{"id":7799,"date":"2012-05-12T10:30:53","date_gmt":"2012-05-12T14:30:53","guid":{"rendered":"http:\/\/yang-sheng.com\/?p=7799"},"modified":"2012-05-11T23:19:38","modified_gmt":"2012-05-12T03:19:38","slug":"scientific-qi-exploration-the-fu-yang-organs","status":"publish","type":"post","link":"https:\/\/yang-sheng.com\/?p=7799","title":{"rendered":"Scientific Qi Exploration — The Fu (Yang) Organs"},"content":{"rendered":"

 <\/p>\n

1. Introduction<\/span><\/span><\/strong><\/p>\n

\"\"<\/a><\/span><\/span><\/strong><\/p>\n

The six Yang Organs are the Gall Bladder, Stomach, Small Intestine, Large Intestine, Bladder and Triple Heater or Burner will be studied (1,2,3). The Triple Heater does not have a physical structure and is considered a functional unit. The Yang Organs are mainly responsible for digesting food and transmitting nutrients to the body. Usually, Yang Organs are hollow but do not store anything, in contrast to the Zang (Yin Organs) which store vital substances (Qi, Essence, Blood, Body Fluids and Spirit). The Yang Organs function to receive, move, transform and excrete substances. Functions of western organs with the same names are summarized after the study of each Chinese Organ (4).<\/span><\/h4>\n

After describing the functions of the Yang Organs, their relationships with each other will be studied.<\/h4>\n

2.<\/span> <\/strong> Stomach (Wei)<\/span><\/span><\/strong><\/p>\n

(a)<\/span> R<\/span><\/span> <\/span><\/span>ots and Ripens Food<\/span><\/span><\/strong>. <\/span><\/span><\/p>\n

<\/span>In chapter 31 of the Classics of Difficulties it is stated that the Stomach controls the rotting and ripening of food and drink.<\/span> <\/span>This describes the Stomach\u2019s role in digestion of the ingested food and drink as the activity of rotting and ripening.<\/span> <\/span>This step prepares the food and drink for transformation and separation by the Spleen into a \u201cclean\u201d or \u201cclear\u201d part and a \u201cdirty\u201d or \u201cturbid\u201d part.<\/span> <\/span> <\/span>The clean <\/span><\/span>part consisting of Gu Qi and Food Essence is transported to various parts of the body by the Spleen aided by the Stomach.<\/span> <\/span>Recall that the Gu Qi is sent upwards to the Lungs by the Spleen, where it combines with the air to form Gathering Qi, and to the Heart, where Blood is formed ( ).<\/span> <\/span>The dirty part is passed down to the Small Intestine for additional separation and absorption.<\/span><\/span><\/p>\n

<\/span>The Stomach is sometimes called the \u201cRoot of Post-Heaven Qi\u201d because it is the origin of Qi in the body through its action in transforming food with the aid of the Spleen.<\/span> <\/span>Chapter 19 in the Simple Questions states that the 5 Yin Organs derive Qi from the Stomach; hence it is the root of the 5 Yin Organs.<\/span> <\/span>During the development of Chinese medicine, ancient physicians believed that gravely ill patients still had a good chance of recovery if their Stomach Qi was strong.<\/span><\/span><\/p>\n

(b) <\/span>Transportation of<\/span> <\/span>Food Essences<\/span><\/span><\/strong> <\/span><\/span><\/p>\n

The Stomach in conjunction with the Spleen transports Food Essences to the whole body. If the Stomach has sufficient Qi to extract and transport Food Essences throughout the body, one will be strong and energetic; otherwise one will be tired and weak. <\/span><\/span><\/p>\n

<\/span>(c) <\/span>Related to the Tongue Coating<\/span><\/span><\/strong><\/h4>\n

<\/span>A by-product of the digestive action of the Stomach\u2019s rotting and ripening is called \u201cDirty Dampness\u201d. <\/span>A consequence of (b) is that the Dirty Dampness is transported upward to form the tongue\u2019s coating.<\/span> <\/span>From clinical experience, a thin white coating signifies a properly functioning Stomach.<\/span> <\/span>No coating means that the Stomach\u2019s digestion is impaired and its Qi badly weakened.<\/span><\/span><\/p>\n

<\/span>(d) <\/span>Reflected in the Pulse<\/span><\/span><\/strong><\/p>\n

<\/span>Another consequence of (b) is that the Qi of the organs reaches the Pulse.<\/span> <\/span>Chapter 19 of Simple Questions states that the Qi of the Organs depends on the Stomach Qi to reach the Lung Meridian.<\/span> <\/span>The Lung Meridian runs through the region of the radial pulse. <\/span><\/span><\/p>\n

<\/span>Good Stomach Qi produces a Pulse has a regular and slow beat. <\/span>Yin and Yang are balanced so that the Pulse is neither strong nor weak and feels soft and gentle.<\/span> <\/span>A Pulse that feels too rough or hard indicates a lack of Stomach Qi.<\/span><\/span><\/p>\n

<\/span>(e) <\/span>Descends Qi<\/span><\/span><\/strong><\/p>\n

<\/span>Stomach Qi moves normally moves downward because it must send transformed food downwards to the Small Intestine. <\/span>Liver Qi helps digestion by aiding the descent of Stomach Qi.<\/span><\/span><\/p>\n

<\/span>A disturbance in the Descending Function will allow Turbid Qi to ascend which produces symptoms such as a foul smell in the mouth, epigastric distention or pain, and constipation.<\/span> <\/span>Furthermore, Stomach Qi can perversely attack upwards, leading to symptoms such as hiccups, nausea, belching, acid regurgitation and vomiting.<\/span> <\/span>If Liver Qi stagnates in the Middle Burner, it can prevent the descent of Stomach Qi producing the previously mentioned symptoms.<\/span><\/span><\/p>\n

<\/span>(f) <\/span>Origin of Fluids<\/span><\/span><\/strong><\/p>\n

<\/span>The Stomach is an important source of Fluids in the body. <\/span>The Stomach uses the part of ingested food and drink that is not transformed into Food Essence to form Fluids.<\/span> <\/span>Moreover, sufficient fluids are required by the Stomach to rot and ripen food.<\/span> <\/span>This is for the saying that the Stomach \u201clikes wetness and dislikes dryness\u201d.<\/span><\/span><\/p>\n

<\/span>A deficiency of Stomach Fluids will cause thirstiness, a dry and cracked tongue and poor digestion.<\/span> <\/span>A common cause of this deficiency is eating large meals late at night.<\/span><\/span> <\/span><\/p>\n

(g) <\/span>Mental Character<\/span><\/span><\/strong><\/p>\n

<\/span>The Stomach is affected easily by Excess Patterns like Fire or Phlegm Fire. <\/span>A mild attack of these pathogenic factors may cause hyperactivity, hypomania, mental confusion or anxiety.<\/span> <\/span>In more serious cases the symptoms of manic behavior can appear: uncontrollable talking, laughing or singing, violent behavior, removing clothing, wanting to be alone, closing all doors, windows and shutting oneself in the house. <\/span><\/span><\/p>\n

(h) <\/span>Dreams<\/span><\/span><\/strong><\/p>\n

<\/span>Chapter 43 of the Spiritual Axis states that when the Stomach is deficient one dreams of having large meals.<\/span><\/span> <\/span><\/p>\n

Western Medical Functions<\/span><\/strong><\/h4>\n

<\/span>Masticated food (bolus) passes to the stomach through the esophagus via the cardiac sphincter, a valve-like ring of muscle.<\/span> <\/span>This sphincter relaxes as the bolus passes through and then quickly closes to prevent food from passing back to the esophagus. Heart burn is the sensation caused by gastric, stomach juices seeping bask through the sphincter into the esophagus.<\/span> <\/span>The other end of the stomach empties into the duodenum, the first section of the small intestine. The pyloric sphincter separates the stomach from the duodenum.<\/span> <\/span>The stomach can expand to accommodate about a liter of food.<\/span><\/span><\/p>\n

<\/span>The stomach stores large quantities of food and prepares the food for further digestion.<\/span> <\/span>It mixes the food with gastric secretions to form chyme (a semifluid mixture) and slowly empties the chyme into the small intestine at a rate suitable for proper digestion and absorption by the small intestine. <\/span><\/span><\/p>\n

<\/span>The stomach plays a major role in protein digestion. Gastric glands release proteases (protein-digesting enzymes, such as pepsin).<\/span> <\/span>Hydrochloric acid is secreted by parietal cells in the stomach lining.<\/span> <\/span>The hydrochloric acid kills or inhibits bacteria, helps convert some precursors to proteases and provides the acidic pH of two, for the proteases to work.<\/span> <\/span>The protease digest large proteins into smaller proteins called peptides. To protect the stomach lining from the acid, a third type of cell secretes mucus that lines the stomach cavity. An overabundance of acid due to mucus failure may lead to an ulcer. <\/span><\/span><\/p>\n

<\/span>The rate of emptying of the stomach contents into the small intestine depends on the type of food.<\/span> <\/span>Fats inhibiting emptying the most, sometimes delaying the emptying of a fatty meal for 3 to 6 hours, proteins have an intermediate affect, and carbohydrates only a mild delay.<\/span> <\/span>Some foods, like alcohol, are directly absorbed from the stomach by the body.<\/span> <\/span><\/span> <\/span><\/p>\n

4. <\/span>Small Intestine (Xiao Chang)<\/span><\/span><\/strong> <\/span><\/p>\n

(a) <\/span>Receives and Transforms<\/span><\/span><\/strong><\/p>\n

<\/span>The Small Intestine receives the digested food (turbid part) from the Stomach.<\/span> <\/span>It carries out its transforming function and separates a clear (i.e. reusable) part from a turbid part.<\/span> <\/span>The clear part is then transported by the Spleen to all parts of the body.<\/span> <\/span>The dirty part is transmitted to the Large Intestine and Bladder for excretion. <\/span><\/span> <\/span><\/p>\n

(b) Separates Fluids<\/span><\/span><\/strong><\/p>\n

<\/span>It separates Fluids as described in (a).<\/span> <\/span>The clear part goes to the Large Intestine for re-absorption and the turbid part to the Bladder for excretion as urine.<\/span> <\/span>Hence the Small Intestine has a functional relation to these two organs.<\/span> <\/span>In fact, if this separation function is impaired there may be scanty or excessive urination if the Small Intestine is Hot or Cold, respectively.<\/span> <\/span>Watery stools can also occur for which there exists a treatment called \u201cpromotion of the function of the Small Intestine in separating clear from turbid to benefit feces\u201d.<\/span><\/span><\/p>\n

<\/span>The separation of Fluids by the Small Intestine is dependent on Kidney Yang, which provides the necessary Heat for the separation.<\/span> <\/span><\/span> <\/span><\/p>\n

(c) Mental Aspect<\/span><\/span><\/strong><\/p>\n

<\/span>The Small Intestine has an influence on judgment and mental clarity.<\/span> <\/span>It also has an influence on decisions, different than the Gall Bladder, which gives the capacity and courage to make decisions.<\/span> <\/span>The Small Intestine provides the power to distinguish relevant issues with clarity before making a decision. <\/span><\/span> <\/span><\/p>\n

(d) Dreams<\/span><\/span><\/strong><\/p>\n

<\/span>Chapter 17 of Simple Questions states that if one has small intestinal parasites one will dream of crowds and if long one will dream of fights and mutual destruction.<\/span><\/span><\/p>\n

<\/span>Chapter 43 of the Spiritual Axis states that if the Small Intestine is deficient, one dreams of large cities.<\/span><\/span> <\/span><\/p>\n

Western Medical Functions<\/span><\/strong><\/h4>\n

C<\/span>hyme passes from the stomach into the small intestine through the pyloric sphincter. An adult’s small intestine is about 23 feet long and is divided into three sections: the first 10 to 12 inches is called the duodenum; the next 10 feet forms the jejunum; and the final 12 feet forms the ileum. The inner surface of the small intestine contains numerous finger-like projections called villi. Each villus has projections of cells called microvilli to increase the surface area. <\/span><\/span><\/p>\n

<\/span>Most chemical digestion takes place in the duodenum.<\/span> <\/span>Here, enzymes digest nutrients into simpler, absorbable forms.<\/span> <\/span>Other enzymes, from the pancreas, are secreted into the small intestine to aid digestion. <\/span> <\/span>Bile, from the gall bladder, also enters the small intestine to aid fat digestion.<\/span><\/span><\/p>\n

<\/span>The enzymes functioning in carbohydrate digestion include amylase (for starch), maltase (for maltose), sucrase (for sucrose) and lactase (for lactose). <\/span> <\/span>The principal enzyme for fats, is lipase. Before this enzyme can act, the large globules of fat must be broken into smaller droplets by bile. Bile is a mixture of salts, pigments, and cholesterol that is produced by the liver and stored in the gall bladder. <\/span><\/span><\/p>\n

<\/span>Protein digestion is accomplished by several enzymes, including two pancreatic enzymes: trypsin and chymotrypsin. Peptides are broken into smaller peptides, and peptidases reduce the enzymes to amino acids. Nucleases digest nucleic acids into nucleotides in the small intestine.<\/span><\/span><\/p>\n

<\/span>Most absorption in the jejunum. The products of digestion enter cells of the villi, move across the cells, and enter blood vessels called capillaries. Diffusion accounts for the movement of many nutrients, but active transport is responsible for the movement of glucose and amino acids. The products of fat digestion pass as small droplets of fat into lacteals, which are branches of the lymphatic system. <\/span><\/span><\/p>\n

<\/span>Absorption is completed in the final part of the ileum.<\/span> <\/span>Substances that have not been digested or absorbed then pass into the large intestine through the ileocecal valve.<\/span> <\/span>An important function of this valve is to prevent the backflow of fecal contents from the colon into the small intestine.<\/span><\/span><\/p>\n

<\/span>Small regular and irregular ring-like contractions occur throughout the small intestine.<\/span> <\/span>These contractions called segmentations give the intestines the appearance of a string of sausages.<\/span> <\/span>The segmentations divide the chyme in order to mix the solid suspensions of food with the secretions of the small intestines many times a minute.<\/span> <\/span>The chyme is also rotated counter-clockwise as it moves along the intestines.<\/span> <\/span>These mixing movements not only mix the chime with secretions of the small intestines, but also expose all parts of the chyme to the mucosa so that adequate absorption occurs.<\/span><\/span><\/p>\n

<\/span>Chyme is move slowly along the intestine by peristaltic waves to spread it out along the mucosa after it is emptied from the stomach.<\/span> <\/span>Normally, the chyme passes from the pylorus to the ileocecal valve in about 3 to 10 hours.<\/span> <\/span>Upon reaching the ileocecal valve, the chyme is blocked, sometimes for several hours, until another meal is eaten.<\/span> <\/span>Then, a gastroenteric (gastroileal) reflex occurs, which intensifies the peristalsis in the ileum and so forces the remaining chyme through the ileocecal valve into the cecum.<\/span> <\/span><\/span><\/p>\n

<\/span>5. Large Intestine (Da Chang) <\/span><\/span><\/strong><\/p>\n

<\/span> <\/span>The Large Intestine is dealt with very briefly in Chinese Medicine because many of its treatments and attributed functions in Western Medicine are relegated to the Spleen in Chinese medical theory.<\/span> <\/span>The Spleen controls the transformation and transportation of foods and drink throughout the body, including the Small and Large Intestines.<\/span> <\/span>Hence, problems such as abdominal distention and pain or<\/span> <\/span>diarrhea are usually Spleen disharmonies.<\/span><\/span> <\/span><\/p>\n

(a) Receives, Absorbs and Excretes<\/span><\/span><\/strong><\/p>\n

<\/span>The Large Intestine receives the turbid part of food and clear part of Fluids from the Small Intestine, reabsorbs some of the Fluids and forms the remainder into feces, to be excreted.<\/span><\/span><\/p>\n

<\/span>The function of the Large Intestine in transportation is related to the Lungs descending function and also to Kidney Qi, since the Kidney controls the anterior and posterior orifices.<\/span><\/span><\/p>\n

<\/span>If insufficient Lung Qi is supplied to the Large Intestine for defecation, them constipation will occur.<\/span> <\/span>This is common in seniors with declining Lung Qi.<\/span> <\/span>Conversely, the descending power of the Lung depends on proper excretion of waste by the colon.<\/span> <\/span>If there is constipation, the stagnation of food in the Large Intestine may impair the lung\u2019s descending function, leading to breathlessness.<\/span><\/span> <\/span><\/p>\n

(b) Dreams<\/span><\/span><\/strong><\/p>\n

<\/span>Chapter 43 in the Spiritual Axis states that if the large Intestine is deficient, one dreams of open fields. <\/span><\/span> <\/span><\/p>\n

Western Medical Functions <\/span><\/span><\/strong><\/h4>\n

<\/span>The small intestine joins the large intestine in the lower right abdomen of the body. The two organs meet at a blind sac called the cecum, which marks the beginning of the colon, and a small fingerlike process called the appendix. Biologists theorize that the cecum and appendix are vestiges of larger organs that may have been functional in our ancestors. <\/span><\/span><\/p>\n

\"\"<\/a>

Figure 1. The Large Intestine <\/p><\/div>\n

<\/span><\/span><\/p>\n

<\/span>The large intestine is composed of three parts: the cecum, the colon, and the rectum (Fig. 1). The cecum is a pouch-shaped member that connects the colon to the ileum.<\/span> <\/span>The colon has four divisions. The first three are each about a foot long and are: the ascending colon (which is continuous with the cecum), the transverse colon and the descending colon. The descending colon terminates in the sigmoid colon, which forms a loop of about 40 centimeters.<\/span> <\/span>The rectum is the final straight portion of the large intestine that terminates in the anus.<\/span><\/span><\/p>\n

<\/span>The colon\u2019s chief functions are to absorb water and electrolytes and to store and eliminate the residue.<\/span> <\/span>The large intestine teems with microbes which produce enzymes capable of digesting many of molecules that are indigestible.<\/span> <\/span>Feces are the matter remaining after water has been reabsorbed.<\/span> <\/span>Feces consist of undigested food (such as cellulose), billions of mostly harmless bacteria, bile pigments, and other materials. The feces are stored in the rectum and passed out through the anus.<\/span><\/span><\/p>\n

<\/span>Contractions of the circular and longitudinal smooth muscles of the colon cause the non \u2013stimulated part of the colon to bulge outward into sacs, known as haustrations<\/span>.<\/span> <\/span>In a few minutes, new haustral contractions occur in adjacent areas, but not in the same areas.<\/span> <\/span>They move slowly toward the anus.<\/span> <\/span>This process gradually exposes the fecal material to the surface of the colon allowing large amounts of fluid to be absorbed.<\/span> <\/span>In a daily load of 450 ml. of chime only 80 ml. is lost in the feces.<\/span> <\/span>These contractions also serve as very weak propulsive forces and help move the contents of the cecum and ascending colon into the transverse colon. <\/span><\/span><\/p>\n

<\/span>Another type of movement, known as mass movement, propels the feces toward the anus.<\/span> <\/span>Normally, these movements only occur a few times a day, frequently around the first hour after breakfast, but can occur after meals.<\/span> <\/span>They result mainly from the filling of the duodenum, which causes a reflex, the duodenocolic reflex, which increases the excitability of the whole colon.<\/span> <\/span>However, they occur most often in the transverse or descending colon.<\/span> <\/span>Mass movements also occur to a lesser extent from a gastrocolic reflex, which <\/span>increases the motility of the colon in response to a stretch in the stomach and the byproducts of digestion in the small intestine.<\/span><\/span><\/p>\n

<\/span>The internal anal sphincter, composed of circular smooth muscle, that lies inside the anus and the external anal sphincter, composed of striated voluntary muscle,<\/span> <\/span>prevent the feces from dribbling out.<\/span> <\/span>Defecation occurs from the defecation reflex.<\/span> <\/span>This reflex is initiated by feces sufficiently distending the rectal wall to send signals to the spinal cord and reflexively back to the descending colon, sigmoid and anus via parasympathetic nerve fibers.<\/span> <\/span>These signals intensify the peristalsis in the descending colon and sigmoid, forcing the feces toward the anus.<\/span> <\/span>The internal anal sphincter is also relaxed and defecation occurs.<\/span> <\/span><\/span><\/p>\n

<\/span>However, defecation can normally be prevented, until suitable, by voluntary contraction of the external anal sphincter.<\/span> <\/span>Doing this stops the defecation reflex in a few minutes and it normally will not return until hours later.<\/span> <\/span>Newborns or people with a transected spinal cord, the defecation reflex causes automatic bowel movements.<\/span> <\/span>People who frequently inhibit their defecation reflex often become constipated.<\/span><\/span> <\/span><\/p>\n

6. <\/span>Gallbladder (Dan)<\/span><\/span><\/strong> <\/span><\/p>\n

The Gallbladder is unlike the other 5 Yang Organs because it does not deal with food, drink or waste products. <\/span>It stores Bile, a refined product, like the Yin Organs.<\/span> <\/span>For these reasons it is also classified as an Extraordinary Organ (Uterus, Brain, Marrow, Bones, Blood Vessels and Gallbladder).<\/span><\/span> <\/span><\/p>\n

(a) <\/span>Stores<\/span> and Excretes Bile<\/span><\/span><\/strong><\/p>\n

<\/span>The Gallbladder receives Bile from the Liver and stores it, until required to help the Spleen and Stomach during digestion.<\/span> <\/span>The Liver provides the necessary Qi for secretion of Bile by the Gallbladder as part of its function of ensuring smooth Qi flow.<\/span> <\/span>Normally, the Qi of the Gallbladder descends.<\/span><\/span><\/p>\n

<\/span>Upward perversion of Gallbladder Qi may result in a bitter taste in the mouth and vomiting of bitter fluid, since Bile tastes bitter. In addition, the Stomach and Spleen will not be aided in digestion causing symptoms such as abdominal distention and loose stools.<\/span> <\/span><\/span><\/p>\n

<\/span>If Liver Qi is stagnant so that Bile is not secreted smoothly, the functions of the Stomach and Spleen may be impaired.<\/span> <\/span>If the Stomach Qi cannot descend symptoms like belching and nausea will occur.<\/span><\/span> <\/span><\/p>\n

(b) Decisiveness and Courage<\/span><\/span><\/strong><\/p>\n

<\/span>The Liver has control over planning life, while the Gallbladder controls the ability to make decisions.<\/span> <\/span>These two functions must work together so that one can plan and act according to the chosen plan.<\/span><\/span><\/p>\n

<\/span>The relation of the Liver to emotional changes is also shared by the Gallbladder.<\/span> <\/span>This is taken into account when treating symptoms such as fear, palpitations, dream-disturbed sleep and insomnia. <\/span> <\/span><\/span><\/p>\n

<\/span>The Gallbladder also gives one the courage and drive to take decisions and turn them into positive, decisive actions.<\/span> <\/span>It provides courage for the Mind, governed by the Heart, to carry out decisions.<\/span> <\/span><\/span><\/p>\n

<\/span>A person with a deficient Gallbladder will be easily discouraged by the slightest difficulty and be timid and indecisive.<\/span> <\/span>People suffering from a weak Mind due to a Heart deficiency are often treated by tonifying the Gallbladder to support the Heart. <\/span><\/span> <\/span><\/p>\n

(c) Sinews<\/span><\/span><\/strong><\/p>\n

The Gallbladder provides Qi to the sinews for proper movement and agility. <\/span>Recall that the Liver was also said to control the Sinews but does so by nourishing them with Blood.<\/span> <\/span>The fact that the Gallbladder controls the Sinews explains why the Influential Point of the Sinews, Gallbladder 34 (Yanglingquan) lies on the Gallbladder Meridian.<\/span><\/span> <\/span><\/p>\n

(d) Sleep and Dreams<\/span><\/span><\/strong><\/p>\n

<\/span>The Gallbladder influences the length and quality of sleep.<\/span> <\/span>A person with a Gallbladder deficiency will awaken early in the morning and be unable to fall asleep again.<\/span><\/span><\/p>\n

<\/span>Chapter 43 in the Spiritual Axis states that if the Gallbladder is deficient one dreams of fights, trials and suicide.<\/span><\/span><\/p>\n

<\/span>Western Medical Functions<\/span><\/strong><\/h4>\n

<\/span><\/strong><\/h4>\n

<\/span>The gallbladder is a slate-blue, pear-shaped, hollow structure located under surface of the right lobe of the liver. It is about 7\u201310 cm long with a maximum width of 3 cm. and a 30\u201350 ml capacity.<\/span> <\/span>Its function <\/span>is to store, concentrate and release bile, a yellow-brown digestive liquid produced by the liver, which aids fat digestion. <\/span>The gallbladder’s epithelial lining concentrates the stored bile, which increases its potency and intensifies its effect on fats.<\/span> <\/span>A 10-fold concentration effect is achieved by the transport of water from the bile to the bloodstream within the wall of the gallbladder.<\/span><\/span><\/p>\n

\"\"<\/a><\/span><\/strong><\/h4>\n

<\/span>Bile ducts from the lobules of the liver merge into the right and left hepatic ducts to form a single common hepatic duct. The common hepatic duct merges with the cystic duct from the gallbladder to form the common bile duct, which in turn merges with the pancreatic duct to form the hepatopancreatic ampulla. This last duct delivers the bile to the duodenum (Fig. 2). <\/span><\/span><\/p>\n

<\/span>When food containing fat enters the small intestine, it stimulates the secretion of the hormone cholecystokinin (CCK). <\/span>CCK signals the gallbladder to contract and release its stored bile into the duodenum to emulsify fats. <\/span>Emulsification is the breaking up of fat globules into smaller fat droplets.<\/span> <\/span>This increases the surface area upon which fat-digesting enzymes (lipases) from the pancreas can operate in breaking chemical bonds of the fat molecules to allow absorption through the intestinal walls. Bile is also alkaline and helps neutralize the hydrochloric acid in the chyme.<\/span> <\/span>After the duodenum is empty, the hepatopancreatic sphincter closes the hepatopancreatic ampulla and bile backs up and fills the gallbladder.<\/span> <\/span>B<\/span>ile acids are reabsorbed from the intestine to minimize their loss in feces. Reabsorbed bile acids are transported by the bloodstream back into the liver, where they are available for further recycling into the bile.<\/span><\/span><\/p>\n

Bile consists of bile pigments and salts, cholesterol, phospholipids (including lecithin), , and various ions. Bilirubin, the main bile pigment, is an end product of the degradation of hemoglobin from the breakdown of red blood cells. The body’s natural way of getting rid of bilirubin is via the bile lost in the feces.<\/span> The brown color of feces is due to their bilirubin content.<\/span><\/span><\/p>\n

The most common gallbladder disease is the formation of gallstones affecting at <\/span>least 15% of the adult population. <\/span>Excessive breakdown of red blood cells results in increased production of bilirubin and so an increased risk of the formation of pigment gallstones. Metabolic defects which produce the super-saturation of bile with insoluble cholesterol, promotes the formation of cholesterol gallstones.<\/span> <\/span>The third class of gallstones is the mixed type.<\/span><\/span><\/p>\n

<\/span>Many people with gallstones never have any symptoms and it is not dangerous. Symptoms that may occur include: fever,<\/span> pain in the right upper or middle upper abdomen, which may go away and come back, may be sharp, cramping, or dull and also referred to the back or below the right shoulder blade. The pain usually occurs within minutes of a meal.<\/span> A large stone blocking either the cystic duct or common bile duct is called choledocholithiasis.<\/span> The cramping pain produced in the middle to right upper abdomen is known as biliary colic and will go away if the stone passes into the duodenum.<\/span> <\/span><\/span><\/p>\n

Obstruction of the bile ducts, especially the <\/span>hepatopancreatic ampulla,<\/span> can lead to serious conditions such as, pancreatitis or ascending cholangitis. <\/span>Either of these two conditions can be life-threatening medical emergencies.<\/span> <\/span>If the gallbladder has to be removed to treat gallstones, then dilute bile drains directly into the intestine from the liver.<\/span> <\/span>In most people digestion of fatty food is still adequate.<\/span><\/span><\/p>\n

<\/span>Gall bladder inflammation in the absence of gallstones is called acalculous cholecystitis.<\/span> <\/span>It may result from typhoid fever. In a few cases, the responsible bacterium, Salmonella typhi, persists in the gallbladder after the acute illness has resolved, and is excreted in the feces.<\/span> <\/span>About 2\u20135% of individuals still excrete bacteria after a year and some, mainly females, do so indefinitely. These carriers may spread the infection orally to others if they don\u2019t wash their hands thoroughly.<\/span> <\/span>In the early 1900\u2019s, Typhoid Mary, who was identified as the first asymptomatic carrier of typhoid fever in the USA, infected <\/span>53 people, three of whom died, over the course of her career as a cook. <\/span><\/span> <\/span><\/p>\n

7. Bladder (Pang Guang)<\/span><\/span><\/strong><\/p>\n

<\/span>(a) Removes Water By Qi Transformation<\/span><\/span><\/strong><\/p>\n

<\/span>The Small Intestine separates the turbid part of fluids and sends it down to the Bladder.<\/span> <\/span>The Bladder transforms it into urine.<\/span> <\/span>The Bladder\u2019s function of transforming fluids requires Qi and Heat, provided by Kidney Yang and so is related to the Gate of Vitality.<\/span> <\/span>It will be seen in Section 8, that the Lower Burner ensures that the water passages in the lower body are free and open and so assists the Bladder\u2019s fluid transformation.<\/span> <\/span>Urine is stored in the Bladder and is discharged when a sufficient quantity has accumulated.<\/span><\/span><\/p>\n

<\/span>A rationale for using some Small Intestine acupoints, such as Qiangu (Small Intestine 2), for urinary diseases follows from the fact that the Small Intestine and Bladder work together to move fluids.<\/span> <\/span>In the next article, discussing the relations between the Zang and Fu Organs, it will be seen that the Small Intestine is related to the Heart ( ).<\/span> <\/span>Thus, some Heart problems can affect the Bladder via the Small Intestine. <\/span><\/span><\/p>\n

<\/span>Bladder diseases can have symptoms such as anuria, enuresis and difficult or painful urination.<\/span> <\/span>Symptoms of deficiency of the Gate of Vitality such as abundant, clear urination can also appear as Bladder deficiency symptoms. <\/span><\/span><\/p>\n

(b) Drea <\/span>ms<\/span><\/span><\/strong><\/p>\n

<\/span>Chapter 43 in the Spiritual Axis states that if the Bladder is deficient one dreams of voyages. <\/span><\/span> <\/span><\/p>\n

Western Medical Functions<\/span><\/strong><\/h4>\n

<\/span>The urinary bladder is a muscular, membranous sac in the pelvis, just above and behind the pubic bone. <\/span> <\/span>The bladder is about the size and shape of a pear when it is empty.<\/span> <\/span>Urine is made in the kidneys, and enters the bladder via two tubes called ureters and is discharged via the urethra.<\/span> <\/span>The bladder stores urine, allowing urination to be voluntary and not too frequent. The bladder is lined by layers of muscular tissue that stretch to accommodate urine.<\/span><\/span><\/h4>\n

<\/span>The bladder wall has a layer of smooth muscle fibers, the detrusors, arranged in spiral, circular and longitudinal bundles. During the storage of urine, the internal urethral sphincter remains tense and the detrusor muscle relaxed by sympathetic stimulation.<\/span> <\/span>Stretching of the bladder signals the parasympathetic nervous system and produces the urge to urinate.<\/span> <\/span>During micturition, parasympathetic stimulation causes the detrusor muscle to contract and the internal urethral sphincter to relax. The external urethral sphincter (sphincter urethrae) is under somatic control and is consciously relaxed during micturition.<\/span> <\/span>The involuntary controlled internal sphincter may be open but the voluntary controlled external sphincter can usually be held closed to postpone urination, if the bladder is not completely filled.<\/span> <\/span>Urination may occur as an involuntary reflex in infants (under 2 to 3 years), the elderly and those with neurological injury,<\/span><\/span><\/p>\n

<\/span>The desire to urinate usually starts when the bladder stretches to about 25% of its working volume, but it is easy to resist the urge to urinate.<\/span> <\/span>The urge to urinate becomes stronger as the bladder continues to fill. Eventually, the bladder will fill to the point where the desire to urinate becomes unbearable. When the volume of urine reaches 100% of the bladder’s capacity, loss control of the voluntary sphincter occurs, and the urine will be ejected instantly. <\/span><\/span> <\/span><\/p>\n

8. Triple Burner (San Jiao)<\/span><\/span><\/strong><\/p>\n

<\/span>The Triple Burner (Heater) has been a controversial topic throughout the history of Chinese medicine.<\/span> <\/span>The following 3 descriptions have been postulated.<\/span><\/span> <\/span><\/p>\n

I.\u00a0 Actual Yang Organ<\/span> <\/span><\/span><\/strong><\/p>\n

<\/span>In a discussion of the functions of the Organs in Simple Questions, it is stated in Chapter 8 that the Triple Burner is the official in charge of irrigation and controls the water passages.<\/span> <\/span>Thus, it seems that in Simple Questions the Triple Burner is considered as one of the Yang Organs and so has a \u201cform\u201d like all the others.<\/span> <\/span><\/span><\/p>\n

<\/span>The Triple Burner aids the production of Nutritive and Defensive Qi after the food is separated into a Clear and Turbid part, respectively, and also the excretion of Fluids.<\/span> <\/span>Its contribution is that it ensures that the various types of Qi are \u201clet out (chu<\/span>)\u201d in a smooth way as shown in Table 1. <\/span><\/span> <\/span><\/span><\/p>\n\n\n\n\n\n\n
Part<\/span><\/strong><\/td>\nFunction (Chu)<\/span><\/span><\/strong><\/td>\nMalfunction<\/span><\/span><\/strong><\/td>\nSymptoms<\/span><\/span><\/strong><\/td>\n<\/tr>\n
Upper<\/span><\/td>\nDirects Defensive Qi smoothly to Lung<\/span><\/span><\/td>\nBlockage of Defensive Qi leads to impairment of Lung dispersing function <\/span><\/span><\/td>\n <\/span>Sneezing<\/span><\/span><\/td>\n<\/tr>\n
Middle<\/span><\/td>\nDirects Nutritive Qi smoothly to all organs<\/span><\/span><\/td>\nBlockage of Nutritive Qi leads to impairment of Spleen transportation<\/span><\/span><\/td>\n <\/span>Abdominal distention<\/span><\/span><\/td>\n<\/tr>\n
Lower<\/span><\/td>\nDirects Body Fluids smoothly to Bladder<\/span><\/span><\/td>\nBlockage of Body Fluids leads to impairment of Bladder Qi transformation<\/span><\/span><\/td>\n <\/span>Retention of urine<\/span><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

<\/span><\/p>\n

<\/span>Table 1.<\/span> Parts, Function and Malfunction of the Triple Burner Organ<\/span><\/strong><\/span><\/p>\n

<\/span>II. Avenue for Original Qi<\/span><\/span><\/strong><\/p>\n

<\/span>The Classics of Difficulties, chapter 66, the Triple Burner has a name but no form and so is a collection of functions and not an actual Organ.<\/span> <\/span>It states that the Original Qi resides in the lower abdomen between the two Kidneys and spreads to the 6 Yin and 5 Yang Organs via the Triple Burner.<\/span> <\/span>Then, this Qi enters the 12 meridians and emerges at the Source (Yuan) acupoints.<\/span> <\/span>This explanation of the Triple Burner led to its description as the avenue for the Original Qi.<\/span><\/span><\/p>\n

<\/span>Chapter 31 in the Classics of Difficulties explains the purpose of this Qi conduction by stating that the Triple Burner is the avenue of food and drink, the beginning and end of Qi.<\/span> <\/span>It also states that the Upper, Middle and Lower Burners control: \u201creceiving but not excreting\u201d, \u201crotting and ripening\u201d and \u201cexcreting but not receiving\u201d, respectively.<\/span> <\/span>This interprets digestion as a process of Qi transformation, activated by the Original Qi via the aid of the Triple Burner.<\/span><\/span><\/p>\n

<\/span>The Triple Burner in Simple Questions is assumed to be an Organ which \u201clets out\u201d and in the Classics of Difficulties \u201cavenue of Original Qi\u201d.<\/span> <\/span>Even though the beginning assumptions are different, both lead to the same functions of the Triple Burner: aiding<\/span> <\/span>the process of Qi transformation in transportation, transformation, and excretion of food and fluids. <\/span><\/span> <\/span><\/p>\n

III. Three Divisions of the Body<\/span> <\/span><\/span><\/strong><\/p>\n

<\/span>This interpretation of the Triple Burner arises from the Spiritual Axis (chapter18) and the Classics of Difficulties (chapter 31).<\/span> <\/span>It is outlined in Table 2 along with a descriptive comparison or analogy to a familiar object, which depends on the function of the division.<\/span><\/span><\/p>\n

<\/span>Another interpretation of the Triple Burner as three divisions of the body in terms of the mutual assistance and the transformation into each other of the Gathering, Central and Original Qi, in the Upper, Middle and Lower Burner, respectively. <\/span><\/span> <\/span><\/p>\n\n\n\n\n\n\n
Division<\/span><\/strong><\/td>\nBoundary<\/span><\/strong><\/td>\nOrgans<\/span><\/strong><\/td>\nFunction<\/span><\/strong><\/td>\nComparison<\/span><\/strong><\/td>\n<\/tr>\n
Upper<\/span><\/span><\/td>\nAbove diaphragm<\/span><\/span><\/td>\nLungs, Heart, Pericardium, throat & head<\/span><\/span><\/td>\nLung disperses fluids all over the body as fine vapor<\/span><\/span><\/td>\nMist<\/span><\/span> <\/span><\/td>\n<\/tr>\n
Middle<\/span><\/span><\/td>\n <\/span>Between diaphragm & navel<\/span><\/span><\/td>\n <\/span>Stomach, Spleen & Gallbladder<\/span><\/span><\/td>\nDigests & transports food & drink.<\/span><\/span>Transports extracted nourishment all over the body.<\/span><\/span><\/td>\n <\/span>Maceration chamber or<\/span><\/span>Bubbling cauldron<\/span><\/span> <\/p>\n

<\/span><\/td>\n<\/tr>\n

Lower<\/span><\/span><\/td>\nBelow navel<\/span><\/span><\/td>\nLiver, Kidneys, intestines & Bladder<\/span><\/span><\/td>\nSeparates Food Essences into clear and turbid parts.<\/span> <\/span>Excretes dirty part. <\/span><\/span><\/td>\n <\/span>Drainage ditch<\/span><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

<\/span>Table 2 Divisions of the Triple Heater, boundaries, Organs, functions & comparison<\/span><\/span><\/strong><\/p>\n

9. Interrelation Among the Fu Organs<\/span><\/span><\/strong> <\/span><\/p>\n

<\/span>Food entering the Stomach is digested- that is, separated into clear and turbid parts.<\/span> <\/span>The clear parts nourish the whole body. <\/span> <\/span>The turbid parts are sent down to the Small Intestine for further digestion.<\/span> <\/span>It sends the turbid parts of food to the Large Intestine and the turbid parts of fluids to the Bladder.<\/span> <\/span>The clear parts of food are distributed to the whole body with the aid of the Spleen.<\/span> <\/span>The clear parts of fluid are sent to the Large Intestine for reabsorption.<\/span> <\/span>The fluid in the Bladder is excreted as urine by the action of Qi and the waste matter in the Large Intestine is discharged as feces by its transformation and transportation function.<\/span> <\/span>The Gallbladder aids digestion, absorption and excretion by excreting Bile.<\/span><\/span><\/p>\n

<\/span>The whole digestive process depends on the functions of: the Liver and Gallbladder in producing smooth and free movements for digestion, the Triple Burner in distributing Original Qi and circulating fluids; the six Fu Organs acting in unity to transport and transform foods and fluids.<\/span> <\/span>The Fu Organs alternate between emptiness and fullness to receive, digest, transmit and excrete.<\/span> <\/span>Since the Fu organs are emptying and filling, they work best when they are not blocked.<\/span> <\/span><\/span><\/p>\n

<\/span>Further evidence of the close interrelationship among the Fu Organs is revealed in transmission of pathological dysfunctions from one of these Organs to another.<\/span> <\/span>For example, Excessive Stomach Heat can consume body fluids which can lead to constipation.<\/span> <\/span>Conversely constipation caused by dryness in the Large Intestine can affect the Descending function of the Stomach and so will produce nausea or vomiting.<\/span> <\/span><\/span><\/p>\n

<\/span>References<\/span><\/span><\/strong><\/h4>\n

1.<\/span> <\/span><\/span>Johnson, J.A. <\/span>Chinese Medical Qigong Therapy.<\/span> <\/span>Int. Institute of Medical Qigong, Pacific Grove, CA, 2000.<\/span><\/span><\/p>\n

2.<\/span> <\/span><\/span>Maciocia, G. <\/span>The Foundations of Chinese Medicine.<\/span> <\/span>Churchill Livngstone, New York, 1989. <\/span><\/span><\/p>\n

3.<\/span> <\/span><\/span>Zu Bing andWang Hongcai, Eds. <\/span>Basic Theories of Traditional Chinese Medicine.<\/span> <\/span>Singing Dragon, Philadelphia, PA, 2010.<\/span> <\/span><\/span><\/p>\n

4.<\/span> <\/span><\/span> <\/span>Guyton, A.C. <\/span>Textbook of Medical Physiology, W.B. Saunders Co., Philadelphia, PA, 1971.<\/span><\/span><\/p>\n


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