TCM organs - why they do what they do

[Guest guest]

I got an interesting inquiry from one of my students. Here is her

question:

 

" I want to know WHY and HOW the spleen is associated with yellow and

the lips, so I can more deduce the symptoms...instead of memorizing

that a yellow face can mean spleen deficiency. I guess I want the

story behind each organ, and how they work. "

 

I haven't seen any books that attempt to explain this, since most of

this knowledge is based on observation, not deduction. If anybody

knows of a book that attempts to explain this sort of thing, please

let me know.

 

- Bill

[Guest guest]

On 10/1/07, bill_schoenbart <plantmed2 wrote:

>

> I got an interesting inquiry from one of my students. Here is her

> question:

>

> " I want to know WHY and HOW the spleen is associated with yellow and

> the lips, so I can more deduce the symptoms...instead of memorizing

> that a yellow face can mean spleen deficiency. I guess I want the

> story behind each organ, and how they work. "

>

 

 

 

 

 

 

 

 

 

Your student is asking about " mechanisms " . Sometimes, mechanisms default

back to " because the nei jing says so " basically. Bob Flaws calls these

" statements of fact " in TCM. Not sure if that's his unique saying or if

that's an academia-wide distinction, but it often goes back to nei jing, and

before that, observation of nature. Wood is green, because when it is supple

and well nourished by water, the leaves are green, etc. The " earth is

yellow " isn't quite as easy to explain, but as I understand it, the Yellow

River passes through the center of China and deposits into the adjacent soil

a yellow color. Don't quote me on that, but it may give you a clue as to one

possible explanation why " earth is yellow "

 

Dr. Yi Qiao and I have just completed a book on OM Diagnosis. It will

include many visual graphs that describe mechanisms as your student is

asking about. For instance, the cause of the yellow complexion is dampness

accumulates which limits Spleen's transportation function leading to a lack

of blood rising to the face, a slightly pale or yellow color ensues. Also:

damp heat obstructs and steams the bile to the surface (which is yang-type

jaundice).

 

The book is expected to be available in early 2008 and will be published by

Eastland Press. Its working title is " The Traditional

Diagnosis Study Guide " . I'm not sure it that's what it'll be called when it

is in print, though.

 

As a student (and practitioner) I've always found that spending a few

minutes understanding mechanisms to be superior to avoid hours and hours of

memorization.

 

-al.

 

--

, DAOM

Pain is inevitable, suffering is optional.

 

 

 

[Guest guest]

Hi Bill,

 

I'm not sure, but from my experience, what help me a lot with my

understanding are the books from Elisabeth Rochat and Claude Larre, you can

find the " list " in Amazon or in " google " . I can assure you that it helped my

understanding, not sure if it will not be necessary to memories all symptoms

by heart.

 

 

 

Aln

 

 

2007/10/1, bill_schoenbart <plantmed2:

>

> I got an interesting inquiry from one of my students. Here is her

> question:

>

> " I want to know WHY and HOW the spleen is associated with yellow and

> the lips, so I can more deduce the symptoms...instead of memorizing

> that a yellow face can mean spleen deficiency. I guess I want the

> story behind each organ, and how they work. "

>

> I haven't seen any books that attempt to explain this, since most of

> this knowledge is based on observation, not deduction. If anybody

> knows of a book that attempts to explain this sort of thing, please

> let me know.

>

> - Bill

>

>

>

 

 

 

[Guest guest]

Al,

 

Yeah, I did coin the term statements of fact.

 

Bob

 

 

, " Al Stone " <al wrote:

>

> On 10/1/07, bill_schoenbart <plantmed2 wrote:

> >

> > I got an interesting inquiry from one of my students. Here is her

> > question:

> >

> > " I want to know WHY and HOW the spleen is associated with yellow and

> > the lips, so I can more deduce the symptoms...instead of memorizing

> > that a yellow face can mean spleen deficiency. I guess I want the

> > story behind each organ, and how they work. "

> >

>

>

>

Your student is asking about " mechanisms " . Sometimes, mechanisms default

> back to " because the nei jing says so " basically. Bob Flaws calls these

> " statements of fact " in TCM. Not sure if that's his unique saying or if

> that's an academia-wide distinction, but it often goes back to nei

jing, and

> before that, observation of nature. Wood is green, because when it

is supple

> and well nourished by water, the leaves are green, etc. The " earth is

> yellow " isn't quite as easy to explain, but as I understand it, the

Yellow

> River passes through the center of China and deposits into the

adjacent soil

> a yellow color. Don't quote me on that, but it may give you a clue

as to one

> possible explanation why " earth is yellow "

>

> Dr. Yi Qiao and I have just completed a book on OM Diagnosis. It will

> include many visual graphs that describe mechanisms as your student is

> asking about. For instance, the cause of the yellow complexion is

dampness

> accumulates which limits Spleen's transportation function leading to

a lack

> of blood rising to the face, a slightly pale or yellow color ensues.

Also:

> damp heat obstructs and steams the bile to the surface (which is

yang-type

> jaundice).

>

> The book is expected to be available in early 2008 and will be

published by

> Eastland Press. Its working title is " The Traditional

> Diagnosis Study Guide " . I'm not sure it that's what it'll be called

when it

> is in print, though.

>

> As a student (and practitioner) I've always found that spending a few

> minutes understanding mechanisms to be superior to avoid hours and

hours of

> memorization.

>

> -al.

>

> --

> , DAOM

> Pain is inevitable, suffering is optional.

>

>

>

[Guest guest]

Wood: What is actually being spoken of when we refer

to wood is bamboo, which is green,

long, thin, sinewy and flexible when well nourished

and brown, stiff, and hard when dried out.

 

Earth: Indeed, it is the earth of China that we must

think about. In the area where the Han Chinese

originated, the earth is something called Loess. This

is a very silty, wet earth that is yellow. If there

is too

much water/damp it falls from the banks and clogs up

the rivers (channels), causing them to be unable

to contain the fluids and resulting in flooding.

However, it is also the earth that is best for growing

rice, which

is the staple food of the Chinese diet and which, as a

character, is contained in words such as

" qi " , " jing " etc. It is the yellow earth that

produces the food that produces the qi, but which,

when there

is disharmony can cause great damage to the

surrounding areas.

 

Marnae

[Guest guest]

Al,

Sounds great - let us know when it comes out. The rational behind the

axims are missing from a lot of texts, but the rationale makes it all

come to life.

 

Geoff

 

, " Al Stone " <al wrote:

>

> Dr. Yi Qiao and I have just completed a book on OM Diagnosis. It will

> include many visual graphs that describe mechanisms as your student is

> asking about. For instance, the cause of the yellow complexion is

dampness

> accumulates which limits Spleen's transportation function leading to

a lack

> of blood rising to the face, a slightly pale or yellow color ensues.

Also:

> damp heat obstructs and steams the bile to the surface (which is

yang-type

> jaundice).

>

> The book is expected to be available in early 2008 and will be

published by

> Eastland Press. Its working title is " The Traditional

> Diagnosis Study Guide " . I'm not sure it that's what it'll be called

when it

> is in print, though.

>

> As a student (and practitioner) I've always found that spending a few

> minutes understanding mechanisms to be superior to avoid hours and

hours of

> memorization.

>

> -al.

>

> --

> , DAOM

> Pain is inevitable, suffering is optional.

>

>

>

[Guest guest]

Hello Bill,

about the organ-color-element and so on correspondances: I dont know if

Marcel Granets book " chinese thinking " has been translated into english,

he is a french sinologue who has worked alot on correspondances. In his

book one can find documented the evolution of different correspondances

and how eventually the one we use today (which is the one used in the

Huang di nei jing) appeared.

 

Anina

[Guest guest]

Funny about yellow complexion signifying spleen dampness but in reality it

physiologically comes poor elimination of bile from the liver-gall bladder.

I've generally thought that there is little that is " true " in TCM -- the

color is yellow because treatment of the spleen with diuretics and heat

clearing (which usually include liver herbs) and spleen acupoints like

spleen 9, 10, etc are used. I still think the yellow complexion thing is

another TCM accomodation to Confucian philosophy.

 

Michael Tierra

www.planetherbs.com

 

_____

 

 

On Behalf Of Bob Flaws

Tuesday, October 02, 2007 9:04 AM

 

Re: TCM organs - why they do what they do

 

 

 

Al,

 

Yeah, I did coin the term statements of fact.

 

Bob

 

@ <%40>

, " Al Stone " <al wrote:

>

> On 10/1/07, bill_schoenbart <plantmed2 wrote:

> >

> > I got an interesting inquiry from one of my students. Here is her

> > question:

> >

> > " I want to know WHY and HOW the spleen is associated with yellow and

> > the lips, so I can more deduce the symptoms...instead of memorizing

> > that a yellow face can mean spleen deficiency. I guess I want the

> > story behind each organ, and how they work. "

> >

>

>

>

Your student is asking about " mechanisms " . Sometimes, mechanisms default

> back to " because the nei jing says so " basically. Bob Flaws calls these

> " statements of fact " in TCM. Not sure if that's his unique saying or if

> that's an academia-wide distinction, but it often goes back to nei

jing, and

> before that, observation of nature. Wood is green, because when it

is supple

> and well nourished by water, the leaves are green, etc. The " earth is

> yellow " isn't quite as easy to explain, but as I understand it, the

Yellow

> River passes through the center of China and deposits into the

adjacent soil

> a yellow color. Don't quote me on that, but it may give you a clue

as to one

> possible explanation why " earth is yellow "

>

> Dr. Yi Qiao and I have just completed a book on OM Diagnosis. It will

> include many visual graphs that describe mechanisms as your student is

> asking about. For instance, the cause of the yellow complexion is

dampness

> accumulates which limits Spleen's transportation function leading to

a lack

> of blood rising to the face, a slightly pale or yellow color ensues.

Also:

> damp heat obstructs and steams the bile to the surface (which is

yang-type

> jaundice).

>

> The book is expected to be available in early 2008 and will be

published by

> Eastland Press. Its working title is " The Traditional

> Diagnosis Study Guide " . I'm not sure it that's what it'll be called

when it

> is in print, though.

>

> As a student (and practitioner) I've always found that spending a few

> minutes understanding mechanisms to be superior to avoid hours and

hours of

> memorization.

>

> -al.

>

> --

> , DAOM

> Pain is inevitable, suffering is optional.

>

>

>

[Guest guest]

Michael,

Perhaps we should discuss what is 'real' in terms of human

physiology. Why is western physiology more real than the

observations of Chinese medicine? Remember, that there are two

schools of thought on the yellow color, one the spleen, one the gall

bladder.

 

 

 

On Oct 5, 2007, at 12:42 PM, Michael Tierra wrote:

 

> Funny about yellow complexion signifying spleen dampness but in

> reality it

> physiologically comes poor elimination of bile from the liver-gall

> bladder.

> I've generally thought that there is little that is " true " in TCM

> -- the

> color is yellow because treatment of the spleen with diuretics and

> heat

> clearing (which usually include liver herbs) and spleen acupoints like

> spleen 9, 10, etc are used. I still think the yellow complexion

> thing is

> another TCM accomodation to Confucian philosophy.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

An interesting aspect of this can be found in yellow skin caused by

hypothyroid, a deficient cold condition. This yellow color is caused

by an impairment in carotene metabolism. Theoretically, it can fit

under the " yin yellow " category.

 

- Bill

 

 

, " "

<zrosenbe wrote:

>

> Michael,

> Perhaps we should discuss what is 'real' in terms of human

> physiology. Why is western physiology more real than the

> observations of Chinese medicine? Remember, that there are two

> schools of thought on the yellow color, one the spleen, one the

gall

> bladder.

>

>

>

> On Oct 5, 2007, at 12:42 PM, Michael Tierra wrote:

>

> > Funny about yellow complexion signifying spleen dampness but in

> > reality it

> > physiologically comes poor elimination of bile from the liver-

gall

> > bladder.

> > I've generally thought that there is little that is " true " in

TCM

> > -- the

> > color is yellow because treatment of the spleen with diuretics

and

> > heat

> > clearing (which usually include liver herbs) and spleen

acupoints like

> > spleen 9, 10, etc are used. I still think the yellow complexion

> > thing is

> > another TCM accomodation to Confucian philosophy.

>

>

> Chair, Department of Herbal Medicine

> Pacific College of Oriental Medicine

> San Diego, Ca. 92122

 

[Guest guest]

another source of yellow can be kidney disfunction, note the small k. The

kidneys may have poor erthyropoietin production which will inhibit rbc

production. (Spleen xue production anybody?)

 

The energetic organs are functional groupings that may or may not have any

basis in their synonymously named western organs, but that does not detract

from their clinical significance.

 

On 10/13/07, bill_schoenbart <plantmed2 wrote:

>

> An interesting aspect of this can be found in yellow skin caused by

> hypothyroid, a deficient cold condition. This yellow color is caused

> by an impairment in carotene metabolism. Theoretically, it can fit

> under the " yin yellow " category.

>

> - Bill

>

> --- In

<%40>,

> " "

>

> <zrosenbe wrote:

> >

> > Michael,

> > Perhaps we should discuss what is 'real' in terms of human

> > physiology. Why is western physiology more real than the

> > observations of Chinese medicine? Remember, that there are two

> > schools of thought on the yellow color, one the spleen, one the

> gall

> > bladder.

> >

> >

> >

> > On Oct 5, 2007, at 12:42 PM, Michael Tierra wrote:

> >

> > > Funny about yellow complexion signifying spleen dampness but in

> > > reality it

> > > physiologically comes poor elimination of bile from the liver-

> gall

> > > bladder.

> > > I've generally thought that there is little that is " true " in

> TCM

> > > -- the

> > > color is yellow because treatment of the spleen with diuretics

> and

> > > heat

> > > clearing (which usually include liver herbs) and spleen

> acupoints like

> > > spleen 9, 10, etc are used. I still think the yellow complexion

> > > thing is

> > > another TCM accomodation to Confucian philosophy.

> >

> >

> > Chair, Department of Herbal Medicine

> > Pacific College of Oriental Medicine

> > San Diego, Ca. 92122

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Why is western physiology more real than the

> > observations of Chinese medicine?

 

 

Z'ev,

 

The observations of Chinese medicine are just as real as anything. It's the

explanations that are less " real " in a scientific sense. And by " scientific, "

I mean the ability to determine cause, effect and predict future outcomes.

 

Besides the discussion of the death pulses, I haven't read much about

prognosis in TCM.

 

Also, the explanations about the organs are absolutely brilliant for the

information available at the time, but now, with the advantage of all we can

know by looking through microscopes and knowing about chemical constituents, the

discussion about Chinese physiology is somewhat reminiscent (IMO) of the

fundamentalists who refuse to believe in evolution because the Bible (Nei Ching)

says differently.

 

I don't advocate throwing away the wholistic nature of this medicine, but

untestable explanations just don't allow for exploration or progress. After all,

you can debate all day if you can't refute anything.

 

Guy Porter

 

 

 

 

 

************************************** See what's new at http://www.aol.com

 

 

 

[Guest guest]

Guy,

I have to strongly disagree with you. There is a great deal of

information on prognosis in Chinese medicine. . .the Shang Han Lun

has all about prognosis! Have you studied it?

 

Secondly, there is nothing in Chinese medical theory that cannot

accept the new data from Western medicine. But since Chinese

medicine is based on functional systems gained from naked sense

perception, and has a theoretical structure, it is a self-contained

system that works within its limitations.

 

There is nothing 'fundamentalist' about it. We don't need to

use religious metaphors here when we are talking about medicine.

" Presentism " , the belief that we live in the ideal era, and

" scientism " , that science holds the truth about life, are also belief

systems.

 

 

On Oct 14, 2007, at 5:37 AM, DrGRPorter wrote:

 

>

> Z'ev,

>

> The observations of Chinese medicine are just as real as anything.

> It's the

> explanations that are less " real " in a scientific sense. And by

> " scientific, "

> I mean the ability to determine cause, effect and predict future

> outcomes.

>

> Besides the discussion of the death pulses, I haven't read much about

> prognosis in TCM.

>

> Also, the explanations about the organs are absolutely brilliant

> for the

> information available at the time, but now, with the advantage of

> all we can

> know by looking through microscopes and knowing about chemical

> constituents, the

> discussion about Chinese physiology is somewhat reminiscent (IMO)

> of the

> fundamentalists who refuse to believe in evolution because the

> Bible (Nei Ching)

> says differently.

 

 

Chair, Department of Herbal Medicine

Pacific College of Oriental Medicine

San Diego, Ca. 92122

 

 

 

 

 

 

 

[Guest guest]

Guy,

I'm just jumping in here, so I'm not sure if you are an MD, DOM or what...

 

I have had (and witnessed) many conversations with empiricists

regarding your points. The parties involved often end up talking past

each other. It is difficult for " scientists, Md's, etc. " to grasp the

" flavor " of TCM theory. The problem is, generally, one of semantics

and framework. The TCM explanation of " the organs " is still

brilliant...even by today's standards. It is difficult to reconcile

the two viewpoints of empirical reductionism and holism.

 

Remember that TCM organs are really more like the concept of organ

function and not necessarily the organ itself. There is even an organ

that has no physicality...san jiao or triple warmer. It's just a

functional concept.

 

Consider the TCM dysfunction of " liver overacting on the

spleen/stomach " resulting in nausea/vomiting (to keep it simple). Can

this be explained by western physiology regarding liver function??

Probably. Does it matter from the TCM doctors point of view?? Not

really.... treat with ban xia ho po tang, needle liver 3 and gall

bladder 34... patient cured!!

 

In order to truly appreciate the subtlety and efficacy of TCM, one

really needs to thoroughly understand the theories involved. It is not

a right/wrong, worse/better issue. Our goal as physicians (of any ilk)

is to help the patient. If that truly requires something like

angioplasty or such...fine. Or, maybe the patient just needs to take

xue fu zhu yu tang.

 

There are many efficacy points about western medicine that can't be

explained... " it works but we don't know what the exact mechanism is. "

The same may be said of TCM from a western perspective...ultimately,

it doesn't matter.

For an interesting exploration of what Qi might be from a western

scientific viewpoint check out this link...

 

http://www.quantumconsciousness.org/documents/chi_hameroff_000.pdf

 

Is this it?? maybe... does it matter?? not really.

 

As far as the ?? of prognosis goes, Zev is right... wade into the

Shang Han Lun...it's all about prognosis... and brilliant to boot...

even by today's standards.

 

Regards,

dr.w

[Guest guest]

Dr _Waldrope_ (Waldrope) ,

 

Thank you for the thought provoking response. I am still formulating an

answer to Z'ev's.

 

 

I have had (and witnessed) many conversations with empiricists

regarding your points. The parties involved often end up talking past

each other. It is difficult for " scientists, Md's, etc. " to grasp the

" flavor " of TCM theory. The problem is, generally, one of semantics

and framework.

I have seen the same conversations. Almost all of use here on the list were

raised in 20th century Western civilization. We were taught that big things

are made up of little things and we took a lot of science classes. Thus,

Western explanations seem more real because they are more congruent with our

entire thought process, try as we might to live in 16th century China.

 

The TCM explanation of " the organs " is still

brilliant...even by today's standards. It is difficult to reconcile

the two viewpoints of empirical reductionism and holism.

 

I totally agree! That was what attracted me to it. I was involved with

Martial arts as a teen, saw amazing things in Chinatown (NYC) and brought this

bent with me to university where I studied Philosophy and Neurobiology. I have a

great deal of respect for both systems. (It's the people in them that bother

me! jk)

 

Nevertheless, there is a substantial difference between coincidence and

causation, as well as correspondence and causation. I practiced TCM for about 15

yrs.

 

 

Remember that TCM organs are really more like the concept of organ

function and not necessarily the organ itself. There is even an organ

that has no physicality...san jiao or triple warmer. It's just a

functional concept.

 

I'm familiar. Though I didn't like him at the time, I am becoming more and

more fond of Porkert and his system of categorization. It helps stop people

from thinking a Chinese spleen is a Western spleen.

 

 

Consider the TCM dysfunction of " liver overacting on the

spleen/stomach " resulting in nausea/vomiting (to keep it simple). Can

this be explained by western physiology regarding liver function??

Probably. Does it matter from the TCM doctors point of view?? Not

really.... treat with ban xia ho po tang, needle liver 3 and gall

bladder 34... patient cured!!

 

Have to say, this gives me an eye roll. In the first place, anyone calling

themselves a doctor or physician (at least in my state, MO) is required to

recognize that unresolved vomiting can be a sign which might eventually point

to

a grave disease and they are responsible for appropriate referral if the

patient isn't " cured, " or if their treatment actually stops the vomiting and

causes delay of diagnosis of a grave condition. I understand though that you

picked a simple explanation for me and that all we know about this hypothetical

case is really " vomiting. "

 

What if the patient isn't " cured? " How often does that treatment cure

vomiting? How do you know? I am not asking this in a derogatory way, it's just

that

with all it's faults, WM and Western science really allows us to get a much

better handle on things than most of what I have read and seen done and in

fact done myself for patients.

 

 

In order to truly appreciate the subtlety and efficacy of TCM, one

really needs to thoroughly understand the theories involved.

I think this gets to the heart of the matter. I really enjoy the clinical

efficacy of TCM. I have yet to read of a testable hypothesis in regard to the

theories. The theories of TCM don't allow for any falsification, so explanation

one puts forth could be correct.

 

For a fantastic example of this, you should rent the movie " The Madness of

King George. " There is a scene in which the College of Physicians tries to

discuss the case at a point when WM was still humorally based. It's a must see,

and it illustrates what I feel is missing from TCM physiology. A system of

correspondences is a great heuristic device, but it is just a beginning compared

to what we have available to us in Western Civ.

 

It is not

a right/wrong, worse/better issue. Our goal as physicians (of any ilk)

is to help the patient. If that truly requires something like

angioplasty or such...fine. Or, maybe the patient just needs to take

xue fu zhu yu tang.

 

There is a way to find out if the statement above is true. It doesn't

involve any " explanations " of Chinese physiology.

 

 

There are many efficacy points about western medicine that can't be

explained... " it works but we don't know what the exact mechanism is. "

The same may be said of TCM from a western perspective...ultimately,

it doesn't matter.

 

It doesn't matter if the patient gets better and the doctor gets paid. It

does matter if you are trying to figure out how best to serve millions of

patients across the country. I'm going to give you a hypothetical along the same

lines that you gave me and it has all the same shortcomings I admit.

 

Patient has a sore elbow that extends down his ulnar surface to the wrist.

 

Six treatments with acupuncture or 6 days of ibuprofen? Please explain your

reasoning.

 

Before you answer, I have to tell you that I treated someone who was on

total social security disability from bilateral lateral epicondylitis, so this

is

not a frivolous issue and I don't want to hear in the answer that you can

always cure that in one visit. Let's say that we surveyed every acupuncturist

across the country and the average number of visits was 6 for the presenting

complaint of sore elbow (sore enough to take the time to go to a doctor's off

ice)

 

I'd like to hear your reasoning on the answer as it will inform the

conversation.

 

 

 

For an interesting exploration of what Qi might be from a western

scientific viewpoint check out this link...

 

http://www.quantumconsciousness.org/documents/chi_hameroff_000.pdf

 

Is this it?? maybe... does it matter?? not really.

 

I read the paper you cited. It does matter. If everyone with nausea or sore

elbows gets better with a formula and a few points, it doesn't. But in

everyone's clinical experience, there are patients who got worse. In some cases,

much worse.

 

It matters for them and those are the ones we have to work really hard for.

 

This paper: Rupali P. Dhond, Norman Kettner, Vitaly Napadow. The Journal of

Alternative and Complementary Medicine. 2007, 13(6): 603-616.

doi:10.1089/acm.2007.7040. and the other papers that team produced are far

better for our

profession because instead of postulating mechanisms, they actually showed that

there are definite brain and nervous responses with acupuncture.

 

In fact, most acupuncturists would do well to follow the progress of this

research since it shows a clear difference between placebo/sham acupuncture and

true acupuncture. This has been a sticky (couldn't resist) point for many

years in the community and these people are getting to the heart of it.

 

That matters for everyone on this list who hopes to make a living from TCM.

If TCM is thought to be a mere placebo or so simple that it can be applied by

a nurse, then we're all in trouble, to say nothing of the patient's plight.

 

Using reductionist science in order to show this difference is a big deal.

It speaks to adding more, not less Western science to the curricula.

 

 

As far as the ?? of prognosis goes, Zev is right... wade into the

Shang Han Lun...it's all about prognosis...

I'm finished wading around there. I am unable to practice any longer because

of a pretty serious case of psoriatic arthritis that has affected many of my

joints. So if it's a place where you have swum, please let me know about

some of the prognostication, the reasoning and how it was tested or better yet,

how we might test it in the present day.

 

 

 

and brilliant to boot...

even by today's standards.

 

No argument here.

 

 

Regards,

dr.w

 

 

Thank you so much for the careful and considered discussion. I look forward

to further dialog.

 

Guy Porter

 

 

 

 

 

************************************** See what's new at http://www.aol.com

 

 

 

[Guest guest]

Hi Everyone,

 

Bill’s student asked,

" I want to know WHY and HOW the spleen is associated with yellow and

the lips, so I can more deduce the symptoms...instead of memorizing

that a yellow face can mean spleen deficiency. I guess I want the

story behind each organ, and how they work. "

 

This is an interesting question that has many different facets.

According to the text the Huang di Nei jing in the Su wen it says:

 

“The spleen associates with the color yellow, its characteristic is wet when

ill …” 1

 

At the time of the origin of this text (2nd or 1st century BCE), it is

probable that there wasn’t necessarily a reductionistic way of thinking

regarding TCM. In other words they didn’t necessarily have a rationale for why

these observations were present. It was enough to see that there was a

correlation and that by treating the spleen for example that the yellowish

complexion went away.

In chapter 10 of the Su wen1 “When the quintessence of the five viscera

reflected on the complexion appears to be yellow like the fruit of the unripen

citron, the patient will die … when it appears to be … yellow like the belly of

a crab, the patient will live … the color of vitality of spleen is like

trichosanthes seed (reddish-yellow) wrapped in white thin silk.” Later in

chapter 17 of the Su wen1 it goes on to say, “…The five-color of the complexion

is the outer appearance of the vital energy, when it is … yellow, it should like

realgar wrapped in a piece of white thin silk in reddish-yellow, and does not

like earth in yellow with residue … If the decay phenomena of the five colors

appear, the life of the patient will not last long”.

 

There is evidence supporting the correlative thought processes regarding

the treatment methods and the treatment principles. However, at the time of its

writing these associations are presented rather as a statement of fact,

presumably based on observation, rather than based on a pathophysiology

especially from a modern day explanation. 2

 

Here is the conundrum do we find value in taking our current expanded

knowledge of human anatomy & physiology and then make a rationale for how we

could explain this reported observable phenomenon and, in so doing, are we

taking away from the student’s experience? By emphasizing this western

paradigm way of thinking are we not getting away from the way of thinking of our

traditional forefathers and in so doing placing a greater sense of importance on

it over the traditional way of learning (memorizing) this information. More

importantly are we taking the student’s mind set, out of the traditional

importance for observation and internalizing it into this act of mental

cogitation, which we really can’t substantiate because it is based on

observational data which was not present at the time of these original

statements. For an interesting discussion on acupuncture, evidenced-based

medicine & philosophy see:

http://www.medicalacupuncture.com/aama_marf/journal/vol13_2/article4.html

 

The point being I think it is important to recognize these observations

as being as valuable in their time in the treatment of medical conditions as our

more modern day observations today. For example with the invention of the

microscope we can see pathogens that were previously invisible to our ancient

ancestors. Yet, it is apparent that they certainly were quite capable of

treating diseases even though they probably didn’t even know about the existence

of these unseen pathogens.

 

I think it is well enough to merely emphasize the significance of these

observations on their own merits without necessarily having to have an

explanation for why this is so. That being said, I am a big advocate myself of

trying to understand what is going on and for me it makes it easier to learn

rather than rote memorization.

 

J.R. Worsley he wrote, “The color yellow is often likened to the harvest

color of the corn in the field. Despite the resonance this has for us in the

west, anyone with a passing knowledge of China will know that the Chinese

immediately associate yellow with the earth of Northern China which forms the

rich and fertile silt flowing down the Yellow river, for the Chinese the color

yellow naturally represents the qualities of the Earth as our physical mother,

as the basis of our nourishment and survival” 3.

It is the pancreas, (which isn’t otherwise mentioned in TCM), which is

responsible for producing the pancreatic enzymes (amylase, trypsin, and lipase

which respectively digest starch, protein, and triglycerides) necessary for the

breakdown and assimilation of necessary nutrients for example protein into amino

acids the necessary building blocks to support growth & development of the body.

Insulin produced by the & #946;-cells of the islets of Langerhans in the pancreas

for the cellular uptake of glucose used by the cell to produce energy (ATP) is

also pretty important.

 

Giovanni does a good job of explaining the relationship between the

spleen and the mouth & lips based on the Su wen4. As for why, let us consider

the extremes, they didn’t always have plenty to eat in those days, and when

someone went hungry for too long they became emaciated their lips became thin

possibly from blood deficiency & lack of collagen due to protein deficiency.

 

One way to take this statement about the spleen and the color yellow is

not diagnostically. Leaves are green in the Spring, they turn red during the

summer, and change to yellow in the late summer which is the season associated

with the Spleen. Spring is associated with rebirth following the winter

hibernation. The Liver stores the blood which is the mother of Qi. The mother

gives birth to new life, hence the association. The Summer is a time for

tending the crops and overseeing the growth & development in anticipation of a

favorable harvest. The Heart is the emperor which oversees the growth &

development of the people of the country.

 

The harvest in Fall is literally the turning point between whether or not

the individual is going to be able to make it without starving through the

winter as a human or end up leaving the earth as a spirit. The Fall can be

considered a pivotal season hence the association with the spleen & Earth. This

can be seen in some diagrams of the five elements (wu xing) with the spleen

drawn in the center. Which is fitting since they are the source of

post-heavenly Qi and the origin of Qi & blood. This is the foundation for the

“Preserving Stomach Qi) school from which Li Dong Yuan (1180-1251) wrote the

Treatise on the Spleen & Stomach (Pi Wei Lun)

 

Statement of fact in TCM, “the spleen engenders dampness and the lung is the

receptacle of dampness”.

 

We have these concepts of the spleen acting as the “pivot” acting in the

process of separating the clear yang from the turbid yin. This descending of

the turbid yin can be seen with the elimination of urine and the stools. The

role of the spleen as the pivot in the water pathways of the san jiao providing

the key link between the upper jiao (Heaven) & lower jiao (Earth) in the (earth

falling to transport water) edema do to spleen Qi deficiency Wu Ling San

(Five-Ingredient Powder with Poria) pattern5.

 

Another way to look at the student’s question is by thinking about the

observation. In four element school diagnosis is based on four observations

namely color, smell, sound, and emotion. J.R. Worsley said that the color can

be seen in the flesh over the temple area. “As soon as a person becomes

imbalanced, a color appears on the face. This in not a color of the skin but a

hue on the face which is often more easily seen when the face is viewed

indirectly, glanced out of the corner of the eye. The best area to see the

color is on the temple, just to the side of and above the eyes. It is also

visible under the eyes, in the laugh lines, and also around the mouth. These

lower areas are not so reliable, however, as they can be affected by other

things, such as lack of sleep … the color associated with the Fire element is

more often a ‘lack of red’, represented by an ashen, grey color … the blue can

range from the very pale blue or a distant sky to the inky

blue-black of deep water. Yellow can range from almost cream to the kind of

orange-yellow that borders on red. This is, of course where diagnostic

complication begins. Am I seeing a shade of yellow or green, of red or yellow,

blue or green? This is why accurate diagnosis requires at least three of the

signs presenting in the patient to be indicating at the same element. Color

alone, sound alone, odor alone, or emotion alone is not evidence enough to be

sure.” 6 “When seeing the color on the face, it is more like noticing it, or

letting it appear to us”. 6

 

In Chapter 13 of the Su Wen Qi Bo said, “The most important crux of treating

is to abide with the inspection of patient’s complexion and his pulse condition,

and insist on this highest principle.” It seems that complexion inspection is

important in diagnosis!

 

Statement of fact in TCM, “A yellow color indicates an earth element is the

origin of the disharmony”.

 

(huángsè) Yellow discoloration of the skin or complexion, seen in cases

of dysfunction of the spleen or in icteric (pertaining to jaundice) patients,

indicating presence of dampness. (w & #283;ihuáng) sallow skin or complexion

caused by dysfunction of the spleen or deficiency of blood. 7

 

Jaundice – (a yellow discoloration of the eyes and mucous membranes). A

condition that occurs as a result of rising bilirubin (hyperbilirubinemia, a

pigment generated in the breakdown of heme released from old red blood cells

(hemolysis),, which is normally removed from the bloodstream via the biliary

system. It may be caused by obstruction of bile passageways, excess destruction

of red blood cells or disturbances in the functioning of liver cells … hemolytic

jaundice - … serum bilirubin may be only slightly elevated even though bile

pigment production may be increased to as much as six times normal. The

bilirubin, which is mostly conjugated and therefore insoluble in water, does not

appear (in high levels) in the urine. The spleen is usually enlarged.

 

Around 158 – 166 AD in the Jin Gui Lao Yue, (Prescriptions of the Golden

Cabinet), in Chapter XV Zhang Zhong Jing wrote In clause 15-2 he describes four

types of jaundice based on their etiology. They are gu dan (“cereal jaundice”

jaundice due to improper diet), nü lao dan (jaundice due to sexual

overindulgence and fatigue), jiu dan (wine jaundice), and hei dan (dark

jaundice) which is a complication of mistreated jiu dan (wine jaundice) by

purgation. He also makes mention of “Sunlight yang disease” which can lead to

gu dan (cereal jaundice)8

 

During the Jin -Yuan period, a distinction was made between yin jaundice

and yang jaundice. The three patterns of Yin type jaundice are cold-damp, SP xu

& xue depletion, and accumulation of static blood. The etiology of yang

jaundice is from contraction of external evils, Damp-heat invading LV & GB, and

resultant GB heat causing bile to percolate to the skin. Yin jaundice & yang

jaundice can be clinically differentiated by comparison of patient’s skin color.

The yin type patterns present with a somber yellow facial complexion whereas the

yang type produces a (vivid yellow) “tangerine color” and has more heat signs

present.

 

From a western biomedical perspective the yin jaundice could correspond

with diseases such as cirrhosis or cancer of the head of the pancreas, and the

yang jaundice corresponds with acute icteric infectious hepatitis, obstructive

biliary tract diseases such as acute cholecystitis, cholelithiasis, or toxic

hepatitis.

 

“The spleen may be best understood as a discriminatory filter, consisting of

specialized vascular spaces through which blood flows. The foundation of its

structure and its filtration capacities is a reticular meshwork fashioned of

reticular fivers. There is no element of the blood, cellular or plasmal, which

the spleen may not affect. It monitors the red blood cells in the circulation

and destroys or modifies imperfect ones. It removes other blood cells when

damaged or aged. It sequesters monocytes and holds them as spenic macrophages

which act in antibody formation and other spenic functions. It traps T and B

cells from the blood and sorts them into compartments, permitting them to

interact with macrophages and antigen in immune responses. It stores as many as

a third of the platlets of the body in a ready reserve. In certain species, it

can also function as a reservoir for erythrocytes and granulocytes, capable of

delivering them rapidly to the blood when

needed”. 10

 

Statement of fact in TCM “The spleen manages the blood” (Pi tong xue)

 

In Western medicine the functions of the spleen are:

1) In the embryo, the spleen forms both red & white blood cells, but after

birth, only lymphocytes and monocytes are produced.

2) The macrophages of the spleen remove all kinds of pathogens from the

circulating blood

3) Old red blood cells are removed from circulation and form bilirubin (from

the heme of the hemoglobin) that will circulate to the liver to be excreted in

the bile.

Incidentally, the yellow color of the urine (as well as the brown color of the

stool) is produced by the presence of bilirubin in the bile which comes from the

breakdown of red blood cells. And, where do you think this process takes place?

You guessed it, in the spleen.

 

The spleen stores some of the breakdown products of RBCs for later reuse and

releases others to the blood for processing by the liver (i.e. spleen

macrophages salvage and store iron for later use by the bone marrow in making

hemoglobin). 11

 

The bilirubin which is a source of hemoblobin is necessary or the production

of new RBC’s and so the spleen which produces the bilirubin is important for its

role in blood production.

 

Statement of fact in TCM “The spleen is the root of construction and blood.”

(Pi wei ying xue zhi ben).

 

Look at the formula Dang Gui Bu Xue Tang (Tangkuei Decotion to Tonify the

Blood) this is a very simple formula used for treating consumptive fatigue do to

blood deficiency. It has only two ingredients: huang qi (Rx Astragali

Membranacei) and dang gui (Rx Angelicae Sinensis) It is said that huang qi a Qi

tonic tonifies the Spleen & Lung and therefore reinforces the source of blood

where as dang gui, which is in the tonify blood category, tonifies the Qi of the

blood. 5

 

The important thing to note is that the yellow complexion symptom

resolves by treating the spleen. That would seem to lend support to the

initial observation that the color yellow is associated with the spleen.

 

References

1 Chapter 22 of the Su Wen (Plan Questions) from the Huang di Nei Jing

(Yellow Emperor’s Canon of Internal medicine) entitled Zang Qi Fa Shi Lun (On

the Relation Between Energies of Five Viscera and the Four Seasons)

 

2 Wood, A. ’The Journal of : Vessel Theory, Acupuncture and

Correlative Thinking in Early ’ Number 84, June 2007 North

America

 

3 Worsley, J.R. Classical Five-Element Acupuncture Volume III

The College of Tradional Acupuncture, U.K. Royal Leamington Spa, 1990, Ch. 8

P. 83

 

4 Maciocia (1998), The Foundations of

New York: Churchill Livingstone, P. 91

 

5 Bensky & Barolet (1990), Chinese Herbal Medicine Formulas & Strategies (1st

ed.)

Seattle: Eastland Press, Inc., P. 175

 

6 Worsley, J.R. Traditional Acupuncture Volume II Traditional Diagnosis

The College of Tradional Acupuncture, U.K. Royal Leamington Spa, 1990, Pp.

32-3, 56

 

7 (1980) Common Terms of Traditional in English, Method of

Diagnosis

Bejing Medical College, P. 77

 

8 Jing, Z.Z, Jiyuan, R., Guangji, Z. (2002) ’Chinese-English Textbook Synopsis

of Prescriptions of the Golden Cabinet CH XV, Pp.97-98

 

10 Weiss, L. (1972), The Cells and Tissues of the Immune System

 

11 Marieb, E. (2001) Human Anatomy & Physiology Ch. 21 The

Lymphatic System

San Francisco: Benjamin Cummings, P. 784

 

13 Downloaded from the world wide web on October 17, 2007 from:

http://www.answers.com/topic/pancreas?cat=health

 

14 Downloaded from the world wide web on October 17, 2007 from:

http://patients.uptodate.com/topic.asp?file=red_cell/30042

 

15 Downloaded from the world wide web on October 17, 2007 from:

http://www.charm.ru/library/faq006.htm

 

Hopefully this is helpful to someone!

Sincerely,

 

Steve Sterling, L.Ac.

[Guest guest]

Steve,

you have written a beautiful essay. Thank you for the effort. I enjoyed

reading it.

 

C

 

 

 

 

 

Steve Sterling <acusteve1

 

Thu, 25 Oct 2007 22:02:32 -0700 (PDT)

 

Re: TCM organs - why they do what they do

 

 

 

 

 

Hi Everyone,

 

Bill¹s student asked,

" I want to know WHY and HOW the spleen is associated with yellow and

the lips, so I can more deduce the symptoms...instead of memorizing

that a yellow face can mean spleen deficiency. I guess I want the

story behind each organ, and how they work. "

 

This is an interesting question that has many different facets. According

to the text the Huang di Nei jing in the Su wen it says:

 

³The spleen associates with the color yellow, its characteristic is wet

when ill Š² 1

 

At the time of the origin of this text (2nd or 1st century BCE), it is

probable that there wasn¹t necessarily a reductionistic way of thinking

regarding TCM. In other words they didn¹t necessarily have a rationale for

why these observations were present. It was enough to see that there was a

correlation and that by treating the spleen for example that the yellowish

complexion went away.

In chapter 10 of the Su wen1 ³When the quintessence of the five viscera

reflected on the complexion appears to be yellow like the fruit of the

unripen citron, the patient will die Š when it appears to be Š yellow like

the belly of a crab, the patient will live Š the color of vitality of spleen

is like trichosanthes seed (reddish-yellow) wrapped in white thin silk.²

Later in chapter 17 of the Su wen1 it goes on to say, ³ŠThe five-color of

the complexion is the outer appearance of the vital energy, when it is Š

yellow, it should like realgar wrapped in a piece of white thin silk in

reddish-yellow, and does not like earth in yellow with residue Š If the

decay phenomena of the five colors appear, the life of the patient will not

last long².

 

There is evidence supporting the correlative thought processes regarding

the treatment methods and the treatment principles. However, at the time of

its writing these associations are presented rather as a statement of fact,

presumably based on observation, rather than based on a pathophysiology

especially from a modern day explanation. 2

 

Here is the conundrum do we find value in taking our current expanded

knowledge of human anatomy & physiology and then make a rationale for how we

could explain this reported observable phenomenon and, in so doing, are we

taking away from the student¹s experience? By emphasizing this western

paradigm way of thinking are we not getting away from the way of thinking of

our traditional forefathers and in so doing placing a greater sense of

importance on it over the traditional way of learning (memorizing) this

information. More importantly are we taking the student¹s mind set, out of

the traditional importance for observation and internalizing it into this

act of mental cogitation, which we really can¹t substantiate because it is

based on observational data which was not present at the time of these

original statements. For an interesting discussion on acupuncture,

evidenced-based medicine & philosophy see:

http://www.medicalacupuncture.com/aama_marf/journal/vol13_2/article4.html

 

The point being I think it is important to recognize these observations as

being as valuable in their time in the treatment of medical conditions as

our more modern day observations today. For example with the invention of

the microscope we can see pathogens that were previously invisible to our

ancient ancestors. Yet, it is apparent that they certainly were quite

capable of treating diseases even though they probably didn¹t even know

about the existence of these unseen pathogens.

 

I think it is well enough to merely emphasize the significance of these

observations on their own merits without necessarily having to have an

explanation for why this is so. That being said, I am a big advocate myself

of trying to understand what is going on and for me it makes it easier to

learn rather than rote memorization.

 

J.R. Worsley he wrote, ³The color yellow is often likened to the harvest

color of the corn in the field. Despite the resonance this has for us in

the west, anyone with a passing knowledge of China will know that the

Chinese immediately associate yellow with the earth of Northern China which

forms the rich and fertile silt flowing down the Yellow river, for the

Chinese the color yellow naturally represents the qualities of the Earth as

our physical mother, as the basis of our nourishment and survival² 3.

It is the pancreas, (which isn¹t otherwise mentioned in TCM), which is

responsible for producing the pancreatic enzymes (amylase, trypsin, and

lipase which respectively digest starch, protein, and triglycerides)

necessary for the breakdown and assimilation of necessary nutrients for

example protein into amino acids the necessary building blocks to support

growth & development of the body. Insulin produced by the & #946;-cells of

the islets of Langerhans in the pancreas for the cellular uptake of glucose

used by the cell to produce energy (ATP) is also pretty important.

 

Giovanni does a good job of explaining the relationship between the spleen

and the mouth & lips based on the Su wen4. As for why, let us consider the

extremes, they didn¹t always have plenty to eat in those days, and when

someone went hungry for too long they became emaciated their lips became

thin possibly from blood deficiency & lack of collagen due to protein

deficiency.

 

One way to take this statement about the spleen and the color yellow is not

diagnostically. Leaves are green in the Spring, they turn red during the

summer, and change to yellow in the late summer which is the season

associated with the Spleen. Spring is associated with rebirth following the

winter hibernation. The Liver stores the blood which is the mother of Qi.

The mother gives birth to new life, hence the association. The Summer is a

time for tending the crops and overseeing the growth & development in

anticipation of a favorable harvest. The Heart is the emperor which

oversees the growth & development of the people of the country.

 

The harvest in Fall is literally the turning point between whether or not

the individual is going to be able to make it without starving through the

winter as a human or end up leaving the earth as a spirit. The Fall can be

considered a pivotal season hence the association with the spleen & Earth.

This can be seen in some diagrams of the five elements (wu xing) with the

spleen drawn in the center. Which is fitting since they are the source of

post-heavenly Qi and the origin of Qi & blood. This is the foundation for

the ³Preserving Stomach Qi) school from which Li Dong Yuan (1180-1251) wrote

the Treatise on the Spleen & Stomach (Pi Wei Lun)

 

Statement of fact in TCM, ³the spleen engenders dampness and the lung is

the receptacle of dampness².

 

We have these concepts of the spleen acting as the ³pivot² acting in the

process of separating the clear yang from the turbid yin. This descending

of the turbid yin can be seen with the elimination of urine and the stools.

The role of the spleen as the pivot in the water pathways of the san jiao

providing the key link between the upper jiao (Heaven) & lower jiao (Earth)

in the (earth falling to transport water) edema do to spleen Qi deficiency

Wu Ling San (Five-Ingredient Powder with Poria) pattern5.

 

Another way to look at the student¹s question is by thinking about the

observation. In four element school diagnosis is based on four observations

namely color, smell, sound, and emotion. J.R. Worsley said that the color

can be seen in the flesh over the temple area. ³As soon as a person becomes

imbalanced, a color appears on the face. This in not a color of the skin

but a hue on the face which is often more easily seen when the face is

viewed indirectly, glanced out of the corner of the eye. The best area to

see the color is on the temple, just to the side of and above the eyes. It

is also visible under the eyes, in the laugh lines, and also around the

mouth. These lower areas are not so reliable, however, as they can be

affected by other things, such as lack of sleep Š the color associated with

the Fire element is more often a Œlack of red¹, represented by an ashen,

grey color Š the blue can range from the very pale blue or a distant sky to

the inky

blue-black of deep water. Yellow can range from almost cream to the kind

of orange-yellow that borders on red. This is, of course where diagnostic

complication begins. Am I seeing a shade of yellow or green, of red or

yellow, blue or green? This is why accurate diagnosis requires at least

three of the signs presenting in the patient to be indicating at the same

element. Color alone, sound alone, odor alone, or emotion alone is not

evidence enough to be sure.² 6 ³When seeing the color on the face, it is

more like noticing it, or letting it appear to us². 6

 

In Chapter 13 of the Su Wen Qi Bo said, ³The most important crux of

treating is to abide with the inspection of patient¹s complexion and his

pulse condition, and insist on this highest principle.² It seems that

complexion inspection is important in diagnosis!

 

Statement of fact in TCM, ³A yellow color indicates an earth element is the

origin of the disharmony².

 

(huángsè) Yellow discoloration of the skin or complexion, seen in cases of

dysfunction of the spleen or in icteric (pertaining to jaundice) patients,

indicating presence of dampness. (w & #283;ihuáng) sallow skin or complexion

caused by dysfunction of the spleen or deficiency of blood. 7

 

Jaundice ­ (a yellow discoloration of the eyes and mucous membranes). A

condition that occurs as a result of rising bilirubin (hyperbilirubinemia, a

pigment generated in the breakdown of heme released from old red blood cells

(hemolysis),, which is normally removed from the bloodstream via the biliary

system. It may be caused by obstruction of bile passageways, excess

destruction of red blood cells or disturbances in the functioning of liver

cells Š hemolytic jaundice - Š serum bilirubin may be only slightly elevated

even though bile pigment production may be increased to as much as six times

normal. The bilirubin, which is mostly conjugated and therefore insoluble

in water, does not appear (in high levels) in the urine. The spleen is

usually enlarged.

 

Around 158 ­ 166 AD in the Jin Gui Lao Yue, (Prescriptions of the Golden

Cabinet), in Chapter XV Zhang Zhong Jing wrote In clause 15-2 he describes

four types of jaundice based on their etiology. They are gu dan (³cereal

jaundice² jaundice due to improper diet), nü lao dan (jaundice due to sexual

overindulgence and fatigue), jiu dan (wine jaundice), and hei dan (dark

jaundice) which is a complication of mistreated jiu dan (wine jaundice) by

purgation. He also makes mention of ³Sunlight yang disease² which can lead

to gu dan (cereal jaundice)8

 

During the Jin -Yuan period, a distinction was made between yin jaundice

and yang jaundice. The three patterns of Yin type jaundice are cold-damp,

SP xu & xue depletion, and accumulation of static blood. The etiology of

yang jaundice is from contraction of external evils, Damp-heat invading LV &

GB, and resultant GB heat causing bile to percolate to the skin. Yin

jaundice & yang jaundice can be clinically differentiated by comparison of

patient¹s skin color. The yin type patterns present with a somber yellow

facial complexion whereas the yang type produces a (vivid yellow) ³tangerine

color² and has more heat signs present.

 

From a western biomedical perspective the yin jaundice could correspond

with diseases such as cirrhosis or cancer of the head of the pancreas, and

the yang jaundice corresponds with acute icteric infectious hepatitis,

obstructive biliary tract diseases such as acute cholecystitis,

cholelithiasis, or toxic hepatitis.

 

³The spleen may be best understood as a discriminatory filter, consisting

of specialized vascular spaces through which blood flows. The foundation of

its structure and its filtration capacities is a reticular meshwork

fashioned of reticular fivers. There is no element of the blood, cellular

or plasmal, which the spleen may not affect. It monitors the red blood

cells in the circulation and destroys or modifies imperfect ones. It

removes other blood cells when damaged or aged. It sequesters monocytes and

holds them as spenic macrophages which act in antibody formation and other

spenic functions. It traps T and B cells from the blood and sorts them into

compartments, permitting them to interact with macrophages and antigen in

immune responses. It stores as many as a third of the platlets of the body

in a ready reserve. In certain species, it can also function as a reservoir

for erythrocytes and granulocytes, capable of delivering them rapidly to the

blood when

needed². 10

 

Statement of fact in TCM ³The spleen manages the blood² (Pi tong xue)

 

In Western medicine the functions of the spleen are:

1) In the embryo, the spleen forms both red & white blood cells, but after

birth, only lymphocytes and monocytes are produced.

2) The macrophages of the spleen remove all kinds of pathogens from the

circulating blood

3) Old red blood cells are removed from circulation and form bilirubin

(from the heme of the hemoglobin) that will circulate to the liver to be

excreted in the bile.

Incidentally, the yellow color of the urine (as well as the brown color of

the stool) is produced by the presence of bilirubin in the bile which comes

from the breakdown of red blood cells. And, where do you think this process

takes place? You guessed it, in the spleen.

 

The spleen stores some of the breakdown products of RBCs for later reuse

and releases others to the blood for processing by the liver (i.e. spleen

macrophages salvage and store iron for later use by the bone marrow in

making hemoglobin). 11

 

The bilirubin which is a source of hemoblobin is necessary or the

production of new RBC¹s and so the spleen which produces the bilirubin is

important for its role in blood production.

 

Statement of fact in TCM ³The spleen is the root of construction and

blood.² (Pi wei ying xue zhi ben).

 

Look at the formula Dang Gui Bu Xue Tang (Tangkuei Decotion to Tonify the

Blood) this is a very simple formula used for treating consumptive fatigue

do to blood deficiency. It has only two ingredients: huang qi (Rx Astragali

Membranacei) and dang gui (Rx Angelicae Sinensis) It is said that huang qi

a Qi tonic tonifies the Spleen & Lung and therefore reinforces the source of

blood where as dang gui, which is in the tonify blood category, tonifies the

Qi of the blood. 5

 

The important thing to note is that the yellow complexion symptom resolves

by treating the spleen. That would seem to lend support to the initial

observation that the color yellow is associated with the spleen.

 

References

1 Chapter 22 of the Su Wen (Plan Questions) from the Huang di Nei Jing

(Yellow Emperor¹s Canon of Internal medicine) entitled Zang Qi Fa Shi Lun

(On the Relation Between Energies of Five Viscera and the Four Seasons)

 

2 Wood, A. ¹The Journal of : Vessel Theory, Acupuncture and

Correlative Thinking in Early ¹ Number 84, June 2007 North

America

 

3 Worsley, J.R. Classical Five-Element Acupuncture Volume III

The College of Tradional Acupuncture, U.K. Royal Leamington Spa, 1990, Ch.

8 P. 83

 

4 Maciocia (1998), The Foundations of

New York: Churchill Livingstone, P. 91

 

5 Bensky & Barolet (1990), Chinese Herbal Medicine Formulas & Strategies

(1st ed.)

Seattle: Eastland Press, Inc., P. 175

 

6 Worsley, J.R. Traditional Acupuncture Volume II Traditional Diagnosis

The College of Tradional Acupuncture, U.K. Royal Leamington Spa, 1990, Pp.

32-3, 56

 

7 (1980) Common Terms of Traditional in English, Method

of Diagnosis

Bejing Medical College, P. 77

 

8 Jing, Z.Z, Jiyuan, R., Guangji, Z. (2002) ¹Chinese-English Textbook

Synopsis of Prescriptions of the Golden Cabinet CH XV, Pp.97-98

 

10 Weiss, L. (1972), The Cells and Tissues of the Immune System

 

11 Marieb, E. (2001) Human Anatomy & Physiology Ch. 21 The

Lymphatic System

San Francisco: Benjamin Cummings, P. 784

 

13 Downloaded from the world wide web on October 17, 2007 from:

http://www.answers.com/topic/pancreas?cat=health

 

14 Downloaded from the world wide web on October 17, 2007 from:

http://patients.uptodate.com/topic.asp?file=red_cell/30042

 

15 Downloaded from the world wide web on October 17, 2007 from:

http://www.charm.ru/library/faq006.htm

 

Hopefully this is helpful to someone!

Sincerely,

 

Steve Sterling, L.Ac.

 

 

 

 

 

 

 

 

[Guest guest]

, Steve Sterling

<acusteve1 wrote:

>

> Hi Everyone,

>

> Bill's student asked,

> " I want to know WHY and HOW the spleen is associated with yellow

and

> the lips, so I can more deduce the symptoms...instead of memorizing

> that a yellow face can mean spleen deficiency. I guess I want the

> story behind each organ, and how they work. "

>

 

 

Nice job!

[Guest guest]

I think the confusion lies between liver-bile congestion as in hepatitis

with the TCM Spleen description. As you know, TCM does not have a built in

mandate to be physiologically or anatomically accurate only to express a

system that allows us to arrive at an effective treatment.

 

Yellow color is symptomatic of the back up of bilirubin (bile) in the blood

and tissues. It is associated with hepatitis where the biliary hepato duct

is swollen due to inflammation and bile does not flow out through the gall

bladder. Ethnicty aside, some people may normally have a slight tendency to

have a more yellow pallor than others which perhaps suggests that a certain

amount of bile retained in the tissues is not abnormal.

 

5 element Confucian TCM equates yellow with the earth element -- because the

color is the transposition from Red (fire) to the more moderate

earth-life-affirming warmth (sun). So its warm just right for the metabolic

'cooking' organs, stomach and spleen to do their job.

 

So actual physiological liver cause aside, the most obvious " damp-heat' in

the body is bile. Dampness comes from the spleen and therefore the yellow

color represents damp heat -- even though the physiological cause would be

the liver and gall bladder.

 

Interestingly, the herbs that clear damp heat are for the most part also

herbs that go to the liver as well.

 

Michael Tierra

www.planetherbs.com

 

 

 

_____

 

 

On Behalf Of bill_schoenbart

Saturday, October 27, 2007 8:43 AM

 

Re: TCM organs - why they do what they do

 

 

 

@ <%40>

, Steve Sterling

<acusteve1 wrote:

>

> Hi Everyone,

>

> Bill's student asked,

> " I want to know WHY and HOW the spleen is associated with yellow

and

> the lips, so I can more deduce the symptoms...instead of memorizing

> that a yellow face can mean spleen deficiency. I guess I want the

> story behind each organ, and how they work. "

>

 

Nice job!

 

 

 

 

 

_____

 

<< ella for Spam Control >> has removed 3209 Spam messages and set aside

2023 Newsletters for me

You can use it too - and it's FREE! www.ellaforspam.com