Things have been quiet on here the last year but I have not been idle. Last year I completed a Masters degree in Chinese herbal medicine at the University of Westminster and since then I have been both busy with patients, setting up a dispensary, modernising my record-keeping and developing some tools to help me in my practice. One of these is my formula database which currently holds about 400 formulas and has a drill down search tool to help narrow down any particular presentation to a few that can be used as a basis for formula construction. In other related news I am now training two evenings a week in Tai Ji plus workshops on many weekends and assisting the instructor in classes.
With this bank holiday I decided to spend some of it researching the meanings and etymologies behind some common terms used in Chinese medicine. In a previous post I argued that the common practice of referring to the channels by their Zangfu organ names is confusing and can even be troubling when someone comes to their Chinese medical specialist for stress relief and leaves believing themselves to have been diagnosed with a liver disease. In there I suggested that the classical way to reference these channels, as primarily greater or lesser Yang or Yin makes more sense if we take some effort to understand what those terms really meant. It is hardly surprising that two-thousand year old Chinese concepts do not neatly translate into modern English without a certain amount of distortion but the degree to which this happens is often underestimated, even by professionals. Some have even argued that the entire of TCM has systematically done this as it attempted to materialise classical terms which referred to function instead of structure (Prescott, n.d.). Today I am going to continue that theme by looking at what the organ names actually refer to in terms of their pictograms and etymology.
I am no scholar of Chinese language and do not make any attempt to presume these expositions are definitive. Most of the meanings and origins have simply been traced through wiktionary with some help from a document I found by Andrew Prescott (n.d.) on the same subject.
The most important character for general consideration is 肉: “meat or flesh” and represents the ribs of an animal’s torso. When it is appended to another character it looks like ⺼ although it is also often drawn as 月. This radical appears in all but one of the terms described here and simply shifts the meaning of the rest of the character to being in relation to the body.
The next two characters for general consideration are those that make up the general term for organs themselves, 臟腑:Zangfu. Paul Unschuld (2016), in his recent translation of the Ling Shu, uses “Long Term Depots” and “Short Term Repositories”. 臟:Zang refers to the solid organs or viscera and is comprised of ⺼ and 藏: “to hide, conceal, hoard or store” suggesting places in the body where precious things are kept. 腑:Fu refers to the hollow organs, bladders and bowels, derived from ⺼ and 府: “a government office, official residence or building where documents are consigned”. This last character itself is made up of the characters for a building (广) and the character 付 meaning “to deliver or hand over” (a hand giving to a person). This suggests a place where orders are carried out and reflects the hollow organs function of filling and emptying.
The last character for general consideration is 官: guan, “a government official or officer”, which is used to describe each of the organs in Su Wen Ch. 8, by far the most important text in defining the the organs. It suggests that each one is in charge of a function. This brings us back to the essential point that each “organ” is not the physical structure in the body but rather a function which can be seen in most living things, including plants or single cells. Their structural equivalents in the body are simply the areas where this function is most condensed in the human form.
Each organ will now be discussed in the order presented in the Su Wen, Ch. 8:
心 Xin, Heart
Probably the most literal: a stylised picture of a heart. The importance of it being the only character that is not a composite of other characters and the only one without the radical ⺼ is certainly noteworthy but probably worthy of a post in itself. Suffice to say that even from early times it was probably an organ known as vital to life and closely connected to the spirit. The Su Wen, Ch. 8, introduces the Heart first and describes it as “the official functioning as ruler. Spirit brilliance originates in it.”
肺 Fei, Lung
Comprised of ⺼ and 市: “a city, town, market or trade centre”, itself derived from 兮: “bustling”. The implication is the aspect of a body which is in continual exchange, as the lungs are continuously exchanging with the air around us. The Su Wen, Ch. 8, describes it as “the official functioning as chancellor and mentor. Order and moderation originate in it” which suggests its role is subordinate to the Heart (ruler) which issues orders and cannot be directly controlled, whereas the breath can be regulated and through it many functions in the body can be moderated.
肝 Gan, Liver
Comprised of ⺼ and 干: “a shield”. Other meanings include “to request, to ask, to offend, to encroach on, to interfere, to intervene, to concern, to be implicated in, or a bank or edge of a body of water”. Essentially it is to do with boundaries, primarily preserving one’s own in its original meaning of a shield but also to do with breaching the boundaries of others. This relates directly to its description in the Su Wen, Ch. 8, which describes it as “functioning as general. Planning and deliberation originate in it.” In terms of medicine it is most often implicated in disorders arising from frustration and anger, when we feel our boundaries have been breached and we seek to retaliate.
膽囊 Dan Nang, Gall Bladder
Consists of 膽 and 囊. The last character means “a bag or pocket” and is a complicated character deriving from a picture of a bag, tied up with various items in, simply suggesting its role as a repository or temporary storage. The first character is more interesting as it is comprised of ⺼ and 詹: “verbose”, itself a compound of 厃: “to look upward”, 儿: “child”, a picture of a standing person, and 言: “speech”, a picture of a man 辛 (actually a tool used to mark slaves and criminals, also meaning “laborious or hardship”) with words coming from his mouth 口. I find this character interesting because it shows the nature of the Gall Bladder as described in the Su Wen, Ch. 8, as the “the official functioning as rectifier. Decisions and judgments originate in it” and defines that courage required to rectify decisions and judgements as being like a slave, criminal or inferior person daring to speak up to a superior, the other Zangfu. It is also worth noting that this is the first Fu to be described by the Su Wen, Ch. 8, indicating its importance in relation to the other organs, just below the Heart (ruler), Lung (chancellor) and Liver (general).
膻中 Dan Zhong, Pericardium
Consists of two characters, 膻 and 中. Generally translated as 膻: “Chest” 中: “Centre” but the first character is no longer really used in modern language, maintaining the curious definition of “a rank, sheepy odour” but has some interesting historical and etymological definitions. Consisting of ⺼ and 膻: “sincere, truthful”, the second part derives from 㐭: “a granary, supply or store” and 旦: “dawn”, the sun (日) appearing over the horizon (一). The idea of a place to store the dawn is a poetic description of a Taoist altar where sincere rituals are performed at dawn. This is not always considered an organ in its own right but an aspect of the Heart although it is considered an official in the Su Wen, Ch. 8, which describes it as the “minister and envoy [from which] joy and happiness originate”. This suggests the emotional side of the Heart which is only really happy when it is being genuine. This makes the usual translation of “pericardium”, the sac surrounding the heart, a very awkward translation with a clear anatomical agenda, and an inaccurate one at that.
胃 Wei, Stomach
Comprised of ⺼ (this time squashed on the bottom) and 田: “a field”. A fairly straightforward representation of the stomach as the place we sew the grains that we eat in the inner landscape of our body. This is echoed by the Su Wen, Ch. 8, where both the Spleen and the Stomach are described as “responsible for grain storage”. Spleen is mentioned first but since the character for Spleen seems to build on the one for Stomach I have reversed their order here.
脾 Pi, Spleen
Comprised of ⺼ and 卑. 卑 translates as “low, humble, mean, ignoble” and may refer to its relationship to the flesh as the general substance of the body but given its importance in Chinese medicine it seems an unusual choice of character. If we break it down we find 田: “field” (recall the Stomach above) with 十: “ten” and 丿: “slash” which implies the work of the farmer, ploughing the field and slashing the crops to harvest them which bears a greater relevance to the function of the Spleen as the ability to extract energy and nutrition from the food we eat at all points in the body, from the gut to individual cells’ ability to utilise that energy.
大腸 Da Chang, Large Intestine
Consists of 大:”big, great, large” with 腸. 腸 is an interesting term translating as “intestines” but also “emotions”. The last definition makes some sense if we see it derives from our usual “flesh” radical ⺼ plus 日:”Sun”, 示: “to show”, referring to an image of an altar, and 彡: “hair”, which combined with the radical for the sun indicates the rays of the sun. When combined the definition of “emotions” makes more sense if we see it as meaning to show the rays of the sun, especially if we consider the Heart, the seat of the Shen, to be related to the sun in the seasonal iconography of the seasons (Heart = Summer in Su Wen, Ch. 2). It also helps to explain why there is such an emphasis on treating the Yangming and Taiyang meridians (which contain the Large and Small intestine respectively) in Ch. 22 of the Ling Shu on 癲狂 Dian Kuang manic disorders. This makes sense in light of the Su Wen, Ch. 8, which describes it as the “transmitter along the Way [Dao, 道]. Changes and transformations originate in it” ascribing a much more spiritual function than just defecation.
小腸 Xiao Chang, Small Intestine
Consists of 小: “small, minor” and 腸: “intestine, emotion”. See the entry on the Large Intestine above. The Su Wen, Ch. 8, describes it as the “recipient of what has been perfected. The transformation of things originates in it” which connects it to the function of the Large Intestine and its psycho-spiritual connotations. It is worth noting that in the Shang Han Lun there is some overlap between the Heart and upper intestinal tract with the various Xie Xin Tang (Drain the Heart Decoction) formulas being used primarily to clear an obstruction in the epigastrium.
腎 Shen, Kidneys
Comprised of ⺼ and 臤: “firm and solid, rigid, stable”. This indicates their role as the foundation of Yin and Yang, the substances which form the basis of all things and whose balance is the basis of life. Life begins when these two interact to generate Qi and their separation is its end. This character is derived from 臣: “minister” and 又: “right hand”, calling to mind the idea of a right-hand man to the emperor, the Heart, but also indicating repetition which may refer to the Kidneys being the only organs which are plural, or reinforce the idea of stability as able to perform an action over and over again without depletion. The Su Wen, Ch. 8, describes them as an “operator with force. Technical skills and expertise originate from them.” Tang Rongchuan (cited in Unschuld and Tessenow, 2011) relates this to the bones which are both the stable structure around which the rest of the body is constructed and enable us to perform technical manipulations.
三焦 San Jiao, Triple Burner
Probably the most complex organ to translate, being described as the organ with “name but no form” and having functions which vary throughout history from being the water passageways, to the body cavities and interstitial spaces, to having functions like the endocrine and thermoregulatory systems which are distributed throughout the body and have no one particular locus. It consists of 三: “three” and 焦: “burned, scorched or anxious, vexed”. The last character is made of 隹: “a short-tailed bird, e.g. a sparrow” and 灬: “fire”, simplified form of 火. I do not know whether it may have represented a ritual sacrifice of a bird by burning or be a representation of a phoenix-like creature like the 鳳凰 Fenghuang. In the Su Wen, Ch. 8, it appears between the Kidneys and Bladder and is described as “opener of channels. The paths of water originate in it” suggesting it is the link between the Kidneys and Bladder. I discussed the alchemical implications of a system which simultaneously combines water and fire imagery in my previous post.
膀胱 Pang Guang, Bladder
Consists of two characters. 膀 means “upper arm, wing, shoulder or flank” of obscure origin but presumably an anatomical reference to the location of the channel traversing the arm and shoulder. 胱 is ⺼ plus 光: “a beam of light”, pictographically a representation of a person holding fire over their head (光: 火 “fire” and 卩 “a kneeling person” emphasising the shining of light). This seems to relate more to the designation of this meridian as Taiyang (Greater Yang) and the fact that it passes through all of the back Shu points and so shines its light on all regions of the body, like the rays of sun shine on all the provinces of the land. As I discussed in my previous post, the Taiyang are also the Yang partners of the Shaoyin organs and so the reference to light may also represent the Yang, outer and active, aspect of the Heart and Kidneys, the ones who bring the light of the emperor and his ministers to the world and transform it into outer action and movement. This may be speculative but it obviously refers to a lot more than the temporary storage of urine which the simple translation of “bladder” implies.
Confucius called for the “rectification of names” (Analects, Book XIII, Chapter 3, verses 4-7 in Legge, 1971) to ensure we maintain the correct relationship with the things we refer to. In Chinese medicine we have the challenge of adopting words and terms that are not only in a foreign language but also from another time and a different mindset to the one we are brought up with in contemporary western civilisation. This may threaten many of the most powerful concepts in Chinese medicine, those which deal with functional relationships rather than material structures, to disappear from our practice if we do not remain mindful of the original meanings behind the clumsy translations which have now become standardised. This may not be occurring only in the west but in China too where disciplines like TCM have become official. Fortunately, due to the pictographic nature of Chinese writing it is possible to tease out the ancient meanings of these terms no matter how long it has been since the word was understood in its original context. If we can expand our possibilities for interpreting the basic terms we use it can lead us to developing new possibilities for applying them in practice.
Legge, J. (1971). Confucian Analects: The Great Learning, and The Doctrine of the Mean. Dover Publications. pp. 263–264.
Prescott, A. (n.d.). Twelve Officials and Five Zang & Six Fu. Available from: http://www.harmonygate.com/chinesemedicine/officialszangfu.pdf.
Unschuld, P. & Tessenow, H. (2011). Huang Di Nei Jing Su Wen: An Annotated Translation of Huang Di’s Inner Classic – Basic Questions: 2 volumes. University of California Press.
Unschuld, P. (2016). Huang Di Nei Jing Ling Shu: The Ancient Classic on Needle Therapy. University of California Press.
Wiktionary. Available from: https://en.wiktionary.org