pernicious qi): righteous qi can be understood as the traditional equivalent to the
immune system, responding to the invasion of external pathogens. The scholar Xie Liheng once made the following
remark about the origins of righteous qi: "zheng qi (righteous qi) is actually a manifestation of the power of yuan qi
(original qi)." His colleague Li Zhongzhai elaborated on the meaning of its antagonist, pernicious qi: "xie qi
(pernicious qi, evil qi) is nothing else but the six pathogenic influences of wind, cold, summer heat, dampness,
dryness, and fire."
Zangfu Jiinglluo Zhii Qii (organ and channel network qi): organ qi (liver qi, spleen qi, etc.) refers to the respective
functions of different organ networks. Channel network qi refers to the qi flowing through the meridians that
produces the feeling of local distention during needling or acupressure.
Zhong Qii (central qi): qi of spleen and stomach. Mostly refers to the transporting function of the spleen,
specifically referring to its rising action. When the central qi collapses, there will be signs of downward leakage
such as diarrhea, profuse urination, prolapse of anus, etc.
It is important to note that all of these different types or layers of qi are governed by the lung, and can be
coordinated in a fruitful way only by the lung. In other words, all four of the basic qi movements of ascending,
descending, going out, and coming in are influenced by the lung. This governing of the qi includes influence on the
spleen qi raising food essence to the lung, from where it is distributed over the entire body; stomach qi descending,
passing waste to the intestines to be discarded; kidney yang "steaming" vital fluids (jing) upwards; liver qi rising;
lung qi descending. etc.
Po is an ancient astronomical term designating the material body of the moon, while its counterpart, hun, is used to
specify the light of the moon. In nature, the term po is thus used to represent the visceral life force that lies latent in
the earth, and in medicine it is used to describe both measurable physiological functions and development. The
scholar Kong Yingda explains: "The spirit of form is called po. When human beings are first born, they can see and
hear, their hands and feet can move; these actions are due to the workings of po." Zhang Jingyue, the master
physician of the Ming Dynasty, further elaborated: "The effect of po is that we can move and do things, that there is

itching and pain." In sum, po entails the basic instincts that we possess from birth, enabling us to see and hear and
eat and cry, even with the early state of awareness and activity of a baby. Since breathing is the most fundamental
of all instincts, the lung is the residence of the po spirits.
According to the classic definition in the Neiijjiing, "Po follows jing." In Chinese colloquial language, people
with a voluminous voice, intense eyes, or reflexes suited to the performance of martial arts are said "to have a lot of
qi po."
The lung is closely associated with the heart, just as the qi is closely associated with the blood. The administrating
aspect of the lung mostly refers to its controlling and harmonizing function in regard to the flow of blood. As the
Neiijjiing definition reads: "The lung opens the one hundred vessels." Concerning the intimate relationship of qi and
blood, the classic further states: "Qi is the commander of blood; if qi moves, blood moves."
Just like a metal object absorbs the temperature of its environment in an instant, the metal organ (lung) is most
easily influenced by external influences of pernicious heat or cold.
Lung qi constantly descends, moving water downwards: it thus provides the rest of the organ networks with fluids,
and even regulates urination. The defining Neiijjiing line reads: "The lung is the upper source of water." If it loses its
crucial descending function, there may be symptoms of stuffy chest, cough, asthma, or signs of water stagnation
such as phlegm, urinary problems, edema, etc.
The lung qi is in charge of propelling the protective qi (wei qi), the fluids, and the food essence over the entire
body. It thus warms the muscles and the surface, harmonizes the opening and closing action of the surface pores,
and moistens the body hair and the skin. If lung qi is weak, the protective qi (wei qi) cannot nourish the body hair
properly, causing it to become brittle. Similar to the pores on the surface of the lung, moreover, the pores on the
surface of the skin are qi gates in charge of "body breathing." If the protective qi is too weak to properly close the
pores, sweat pours out. If there is an excess of pernicious qi in the lung, on the other hand, the opening mechanism
of the pores easily gets jammed; then the ventilating function of the pores gets disturbed, and there may be
symptoms of inhibited sweating, such as no sweating during a fever.
A branch of the lung channel connects with the large intestine below, thus forming a pair. The lung is known as yin
(structural, essence storing) metal, the large intestine as yang (hollow, transmitting) metal. Lung qi is the pushing
power behind the large intestine's action of transporting and discarding waste materials. From a more general
perspective, it could be said that the large intestine acts in accordance with the qi from the five organ networks
which reaches it via the lung. Constipation may be due to a deficiency or stagnation of propelling power, or a fluid
problem (dryness) related to the lung. The anus, because of the large intestine's intimate relationship with the lung,
is called the po gate.
The nose is in charge of breathing and smelling; functions that depend entirely on a healthy lung. Also, the nose is
one possible gateway through which external pernicious qi can invade the lung. If the lung is invaded by pernicious
qi, there may be nasal symptoms such as stuffy nose, nasal discharge, or loss of smell. If there is an acute
obstruction of qi due to lung heat, there will be asthmatic breathing, in which case the nose may quiver.
The throat is in charge of the voice, which can be compared to the sound emanating from a metal bell. When
the metal organ (lung) is afflicted by disease, the voice may appear changed, muffled, or even lost as in the case of
sore or hoarse throat.
Abnormall Upbeariing and Downbeariing of Lung Qii:: If the body surface is invaded by cold, or if there is internal
heat obstructing the lung, the smooth process of dissipating qi, as governed by the lung, will be disturbed. This
disturbance of outwardly flowing qi typically results in sensations of chills, drafts, fever, spontaneous sweating, or
inhibited sweating-a symptom complex that is generally labeled as a "disharmony between the body's ying
(nutritive) and wei (protective) layers."
If lung qi is deficient, and thus falls short in fulfilling its physiological duties of "misting" postnatal essence
over the organ networks or disseminating wei qi and essence to the skin and body hair, then dry skin, spontaneous
sweating, or a propensity to catch frequent colds may result. Every disturbance of outward qi flow, moreover, will
necessarily involve disruption of the downward distribution of qi. Coughing, asthmatic breathing, and a stuffy

sensation in the chest are typical indications for a reversal of the lung's downward qi flow.
Lung Imballance Affecttiing Itts Openiing and Regullattiing Affectt on tthe Watter Patthways:: The lung is situated in
the upper burner and referred to as the upper source of water. If lung qi fails to descend, it cannot open and regulate
the water pathways and ensure the unobstructed transportation of fluids to the bladder. Signs of water stagnation
will inevitably ensue, such as phlegm buildup, a puffy face, edema, or inhibited urination. As the Neiijjiing points
out: "Lung qi disperses jing; in the upper part of the body, it is rooted in the lung; below, it feeds into the bladder."
The lung disseminates essential fluids: physiological jing (essence), jin (body fluids), and ye (body humors). At the
same time, it feeds into and excretes superfluous fluids from the body via the bladder. Lung malfunction therefore
can easily cause pathological changes in water metabolism, particularly bladder function.
Dryness Affecttiing tthe Lung Causiing a Depllettiion of Liiquiids and Humors:: External conditions like
environmental cold, heat, and dryness, or internal dryness of the lung or large intestine all have the potential to
injure the fluid supply of the body and cause dryness symptoms in the nose, throat, lungs, skin, body hair, or
intestines. The Neiijjiing comments: "The lung has a natural aversion to dryness." In addition to being easily harmed
by dryness, it passes on the condition as symptoms of dryness elsewhere.
Griief and Sadness Harmiing tthe Lung:: Grief, sadness, and melancholy are associated with the lung. If one
indulges in these emotional states, harm to the lung network will result and symptoms of emaciation, lack of
energy, or dry skin may occur. The other way around, a low supply of lung qi can cause a gloomy state of mind. A
particularly sad experience, moreover, may cause a person to adopt a pessimistic attitude toward life (which is
really a state of dampened qi). "If a person is sad," it is said in the Neiijjiing, "his qi will dissipate."
Lung Diisease Inflluenciing tthe Nose,, Throatt,, and Large Inttesttiine:: If external pathogens invade the lung, its
orifice, the nose, will manifest symptoms of stuffiness, nasal discharge, inability to distinguish smell, or quivering
nostrils (in asthma patients). Since the throat is governed by lung qi, an invasion of external pathogens can easily
cause a loss of voice. Both external (excess) and internal (deficiency) conditions, moreover, can be the cause of
swelling and pain in the throat, including enlargement and suppuration of the tonsils. If the lung is unable to
disseminate enough fluids to its associated fu organ below, the large intestine, or if the fluids are scorched by lung
heat, there will be constipation. As the primary text of the fever school, Systtemattiic Diifferenttiiattiion of Warm
Diiseases (Wenbiing Tiiaobiian), describes: "If somebody suffers from invasion of pernicious dry metal qi that is
prominent during the fall, it will gradually lead to intestinal coagulation that will become harder and harder, and
that must be purged." Heat accumulation in the large intestine, in turn, can interrupt the proper up/down dynamics
of lung qi, and become a potential cause of coughing or asthmatic breathing.
Diissiipatte llung qii (xuan feii):: platycodon (jiegeng), scallions (congbai), fermented soy (dan douchi), lotus leaf
(heye).
Open up tthe surface (fa biiao):: ma-huang (mahuang), perilla leaf (zisuye), schizonepeta (jingjie), mentha (bohe),
angelica (baizhi).
Cllear llung heatt (qiing feii):: scute (huangqin), morus leaf (sangye), phragmites (lugen), anemarrhena (zhimu),
gypsum (shigao).
Moiistten llung yiin (run feii):: lily (baihe), ophiopogon (maimendong), scrophularia (xuanshen), polygonatum
(yuzhu), trichosanthes root (tianhuafen).
Asttriinge tthe llung (lliian feii):: schizandra (wuweizi), mume (wumei), (yingsuke), terminalia (hezi).
Sttop coughiing (zhii ke):: stemona (baibu), aster (ziwan), (madouling), tussilago (kuandonghua).
Callm astthmattiic breatthiing (piing chuan):: ma-huang (mahuang), apricot seed (xingren), perilla seed (zisuzi),
honey baked eriobotrya (zhi pipaye).
Diisiinhiibiitt phllegm (llii ttan):: pinellia (banxia), peucedanum (qianhu), fritillaria (beimu), bamboo skin (zhuru), bile
treated arisaema (dan nanxing).
Purge llung qii (xiie feii):: lepidium (tinglizi), morus bark (sangbaipi), water melon rind (xiguapi), (baiqiangen)
Raiise llung qii (sheng feii qii) ::platycodon (jiegeng), cimicifuga (shengma).
Toniify llung qii (bu feii qii):: ginseng (renshen), astragalus (huangqi), gecko (gejie).
Cllear heatt iin tthe llarge iinttesttiine (qiing chang):: phellodendron (huangbai), coptis (huanglian), rhubarb (dahuang),
sterculia (pangdahai).
Moiistten tthe llarge iinttesttiine (run chang):: linum (huoma ren), trichosanthes seeds (gualou ren), apricot seed
(xingren), cistanche (roucongrong), tang-kuei (danggui).
Since the lung is primarily in charge of qi, lung therapy should mostly utilize medicinal substances that affect the
qi, not the blood. It is the particular function of lung qi to dissipate outwards, and to descend and dispense
downwards. If these functions are compromised, they need to be rectified by restoring the outwardly dissipating
function of the lung (primarily by opening up the surface with diaphoretics), and/or restoring the downward flow of
lung qi (by calming coughing and asthmatic breathing, or opening up the water passages, or purging lung qi).

Since the lung is located in the highest position of the organ networks, it is accustomed to a clear and pure
environment comparable to the crisp and fresh air on a mountain top. It is most appropriate, therefore, to treat lung
disorders with light and purifying herbs (consisting mostly of the leaf and blossom parts of plants). The lung,
moreover, is known as the "fragile organ," and thus should not be treated with methods that are extreme. Ideal
herbs are pungent (but not too hot or too cold), and sweet and moistening.
If phlegm or heat accumulation obstructs the downward flow of lung qi (primarily manifesting in coughing or
asthmatic breathing), the lung should be purged by the application of bitter herbs that initiate downward movement,
such as apricot seeds (xingren), scute (huangqin), or lepidium (tinglizi).
Lung tonification, in addition to using qi tonics with a specific affinity to the metal system (like ginseng or
astragalus), entails astringing the patient's surface energy. In order to achieve this astringing affect, sour and
moisturizing herbs (particularly schizandra) are often included in therapeutic approaches to chronic lung disorders.
Pungent flavors have a particular affinity for the lung network. It is a characteristic of spicy substances that
they generally have a dispersing effect. In a healthy individual, pungent food assists the lung's outwardly
dissipating function which is involved in nourishing and regulating the pores on the body surface. In a person
suffering from a common cold, pungent substances can help to relieve the blocked surface by inducing diaphoresis.
Chinese peasants often take a pungent decoction of ginger, garlic, and scallions to fight off wind cold disorders.
Horseradish, garlic, onions, ginger, mustard, and other pungent foods and spices are deemed beneficial to the lung
if used in moderation. "Pungent flavors generate the lung," states the Neiijjiing. The Classic warns immediately,
however, that if used inappropriately or excessively, they will cause harm to the lung, the skin, and the body hair.
Eating too much pungent food disperses the lung's physiological qi and dries its yin.
If there is excess heat in the lung network, the large intestine can be purged to relieve lung heat and restore the
descending dynamic of the lung system. If there is constipation due to lack of fluids in the large intestine, consider
possible causes in its zang organ pair: nourish lung yin to moisturize the zang and fu metal organs (e.g., use
trichosanthes root), and/or fortify lung qi (e.g., use astragalus) so that physiological fluids can be properly
distributed to the large intestine.
LUNG QI DEFICIENCY (feii qii xu):: primary symptoms include a pale face; shortness of breath during physical
activity; a low voice; a general aversion to cold temperatures; cough/asthma without force; and spontaneous or
inhibited sweating. Lung qi deficiency usually entails surface deficiency, manifesting either in a proneness to colds
and flus; or a general sense of "being invaded" or overwhelmed by people or events. Secondary symptoms may be
fatigue; disinclination to talk; chronic presence of clear and watery phlegm. The tongue typically presents with a
pale body and a thin white coating; the pulse tends to be weak.
Representtattiive Herbs:: astragalus (huangqi), ginseng (renshen), atractylodes (baizhu), dioscorea (shanyao),
schizandra (wuweizi), jujube (dazao), licorice (gancao), siler (fangfeng).
Representtattiive Formullas:: Ginseng and Astragalus Combination (Buzhong Yiqi Tang); Jade Screen Formula
(Yuping Feng San); Decoction for Replenishing Original Qi (Baoyuan Tang) minus cinnamon bark (rougui) plus
schizandra (wuweizi).
LUNG YIN DEFICIENCY (feii yiin xu):: primary symptoms include a dry cough with no phlegm or small
amounts of sticky phlegm (possibly with traces of impacted blood); dry nose and throat; and hoarseness or loss of
voice. Secondary symptoms include a skinny constitution; chronic sore throat; hot flashes; flushed cheeks in the
afternoon; a burning sensation in the palms or soles of the feet; and night sweats. The tongue typically presents
with a dry body and little or no coating; the pulse tends to be fine and rapid.
Representtattiive Herbs:: lily (baihe), ophiopogon (maimendong), glehnia (bei shashen), scrophularia (xuanshen),
polygonatum (yuzhu), white tree fungus (yin'er), cordyceps (dongchong xiacao), raw rehmannia (sheng dihuang),
asparagus (tianmendong), fritillaria (beimu), platycodon (jiegeng).
Representtattiive Formullas:: Lily Combination (Baihe Gujin Tang); Nourish the Yin and Clear Heat in the Lung
Decoction (Yangyin Qingfei Tang).
LUNG YANG DEFICIENCY (feii yang xu):: symptoms similar to lung qi deficiency, with emphasis on cold
symptoms that require warming.
Representtattiive Herbs:: dry ginger (ganjiang), asarum (xixin).
Representtattiive Formullas:: Licorice and Ginger Decoction (Gancao Ganjiang Tang); Hoelen, Licorice, Schizandra,
and Asarum Decoction (Ling Gan Wuwei Jiang Xin Tang).
LUNG QI AND YIN DEFICIENCY (feii qii yiin lliiang xu zheng):: primary symptoms are chronic cough without
force; shortness of breath when physically active; spontaneous sweating and/or night sweats; dry mouth and throat.
Secondary symptoms may include mental and physical fatigue; low voice; pale face; flushed cheeks; little but
sticky phlegm; traces of blood in the phlegm; low grade afternoon fevers; and skinny constitution. The tongue is
typically pale with a gloss of tender redness; and the pulse tends to be fine and weak.
Representtattiive Herbs:: ginseng (renshen), ophiopogon (maimendong), astragalus (huangqi), schizandra (wuweizi),
dioscorea (shanyao), raw rehmannia (sheng dihuang), lily (baihe), anemarrhena (zhimu), fritillaria (beimu), peony
(baishao), licorice (gancao).
Representtattiive Formullas:: Generate the Pulse Powder; Ginseng and Ophiopogon Formula (Shengmai San); Lily

Combination (Baihe Gujin Tang).
WIND COLD INVADING THE LUNG (feng han fan feii):: primary symptoms are chills; stuffy nose; clear and
copious discharge, and/or cough. Secondary symptoms may include headache; sneezing; obstructed voice; fever;
and body pain. The tongue is typically covered with a thin white coating; the pulse is floating.
Representtattiive Herbs:: ephedra (mahuang), apricot seeds (xingren), cinnamon twig (guizhi), asarum (xixin), fresh
ginger (shengjiang), citrus (chenpi), pinellia (banxia), platycodon (jiegeng), aster (ziwan).
Representtattiive Formullas:: Ma-huang Combination (Mahuang Tang); Apricot Seed and Perilla Formula (Xing Su
San).
WIND HEAT INVADING THE LUNG:: primary symptoms are fever with slight aversion to wind and cold, and
sore throat or cough with possibly some sticky or yellow phlegm. Secondary symptoms may include nasal
discharge; thirst; asthma; red and itchy skin rashes; and restlessness. The tongue typically presents with a red tip, is
covered with a thin white or yellow coating; the pulse is floating and rapid.
Representative Herbs: morus leaves (sangye), platycodon (jiegeng), forsythia (lianqiao), lonicera (yinhua),
ma-huang in combination with gypsum (shigao), apricot seeds (xingren), phragmites (lugen), houttuynia
(yuxingcao).
Representtattiive Formullas:: Morus and Chrysanthemum Combination (Sang Ju Yin); Lonicera and Forsythia
Formula (Yin Qiao San).
DRYNESS INVADING THE LUNG (zao xiie fan feii):: primary symptoms are dry cough without phlegm; dry
nose and throat. Possibly small amounts of sticky phlegm that is hard to expectorate or causes pain when coughing;
traces of blood in the phlegm; headache. The tongue is typically red and covered with a thin; dry yellow coating;
and the pulse is floating; fine; and rapid.
Representtattiive Herbs:: glehnia (bei shashen), eriobotrya (pipaye), fritillaria (beimu), trichosanthes root (gualou),
phragmites (lugen).
Representtattiive Formullas:: Eriobotrya and Ophiopogon Combination (Qingzao Jiufei Tang); Morus Leaf and
Apricot Seed Decoction (Sang Xing Tang).
COLD PHLEGM OBSTRUCTING THE LUNG (han ttan zu feii):: primary symptoms are expectoration of runny
white phlegm, or asthmatic breathing accompanied by an inability to lay down on the back. Secondary symptoms
include profuse amounts of phlegm that is easy to cough up; rattling phlegm sound in throat; aversion to cold;
stuffy sensation in chest; white and greasy tongue coating; and a deep and slow pulse that is often slippery in the
first pulse positions.
Representtattiive Herbs:: perilla seed (zi suzi), sinapis (baijiezi), raphanus (laifuzi), asarum (xixin), citrus (chenpi),
pinellia (banxia), hoelen (fuling); ma-huang (mahuang), apricot seed (xingren), belamcanda (shegan).
Representtattiive Formullas:: Belamcanda and Ma-huang Combination (Shegan Mahuang Tang); Atractylodes and
Hoelen Combination (Ling Gui Zhu Gan Tang).
HEAT PHLEGM OBSTRUCTING THE LUNG (ttan re yong feii):: primary symptoms are coughing or asthmatic
breathing accompanied by phlegm sounds in the chest or throat; and expectoration of thick, yellow phlegm.
Secondary symptoms include fever and choppy breathing; coagulation of phlegm into rubbery clots that are
difficult to expectorate; traces of blood in phlegm; stuffiness and distention in the chest. Patient typically presents
with red tongue with yellow and greasy coating, and a slippery and possibly rapid pulse.
Representtattiive Herbs:: trichosanthes fruit (gualou), fritillaria (beimu), bamboo skin (zhuru), scute (huangqin),
houttuynia (yuxingcao), morus bark (digupi), peucedanum (qianhu), eriobotrya (pipaye), apricot seed (xingren),
lepidium (tinglizi).
Representtattiive Formullas:: Minor Trichosanthes Combination (Xiao Xianxiong Tang); Phragmites Combination
(Weijing Tang).
WATER AND COLD AFFLICTING THE LUNG (shuii han she feii):: primary symptoms are coughing;
asthmatic breathing accompanied by an inability to lay down on one's back; and edema or swelling in the lower
extremities. Secondary symptoms include copious amounts of phlegm; stuffiness and fullness in sides of chest;
distention and fullness in the lower abdomen; cold pain in the lower back; cold knees; inhibited urination; or chills
and fever with body pain and no sweat. Patient typically presents with a thin white and moist (or greasy) tongue
coating; and a floating and tight pulse.
Representtattiive Herbs:: ma-huang (mahuang), cinnamon twig (guizhi), asarum (xixin), dry ginger (ganjiang), aster
(ziwan), apricot seed (xingren), perilla seed (zi suzi), aconite (fuzi), hoelen (fuling), alisma (zexie), atractylodes
(baizhu).
Representtattiive Formulla:: Minor Blue Dragon Combination (Xiao Qinglong Tang).

From Wang Kentang and Wu Mianxue, The Compendiium of Tradiittiionall Diiagnosiis (Gu Jiin Yiittong Zhengmaii
Quanshu), 1601:
The stomach is called the sea of grain and water; everything is assimilated here. The spleen is in charge
of transportation; everything is moved by its workings. Absorbing and moving: these are the essential
actions which define the spleen/stomach network as the main source of the life-sustaining postnatal
energy.
From Li Zhongzi, A Priimer of Mediicall Objjecttiives (Yiizong Biidu), 1637:
What makes the spleen the source of postnatal energy? Once a child has been born, it will feel hungry
after one day without food, and it will die after seven days without food. Once we have entered the realm
of the physical body, therefore, we have to be nourished by qi that is derived from food (gu qi). Once the
food enters the stomach, it is transported to the six fu organs, and thus there will be qi. It will be
appropriately dispensed to the five zang organs, and thus there will be blood. Human beings must rely on
this type of nourishment in order to stay alive. It is for this reason that the spleen is called the source of
postnatal energy.
From Cheng Wenyou, Quottes from Mediiciine (Yiishu), 1826:
Be aware that the spleen network cannot be compared to a system of mills or mortars that grind or pound
away on the incoming food. Rather, the spleen's ability to transform food and drink primarily depends on
its suctioning affect: preventing the food from falling down! Every food item entering the stomach
consists of both a qi component and a material component. The material component of the food naturally
sinks downwards, while its qi component naturally rises upwards. Once in the stomach, the food gets
"steamed" under the influence of stomach qi. Then, in the process of being separated into its material and
its light parts, it is being suctioned by the qi of the neighboring spleen. In this fashion, the stomach qi is
being assisted in its vital work and all of the food essence remains where it needs to be for processing-all
the way until every bit of food qi has been extracted and only the material shell remains, at which time
the lower gate of the stomach opens and the dregs are being discarded downwards.
From Li Dongyuan, A Treattiise on tthe Splleen and Sttomach (Piiweii Lun), 1249:
The stomach is called the sea of grain and water. Once food enters the stomach, its essential energy is
moved upwards to infuse first the spleen and then the lung. In this fashion, the command of spring and
summer is being carried out, and the entire body receives nourishment. This is due to the influence of
clear heavenly qi.
Once the ascending motion has reached its climax, this current shifts directions and flows downwards
toward the bladder. In this fashion, the command of autumn and winter is being carried out, and the
waste becomes processed and the flavors will manifest. This is due to the influence of turbid earth qi.
If we then regulate our daily lives by adjusting them to the prevailing energy of the seasons, if we avoid
exposure to extreme cold and extreme heat, if we eat and drink in regular intervals, if we protect our
shen by avoiding states of extreme anger or extreme ecstasy, and if we strive for balance by living in
moderation during all four seasons, there will be peace. Otherwise, the spleen and stomach will suffer
harm, and our true qi will leak downward in trickles or currents [i.e., diarrhea], with the possibility of
failing to rise again. This, then, would be like having autumn and winter but no spring and summer, and
a situation would arise in which the functions of birth and growth are muffled by the qi of death and
extinction. Naturally, all kinds of diseases would arise from such a situation. At the same time it is
without question that if there was only rising and no descending momentum within the body there would

e disease.
From Yu Chang, The Sttattuttes of Mediiciine (Yiimen Fallü), 1658:
Both the zang and the fu organ networks depend primarily on the spleen and the stomach. All food we
eat enters the stomach and is then transported by the spleen, just like the dirt on earth [is distributed by
wind and water to nourish all life forms]. It should be pointed out, however, that the spleen/stomach's
capability of transforming the food is actually dependent on the two essential qualities of fire and water.
The spleen and stomach cannot do this by themselves. When fire is in a state of excess, the spleen and
stomach will be dry; when water is in a state of excess, the spleen and stomach will be damp. Either
situation will cause the hundred diseases to arise.
From Yang Jizhou, The Greatt Compendiium of Acupunctture and Moxiibusttiion (Zhenjjiiu Dacheng), ca. 1590;
listed in the spleen channel section as a quote from an older Daoist source, The Oriigiinall Cllassiic of Guiidiing tthe
Breatth (Daoyiin Benjjiing) :
The spleen is situated at the center of the five organ networks. Therefore, it is assigned to no particular
season but flourishes during all four seasons. It contains and fosters the five flavors, it brings about the
five mental faculties, and it moves the four extremities and the one hundred marrows.
As soon as there is irregular intake of food and drink or overexertion of any kind, the spleen qi will be
harmed. As soon as the spleen and stomach suffer damage, food and drink stagnate and do not transform:
the mouth loses its ability to distinguish flavors, the extremities feel limp and tired, discomfort and
distention is felt in the stomach and abdominal regions, symptoms of vomiting and diarrhea appear, and
there may be dysentery or a host of other symptoms which have been specified in the Neijing and other
books, and which can be looked up there.
If we therefore force ourselves to eat when we are not hungry, the spleen will suffer. If we force
ourselves to drink when we are not thirsty, the stomach will bloat. If we eat beyond capacity, the vessels
in which the qi circulates will become obstructed, and the body's center (stomach region) will become
jammed and shut off. If we eat too little, on the other hand, the body will become emaciated, the stomach
will grow anxious, and our thoughts will become unsteady. If we eat contaminated food, the heart's
ability to differentiate will become blurred, and we will grow more and more restless. If we eat things
that we should not eat, the four great upheavals will occur and bring along disease. None of these types
of behavior represents the way of good health.
Therefore, it is most important to consume our food at the appropriate time, to drink our fluids in regular
intervals, and to avoid both overeating and hunger pains. If we eat and drink according to these simple
guidelines, then not only the spleen/stomach network itself will remain unspoiled and function perfectly,
but also the five zang and the six fu organ networks will all be in a harmonious state of health.
After food and drink enter the mouth, they pass through the epigastric region into the stomach. From the
stomach, the immaterial flavors contained in the food penetrate the five organs, whereas the material
components enter the small intestine where they are further transformed. When they reach the lower
opening of the small intestine, the first stage of the process of separating clear and murky materials
occurs. Murky materials are the waste, to be passed on to the large intestine. The clear materials are the
source of all bodily fluids; they enter the bladder which is called the store house of fluids. In the bladder,
once again a separation of pure and murky materials takes place. The murky debris goes into the urine to
be excreted, while the clear material enters the gallbladder. The gallbladder, finally, guides this purified
fluid essence to the spleen which dispenses it to the five organ networks; they, in turn, utilize it to
produce digestive saliva, nourishing saliva, nasal discharge, tears, and sweat. The flavors, meanwhile,
penetrate the five organs and transform into the five types of essential dew, which return to the spleen
where they are transformed into blood. In the form of nourishing blood, finally, they are returned to the
organs.
The Classic states: "When the spleen is healthy it can generate all living things. If it becomes depleted, it
can bring about the hundred diseases." The ancient poet, politician, and medical scholar Su Dongpo
(1037-1101) used to harmonize the spleen by moderating food intake, even when there was enough
money to eat lots. Therefore, I wish to extend the following advice to people who are in the habit of
throwing lavish banquets: derive happiness from internal peace; always leave room in your stomach, so
you can nourish your qi; and spend less if you wish to increase your material wealth.
The healthy person maintains the inside, while the unhealthy person maintains the outside. The person
who maintains the inside pacifies his/her zang and fu organ networks, and thus causes the blood in the
vessels to flow smoothly and uninhibited. The person who maintains the outside indulges in dazzling
flavors and luxuriant culinary delights; albeit at first glance the body of such a person may appear strong
and sturdy, a fierce verminous qi is corroding the zang and fu organs inside.
The stomach is in charge of receiving food and drink via the mouth and esophagus, containing them, and finally
fermenting them. The stomach is therefore called the "sea of grain and water." After "grinding and fermenting" the
incoming materials part of the essence distilled from food is passed on to the spleen, while the rest is passed on
downwards to the small intestine. If the stomach fails to receive and ferment properly, the supply of postnatal qi to
the other organ networks will be disturbed. Mastter Hua''s Cllassiic of tthe Centtrall Viiscera states: "If the stomach qi

is strong, all of the five zang and the six fu networks will be strong."
The spleen is in charge of the transformation and distribution of food essence and fluids, as well as the
transformation of pathological dampness. A healthy spleen will facilitate the optimal absorption and distribution of
essence. Consequently, the entire body will be provided with the nutrients that are essential for survival. It is for this
reason that the spleen has been labeled the postnatal root of life. If there is proper absorption and transformation of
food essence, the food will turn into refined essence rather than into "damp" slush stagnating in the digestive tract.
Conversely, the presence of dampness in the system will severely hamper the transformative actions of the spleen.
Part of the spleen's transporting function, moreover, is to move fluids upwards to the lung, from where they are
"sprinkled" over the entire body to ensure proper moisturization. If this basic metabolism of fluids can function
undisturbed, no buildup of pathological dampness will occur within the system.
The crucial transporting function of the spleen is entirely based on its action of "raising the pure (essence)." This
means that in its physiological state the spleen qi exhibits a rising momentum. If the spleen qi rises, a "transporting"
affect will ensue.
On the other hand, the equally important action of passing on of the dregs-and the continued differentiation of
pure and turbid fluids-are a result of the stomach's downward momentum, generally referred to as "descending the
turbid." Fluid differentiation and absorption is achieved cooperatively by the small intestine, the triple warmer, and
the bladder, but these aspects of fluid metabolism are often attributed, simply, to the descending function of the
stomach.
The influential Treattiise on tthe Splleen and Sttomach (Pii Weii Lun), written by the Yuan Dynasty medical
authority Li Dongyuan, strongly underscores the rising function of the spleen. To clarify his point, Li refers to the
workings of nature. He reminds his readers that the human body is a miniature replica of the surrounding
macrocosm. All phenomena on earth, the Treattiise points out, are produced by the intercourse of ascending earthly
and descending heavenly qi. The upward momentum of the essence qi, propelled by the spleen, can be compared to
the clear yang of nature which ascends toward heaven until it congeals into clouds in the sky. The ethereal part of
this essence (the yang within yang) purifies and nourishes lung qi, thus maintaining an atmosphere of moistness,
freshness, and clarity in the upper burner (which affects the sensory orifices of the ears, eyes, mouth, and nose). The
denser portion of this ascending yang substance (the yin within yang) moistens the skin, strengthens the pores, and
gives firmness to the limbs. And just as the turbid yin in nature condenses below to form earth, the Treattiise goes on
to explain, the clear essence of the turbid yin derived from food (the yang within yin) "turns red" and transforms into
blood, thus nourishing the body, while the dregs and superfluous fluids are excreted. The turbid part of the turbid
(the yin within yin), finally, forms the material basis for the bone marrow.
The Qing Dynasty essay collection, Sponttaneous Thoughtts Inspiired by Readiing tthe Mediicall Cllassiics
(Duyii Suiibii), summarizes this pivotal role of the spleen/stomach by drawing a Taiji (yin-yang symbol) of bodily
waxing and waning: "The heart and the lung are yang; as they follow the downward impulse of stomach qi and
descend on the right, they transform into yin. The liver and the kidney are yin; as they follow the upward impulse of
spleen qi and ascend on the left, they transform into yang."
The hollow stomach is in charge of "fermenting and ripening" incoming food. The character wei (stomach)
reflects the stomach's likeness to a high altitude field. Since fields in higher locations are closer to the sun and their
moisture can easily drain downwards, their earth has a tendency to get dry, earning it the designation "yang earth."
As the yang earth of the body, the stomach is known to easily become dry.
The spleen, among other things, is in charge of transforming dampness. The character pi (spleen) reflects
the spleen's likeness to a low-altitude field. Like the earth at the bottom of a valley, the spleen has a tendency to
become damp, and is thus known as "yin earth."
The ideal milieu for their functioning is slight moistness for the stomach and near dryness for the spleen; that is
the exact opposite of their natural tendencies, so the spleen and stomach must rely on each other to achieve a state of
balance. Otherwise, the drying action of the stomach may fail to control spleen damp, and signs of stagnant water
accumulation in the system will arise. Or the moistening quality of the spleen may fail to nourish the dry stomach,
and symptoms of thirst, voracious appetite, or other signs of stomach heat will appear.
Although it is primarily the lung which governs bodily qi, and primarily the heart which governs blood, the spleen is
the physical earth center which is the source of both the body's qi and blood. Both of these vital substances are
considered to be transformations of food essence.
Qi does not only move body essences, but it also holds them in place. The fact that the blood circulates in the vessels
without leaving its proper path is particularly attributed to the restraining function of spleen qi. The Cllassiic of

Diiffiicullttiies (Nanjjiing) simply states: "The spleen contains the blood [pi tong xue]" This function of the spleen
[associated with the earth element or phase] is evocative of the characteristics of earth: just as the rivers and streams
are contained by an earthen bed, the body's blood is contained in the channels.
The absorbing and transporting function of the spleen/stomach is directly reflected in the development of a person's
flesh and muscles. Strong and well developed arms and legs are therefore considered to be an important indicator for
good spleen function. Weak, cold, painful, obese, or malformed arms and legs are a primary sign of spleen
weakness.
The condition of the spleen manifests in the flesh of the mouth-the lips. Bright red lips, for instance, may indicate
damp heat in the stomach. Chronic gum bleeding or structural changes of the gums may arise from spleen
deficiency, while symptoms of severe dryness in the mouth, gum swelling, tooth aches, or severe hemorrhaging may
be the result of a stomach excess (heat, dryness) condition. Structural pathologies in the oral cavity (including
tongue shape and tongue coating) and unusual taste sensations in the mouth (or lack thereof) are almost always
indicative of spleen/stomach disturbances.
The mental processes of thinking and remembering are considered to be part of the physiological activity of the
spleen. A person with a poor digestive system usually cannot think clearly. This is because clear yang energy fails to
rise up to the heart and brain, or because of accumulating dampness clouding the orifices. As always, this
relationship also works the other way around: if a person thinks or worries too much, this can easily lead to digestive
symptoms such as poor appetite, diarrhea, or constipation.
The Splleen//Sttomach Is Unablle tto Absorb,, Transform,, and Transportt:: If stomach qi becomes injured, the
stomach loses its ability to contain food, and the person will exhibit symptoms of aversion to food or drink, nausea
and vomiting, hiccuping, or frequent belching. If the spleen loses its ability to transform and transport the essence of
food, abdominal distention, loose stools or diarrhea, fatigue, or emaciation may occur. Also, if the spleen loses its
ability to transport fluids and transform dampness, internal dampness and phlegm will accumulate, potentially
manifesting in a variety of phlegm disorders, diarrhea, or edema.
The Ballance Bettween Raiisiing tthe Cllear and Descendiing tthe Turbiid iis Diistturbed:: If the stomach's turbid
substances do not descend, but push upwards instead, there will be symptoms of distention, vomiting, hiccuping, or
belching of foul gases or sour liquids. If "the clear" cannot be properly raised upwards by the spleen, typical
symptoms that may result are diarrhea, prolapse of the stomach, prolapse of the anus, or prolapse of the
uterus/vagina. Collllectted Sayiings by Dr.. Wu (Wu Yii Huii Jiiang) pointed out: "Among the many therapeutic
approaches to spleen and stomach disorders, none is superior to harmonizing the dynamics of raising and
descending."
Imballance of Dryness and Dampness:: If dampness hampers the free unfolding of spleen yang and thus the
spleen's transporting ability, the stomach function will immediately be affected and symptoms of poor appetite or
nausea will result. On the other hand, if there is excessive heat and dryness present in the stomach, this condition
will in turn influence the function of the spleen: fluids will be scorched, resulting in constipation; or the spleen yang
may collapse downward, causing symptoms of fatigue, constant sleepiness, frail extremities, diarrhea, and a slow
pulse.
Sttomach Diisorder Inflluenciing tthe Siix Fu Organs:: If there is dry heat in the stomach, it scorches the body's
fluids; as a result, there will be constipation, and the transporting function of the large intestine will become severely
inhibited. Damp heat in the spleen/stomach "steaming" the neighboring gallbladder can cause the bile to overflow
and produce jaundice. Downpouring of damp heat from the spleen/stomach can have a detrimental effect on the
triple warmer, the small intestine, and the bladder, and thus cause symptoms of dark and burning urination or
dribbling urinary block. In the stomach itself, dry heat or food stagnation usually cause a loss of descending action,
manifesting as epigastric stuffiness, vomiting, belching, acid regurgitation, abdominal distention, or constipation.
The Splleen Cannott Conttaiin tthe Bllood wiitthiin tthe Vessells:: If spleen qi decreases in strength, a loss of the spleen's
function of containing the blood within the vessels may result. Various types of bleeding are thus sometimes
associated with a deficiency of spleen qi, particularly recurrent hematomas, certain types of purpura, and prolonged
menstrual bleeding. Since spleen-related hemorrhaging is always caused by a deficiency syndrome and usually
involves slow leakage of pale blood, it should not be confused with the acute loss of profuse amounts of dark red
blood caused by blood heat.
Unballanced Menttall Acttiiviitty Harmiing tthe Splleen:: If a person is involved in excessive worrying, thinking in
pensive circles that lead nowhere, or simply has a mental focus that is too narrow or too intense, spleen symptoms
such as loss of appetite, general exhaustion, or inhibited qi flow (causing insomnia, sleepiness, or lack of vision and
mental clarity) may gradually manifest.
Menttall and Physiicall Exhausttiion Takiing Theiir Tollll on tthe Splleen:: Ancient Chinese texts place particular
emphasis on the fact that any exertion beyond one's individual limits will result in injury to the qi of the

spleen/stomach. If a person is not allowed to recover from extreme exhaustion, there may be permanent weakness
and fatigue, shallow breathing and a decreased desire to talk, heat sensations and spontaneous sweating, or asthmatic
breathing that comes on with even slight physical exertion. In Neiijjiing terms: "Exertion fritters away the qi."
The Splleen Is Unablle tto Govern tthe Fllesh and tthe Musclles:: Prolonged sitting or lying down is said to harm the
spleen, and thus cause atrophy of the muscles. Since the spleen governs the flesh layer, all disorders such as a heavy
and sore body, slow healing wounds, bed sores, emaciated arms and legs, the weak extremities of the chronically
bed-ridden patient, and certain types of paralysis are results of spleen injury.
Splleen Diisorder Affecttiing Changes iin Appettiitte and Tastte Sensattiion:: A poor appetite, the feeling that
"everything tastes like nothing," a voracious appetite, sugar cravings, or other pathological changes in appetite or
taste sensation usually involve the spleen/stomach network. As the respective chapter in the historic reference work,
An Illllusttratted Encycllopediia (Tushu Biian), explains: "Poor appetite is a sign of acute food stagnation or injury to
the spleen/stomach. If the patient is hungry, but cannot get much of the food down, this is a sign of cold pathogens in
the spleen. If a person craves sweets, this is a sign of spleen deficiency."
Toniify tthe splleen (wiitth blland//sweett fllavors) (bu pii;; gan dan shii pii):: dioscorea (shanyao), hoelen (fuling), lotus
seed (lianzi), euryale (qianshi), coix (yiyiren), dolichos (biandou).
Buiilld tthe centter and uplliiftt qii (jjiian zhong yii qii):: codonopsis (dangshen), atractylodes (baizhu), astragalus
(huangqi), jujube (dazao).
Warm tthe splleen (wen pii):: dry ginger (ganjiang), evodia (wuzhuyu), black pepper (hujiao), zanthoxylum (shujiao).
Move tthe splleen (yun pii):: red atractylodes (cangzhu), magnolia bark (houpo), cardamon (sharen), amomum
(baidoukou).
Harmoniize tthe centter and regullatte qii (llii qii):: citrus (chenpi), saussurea (muxiang), agastache (huoxiang), perilla
stalk (sugeng), clove (dingxiang), galanga (gaoliangjiang).
Emolllliiatte acutte centtrall diisttrress (huan jjii):: licorice (gancao), jujube (dazao), honey (fengmi).
Raiise centtrall yang and lliiftt collllapse (sheng yang jju xiian):: cimicifuga (shengma), pueraria (gegen), astragalus
(huangqi).
Dry damp (zao shii):: red atractylodes (cangzhu), tsao-kuo (caoguo), cardamon (sharen), pinellia (banxia).
Transform phllegm (hua ttan):: citrus (chenpi), pinellia (banxia), bamboo skin (zhuru), bamboo resin
(tianzhuhuang), bamboo sap (zhuli), sinapis (baijiezi), arisaema (tiannanxing).
Percollatte damp (shen shii):: hoelen (fuling), coix (yiyiren).
Diisiinhiibiitt damp (llii shii):: polyporus (zhuling), alisma (zexie), akebia (mutong), capillaris (yinchen), polygonum
(bianxu).
Driive outt watter rheum (zhu yiin):: zanthoxylum seed (jiaomu), atractylodes (baizhu), euphorbia (daji), daphne
(yuanhua), kan-sui (gansui), phytolacca (shanglu).
Nouriish sttomach yiin (yang weii yiin):: ophiopogon (maimendong), yu-chu (yuzhu), trichosanthes root (tianhuafen),
dendrobium (shihu).
Cllear sttomach heatt (qiing weii re):: gypsum (shigao), coptis (huanglian).
Purge sttomach fiire (xiie weii huo):: rhubarb (dahuang), mirabilitum (mangxiao).
Diissollve food accumullattiion (xiiao dao):: crataegus (shanzha), shen-chu (shenqu), malt (maiya), gallus (jineijin),
chih-ko (zhike), raphanus (laifuzi).
Harmoniize tthe sttomach and descend rebelllliious qii (he weii jjiiang nii):: fresh ginger (shengjiang), pinellia (banxia),
clove (dingxiang), agastache (huoxiang), hematite (daizheshi).
Conttroll aciid (zhii suan):: evodia (wuzhuyu), coptis (huanglian), cardamon (sharen), fritillaria (zhe beimu), cuttlefish
bone (wuzegu), calcined oyster shell (duan muli).
Just as the earth assumes the position of centeredness, balance, and harmony in nature, the spleen/stomach network
is the body's center of balance. All up and down movements pivot around it, and both damp and dry qualities come
together here to form a physiologically beneficial alliance. As the main text of the fever school, Wenbiing Tiiaobiian,
points out: "The spleen should be treated like the beam of a scale: if it is not in horizontal balance, it will not be at
peace." Treating the spleen/stomach also requires the use of substances that are harmoniously balanced. Foods and
herbs that are overly hot or cold or dry or moistening should be avoided.
As a general rule, spleen disorders are usually of a deficient nature, requiring the tonification of central qi and
the stimulation of the ascending movement of clear yang qi. Stomach disorders, though they may be based on
deficient functions, usually involve excess or accumulation problems; accumulation needs to be dissolved and
guided out.
Since the functioning of both the spleen and the stomach are closely tied to their respective directional
momentum, proper qi movement needs to be restored in case of erratic movement. If the upwardly mobile spleen

yang collapses downward (diarrhea, organ prolapse, etc.), it should be lifted by employing measures that tonify the
spleen and boost central qi. If the stomach's descending motion is upset, as is the case with rebellious stomach qi
(nausea, vomiting, etc.), the situation should be rectified by harmonizing the stomach and descending the rebellious
qi.
Herbs that eliminate pathological dampness are common spleen therapies, including bitter herbs that dry damp,
bland herbs that percolate damp, and spicy herbs that break down and eliminate phlegm and other types of
pathological liquid. The stomach is often treated with substances that nourish and protect its physiological fluids:
sweet and cold herbs that moisten dryness; salty and cold herbs that clear stomach heat; and herbs that protect its yin
by clearing stomach heat, cleansing stomach fire, or in severe cases, effecting emetic or purgative action.
As the principal flavor of harmony, sweet has a primary affinity to the earth network. Therefore, if the spleen is
in acute distress, sweet flavors can harmonize the spleen and be beneficial to the production of central qi. As the
Neiijjiing points out: "Sweet generates the spleen." If sweet foods are used excessively, however, they will produce
phlegm, obstruct transformation, and harm the flesh layer that is associated with the spleen. Swelling, bloating, and
obesity will result. Again, this fundamental principle has been recorded by the Neiijjiing, stating that "sweet harms the
flesh," and "if the disease is in the flesh layer, the patient should abstain from the excessive consumption of sweet
flavors."
When treating spleen/stomach disorders, the system's relationship to other organ networks needs to be taken
into consideration. Particularly the liver's overbearing influence needs to be corrected if it is the original cause for
the spleen's distress. Spleen tonics are therefore often accompanied by herbs that smooth and emolliate the liver.
SPLEEN QI DEFICIENCY (pii qii xu):: primary symptoms include decreased appetite; sallow complexion; fatigue;
shallow breathing or shortness of breath; little desire to talk; epigastric and/or abdominal bloating (especially after
eating); loose or unformed bowel movements. Secondary symptoms may include weak or emaciated extremities;
edematous extremities; inhibited urination; decreased amount of (pale colored) menstrual flow. The tongue typically
manifests with a pale body, toothmarks, and a thin white coating; the pulse tends to be weak and slow.
Representtattiive Herbs:: codonopsis (dangshen), astragalus (huangqi), atractylodes (baizhu), hoelen (fuling),
dioscorea (shanyao), lotus seed (lianzi), coix (yiyiren), dolichos (biandou), jujube (dazao); citrus (chenpi), shen-chu
(shenqu).
Representtattiive Formullas:: Four Major Herbs Combination (Si Junzi Tang); Six Major Herbs Combination (Liu
Junzi Tang).
DOWNWARD COLLAPSE OF SPLEEN QI (pii qii xiia xiian):: primary symptoms include weak voice; shortness
of breath; fatigue; bloating sensation right after eating; prolapsing sensation in stomach and abdomen (wan fu zhong
duo); (bianyi pinshuo); or possibly prolapse of anus due to chronic diarrhea; or prolapse of stomach or uterus.
Secondary symptoms may include dizziness; unclear sensory perception (especially blurry vision); poor appetite;
spontaneous sweating; mental and physical fatigue; diarrhea. The tongue typically presents with a pale body and a
thin white coating; the pulse tends to be weak and empty.
Representtattiive Herbs:: astragalus (huangqi), codonopsis (dangshen), atractylodes (baizhu), dioscorea (shanyao),
dolichos (biandou), cimicifuga (shengma), pueraria (gegen); bupleurum (chaihu), citrus (chenpi).
Representtattiive Formulla:: Ginseng and Astragalus Combination (Buzhong Yiqi Tang).
STOMACH YIN DEFICIENCY (weii yiin xu):: primary symptoms include dry lips; frequent thirst sensation; dry
throat; sticky sensation in the mouth; poor appetite; sensation of emptiness, stuckness, or pain in epigastric region.
Secondary symptoms may include hunger sensation without desire for food; constipation; restlessness; sensations of
surging heat. The tongue typically presents with a red body and a mirror surface without coating, or with a red body
and little coating, or with a dry tongue and little moisture; the pulse tends to be fine and rapid.
Representtattiive Herbs:: glehnia (bei shashen), ophiopogon (maimendong), yu-chu (yuzhu), dendrobium (shihu), raw
rehmannia (sheng dihuang), trichosanthes root (tianhuafen), Asian pear juice (li zhi), sugar cane juice (ganzhe zhi);
bamboo skin (zhuru).
Representtattiive Formullas:: Glehnia and Ophiopogon Formula (Shashen Maidong Yin), Boost the Stomach
Decoction (Yiwei Tang).
SPLEEN YANG DEFICIENCY (pii yang xu):: primary symptoms are spleen qi deficiency symptoms with an
emphasis on cold signs, such as abdominal pain that improves with the application of heat and pressure; cold
extremities; poor appetite; abdominal bloating; loose or unformed stools. Secondary symptoms include decreased
taste sensation; little desire to drink; edematous extremities; inhibited urination; increased amounts of clear vaginal
discharge. The tongue typically presents with a pale and tender body and a white and slippery coating; the pulse
tends to be deep and fine, or deep and slow.
Representtattiive Herbs:: dry ginger (ganjiang), aconite (fuzi), evodia (wuzhuyu), zanthoxylum (chuanjiao), clove
(dingxiang), atractylodes (baizhu), codonopsis (dangshen).
Representtattiive Formullas:: Ginseng and Ginger Combination (Lizhong Tang), Fill the Spleen Formula; Magnolia
and Atractylodes Combination (Shipi Yin).
COLD DAMP OBSTRUCTING THE SPLEEN (han shii kun pii):: primary symptoms are a general sense of

heaviness in the body and/or the head; discomfort or bloating in the abdomen or epigastric region; reduced taste
sensation; little or no thirst; abdominal pain; unformed stools or diarrhea. Secondary symptoms include no appetite;
nausea and vomiting; sticky sensation in mouth; puffy face; edematous extremities; bags under the eyes; increased
vaginal discharge. The tongue is typically fat and has a greasy white coating; the pulse tends to be soft and
moderate.
Representtattiive Herbs:: red atractylodes (cangzhu), atractylodes (baizhu), hoelen (fuling), magnolia bark (houpo),
citrus (chenpi), pinellia (banxia), tsao-kuo (caoguo), agastache (huoxiang), (peilan), perilla stalk ( zi sugeng).
Representtattiive Formullas:: Magnolia and Citrus Combination (Pingwei San); Magnolia and Hoelen Combination
(Wei Ling Tang).
DAMP HEAT IMPLICATING THE SPLEEN (shii re yun pii):: primary symptoms are stuffy sensation in the
subcostal and epigastric regions; abdominal bloating; poor appetite; dry and sticky sensation in mouth; aversion to
greasy foods; nausea and vomiting; general sensation of heaviness; jaundiced eyes and face. Secondary symptoms
may be body itch; fever; dark and scanty urination; obstructed bowel movements. The tongue typically presents with
a greasy and yellow coating; the pulse tends to be soft and rapid.
Representtattiive Herbs:: capillaris (yinchen), bamboo skin (zhuru), red atractylodes (cangzhu), atractylodes (baizhu),
hoelen (fuling), polyporus (zhuling), alisma (zexie), chih-shih (zhishi).
Representtattiive Formullas:: Capillaris and Hoelen Five Formula (Yinchen Wuling San); Capillaris and Hoelen Four
Formula (Yinchen Siling San).
THE SPLEEN CANNOT CONTAIN THE BLOOD WITHIN THE VESSELS (pii bu ttong xue):: primary
symptoms are general signs of spleen qi deficiency, such as pale face and tendency towards diarrhea, accompanied
by signs of bleeding, such as blood in the stool, nose bleed, gum bleeding, subcutaneous bleeding (purpura),
increased amounts of menstrual bleeding or continuous spotting. Secondary symptoms may include other spleen
deficiency symptoms, such as decreased appetite; fatigue, bloating after eating; shallow breathing or shortness of
breath; cold extremities; skinny constitution. The tongue typically presents with a pale body and a white coating; the
pulse tends to be soft, fine, and weak.
Representtattiive Herbs:: codonopsis (dangshen), astragalus (huangqi), atractylodes (baizhu), tang-kuei (danggui),
dioscorea (shanyao), lotus seed (lianzi), roasted ginger (paojiang), longan (longyanrou), baked licorice (zhi gancao).
Representtattiive Formulla:: Ginseng and Longan Combination (Guipi Tang).