Section Four extraordinary Fu-organS

Brain, marrow, bone, vessel, gallbladder and uterus are the uncommon fu-organs that are different from five zang-organs and six fu-organs. They are generally named as extraordinary fu-organs.Similar to six fu-organs, most of them are hollow in shape, but their physiological functions are storing essence, which is the same as five zang-organs.

Except the gallbladder, the other extraordinary fu-organs have no interior-exterior relations with five zang-organs, but some of them relate to eight extra meridians.

Some of the extraordinary fu-organs have been mentioned in the part about five zang-organs and six fu-organs. Here only brain and uterus will be introduced.

I The brain

Brain, also known as sea of the marrow and head marrow, is situated in cranial cavity, the top of the body. It is the place where the essence marrow and spirits accumulate highly, so it is said"All marrows belong to brain"in Plain Questions·Generation of Five Zang-organs（Su Wen·Wu Zang Sheng Cheng）.

Brain and skull together are called head. The head is the confluence of yang, the location of clear orifices, from which all clear yang qi come out.The head is situated the top of the body, being the house of spirits and the confluence of yang.

1.Physiological functions

1.1　Governing life activities

Brain, the house of original spirit and the pivot of life, governs life activities of human body. Before one is born, his shape has been formed and his spirit has been inherited, which is known as original spirit.Original spirit is inborn, so it is called innate spirit.Original spirit hides in brain.Original spirit exists and life exists;original spirit fades away and life fades away.Therefore, brain is the key of life activities.

Brain cannot be injured. There is an admonition in Plain Question·Needling Inhibition（Su Wen·Ci Jin Lun）about"The patient will die soon once the needle goes deep into the brain".In clinical acupuncture treatment, when needling points are near the brain such as fengfu, yamen, it must be heeded that the needle cannot go deep in order to avoid death due to injury of midbrain.

1.2　Governing mental and conscious activities

Mental activities of human beings including thinking consciousness and emotional activities are the results of the objective things outside reflected in the brain. Traditional Chinese medicine emphasizes that on one hand consciousness and emotional activities are governed by the heart and on the other hand consciousness and emotional activities are acquired based on the functions of original spirit, which relate closely with the function of brain, i.e.governing spirit, consciousness and thinking.

When the brain governs mental and consciousness activities normally, one can be full of energy, agile in thinking, expressive in communication, with clear consciousness, good memory and normal emotions. Otherwise, abnormality of mental activities would appear, such as insanity, irritability, with destructive tendencies, or listlessness, slow thinking, dizziness, impaired memory, or unconsciousness, even syncope.

1.3　Governing feeling and movement

Eyes, ears, mouth, nose and tongue are the exterior orifices of five zang-organs, which are all located in the head and face and correspond with brain. Watching, listening, speaking and acting all have close relations with brain.Wang Qingren, a physician of Qing Dynasty, pointed out in Correction on the Errors of Medical Works（Yi Lin Gai Cuo）,"Two ears correspond with brain and what they hear belongs to brain;two eyes root in brain like thread and what they see belongs to brain;the nose corresponds with brain and what it smells belongs to brain;brain develops gradually when the baby is one year old when it can say some words".As the house of the original spirit, brain governs the limbs and the body and relates closely with limb movements.If brain marrow is exuberant, thebody can be flexible and strong.

In a word, healthy brain makes healthy spirit. Only when brain governs movement normally can sense of sight, hearing and smelling be agile and feelings and movement be normal.If the sea of marrow is insufficient, it would fail in governing senses and movement, with symptoms of loss of hearing, blurred vision, hyposmia, sensory disorder, akinesia and sluggishness.

2.Relations of brain with essence of zang-fu organs

Brain is formed by marrow, while marrow is generated by essence and essence is stored by the kidney, so brain has close relation with the kidney. If kidney essence is exuberant, the sea of marrow would be nourished and the brain can develop healthily, which can make one energetic, with sound eyesight and hearing, quick in thinking and agile in action.If kidney essence is in deficiency, the sea of marrow would be in poor nourishment and brain marrow is in deficiency, which can cause dizziness, forgetfulness, drumming in the ear or even hypomnesia and mental slowness.However, kidney essence is mainly innate essence which requires the nourishment of acquired essence, so exuberance of brain marrow not only relates to kidney essence but also to the essence of five zang-organs and six fu-organs.Exuberance of essence of zang-fu organs can nourish kidney essence and make it exuberant, which in turn keep brain marrow exuberant.Only this can help brain exert fully its functions.

Spirit, consciousness and thinking governed by brain all attribute to the heart according to the theory of zang-fu manifestation. The heart is the monarch organ, major governor of five zang-organs and six fu-organs, where intelligence comes out and spirit houses, so it is said"heart storing spirit".If the heart dominates spirit normally, one can be energetic, conscious in mind, agile in thinking and quick in response to exterior information, with good memories.If the heart fails in dominating spirit, abnormality of mental and conscious activities may come up.

Meanwhile, spirit can be divided into mind, spiritual soul, corporeal soul, thought and will according to their representation, which attribute respectively to heart, liver, lung, spleen and kidney, i. e."five spiritual zang-organs".That is because mental activities take qi and blood of five zang-organs as the substantial basis and are the exterior manifestation of the functional activities of five zang-organs.Five zang-organs and mental activities are closely related to each other, just as Plain Questions·On Manifestation of Yin and Yang（Su Wen·Yin Yang Yin Xiang Da Lun）says,"Five zang-organs generate five qi, which generates joy, anger, sadness, grief and fear".

Though spirits attribute to five zang-organs respectively, they are related most closely with heart, kidney and liver. Since the heart governs spirit and consciousness, though five zang-organs all store spirit, it is under the guidance of the heart that they exert their functions.Brain is formed by the marrow and essence, so the liver dominates free flow and thoughts to adjust spirit and mental activities.

In general, according to the theory of zang-fu manifestation, five zang-organs are a systematic whole. Though mental activities attribute to five zang-organs respectively, they are governed by the heart.Brain is house of the original spirit.Physiologically and pathologically brain is attributed to five zang-organs.Only when physiological activities of five zang-organs are at normal state can physiological functions of brain be exerted fully.Therefore, pathogenic changes of brains should also be differentiated and treated by differentiating and treating five zang-organs.

II The uterus（Appendix:Essence Chamber）

Uterus, also known as womb, baby organ, blood zang, is situated right in the middle part of lower abdomen, like an inverted pear in shape. It has the functions of governing menstruation and conceiving fetus.

1.Physiological functions

1.1　Governing menstruation

Menstruation is also called in Chinese yuexin（monthly message）,yueshi（monthly matter）,and yueshui（monthly water）. Menstruation is a physiological phenomenon of regular vaginal discharge of blood when female germ cells develop to maturity.When a healthy female is at about 14 years old, sex-stimulating essence would come, reproductive organs are mature and the wombwould change regularly, discharging blood once a month（28 days）.This is the start of menorrhea.Until the female is about 49 years old, sex-stimulating essence is exhausted and menstruation stops.Occurrence of menstruation is the result of qi and blood of zang-fu organs and sex-stimulating essence acting on uterus.Whether uterus functions normally affects directly regular menstruation, so uterus has the function of governing menstruation.

1.2　Conceiving fetus

Uterus is the organ for female to conceive a fetus. When female develops to maturity, menstruation would be on time and the reproductive capability would be acquired.Now once male and female intercourse, conception would be made.After one is pregnant, menstruation would stop and qi and blood of zang-fu organs and meridians would flow into uterus through conception vessel and thoroughfare vessel to nourish the fetus.

2.Relationships of uterus with zang-fu organs and meridians

It is a complex physiological process for uterus governing menstruation and conceiving fetus. It is affected by zang-fu organs, meridians, qi, blood and many other factors, among which it is related to kidney, heart, liver, spleen as well as conception vessel and thoroughfare vessel mostly closely.

2.1　Uterus and zang-fu organs

Blood is the base of female physiological activities. Menstruation is generated by blood, gestation depends on the nourishment of blood, and blood derives from zang-fu organs, among which heart, liver and spleen are responsible for generation, circulation and regulation of blood.The heart dominates blood;the liver stores blood;the spleen governs blood.So, with cooperation of heart, liver and spleen, generation and circulation of blood are ensured, so that uterus can be nourished with blood periodically to maintain the functions of regular menstruation and fostering fetus.If the physiological functions of heart, liver and spleen decline or if abnormality comes up, normal functions of uterus canbe affected, resulting in diseases of menstruation or gestation.For example, deficiency of both heart and spleen can cause poor generation of qi and blood, which may result in mild menses, irregular menstrual cycle, even amenorrhea;spleen failing in governing blood can cause failure of blood to circulate in the vessels, which may result in metrorrhagia and metrostaxis;stagnation of liver qi usually results in menoxenia.The above mentioned syndromes can further give rise to diseases of gestation.

Meanwhile, the functions of uterus producing menstruation and breeding fetus must depend on the regulation of spirit, the promotion of qi and the nourishment of essence. The heart stores spirit and dominates blood and vessels;the liver dominates free flow, and regulates qi movement and emotions;the spleen is the source of qi and blood;and the kidney stores essence, dominates reproduction and is the source of innate essence.The development of uterus relies on the functions of"sex-stimulating essence",which is a kind of refined essence that is generated when kidney essence and kidney qi are exuberant to certain extent.When kidney essence and kidney qi are exuberant, sex-stimulating essence is generated, the thoroughfare vessel and conception vessel are unobstructed and exuberant, and female menstruation comes and the ovum is produced.Now one can be said that she has acquired the ability of reproduction.So five zang-organs all have close relations with uterus, among which uterus are most closely related with the heart, the liver, the spleen and the kidney.

2.2　Uterus and the meridians

Uterus has close relations with thoroughfare vessel, conception vessel, governor vessel and belt vessel, among which"thoroughfare vessel is the sea of blood",and"conception vessel governs embryo". So the functions of uterus relate most closely with thoroughfare vessel and conception vessel.

2.2.1　Uterus and thoroughfare vessel and conception vessel

Both the thoroughfare vessel and the conception vessel originate in uterus. Their functions are mainly circulating qi and blood to nourish uterus and foster fetus.The thoroughfare vessel goes in parallel with the kidney meridian andcorresponds with the meridian of yangming.It is the place where the twelve main meridians converge and it can regulate qi and blood of the twelve meridians.So the thoroughfare vessel is named as"sea of blood",and"sea of twelve meridians".The conception vessel converges with the meridian of foot sanyin.Being"sea of yin vessels",it governs various yin meridians and regulates qi and blood of yin meridians of the body.Conception（ren in Chinese）has the meaning of"to shoulder, to breed and to foster".That is to say the conception vessel has the function of breeding and fostering fetus.So there is the saying"conception vessel governs embryo".Exuberant qi and blood of twelve main meridians flow into the thoroughfare vessel and the conception vessel, by which they are regulated and irrigated into uterus, i.e.only when"conception vessel is clear and meridian of taichong is exuberant"can uterus maintain the functions of governing menstruation and breeding fetus.Conversely, if the thoroughfare and conception vessels are in disorder or deficient in qi and blood due to some reasons, symptoms of irregular menstruation and even infertility may come up.

2.2.2　Uterus and governor vessel

The governor vessel is"sea of yang vessels". Both the conception vessel and the governor vessel originate in uterus.The governor vessel runs through the back of the body and the conception vessel through the front of the body, both of which converge at yinjia.Meridian qi keeps circulating through these two meridians, communicating yin and yang, regulating qi and blood, so as to maintain the normal physiological functions of uterus governing menstruation and breeding fetus.

2.2.3　Uterus and belt vessel

The belt vessel circles around the waist like a belt, restraining longitudinal meridians, governing qi and blood of the thoroughfare vessel, the conception vessel and the governor vessel. It can also fasten and protect fetus, which has some relations with the physiological functions of uterus.

Appendix:Essence Chamber

Essence chamber, also known as essence zang-organ, essence house, is the reproductive organ and one of the extraordinary fu-organs of male. Essence chamber includes testis, epididymis, seminal vesicle and prostate in anatomy.With the functions of generating and storing sperms, it dominates reproduction.Functions of essence chamber relate closely with exuberance and deficiency of essence in the kidney, so it is governed by the kidney.It also has close relations with the governor, conception and thoroughfare vessels.