Plain Questions: Chapter 11 — Different Discussions on the Five Zang Organs
Overall Paraphrase
The Yellow Emperor asked: I have heard that among the various practitioners, some regard the brain and marrow as Zang organs, some regard the stomach and intestines as Zang organs, and others regard them as Fu organs. These claims contradict one another, yet each claims to be correct. I do not understand the reasoning behind this and would like to hear your explanation.
Qi Bo replied: The brain, marrow, bones, vessels, gallbladder, and uterus—these six are generated by Earth Qi (the qi of the earth). They all store in the yin and emulate the earth, thus they store without draining and are called the Extraordinary Fu Organs (extraordinary hollow organs resembling Fu in form but functioning like Zang). The stomach, large intestine, small intestine, sanjiao, and urinary bladder—these five are generated by Heaven Qi (the qi of heaven). Their qi movement emulates the sky, thus they drain without storing; they receive the turbid qi transmitted from the five Zang organs and are called the Transformation and Transportation Fu Organs (Fu organs responsible for transmission, digestion, and excretion). Water and grain cannot remain here for long but must be promptly transmitted and excreted. The Po Gate (anus) is also governed by the five Zang organs, and the residues of water and grain cannot be retained for long.
The so-called five Zang organs store essential qi without draining, so they can only be maintained in fullness and cannot be obstructed into repletion. The six Fu organs transmit and digest food and drink without storing, so they can only be temporarily replete and cannot be overfilled. The reason for this is that when water and grain enter the mouth, the stomach becomes replete while the intestines are still empty; after the food descends, the intestines become replete while the stomach is already empty. Therefore, it is said: the six Fu organs are "replete but not full," while the five Zang organs are "full but not replete."
The Yellow Emperor asked: Why can the Qi Opening (the Cunkou pulse at the wrist) alone reflect the condition of the five Zang organs?
Qi Bo replied: The stomach is the Sea of Water and Grain and the great source of the six Fu organs. When the five flavors of food and drink enter the mouth, they are first stored in the stomach, which nourishes the qi of the five Zang organs. The Qi Opening also belongs to the Hand Taiyin Lung Meridian. Therefore, the essence qi of water and grain received by the five Zang organs and six Fu organs all originates from the stomach, and its changes are manifested at the Qi Opening. The five qi (sourced from clean air) of nature enter through the nose and are stored in the heart and lungs; if the heart and lungs are diseased, the nose will not be unobstructed. In general, when treating disease, one must examine the patient's lower excretions such as urine and stool, regulate the pulse examination, and observe the patient's mental, emotional, and pathological state. With those who are constrained by beliefs in ghosts and spirits, one cannot discuss profound medical principles; with those who detest acupuncture and stone therapy, one cannot discuss refined medical techniques; with those who are ill yet unwilling to receive treatment, the disease will inevitably be difficult to cure, and forced treatment will have no effect.
🧠 Deep Understanding
Core Principles 💡
- Threefold Classification of Zang-Fu: This chapter classifies the body's organs into five Zang organs, six Fu organs, and Extraordinary Fu Organs. The core criterion of classification is the functional tendency of "storing" versus "draining." The five Zang primarily store essential qi, and are suited for fullness rather than repletion; the six Fu primarily transmit and transform water and grain, and are suited for patency rather than fullness; the Extraordinary Fu Organs resemble Fu in form but function like Zang, storing without draining.
- The Stomach as the Root of the Five Zang, and the Qi Opening as the Sole Governor of the Five Zang: The stomach receives water and grain and transforms them into essential qi. The qi and flavors of the five Zang and six Fu all originate from the stomach. The Qi Opening belongs to the Hand Taiyin Lung Meridian, and the lungs connect with all the vessels. Therefore, changes in stomach qi can be reflected at the Qi Opening—hence examining the Qi Opening can monitor the five Zang.
- Comprehensive Examination and Physician-Patient Cooperation: This chapter proposes that treating disease requires "examining the lower excretions, regulating the pulse, and observing the patient's intentions," and emphasizes that if patients are constrained by beliefs in ghosts and spirits, reject acupuncture and stone therapy, or are unwilling to receive treatment, then healing is difficult to achieve.
Modern Perspectives 🌟
- The classification of Zang-Fu is an ancient functional model, not anatomical structures, and cannot be mapped one-to-one to modern anatomical organs. However, the idea that "the six Fu transmit and transform things without storing" bears similarity to the conduction and emptying functions of the hollow organs of the digestive system.
- The categorization of the Extraordinary Fu Organs reflects the ancients' observations of special organs such as the brain, marrow, bones, vessels, gallbladder, and uterus, and holds some value in terms of systemic thinking.
- Qi Opening pulse diagnosis provided the theoretical foundation for later "solely taking the Cunkou" pulse diagnosis. Modern research suggests that the pulse is influenced by the circulatory, nervous, and endocrine systems, and can serve as an auxiliary observation—but should not be used as the sole diagnostic basis.
- The final section emphasizes psychology, belief, and medical cooperation, which resonates with modern concepts of compliance and psychological factors. However, the idea of "ghosts and spirits" is a historical limitation and should be viewed rationally.
Health Cultivation Insights ⚡
- Moderation in Diet: Protect stomach qi, avoid overeating and binge drinking, and maintain the patency of the six Fu organs to facilitate the transformation and transmission of water and grain.
- Respect the Characteristics of Zang-Fu: The five Zang require quiet nourishment and should avoid excessive depletion; the six Fu require patency, with appropriate exercise and regular bowel habits.
- Pay Attention to Heart, Lungs, and Respiration: The patency of the nasal passages is related to heart and lung function; maintain clean air and practice moderate breathing exercises.
- Approach Illness Rationally: Do not delay medical treatment due to superstitious beliefs. Maintain an open attitude toward medical interventions and follow scientific advice.
📚 Related Knowledge
- Related Concepts: Zang-Xiang Theory, Extraordinary Fu Organs, Transformation and Transportation Fu Organs, Stomach Qi, Qi Opening / Cunkou, Po Gate, Hand Taiyin Lung Meridian, Sea of Water and Grain.
- Further Reading: Plain Questions · Chapter on the Six Sections and Zang-Xiang, Plain Questions · Chapter on the Mysterious Canons, Plain Questions · Chapter on the Generation of the Five Zang, Miraculous Pivot · Original Acupoints, Miraculous Pivot · Stomach and Intestines, Classic of Difficulties · Difficulty 35, among others.
This content is based on classical Chinese medicine texts and is provided solely for the study and reading of traditional culture. It does not constitute any medical diagnosis, medication, or treatment advice. If you feel unwell, please seek medical attention promptly.
