How TCM Understands the Body

Traditional Chinese Medicine (TCM) studies the Yin-Yang imbalances in the body with a holistic approach of looking at how all areas of the body are interconnected and treating the root cause of symptoms. So the question is: how do we figure out where the imbalance lies?

With TCM, we look deeper into the underlying relationships between substances, organs, and pathways to see where they are experiencing disharmony. Rather than view them as purely anatomical and biochemical, TCM believes that they have both physical and non-physical compositions that inform their functions. Here are the core parts of the body:

• The Five Fundamental Substances for creating life
• The Zang-Fu organs
• Jing-Luo — the channels that connect everything in the body

The interconnectedness of these parts maintains balance in the body. It enables them to break down food into nutrients and distribute them, move substances around, protect the body from foreign pathogens, and regulate internal temperature. In fact, one substance in particular unifies everything together — Qi, which is the unique, vital life force of the body and the universe.

Fundamental Substances: The Power of Qi

According to TCM, the Five Fundamental Substances are responsible for creating life:

• Energy (Qi) — the vital life force of the body
• Blood (Xue) — the liquid life force of the body
• Essence (Jing) – the raw element or marrow that makes life
• Bodily fluids (Jin Ye) — distributors of nutrients 
• Spirit (Shen) — regulator of emotions

Out of all five, Qi is the most essential because it is the energy that keeps us balanced and gives life to the universe. TCM practitioners study Qi in the body more than anything else. Even Yin and Yang do not exist without it. As a central part of the body, it enables everything to function properly and helps the body navigate any internal and external changes. Note that it has both physical and intangible forms:

• Physical — the energy that makes up air, water, and the food we intake
• Intangible — the fluids and energy that flow through the body

We can further understand its unique configuration from its Chinese character; the radical is for “steam” and the character is for “rice.” It comes from two sources — the kidneys (as a prenatal form, created at conception) and natural material (food, water, air). In the body, Qi flows through the Jing-Luo pathways. Any changes to it — a blockage, stilted flow, or excess, for example — communicates what is happening in the Yin-Yang balance of the body on a macro scale.


Changes in Qi
 

There are four main disharmonies of Qi:

Deficiency: the inability of Qi to perform its usual functions, which creates patterns of imbalance and arises as various symptoms, depending on what area of the body is affected.

An organ might be unable to function properly due to Qi deficiency, or the imbalance can be found throughout the whole body and result in fatigue or no desire to do anything.

Collapse: a subset of deficiency that results in organs not held in place properly. Examples include abdominal distension or the uterus sinking downwards due to a weak pelvic floor.

Stagnancy: its inability to flow smoothly throughout the body’s pathways. It can lead to aching joints when it congregates in the limbs or even impair an organ’s regular function.

Since each organ has their own Qi, any changes can affect their activities and create patterns of imbalance in the body that manifest as illness. For example, a blockage of Qi in the pathways to the liver can affect the organ itself. An excess of Yang would accumulate and result in hypertension symptoms.

Rebellion: when Qi reverses the direction of its flow, the body reacts by showing symptoms of illness. For instance, TCM theory believes that stomach Qi should move downwards. So if it moves upwards instead, symptoms like nausea and vomiting may follow.


Fundamental Substances: Blood and Bodily Fluids

Blood is actually an element of Qi and provides organs with nutrients. The stomach and spleen hold responsibility for blood production. When Qi stimulates the blood, the organs receive nourishment from the blood and thus create more Qi as a cycle of healthy activity. 

Blood’s other primary role involves circulation so that the body continually experiences smooth flow and steady, regular functioning. Imagine if there is either too little or too much Qi — blood would be affected, which then affects the organs, and the body would experience disruptions that result in illness. 

There are also two states of disharmony in the blood: deficiency and stagnation. When the entire body, a particular organ, or specific body part is not well-nourished by blood due to lack of it, symptoms can arise like dizziness, pale skin, or palpitations. A stilted flow of blood can cause a buildup of it, leading to sharp pain, tumors, and cysts. And since TCM holds true to the mind-body connection, blood deficiency and stagnation can also manifest as psychological symptoms — potential challenges with self-esteem, insomnia, shyness, and paranoia. 

Similar to blood, bodily fluids are a component of Qi and consist of both thick and thin liquids that distribute nutrients throughout the body. They basically keep everything (from hair, skin, and nails to the brain, muscles, and organs) moist and nourished. Examples include sweat, tears, urine, and spinal cord fluid. Note that bodily fluids are not as crucial as the other four substances, but they are still used as part of TCM diagnosis.


Fundamental Substances: Essence and Spirit

The connection between the mind and the body also explains why there are intangible, more abstract substances (besides Qi) that influence how the body functions. Essence is the substance that contains every living thing’s raw material for creating life, and it also serves as energy reserves. As the Yin side of Qi, essence takes care of the body’s growth, development, and production of substances like menstrual blood and bone marrow. It also works with Qi to create spirit, which represents the Yang nature of Qi and regulates the body’s emotions. While essence is stored in the kidneys, spirit is stored in the heart. 

Any excess, deficiency, or stagnation with any of these substances — particularly Qi — create numerous possible patterns of imbalance. Far from being a simple form of healing, TCM embraces a detailed, extensive approach that analyzes even the most minute changes in the body’s balance.


What are the Zang-Fu Organs?

The five substances work to maintain balance in the body while the Zang-Fu organs establish and nurture that balance. These organs are the sources for these substances. Unlike Western medicine, TCM perceives organs by what they do, rather than their anatomical structures. 

Where a Western physician would treat a thyroid issue by focusing on the organ directly with surgery, for example, TCM would approach it by treating a combination of multiple organs that include the liver, kidneys, and spleen. Chinese Medicine treats issues at the root cause by examining how the relationships between parts in the body manifest patterns of imbalance.

Zang organs:

• Heart
• Spleen
• Lungs
• Kidneys
• Liver
  
  

Fu organs:

• Stomach
• Small intestine
• Large intestine
• Urinary bladder
• Gallbladder
  
  

There is one more member in the Fu family called Sanjiao, but it is not a physical organ. It represents the separation of organs with three parts — upper, middle, and lower — where specific organs are held in each area, sort of like their own neighborhood. For instance, the heart and lungs are in the upper part, spleen and stomach in the middle, then kidneys and bladder in the lower part. 

Zang organs make and store substances while Fu organs disperse nutrients and remove waste. Since these organs represent Yin and Yang, each Zang organ has its Fu partner, and every organ has its own Qi. The gallbladder and liver are a pair, and so are the heart and small intestine. These relationships are forged through the movement and interactions of substances that flow between them. 

For example, the spleen is Yin and its organ partner is the stomach (Yang). The stomach and spleen both work to care for digestion, but they own separate roles. The stomach breaks down food and sends the nutrients to the spleen, which then synthesizes them into the material for creating Qi and blood. The “physical” part of food is sent downwards from the stomach to the small intestine for more digestion. While the spleen moves substances upwards, the stomach moves things downwards  — a beautiful demonstration of complementary work and Yin-Yang balance. 


How Fundamental Substances and Organs Interact

The spleen can help us further understand the relationship between organs and substances. It is responsible for digestion and serves as a major source of blood and Qi, so naturally, it has a close relationship to these substances. It takes nutrients from food and transports them to muscles, flesh, and other organs via Qi and blood. It also moves nutrients upwards to the lungs so that blood and Qi can be produced there. 

Spleen Qi also ensures that blood moves to where it needs to go, so any Qi deficiency affects blood flow and can cause symptoms like uterine bleeding and bloody stools. Many chronic bleeding diseases arise due to disharmony in the spleen. Otherwise, a healthy spleen leads to an abundance of Qi and blood, along with strong digestive functioning. 

TCM also believes that the spleen is in charge of our decision-making, motivation, and creativity. A healthy spleen means we are better able to make rational decisions, form insights, and maintain clear thoughts. On the other hand, an imbalance in the spleen could be connected to feelings of anxiety, confusion, and indecision.

While the spleen and other organs are important, the heart is the most central, or “emperor,” organ of the human body. It mainly regulates blood flow by ensuring that it courses easily through the vessels. When heart Qi and blood are free-flowing and abundant, the heart feels balanced and indicates that with a steady pulse.

It also stores the spirit (Shen) substance; when the heart’s spirit is balanced, we experience less anxiety or flustered thoughts and more joy. According to TCM, our ability to express ourselves and create conversation stems from the connection between the tongue (which is an organ, in fact) and heart spirit. If the tongue shows inflammation or ulcers like canker sores, TCM doctors may use acupuncture or treatment focused on the heart to care for those patterns of imbalance.

Read more about tongue analysis here: What Your Tongue Reveals About Your Health 


Meridian Pathways

The meridian channels (Jing-Luo) connect organs and substances together so that everything can work in synergy. The word for meridian describes it well, since Jing means “to go through” and Luo means “something that connects or attaches.” Meridians do not have physical, tangible matter like blood veins, but in TCM they play a significant role by carrying Qi and blood throughout the body and linking all its parts together. Harmony does not exist without these channels that ensure the body’s state of balance. 

Read more: What a Balanced Cycle Really Means

There are 72 meridian systems, and 12 of these meridians connect to the network of Zang-Fu organs to move blood and Qi. TCM theory states that disruptions in the meridians can reveal imbalance in organs or disharmony along the pathways themselves. 

For example, pain along the heart channel can result in heart Qi deficiency, just like how a damaged straw cannot allow liquids to flow through easily. If someone experiences an upper toothache, the real issue is disharmony in the stomach because a meridian from the stomach passes through to the upper gums. That is why it is so important to discover the root cause of our symptoms; the truth can be found in unexpected places. 

We can visualize these connections by pressing on a particular point (also known as a pressure point or acupoint) on the outside of the body to inform what is going on internally. The meridians connect the body’s interior to the exterior, and practices such as acupuncture and acupressure focus on healing the root causes of symptoms via these meridians. 

Relief awaits: Read 5 Acupressure Points to Take the Stress and Pain Away


The Body as a Work of Synergy

The TCM approach to how the body works focuses on synergy — where all parts of the body are intertwined and connected. From the interactions between organs, substances, and meridians to the emphasis on Qi and energy, we can begin to holistically understand where imbalance is happening and heal at the root cause. 


Other Sources

Kaptchuk, Ted J., and Ted J. Kaptchuk. The Web That Has No Weaver: Understanding Chinese Medicine. McGraw-Hill, 2008.

This article was reviewed by Dr. Liem Le.
Dr. Liem Le is a Doctor of Chinese Medicine, Functional Medicine Practitioner, and Nutritionist Integrative Medicine Department at H. Lee Moffitt Cancer Center. He is a part of the teaching staff for the Masters program for the Functional Medicine and Human Nutrition program at University of Western States. Dr. Le is currently working on his fellowship in Integrative Medicine with the Academy of Integrative Health and Medicine via a scholarship from the White House to complete the initiative.