Traditional Chinese Medicine

五臟六腑- Oh dear the terminologies

I grew up reading, speaking, and writing Mandarin up until I immigrated to Canada. I pride myself in being able to read long novels written in the traditional Chinese characters even though more than half my life is spent in the Western world. However, I could not conduct my appointments in the language I grew up in. My veterinary training was in English and it was hard enough to memorize the anatomical parts and pathologies with funny pronunciation, let along trying to figure out what the equivalents are in Mandarin. Basically, when I think, I think in English.

You would think it will be easy for me to learn acupuncture and Traditional Chinese Veterinary Medicine (TCVM). It is possible that I have advantage of being able to recognize the characters. However, the course textbooks are written in English, with romanization of Chinese words. And here is where I run into trouble in the first chapter with the characters and concepts that do not match what I know from Western medicine.

With regard to the inner working of our bodies, TCVM has 2 categories, organs that are hollow, and organs that are solid.

Organs that are hollow are called Fu.

Organs that are solid are called Zang.

I immediately made association with Zang. I know its Chinese character is 臟, such as 肝臟 (liver), 心臟 (heart), 脾臟 (spleen), 肺臟 (lung), and 腎臟 (kidneys).  But then what the f$!#^) is Fu? I could not think of what the corresponding Chinese character is for Fu. The textbook says Fu means organs that are hollow, such as intestines, but the word I associate with intestines is Chang – 腸. Furthermore, from the modern medicine point of view, I would think the heart is a hollow organ, composed of 4 chambers. I also think lung is an hollow organ, as it is filled with air.

Then there is the matter of pericardium. Apparently this thin membrane that encases the heart is classified as a Zang as well. Its Chinese is 心包 (pronounced sin- bao), which literally means bag of heart. How would this be considered a solid organ?

Upon further reading, I realized the definition of Zang doesn’t just mean solid organ but also that its content moves slowly (makes sense, it’s harder to move through solid substance) and to be kept within the body, which explains the heart, lung and pericardium. If the contents of these organs are to be moved out of the body, then life cease to exist.

The textbook did warn that the logic in TCVM and modern Western medicine would be very different!

Then from the recess of my memory, I remembered the phrase 五臟六腑, 5 Zahng 6 Fu. I suppose that I am so used this phrase in my reading, that I never stop to think of what the exact definition is, but it would make sense that the hollow organs Fu is associated with the word 腑. Not only are Fu organs hollow, its content moves very fast and are eliminated outside of the body. That being said, what exact are the 6 Fu?

It turns out the 6 Fu is

膽 (Gallbladder)

小腸 (Small intestine)

大腸 (Large intestine)

膀胱 (Bladder)

胃 (Stomach)

三焦 (Triple heater; or triple burner, triple warmer)

Okay, so the first 5 makes sense, but what of the triple burners? Each character makes sense, but when combined, it is a terminology I’ve never encountered before in my entire life, neither in my Western training nor my knowledge of the Chinese language.

Luckily, Wikipedia offers some explanation:

三焦 (triple burners) is 上焦 (upper burner), 中焦 (middle burner) and 下焦 (lower burner). The triple burners do not point to specific organs but rather, anatomical locations as well as metabolic characteristics. To help myself visualize better, I drew a cartoonish rendition.

The torso is arbitrarily visualized as 3 compartments, separated by the diaphragm and the belly button.

上焦如霧,主納 – The Upper Buner

The upper burner is described to be “as fog” and its function is “intake”. This makes sense as the lung, part of the respiratory system, takes in air and distributes oxygen into the blood. The blood is then transported to the heart, where the forceful contraction pushes these oxygen- enriched blood into the rest of the body.

The air that we breath in, mixed with the moisture in the airway, produces a “fog- like” entity. I wonder if the ancients come up with this characterization during the winter time, when the breaths are visible.

中焦如漚,主化- The Middle Burner

The middle burner is supposed to be like “bubble” and its function is to break down. The word 漚 means bubble, or describe a state when things have been soaked in liquid for a long period of time. I suppose this could be viewed through the digestion of food in the stomach, where the food is submerged in a mixture of digestive juice. The process of digestion produces gas, forming bubble at the interface between liquid and air.

下焦如瀆,主出- The Lower Burner

The lower burner is the “ditch” with the function to recycle and eliminate. Digesta is pushed through the intestines to be processed, absorbing more nutrients and water until stool is formed and eliminated through the rectum. Blood travels to the kidneys and proteins, electrolytes, minerals, etc are absorbed or discarded depending on the body’s need and the final product of urine is pushed through the urethra.

Phew! There you have it. I think I am getting the hang of it slowly 😅


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