Visceral manifestation
Lecturer: QU Hongyan
[Objects]
 To master the concept of Zang-fu organs
 To grasp the physiological features of five
Zang organs, six Fu organs and
extraordinary rgans；
 To comprehend the theory of visceral
manifestation
General Introduction
1、Concept of visceral manifestation
2、Formation of theory of visceral manifestation
3、Features of theory of visceral manifestation
Concept
What is visceral manifestation?
it refers to the viscera stored inside the
human body, their external physiological and
pathological manifestations as well as the
corresponding things and phenomena in nature.
Viscera
manifestation
Internal organs
External manifestations
and correspondences
Theory of visceral manifestation
It aims at explain the morphology, structure,
location, physiological function and
interrelationship.
Anatomic
knowledge
Theory of visceral
manifestation
Medical
practice
experience
Infiltration
of ancient
phylosophy
Long term
observation
in daily life
Features of theory of visceral manifestation
 Integrity of the human body itself with five zang organs
as the center
 Unity between five zang organs and natural
environments
?
Zang fu organs
Liver, heart, spleen,
lung, kidney
Five zang organs
Six fu organs
Gallbladder, small
Extraordinary fu organs
intestine, stomach, large
intestine, bladder,
triple energizer
Brain, marrow,
pulse, uterus,
bone, gallbladder
Five zang organs:
generating and storing essence
Features
Six fu organs: receiving, transporting and digesting food
Extraordinary fu organs: with hollow cavities
resemble to six fu organs in morphology and with the function
of storing essence resemble to five zang organs
The main contents
the main physiological functions and features of
five zang organs
the relationship of five zang organs and
constituents, orifices, emotions
and fluids and seasons
Monarch organ （“君主之官”）
Root of life（“生之本”）
The monarch of five zang organs and six
fu organs（“五脏六腑之大主”）
Promote and regulate
the function of zang
fu organs
Heart
spirit
1
2
Governing
blood and
vessels
Storing
spirit
• Governing blood and vessels
Abundant heart qi
Enough blood
Smoothness of vessels
Normal blood
circulation
The heart governs all the psychological
activities, like mind, consciousness and
thinking etc.
In a broad sense means the exterior
manifestation of life activities (e.g. posture,
complexion, eye contact, speech, responds, diet etc)
In a narrow sense refers to mental
activities.
(2) Relationship of heart to its constituent,
orifice, emotion, fluid and season
Corresponding to vessels and manifesting on the face
Opening into tongue
Joy is heart emotion
Sweat is heart fluid

Heart corresponds to Summer

Heart is interiorly-exteriorly related to
small intestine
Lung
Canopy (肺为华盖) ---the location of lung is
the highest of five Zang organs
Delicate viscus(肺为娇脏) ---the lung have
sparse and delicate lobes and
cannot bear coldness and warmth
Physiological functions
1
2
Governing qi
Governing dispersing and purifying and
descending
3
water metabolism
4
Assembling vessels
• Governing qi
it includes governing respiratory qi
and qi of the whole body.
It means that the lung governs
respiration, and is also where internal
It means that the lung governs
and external qi exchange.
respiration, and is also where
internal and external qi exchange.
The
lung participate
the governs
It means
that the lung
production
of and
qi is also where internal
respiration,
and external qi exchange.
The lung regulate the movement
of qi of the whole body
Qi of the whole body
• Innate qi is inherited from parents,
nourished and supplemented by
acquired qi,
• Acquired qi refers to clear qi inhaled
by the lung from nature and food
essence generated by the spleen and
stomach.
Heart qi
primary
qi
Food
Lung qi
qi of the whole
body
Liver qi
essence
pectoral
qi
Clear
qi
Spleen qi
Kidney qi
Functions of pectoral qi
Runs through the inspiratory tract to
regulate respiration
Runs through vessels to promote
circulation of qi and blood
Descends to Dantian to nourish
origninal qi
Respiratory
tract
Pectoral
qi
Dantian
Regulate respiration
vessels
Promote the
circulation of
qi and blood
Nourish the original qi
• Governing dispersing and purifying and
descending
Dispersing means that lung qi can lift
upwards and disperse outwards.
Purifying and descending refers to the lung
has functions of cleaning and descending
inwards and downwards.
Lung qi can lift upwards and disperse outwards
┌Exhaling turbid qi from the body
│
upwards
│
Dispersing ─┤ Distributing food essence
│
outwards
│
└Dispersing defensive qi to the skin, muscles,
and interstices
Inhaling clear qi from nature and
transporting pectoral qi downwards
below the navel to nourish original
qi
Purifying & descending
Transporting downwards and
inwards food essence in the lung
which is transported by spleen qi
to nourish organs and tissues
Transporting downwards
turbid fluid generated
through visceral
metabolism to kidneys to
generate urine
Governing water metabolism
It means that the function of lung
dispersing and descending promotes and
regulates the movement, distribution and
discharge of fluids of the whole body.
It is the manifestation of lung governing
dispersing, purifying and descending on
water metabolism.
Lung is the upper source of water
Assembling vessels and governing coordination
• Assembling vessels means that blood of the body
circulate through the lung and exchange turbid qi
with clear qi in the lung, and blood abundant in clear
qi is transported to the whole body through vessels.
And it is the embodiment of qi promoting blood.
• Governing coordination is a high summarization of
physiological functions of the lung.
(2) Relationship of lung to its constituent,
orifice, emotion, fluid and season

Corresponding to the skin and manifesting on the
hair

Opening into nose

sadness is lung emotion

snivel is lung fluid

Lung corresponds to Autumn

Lung is interiorly-exteriorly related to large
intestine
Spleen
The origin of qi and blood(气血生化之源)
Barn official(仓廪之官)
Acquired root(后天之本)
Physiological functions
Governing transportation
and transformation
Governing blood
spleen
Spleen qi
governing lifting
Governing transportation and transformation
It means that the spleen can transform food into
food essence, and absorb food essence and fluid
further to transport to viscera.
• Transporting and transforming food
Spleen can digest food, absorb nutrient,
transport to the heart and lung, and distribute to the
whole body.
• Transporting and transforming water
It means that spleen qi can absorb, transport and
distribute water to nourish the whole body.
Let’s have a rest!
Governing blood
It means that spleen qi can guide and dominate blood
inside vessels to avoid bleeding.
Spleen governs transportation
and transformation
Generating qi
and blood
Qi consolidates
blood
Spleen qi governing lifting
Spleen functions normally when
its qi ascends
Spleen qi governing lifting is the
movement feature of spleen qi, including
sending up the clear and lifting up viscera.
Sending up the clear
Dizziness and
lassitude
Upper: lack of nourishment
Failure of spleen qi in
deficiency to transport
and transform
Abdominal
distension and
fullness
Middle: stagnation of turbid qi inside stomach
Lower:
adverse downward flow of essential qi
Loose stool
and
diarrhea
Lifting up viscera
It means that spleen qi can lift to maintain the
normal position of viscera to avoid prolapse.
So if the spleen qi functions abnormally, patients
will suffer with prolapse of uterus, prolapse of anus
etc.
(2) Relationship of spleen to its constituent,
orifice, emotion, fluid and season






Corresponding to muscles and governing four
limbs
Opening into mouth and manifesting on lips
Anxiety is spleen emotion
Saliva is spleen fluid
Spleen corresponds to Summer
Spleen is interiorly-exteriorly related to stomach
Liver
• Resolute viscus（刚脏）
• General organ（将军之官）
• Liver is characterized by rising and moving,
prefers smoothness and dislikes depression.
（主升主动，喜条达而恶抑郁）
• Innate root for the woman（肝为女子之先天）
• Blood sea(血海)
Storing blood
Smoothing flow of qi
Physiological functions
 Governing smoothing flow of qi
 Storing blood
Governing smoothing flow of qi
Liver governs
smooth
Flow of qi
Qi movement
of the whole
Body is normal
Life activities
Function normally
The circulation of qi
and blood is freely and
smoothly
Steady and ordered
functional activities
of zang-fu organs,
meridians, constituents
and orifices of the
whole body
Governing smoothing flow of qi
• Promoting circulation of blood and body fluids
• Promoting spleen and stomach’s
transportation and transformation and
secretion and discharge of bile.
• Regulating emotions
• Promoting man’s ejaculation and woman’s
menstruation
Storing blood
It means that the liver can load blood, regulate
blood volume and avoid bleeding.
Movement: blood is in
Regulating blood volume
vessels
Rest:
blood is in liver
Liver storing blood
to nourish itself
Avoid bleeding
surpressing
liver yang to avoid yang hyperactivity
and bleeding
(2) Relationship of liver to its constituent,
orifice, emotion, fluid and season
Corresponding to the tendon and manifesting on the nail
Opening into eyes
Anger is liver emotion
Tear is liver fluid
Liver corresponds to Spring
Liver is interiorly-exteriorly related to
gallbladder
Kidneys
• Innate root (先天之本)
• Root of yin and yang of five zang organs（五
脏阴阳之本）
• The organ in charge of striving（作强之官）
• Root of consolidating（封藏之本）
• Lumbar area is the house of kidneys（腰为肾
之府）
Physiological functions
• Storing essence
• Governing water
• Governing reception of qi
Storing essence
kidneys storing essence means that
kidneys can store and consolidate
essence.
It is the basic material to form
and maintain life activities of the
human body, the root of life
activity, and the material basis for
functional activities of viscera,
constituents and orifices
Reproductive essence from parents
innate essence
supplement
nourishment
Kidney
essence
Food essence generated by the
spleen and stomach
acquired essence
(some part )
Function of kidney essence
• Promoting the growth, development and
reproduction of human body
• Promoting and regulating the qi transformation of
zang-fu organs
Sex-stimulating essence
It refers to a kind of refined material promoting
the development and maturity of the reproductive
organs and sustain the reproductive function, and is
generated when kidney qi increased to a certain
level.
Female:14
Male: 16
Female:49
Male:64
Kidney yin
Kidney
essence
Kidney qi
Inter-restrict
With the function
of moistening
tranquilizing
and depressing
coordinate
transform
Kidney
yang
Promoting,
warming and
exciting
Governing water
It means that kidneys can control and regulate the
circulation, distribution and discharge of water of the
whole body.
• Qi transformation of kidneys is the primary promotive
force for lung, spleen, triple energizer to work on body
fluids metabolism.
• Kidney qi sends up the clear and lowers down the turbid
to generate urine.
•
Kidney qi governs the open and closure of
bladder
for urination.
Governing reception of qi
It means that kidney qi can grasp or hold clear qi
inhaled by the lung from nature to maintain the
depth and rhythm of respiration to avoid superficial
respiration, which is the manifestation of kidneys’
storing function in respiration.
There is a saying
that the lung is
the monarch of qi
and kidneys are
the root of qi
头面诸窍
全身皮毛
dispersing
water
lifting
lung
stomach
descendin
g
spleen
Other
viscera
Turbid
fluids
Clear part
kidneys
transformation
bladder
Turbid part
(2) Relationship of kidney to its constituent,
orifice, emotion, fluid and season
Corresponding to the bone, generating marrow and
manifesting on hair
Opening into ears and two lower orifices
Tear is kidney emotion
Thick saliva is kidney fluid

kidneys correspond to Winter

kidneys are interiorly-exteriorly related to
bladder
Six fu organs
•
•
•
•
•
•
Gallbladder
Small intestine
Somach
Large intestine
Bladder
Triple energizer
Function: accepting
and transporting food
Physiological
features: to lower
down and to dredge
Gallbladder
•
•
•
•
Clear essence house（中精之府）
Pure house（洁净之府）
Middle clean house（中清之府）
Gallbladder is the judging organ to
make decision.(中正之官，决断出焉)
Physiological functions
• Storing and discharging bile
Liver essence
or liver blood
Transforms
into
bile
gallbladder
Excessive
liver qi
promoting
digestion and
absorption of
food
• Governing making decision
In the course of conscious mind, decision-making
is attributed to the gallbladder.
Why the gallbladder is classified as a fu organ and an
extraordinary fu organ?
It is an organ with hollow cavity, interiorly-exteriorly
related to liver, corresponds to wood of five elements.
It stores bile, similar to five zang organs storing
essential qi
It doesn’t contact with food but discharges bile into
the intestine to promote digestion and absorption, so it
pertains to extraordinary fu organs.
Stomach
• Sea of food and water（水谷之海）
• Big barn（太仓）
• Spleen and stomach are acquired root
（脾胃为水谷之海）
• Stomach prefers moisture and dislikes
dryness.(胃喜润而恶燥)
Lower
stomach
pyloru
s
cardia
Middle
stomach
Upper
stomac
h
Physiological functions
Accepting and fermenting food
Accepting means that the stomach can
accept and contain food.
Fermenting means that stomach can
transform food into chyme.
Accepting and
fermenting function
Qi of the whole body
or healthy qi
Characteristic of
pulse
Stomach
qi
Food
essence
Qi movement of
the stomach
Functions of spleen
and stomach
Physiological functions
Governing descending
stomach qi tends to descend, and can
transport chyme down to the small intestine and
large intestine.
Stomach qi takes
descending as its
harmonious state.
Stomach qi descends
Spleen qi ascends
Promoting food
digestion and
absorption
Relationship between heart and lung
heart promotes lung’s respiration
heart
Pectoral qi
lung
lung benefits to heart’s promoting blood circulation
Relationship between heart and spleen
Transportation and
transformation of
spleen qi
Ensuring generation
and distribution
Ensuring blood
generation
Reddening effect
of heart vessels
Promoting food essence
Transforming
Into blood
Relationship between heart and spleen
Promoting function
of heart qi
Smooth and moderate
circulation
Ensuring normal
blood circulation
Consolidating of
spleen qi
Blood circulating inside
Vessels to avoid bleeding
Relationship between heart and liver
heart
blood
spirit
generates
governs
promotes
liver
regulates
blood
stores
houses
Spiritual
soul
Relationship between heart and kidneys
Kidneys
should
ascend
Kidney water
Heart fire
Heart is located
in the upper
energizer
and should
descend
Inter-complementation between essence and spirit
generates
governs
blood
heart
regulates
化养
generates
行摄
Qi
drives
generates
consolidates
kidney
stores
essence
generates
consolidates
spirit