This section describes how Traditional Chinese Medicine (TCM) conceives of the organization of the human being and how it considers the imbalances that can affect its main components:

• the Viscera (ZangFu);
• Substances;
• the Meridian link network (JingLuo) which allows the exchange of Substances between the viscera and all the components of the body such as organic tissues, trunk, head, limbs, etc.

At the next level, all of these elements, and more specifically their relationships and interactions, are described in more detail.

In Western medicine, anatomy and physiology are very descriptive and very detailed. They are based on important notions of chemistry and biochemistry; they accurately describe cells, glands, tissues and the different systems (immune, digestive, circulatory, reproductive, etc.). They also provide a careful description of the biochemical interactions between nutrients, enzymes, neurotransmitters, hormones, etc. She explains that all these elements and all these systems participate in homeostasis, that is to say in maintaining at their normal value the various physiological constants of the individual: temperature, cardiovascular tone, blood composition, acid balance. basic, etc.

In TCM, some texts, defining the characteristics and functions of viscera, substances and meridians, take the place of physiological presentation. Although there are some rather crude descriptions of the shape and weight of certain organs observed with the naked eye during rare dissections, the physiology of TCM mainly includes an analog description of the role of viscera and tissues. Traditional Chinese physiology speaks the old language of pictures. It favors the correspondences between different organic components of which it judges the complementary functions, whether they are viscera, tissues, sensory openings or even emotions and psychic activities.

A whole greater than the sum of its parts

By dint of observation, Chinese doctors have observed that the various components of the body form networks of affinities headed by one of the five major organs, namely the Heart, Lung, Spleen / Pancreas, Liver and Kidneys. These five Organs participate collectively in the balance, both physical and psychic, of the organism, thanks to their network of influence and the management of substances which they preserve or put into circulation throughout the organism by the organism. intermediary of the Meridians. (See Organic spheres.)

For example, the Liver manages the Blood, promotes the free circulation of Qi, influences the circulation of body fluids, digestion, muscle activity, vision, mood (frustration, anger, gloom), menstruation, etc. In addition, its functioning, good or bad, will have a specific impact on other visceral systems and functions. It is therefore from a set of concrete, clinically observable signs that TCM will recognize the proper functioning or pathological state of an organ and its sphere of influence.

This physiology may seem simplistic. Indeed, it has the shortcoming of not being very detailed and would not be of much help to perform brain surgery … On the other hand, it has the advantage of accounting for the whole of the person from a perspective where l he environment, lifestyle, emotions and even personal and spiritual values ​​are intimately linked to health and medicine. This partly explains its effectiveness against chronic or degenerative diseases.

When TCM defines the framework for the onset of an imbalance or disease, it uses the terms External and Internal, which refer to a relationship between the organism and its environment.

Life is essentially a process of exchanges, where our organism must continually assimilate, transform, then reject, a multitude of nutritional contributions from the environment: Air, Food and stimuli. The environment is therefore considered to be an integral part of our “external” physiology. And this environment is itself constantly in transformation, and affected by occasional or cyclical changes. All of these transformations require constant adaptation on the part of our organism so that it remains authentic (Zhen) or correct, (Zheng) to echo both philosophical and medical terms used by TCM. To remain ourselves despite this incessant renewal of what constitutes us, we appeal to another component of our physiology: the Three Treasures of life.

These three treasures represent three forces of our vitality that we perceive through their manifestations, without being able to touch them with our finger.

• The Shén. These are the Spirits who inhabit us. They allow us to be aware, to direct our life, to follow our aspirations, to give a purpose to our existence. The Shén are manifested from the first hours of our existence by a will to exist, and develop according to the experiences of life. (See Spirits.)
• The Jing. Precursors of materiality, they are Essences – in the sense of essential and original – a bit like invisible plans and specifications which weave the web necessary for the manifestation of the Shén. The Essences received from our parents contain the plans of our organism and determine how we will build ourselves: these are the innate or prenatal Essences (see Heredity). Other Essences, said to be acquired or postnatal, are the result of the transformation of Air and Food.

  Acquired Essences can be continuously renewed while innate Essences wear out and are not renewable. Their decline leads to the signs of aging and then death. However, it is possible to save them and take care of them, which is one of the keys to health. (See Substances.) Essences also serve as a support for memory.

• Qi. Considered as “universal energy”, it is the subject of a complete file. In the body, it is perceived as an amalgam of “densified” Breaths. It then takes the form of substances such as blood or organic liquids, which circulate in the body through the networks of different meridians and vessels to reach all the tissues. It also represents the dynamic force which allows to accomplish all the functional activities of the body. Thus, Qi under its dynamic aspects is at the origin of the movement of the various Substances which, for their part, are stable and condensed forms of this same Qi. Just like the Essences acquired, the Breaths must be constantly nourished in order to renew themselves.

Pure and impure are the terms used to qualify the states of Qi. The most refined states are said to be pure; the coarse states (before transformation) and the degraded states of the residues are qualified as impure. To maintain its integrity, the organism constantly operates an assimilation and decantation of the different Qi circulating in the organism. These operations are aimed at the maintenance and preservation of the material framework of the organism, considered as a pure substance.

The decantation of the pure and the impure is done through the viscera. According to their relationship with the pure and the impure, these are classified into two categories, the Bowels (Yang) and the Organs (Yin). The Entrails are responsible for receiving the impure Qi, in the form of Food, extracting the pure components, then rejecting the impure. For example, the Stomach receives Food (coarse, therefore impure) and prepares its decantation; For its part, the Large Intestine, after having completed the recovery of the pure components useful to the organism, eliminates the residues (impure) in the form of stool.

For their part, the Organs are responsible for managing the pure in its various forms: Blood, Organic Liquids, Acquired Essences, Nurturing Qi, Defensive Qi, etc. For example, the Heart circulates the Blood, the Kidneys preserve the integrity of the liquids by eliminating the used liquids and help to refresh and humidify the organism, the Lung distributes the defensive Qi to the Surface, etc.

The Viscera (ZangFu) include on the one hand the so-called “full” Organs (Zang) (Heart, Spleen / Pancreas, Liver, Kidneys and Lung) and on the other hand the “hollow” Bowels (Fu) (Stomach, Small Intestine , Large Intestine, Gallbladder and Bladder).

Although the management of the organism is the responsibility of the Spirits, the balance of physiological functions is attributed to the Viscera. The place of the Brain has been debated at length in Chinese medical texts without ever correctly identifying the functions of the cortex. All Chinese medical theories (Yin Yang, five Elements, Viscera Theory, Meridian Theory, etc.) attribute the control of homeostasis to the viscera and more precisely to the balance of the spheres of influence of the five Organs (Zang) . Before describing the Viscera more precisely, it is important to remember that in Chinese physiology, this description is not exclusively physical.

Several other aspects are an integral part of physiology, including the functions of Organs and their relationship to Substances as well as to emotions. Physiology also takes into account imbalances in organic functions and the deficiency state of Substances or their pathogenic degradations which lead to disorders on all levels, physiological, emotional and psychological. It also takes into account the fact that the non-resolution of internal conflicts, the uncontrollable presence of certain emotions or an imbalance of the Spirits can lead to a bad management of the Substances and a disturbance of the visceral functions.

The division of visceral functions specific to TCM is very old, and includes certain anatomical errors. Even if late, doctors like Wang QingRen (1768-1831) tried to have the errors revised, TCM is slow to change its old codes and its list of functions for the sake of continuity with the clinical expertise that has proven its worth. over the centuries.

The Organs (Zang)

The Chinese names of Organs are difficult to translate, because the entities they describe do not always correspond to the organs defined by Western physiology, hence the use of the capital letter which recalls, for example, that what TCM calls Gan and which is translated as Liver, does not exactly correspond to the liver of Western anatomy.

The Lung (Fei). This organ roughly corresponds to the “western” lung, but it encompasses the exchanges of the right heart and the pulmonary circulation. Indeed, in addition to managing the respiratory system, Fei is the Organ that combines what comes from Food and what comes from Air into a complex Qi that will be distributed to the rest of the body through the blood. arterial.

The heart. It manages the blood vessels and includes the left heart which pulses blood, but it also has certain characteristics of the brain since it is in close relation with the Spirit and the conscience.

The Heart Envelope, located around the heart, has features of the autonomic nervous system that stimulates the heart rate. (Modern Western physiology has also found that part of the heart is made up of nerve cells that are linked to the brain, and that is commonly called the “brain of the heart”.)

The Spleen / Pancreas (Pi). Although it manages the digestive system, it shares some characteristics of other systems (coagulant factors and the role of insulin in cellular absorption, for example).

The Liver (Gan). While corresponding to the hepato-biliary sphere, it has certain characteristics of the hormonal and nervous systems.

The Kidneys (Shèn). They manage the urinary system, but also have certain characteristics of the adrenals and reproductive glands. In addition, between the Kidneys, we theoretically find MingMen, an entity responsible for our original vitality and its maintenance; it is very likely that it is related to the precursor role of hormones from the hypothalamus.

The Entrails (Fu)

With the exception of the Triple Warmer and the “curious” Bowels, the Bowels (Fu) are very similar to those in Western physiology.

The Stomach (Wei) receives and prepares Food.

The Small Intestine (XiaoChang) operates the sorting of Foods.

The Large Intestine (DaChang) eliminates stool.

The Gallbladder (Dan) stimulates the intestines with bile.

The Bladder (PangGuang) eliminates urine.

The Triple Warmer (SanJiao) describes a reality that hardly finds an equivalent in Western physiology. It represents a subdivision of the trunk into three sections also called Foci: the upper Heater, the middle and the lower. All the Viscera (Organs and Entrails) are housed in one or the other of these Foci. We easily perceive the symbolism of the terms Hearth and Heater which designate the places of production and circulation of the different Qi and organic liquids. The Triple Warmer is hollow and is a place of passage and transformation, making it the sixth innards of Chinese medical physiology.

Curious Entrails. In TCM, the vessels, bones, marrow, brain and reproductive organs are part of the Fu Viscera. Even though they are not bowels as we understand them, these tissues correspond fairly well to those described by Western physiology, although the Marrow and Brain have certain functional characteristics unique to TCM.

The Substances constitute the currency of exchange between the Viscera. Blood and Body Fluids, as well as Spirits, various forms of Qi and Essence, are all considered Substances. They constitute all the components which circulate in the body and which activate, protect or nourish the viscera, tissues, sensory organs, etc.

The weakness of a Substance causes pathological signs at the same time as it makes the organism more vulnerable to environmental factors. For example, a weakness of defensive Qi leads to profuse sweating at the slightest effort as well as greater difficulty in warming the skin. This deficiency predisposes to “catch a cold” or to develop repeated infections in areas close to the surface of the body (ear infections, rhinitis, sore throat, cystitis, etc.).

The quality of the Substances depends on the external contributions: on a daily basis, on the diet; in a crisis situation, pharmacopoeia. In addition, acupuncture, massage and health exercises (Qi Gong and Tai Ji) make it possible to act specifically on Substances, activating their circulation, distributing them better in the body and releasing stasis and stagnations. Indirectly, these therapeutic interventions improve the functioning of the viscera which produce the Substances in question (such as the Spleen / Pancreas and the Lung) or those which preserve their quality (such as the Kidneys and the Liver). Finally, as the Spirits are part of the Substances, the meditation exercises (Nei Cong) occupy an important place in the modalities of treatment.

The ability of Air and Food Qi to become Blood, Essences and Body Liquids, and to reach the superficial or deep structures of the organism to defend, nourish, moisten or repair them, depends to a large extent on of their mobility. As we mentioned above, Qi – in multiple forms – enters, rises, falls, and is eventually expelled as waste, through the Triple Heater and the Viscera that work in it.

But this mobility must be projected throughout the organism beyond the Triple Heater, from its center to the periphery, from the viscera to the tissues (bones, skin, muscles and flesh), the sense organs and the limbs. The MTC names JingLuo the distribution network through which this circulation takes place. The JingLuo describes the main axes of circulation (the Meridians), in a simple and rectilinear manner, according to a primarily mnemonic process. Note that modern scientific anatomy has chosen another path by trying to isolate each system and describe it precisely: nerves, arteries, veins, lymphatic vessels, etc. But this way of doing things also has its limits since we note that this vision lacks globality and is never completely complete: we regularly discover new nervous ramifications as well as new networks, such as that of the fascias or those of the currents. ionic and electromagnetic fields.

Rather than seeking to identify with precision the constituents of each network, the MTC lingered, in a very pragmatic way, in discovering the possibilities and the characteristics with regard to the communication, the circulation and the regulation of the functions of the network. ‘organization.

Acupuncture points

Some of the Meridians connect specific points on the body’s surface to various areas within the body. The stimulation of these points, among others by acupuncture, generates a precise action on the circulatory capacities of the meridians and on various organs and various functions.

The mapping of points and meridians is the result of long clinical experimentation. Science is just beginning to see its accuracy and to try to explain the mechanisms involved. In some cases, the peripheral nervous system serves as a support; in others, information travels through the central nervous system or through relational chains such as muscles and fascia; some reactions depend on the release of endorphins; still others are consecutive to the modification of ionic currents in the interstitial fluid caused by acupuncture needles.

The use of instruments specific to acupuncture – needle, heat, electrostimulation, laser light – therefore triggers various reactions, often complementary, which make it possible, for example, to reduce pain and inflammation, to inhibit the exaggerated production of certain transmitters (histamine for example), relax muscles and tendons to straighten the structure, activate blood circulation and nerve impulses to tissues and organs, stimulate hormonal secretions, promote the regeneration of tissues by better elimination of waste and a greater supply of nutrients, allowing repolarization of cells, etc.