ZANG FU fafa The Organ Systems of Traditional Chinese Medicine Functions, Interrelationships and Patterns of Disharmony in Theory and Practice Jeremy Ross Doctor of Acupuncture CAc(Nanjing) BAc(MBAcA) BSc CEd MNIMH Second Edition A Q Oy C7 CHURCHILL LIVINGSTONE EDINBURGH LONDON MELBOURNE AND NEW YORK 1985 noDnv novContents Introduction xi List of Chinese Words xiv Part 1 The Background 1 Chinese and Western Thought Patterns of Change 3 Interrelationship 4 Analysis and Synthesis 4 Yin Yang 5 Structure and Function 6 Precision and Ambiguity 7 Harmony and Disharmony 7 Summary 7 2 The Framework Substances 9 Jing Luo 9 Zang Fu 11 Tissues 11 Summary 11 3 Substances The Five Substances and their Functions 12 ‘Yin Yang and the Substances 13 Formation of the Substances 14 Ambiguities 17 Patterns of Disharmony of the Substances 20 Further Ambiguities 21 Summary 24 4 Origins of Disease Origins of Disease 25 Disease Factors 27 External Factors 27 Internal Factors 40 Miscellaneous Factors 40 Summary 44 5 Patterns of Disease Terminology 45 Classification of Patterns of Disease 45 Patterns of Disharmony of the Eight Principles 46 Combinations of the Patterns of the Eight Principles 27 Apparent Contradictions 55 Qualifications of the Eight Principles Classification 56 Common Disease Patterns 57 Summary 57 viiCONTENTS Part2 Zang Fu 6 Zang Fu Origins of Confusion 61 ‘The Twelve Zang Fu 63 Zang and Fu 63 Zang Fu Pairs 64 Summary 64 7 Shen (Kidneys) and Pang Guang (Bladder) Shen Functions 65 Patterns of Disharmony 70 Deficient Shen Jing 72 Deficient Shen Yang 73 Deficient Shen Yin 76 Summary 78 Pang Guang Functions 80 Patterns of Disharmony 80 Damp Heat In Pang Guang 80 8 Pi (Spleen) and Wei (Stomach) Pi Functions 83 Fluids, Damp and Phlegm 84 Patterns of Disharmony 85 Deficient Pi Qi 86 Deficient Pi Yang 88 Inability of Pi to Govern Xue 89 Sinking of Pi Qi 90 Invasion of Pi by Cold & Damp 90 Damp Heat Accumulates in Pi 92 ‘Turbid Phlegm Disturbs the Head 93 Summary 94 Wei Functions 96 Patterns of Disharmony 96 Retention of Fluid in Wei due to Cold 97 Retention of Food in Wei 98 Deficient Wei Yin 98 Blazing Wei Fire 99 Other Wei Disharmonies 99 Summary 100 viii 9 Gan (Liver) and Dan (Gall Bladder) Gan Functions 101 Patterns of Disharmony 103 Depression of Gan Qi 105 Deficient Gan Xue 107 Hyperactive Gan Yang 109 Blazing Gan Fire 112 Stirring of Gan Wind 113 Damp Heat in Gan and Dan 118 Stagnation of Cold in Gan Jing Luo 119 Summary 120 Dan Functions 121 Patterns of Disharmony 121 10 Xin (Heart) and Xiao Chang (Small Intestine) Xin Functions 122 Patterns of Disharmony 124 Deficient Xin Qi 125 Deficient Xin Yang 125 Stagnant Xin Xue 128 Deficient Xin Xue 129 Deficient Xin Yin 130 Blazing Xin Fire 131 Phlegm Fire Agitating Xin 132 Cold Phiegm Misting Xin 133 Summary 134 Xiao Chang Functions 136 Patterns of Disharmony 136 Obstructed Xiao Chang Qi 136 Excess Heat in Xiao Chang 136 11 Fei (Lungs) and Da Chang (Large Intestine) Fei Functions 138 Patterns of Disharmony 140 Deficient Fei Qi 142 Deficient Fei Yin 143CONTENTS Dryness of Fei 144 Invasion of Fei by Wind 144 Retention of Phlegm in Fei 146 Summary 147 Da Chang Functions 149 Patterns of Disharmony 149 Intestinal Abscess 149 Damp Heat Invading Da Chang Constipation and Diarrhoea 150 Summary 151 150 12. Xin Bao (Pericardium) and San Jiao (Triple Burner) Xin Bao Functions 152 Patterns of Disharmony 152 San Jiao San Jiao as the Three Divisions of the Body 153 San Jiao as the Fu System 154 San Jiao as the Jing Luo 158 San Jiao as the San Jiao Points ‘Treatment of San Jiao Disharmonies 159 Summary 159 158 13 Review of the Five Zang Functions 162 Interrelationships of the Main Zang Functions 162 Origins of Patterns of Disharmony 163 Part3_ Interrelationships 14 Zang Fu Interrelationships Yin Yang 169 Substances 170 Pathology of the Substances 171 Jing Luo 172 Tissues 172 Zang Fu 178 Zang Fu and the Origins of Disease 179 Summary 182 15 Emotions Emotions and Behaviour 183 Classification of the Emotions ‘The Five Feelings and the Five Zang 185 ‘The Five Feelings and the Five Phases 187 Emotions and Yin Yang Emotions and Substances 188 Emotions and Jing Luo 189 Mental Faculties and Emotions Clinical Importance of Emotional Disharmony 190 ‘Treatment of Emotional Disharmony 191 ‘Treatment of Severe Mental Illness 192 Summary 194 184 188 190 16 Disharmonies Involving More than One Zang Disharmonies of Two Zang Together 195 Disharmonies of Three or More Zang Together 201 Interrelationships in Some Common Disease Patterns 207 Summary 210 Part 4 Clinical Practice 17 Clinical Methods Diagnosis 214 Treatment 221 Education of the Patient 225 Sequence of Clinical Procedures 230 Summary 233 18 Case Histories Chronic Otitis Media 234 Tinnitus and Balance 235 Angina Pectoris 236 Chest Pain 238 Urticaria and Stomach Pain 240 Back, Shoulder, Breasts and Respiratory System 242CONTENTS ity and Insomnia 244 Appendix: List of Zang Fu Functions Arthritis and Stress 246 and Disharmonies 254-255 Summary 249 19 Conclusion Bibliography 256 Review 250 General 251 Teaching TCM 251 Index 258Introduction The practice of Traditional Chinese Acupuncture is largely based on a framework of three interwoven categories: Jing Luo Eight Principles Zang Fu The Eight Principles have been clearly dealt with in recent texts, and their fundamental importance is now beginning to be understood. The importance of Jing Luo, the system of channels and collaterals, is one of the few things that has been appreciated in Western Acupuncture from its beginnings. The theory of Zang Fu forms the core of Traditional Chinese Medicine (TCM) and yet has received the least attention and has been subject to the grossest misconceptions. This text deals with the Zang Fu, their functions, Origins of Disease, and Patterns of Disharmony. It studies their interrelationships with each other, with the Substances, Jing Luo, and Tissues, and with the Origins of Disease. It views them in the context of the Body as a whole, in its interactions with the environment. The Purpose of This Book This book aims to: L Provide a clear, well organized foundation for a theoretical understanding of Zang Fu. 2.Explore the interwoven complexities of Zang Fu interrelationships, and to clarify areas of difficulty and ambiguity. xiINTRODUCTION 3.Show how Zang Fu theory is applied in practice, and to provide a basic sequence of clinical procedures. ‘This book is an advanced acupuncture text. It is written for students and practitioners of TCM, and is not meant for the complete beginner. It assumes some degree of familiarity with the theory and practice of TCM, and is meant to be used in conjunction with such excellent texts as ‘Essentials of Chinese Acupuncture’ (9), ‘Acupuncture A Comprehensive Text’ (18), and ‘The Web That Has No Weaver’ (12). It is concerned with one main topic, the application of the Theory of Zang Fu in clinical practice. It deals with other topics, for example, Substances, only in sufficient detail to give an adequate background to the Theory of Zang Fu, and assumes that the reader either has knowledge of these other topics or has access to the textbooks mentioned above. How This Book is Organized ‘The main body of this book is divided into four parts: Part 1 The Background Part 2 Zang Fu Part 3 Interrelationships Part 4 Clinical Practice The whole purpose of this book would be defeated if the reader were to omit Part 1, and go straight to Part 2. The Zang Fu can only really be understood in the context of the basic principles of TCM. Part 1 This section looks at the fundamental differences between Chinese and Western thought, and at the main theoretical principles of Chinese medicine. It considers Zang Fu in the context of the basic organizational framework of the Body: Substances, Jing Luo and Tissues; and in terms of the Origins of Disease. Part 2 ‘This part is of course the core of the book, but meaningless out of the context of Part | and Part 3. After a general introduction to Zang Fu, Part 2 discusses each Zang Fu pair in a separate chapter; and studies the functions, Origins of Disease, and Patterns of Disharmony of each Zang in detail, with many examples, tables and diagrams. Part 3 Interrelationship is the basic theme of this book, and this vital section explores the interrelationships of Zang Fu with Yin Yang, Jing Luo, Tissues, emotions and behaviour, and Origins of Disease. It investigates the interrelationships between Zang Fu in disharmonies involving two, three or more Zang Fu together.