By Martin Eisen, Ph.D.
Chinese medicine regards the body as a unified whole. It is not enough to just understand the different functions of individual Organs, but also how they interrelate. Health depends upon the maintenance of a proper balance between the Organs. Pathology also depends on their mutual influence. The interrelationships of the Yin Organs will be discussed below (1,2,3).
In a future article, the functions of the Yang (Fu) Organs will be discussed. Then, not only the interrelations between them, but also between the Yin and Yang Organs will be described.
2. Heart and Lungs
The Heart governs Blood and the Lungs govern Qi. The circulation of Blood by the Heart is aided by the propelling function of Qi. Qi is attached to the Blood to distribute it through the body, which aids the Lung in dispersing and descending Qi. Both the Heart and Lung, Qi and Blood, rely on each other, as show in Fig. 1.
Patholigically, weakness of Lung Qi results in a deficiency of Pectoral Qi will lead to stagnation of circulation of Blood. This produces chest stuffiness, shortness of breath, palpitations, purple lips and tongue.
Poor circulation of the Blood, because of Heart Qi or Yang deficiency, may impair the Lung’s descending and dispersing of Qi, resulting in coughing, shortness of breath, chest stuffiness and a sense of suffocation.
During the development of febrile disease, Pathogenic Factors in the Lungs sometimes invade the Heart. This is denoted as “invasion of Pathogenic Factors by contrary pathway”. This further illustrates the mutual connection of the Heart and Lungs in pathology.
3. Heart and Spleen
The Spleen and Heart are related through their connection with Blood. The Spleen helps make Blood by providing Food Essence which is essential for the Heart to manufacture Blood. Heart Yang circulates Blood in the Vessels. Heart Blood nourishes the Spleen and Heart Qi aids it so that the Spleen can transport and transform the essential substnces of food and water and keep theBlood in the Vessels. The interrelationship between the Heart and Spleen is depicted in Fig. 2.
Deficiency of Spleen Qi so that enough Blood can be made or hemorrhaging occurs will lead to a deficiency of Heart Blood. Overthinking consumes Heart Blood, which may affect the Spleen’s tranportation and transformation functions, leading to a further deficiency of Heart Blood. Both of these conditions may produce symptoms such as, dizziness, poor memory, insomnia, palpitations, poor appetite, pale complexion and tiredeness. This symptom-complex is known as “deficiency of both Heart and Spleen.
4. Heart and Liver
The close relation between the Heart and Liver is a consequence of their Blood and mental functions as illustrated in Fig. 3.
The Heart governs Blood while the Liver stores and releases Blood. There must be sufficient Heart Blood for the Liver to store and release it to meet the body’s requirements. The Liver maintains the free flow of Qi to enhance the circulation of Blood and ensuring it does not stagnate. This helps nourish the Heart aids the Heart in circulating Blood.
A deficiency of Heart Blood often results in a deficiency of Liver Blood, resulting in palpitations, dream-disturbed sleep, insomnia, pale complexion, dizziness, blurred or impaired vision, oligomenorrhea or delayed menstruation. If Liver Blood is deficient the Heart will not be properly nourished and a Heart Blood deficiency may arise, causing such symptoms as, palpitations and insomnia.
Psychologically, the Heart stores the Mind (Shen) and the Liver maintains a smooth, calm emotional life. Stagnation of Liver Qi may lead to unhappiness and constrained emotions causing the Mind to weaken and lower vitality. A weakened Heart may affect the Mind leading to unhappiness and constrained emotions.
5. Heart and Kidney
The Heart and Kidneys are related in two important ways: the balancing of Fire and Water and the common root of Essence and Mind, as shown in Fig. 4. Here Fire is Yang in nature and is used symbolically to denote properties like warming, evaporating, rising, which are analogous to the actual characteristics of a real fire. Fire is the flame that supplies energy for metabolic functions. Water is also used symbolically and is Yin in nature and relates to functions like moistening and cooling the physiological functions to balance the warming action of Fire. They are also connected via Blood.
Normally, Kidney Yin ascends to nourish and moisten Heart Yang; Heart Yang descends to warm Kidney Yin, so that Yin and Yang balanced is maintained. This constant interchange of energy is called the “mutual support or harmony of Heart and Kidneys” or “harmony of Fire and Water” in Chinese Medicine.
Pathological changes will occur when this Yin-Yang balance between the Heart and Kidneys is disrupted. For instance, if Kidney Yin is deficient it cannot rise to nourish the Heat resulting in hyperactivity of Heart Fire. This causes symptoms such as aching back, seminal emission and night sweats (Kidney Yin deficiency symptoms), mental restlessness, insomnia, dream-disturbed sleep, insomnia, red cheeks and a red, peeled tongue with a central crack (Heart Fire symptoms).
If Kidney Yang is deficient Fire cannot evaporate Water (the Kidneys cannot transform fluids), which then overflows, ascending to depress the function of Heart Yang. This pattern is called “Water insulting the Heart” causing manifestations such as, edema, chills, cold limbs, palpitations, shortness of breath and a stuffy chest.
The Kidney stores Essence, from which Marrow is produced and fills the brain. The Heart houses the Mind, which is an external manifestation of Essence. The foundation of the Mind is Pre-heaven Essence and the nourishment of the Mind is provided by Post-heaven Essence. Normal activity of the Mind requires an adequate supply of Essence and conversely, a properly functioning Mind is a necessary condition for properly functioning Essence. The integration of the body and mind, each influencing the other, is a fundamental tenet of Chinese Medicine.
If the Mind is emotionally disturbed, it will not direct the Essence and one will feel tired all the time and lack motivation. If the Essence is deficient, the Mind will be affected causing lack of vitality, will power and confidence.
The Heart dominates Blood and the Kidney store Essence, which also can produce Blood. Essence and Blood are interrelated. Hence, a deficiency of Kidney Essence can result in a deficiency of Herat Blood and vice versa. Therefore, a deficiency of either of these two substances can lead to symptoms of disturbed consciousness such as insomnia, dream-disturbed sleep and poor memory.
6. Lung and Spleen
Spleen Qi is required for transformation and transportation of food and water. It extracts Food Essence and sends it up to the Lungs to combine with the air and form Gathering Qi. On the other hand, the transporting and transforming function of food and water by the Spleen relies on the coordination of the Lungs’ dispersing and descending function. This mutual assistance is shown in Fig. 5.
If Spleen Qi is deficient the production of Food Qi will be deficient. This usually leads to a deficiency of Lung Qi, resulting in poor appetite, abdominal distention and emaciation, accompanied by lassitude, weak cough and voice. Another consequence of Spleen Qi deficiency is that fluids will not be transformed and may accumulate to form Phlegm. This may settle in the Lungs and impair its functions.
Deficient Lung Qi impairs its descending function and so the Spleen cannot ‘stransform and transport fluids. This may lead to accumulation of body fluids and stasis and dampness in the Spleen, which results in chest stuffiness, coughing with a lot of mucous or abdominal distention, borborygmus and edema.
7. Lungs and Liver
The Lungs and Liver are interrelated through their regulation of Qi and Blood, as shown in Fig. 6. Normally, Lung Qi descends and Liver Qi ascends, in order to maintain the harmonious functions of the body. The Lungs govern Qi and the Liver stores and regulates Blood. The Liver relies on Lung Qi to regulate the Blood and the Lungs rely on the Liver for nourishment and smooth movements of Qi.
Dysfunction of the Lungs in descending can result in dysfunction of the Liver’s free flowing. A person will experience cough, dull pain in chest and hypochondriac region and depression, because of stagnation of Liver Qi. It can also result in stagnation of Liver Qi and after a long time, can lead to Liver Fire, which rises upward to consume the fluid of the Lungs (Lungs’ Yin). This can give rise to symptoms such as hemoptysis (heat causes Blood to leave Vessels), pain on breathing; hypochondriac pain and is known as “invasion of the Lungs by Liver Fire”.
Liver Qi stagnating in the chest can obstruct the Lungs’ descending function causing breathlessness, cough or asthma.
8. Lungs and Kidneys
The main association between these Organs is through Water and Qi, as depicted in Fig. 7. The Lungs send Qi and Fluids down to the Kidneys and the Kidneys hold the Qi down and evaporate some of the Fluids, sending them up to moisten the Lungs.
The Lungs govern respiration and Qi, sending Qi down to the Kidneys. The Kidneys respond by holding the Qi down. Deficient Kidney Qi can result from prolonged Deficiency of Lung Qi. If Kidney Qi is Deficient, it cannot receive Qi and it will flow up to the chest, obstructing the Lungs’ descending function. This causes shortness of breath (more on inhalation and worsened on exertion), cough and asthma.
The Lungs govern Gathering Qi and Kidneys store Original Qi. Original Qi flows upward to aid respiration and the production of Blood, while Gathering Qi flows downwards to the Kidneys for nourishment from the Original Qi. This is another example of the mutual assistance between the Kidneys and Lungs.
If Lung Qi is deficient it cannot communicate with the Kidneys, which may result in incontinence or retention of urine, since the Kidneys control the lower orifices.
If the Lungs’ dispersing and descending function fails, Water can accumulate in the chest causing cough, shortness of breath and dyspnea when lying flat.
If the Kidneys cannot transform and excrete Fluids, they may accumulate to cause edema and so impair the Lungs’ dispersing and descending function.
A Kidney Yin Deficiency results in Fluids not rising to moisten the Lungs causing a dry throat and dry cough at night, night sweats and a feeling of heat in the soles of the feet and the palms.
9. Liver and Spleen
These Organs are interrelated by their actions on digestion and Blood, as briefly summarized in Fig. 8.
The Spleen governs transformation and transportation and the Liver maintains smooth Qi flow. If this Liver function is normal, there will be coordination between the ascending function of the Spleen and the descending function of the Stomach so that normal digestion, absorption and distribution of food will occur. In addition, smooth Bile flow will occur, which also helps digestion.
The essential substance of food and water, transformed and transported by the Spleen, will be plentiful for Blood production. The Liver stores and releases Blood, while the Spleen keeps it in the Vessels. They coordinate these activities to maintain normal Blood circulation.
Stagnant Liver Qi may affect the Spleen’s transportation and transformation, producing poor appetite, lassitude, abdominal distention, hypochondriac pain, irregular bowel movement, mental depression and irritability. This symptom-complex is called “disharmony of Liver and Spleen” or “stagnation of Liver Qi leading to deficiency of the Spleen.”
If Spleen Qi is weak it may cause a dysfunction in transportation and transformation. Food will not be digested properly, which may affect the circulation of Liver Qi, resulting in the problems described in the preceding paragraph. In addition, there will be a deficiency of food Essence, which is the souQrce of Blood; also the Spleen may not keep the Blood in the Vessels. Insufficiency of Blood or loss of Blood may lead to a deficiency of Liver Blood, producing additional symptoms such as blurred vision, amenorrhea or oligomenorrhea.
10. Spleen and Kidney
The Spleen and Kidneys are interrelated through their actions on Congenital (Pre-Heaven) Qi, Acquired (Post-Heaven) Qi and Body Fluids as illustrated in Fig. 9.
Figure 9 Spleen and Kidney Interrelationships
The Acquired Qi, obtained from the Spleen’s transformation of food and fluids, continually replenishes, by the Spleen’s transportation, the Congenital Qi. The Congenital Qi helps produce Qi by providing the Heat required for digestion and transformation by the Fire of the Ming Men (Gate of Vitality). The Spleen’s transportation depends on the propelling force of Kidney Yang. Thus, the Congenital and Acquired Qi mutually support each other.
If there is a deficiency of the Kidneys’ Yang, the Ming Men Fire will not aid the Spleen in transformation and transformation, producing symptoms such as chilliness and diarrhea.
When Spleen Yang is deficient, it may lead to an excess of interior Yin and Cold. If this state prolonged, it may impair Kidney Yang and cause deficiency and the symptom-complex called “deficiency of Yang of both the Spleen and Kidney.” This is characterized by symptoms such as abdominal distention, borborygmus, loose stools, pain in the lower back and knees, aversion to cold and cold limbs.
A Spleen Qi is deficiency will lead to a deficiency of Kidney Essence, since not enough Qi will be produced to replenish it. This causes symptoms such as poor appetite, tiredness, dizziness, tinnitus and lower back ache.
The Spleen and Kidney also aid one another in handling Body fluids. If a Spleen Qi deficiency impairs Transformation and Transportation, Fluid may accumulate causing Dampness. This Dampness can interfere with the Kidneys’ function of Governing Water, which produces more Dampness.
If Kidney Yang is deficient, the Ming Men will not be able to provide enough Heat for the Spleen to transform Fluids, resulting in Dampness, edema, diarrhea and chilliness.
11. Liver and Kidney
The relation between the Kidney and Liver is a consequence of storing Essence and Blood, respectively, and the interaction of these two substances, as appears in Fig. 10. Liver Blood nourishes Kidney Essence. Essence produces Bone Marrow, which produces Blood. Hence, the saying “Essence and Blood have the same source,” and “the Liver and Kidney have the same origin.” In addition, Kidney Yin nourishes Liver Yin, which includes Liver Blood.
A Kidney Essence deficiency can cause a deficiency of Blood, causing symptoms such as dizziness, tinnitus or blurred vision. It can also lead to a deficiency of Liver Yin, resulting in “deficiency of Yin of both Liver and Kidney.” Deficiency of Liver Yin leads to overactive Live Yang rising to produce manifestations such as dizziness, blurred vision, tinnitus, headaches and irritability.
Figure 10 Liver and Kidney Interrelationships
In the reverse direct, a Liver Blood deficiency may lead to a deficiency of Kidney Essence, since it will not be satisfactorily nourished by Liver Blood. This results in tinnitus, deafness and nocturnal emissions.
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