Chinese medicine, the Earth and the Center
When talking about the five elements, particularly as applied to the organ systems of Chinese medicine, it’s easy to find an angle from which to proclaim the supremacy of any of the elements. Fire gets four organs, for instance, one of those being the Emperor - surely it’s the most important. Water, on the other hand, lies at the depths - no element is more revered than water in the cultural literature of the Chinese (the Dao is often said to be like water, the supreme man is said to be like water in taking the lowest place, etc….). Surely water is “top dog,” then. But what of Wood? Wood begins the cycle of the elements from most perspectives - it is the animating principle of the whole system - Wood must be the most important.
So on and so forth. The answer to the question, “Which is most important,” is the absurdly easy and frustrating, “None.” However, Earth could have a better reason than the rest to lay claim to this elusive prize. Earth is the center - the center is the axis upon which everything else spins. Without the center, you just have a group of unassociated pieces, functioning on their own in vain. The center brings it all together, ensures that it functions.
There are two ways to think about Earth seasonally. One perspective holds that Earth is associated with a kind of “late summer,” just before the fall rains begin. Another, which I prefer, holds that the Earth occupies an interstitial space between each season - the 14 days or so around each solstice and equinox - the transitions from one season to another. I’ve heard a variety of perspectives about the actual length of time and the precise arrangement of those periods, but this seems to be a consensus. Regardless, this “in between” nature of the Earth element makes it vital, it governs our transition from one energetic state to another.
Sunday, I went on a beautiful hike in the Columbia River Gorge. I decided to try to open my senses and not impose anything in particular on my experience. The overwhelming message, again and again, spoke of the Earth element. The sweet smell of decay - cloying, almost - with the merest hint of rich wine or butter or something I can’t define. No matter what part of the trail - metallic/mineral rock faces all around sharing their sharp, clean scent - deep, watery pools of clarity lending a weedy, fresh aroma - high and dry grassy plain full of pungency and heat… behind was the deep Earthen bassnote, emanating everywhere. Now, we are not officially in the period around the autumnal equinox, though we are technically within that “late summer” period perhaps - but the working of the Earth energy was present everywhere I looked.
The overwhelming idea that came out of all of this exploration is simple. Earth is at the center, and you must always look to its health. This is why dietary therapy is the root of most successful treatment plans. It’s also why so many of my patients seem to need a simple Earth tonification formula (such as Xiao Jian Zhong Tang) after any other series of formulas. In fact, from now on, I will be carefully examining that possibility with every patient. I feel that this is, in some ways, superior to the rampant practice of throwing some heavily tonifying formula at a patient after a big illness. The idea behind it is the same, but it is actually looking at the source of weakness and not the branches.
(Photos taken by Eric and his family, August 2008)
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Tags: earth, five phases, Organ systems, scent, senses, spleen, stomachRelated posts
The importance of the Spleen in studying Classical Chinese Medicine
I’ve been trying to find a way to make my Year of Sagely Living posts interesting to folks who are not specifically following my progress in that area. To that end, I have created a Year of Sagely Living page of the website where you can see more regular “updates” of my progress, as well as easily access all of the information about the project. When important insights come from that activity, I will expand them into full blog posts here on the main blog. My first insight of enough interest to generate a post involves the symbolism of the Spleen organ system.
脾 Pi - Spleen : Lessons learned from Yin Earth
Earthly Branch Si - The Snake : Lesson - You can take in a lot more than you think, but don’t overdo it
The Spleen is associated with the 6th Earthly Branch 巳 - Si. This is one of the few earthly branches that actually is a picture of the animal that came to be associated with it - the Snake. However, I should note that many people also posit that it is a picture of an infant. The oracle bone figures look more like snakes than babies to me, and as a picture of a snake is how I learned it, but certainly you may disagree.
The snake is a fascinating animal that both attracts and repulses most people. There are many characteristics of the snake that relate to the Spleen in structure and function. I’d like to just mention one that has been particularly helpful to me this week. As the title of this section suggests, I’m interested in the ability of a snake to consume prey much larger than itself.
Now, on the one hand, the Spleen really doesn’t like to be asked to do too much at once - as anyone can attest after a big Thanksgiving dinner. So, perhaps it’s not a perfect symbolic match. On the other hand, the function of the Spleen is to take whatever has been consumed and release the pure essence of that sustenance at a reasonable rate to the rest of the body. Often, even with big meals, we surprise ourselves with our ability to take it in and use it with some effectiveness. As a student, I am consistently asked to shove more information into my head than I think is possible. However, by approaching things deliberately and with confidence, I consistently surprise myself. No jaw dislocation required.
Phase element Earth - the Center : Lesson - Having a solid substrate allows for great transformation
The Spleen is the Yin Earth organ of the body, and as such serves as the stable substrate through which all of the activity of the body takes place. One of our professors mentions how people talk about the Spleen in an inappropriately “active” way. In fact, it is the organ that exemplifies that Wu-Wei principle of getting everything done while doing nothing. It is the rich humus that nourishes everything, yet serves as only a medium for that nourishment - not an active partner in it. Sure, mycobacteria and various little critters serve a vital function in keeping plants healthy, but these are not part of the Spleen principle. The Spleen Earth serves as a healthy place for these organisms to do their work, simply that - and that is more than enough.
Creating a super stable life management system for myself has been vital in my success. Still, it is always a work in progress. Unfortunately instability in my system was one of the keys behind why I was not so productive this week. I thought my system was more or less functional, and that I could work out any kinks quickly and simply. I was wrong. Several scheduling issues emerged that required my immediate attention. I had not fully “cleared my mental inbox” during my last Weekly Review (leaving many projects in an implicit mental stage, cluttering my mind). Most importantly, I had not settled my finances and finished budgeting. Thus, about 80% of my time this week was devoted to rectifying those situations. By the end of this weekend, all of that work will be done and it will serve me for the rest of the term. It will be the medium through which I am able to do all of the other work I do.
Clock pair/hexagram pair with the Triple Burner : Keep a balance between Yin and Yang
Around the organ clock, we can find many interesting relationships among the organ systems. The relationship between Spleen and Triple Burner is particularly interesting because these organs are united by their hexagram relationship and their actual position around the clock. When two organs are directly across the organ clock, we call them clock pairs and as I’ve mentioned before, we were taught to think of them as being able to “take one another’s shift” so they share some type of functionality. Hexagram relationships are more subtle and difficult for me to understand. Here is a diagram I drew during my first 
year at NCNM showing the hexagram relationships around the organ clock. The drawing is, admittedly, a little shaky. :)
The Spleen is associated with Hexagram 1 - 
Qian 乾, often translated as force, heaven, the creative and, sometimes, simply as Yang. It is made of six Yang lines, and is the most Yang hexagram of the Yijing. Funny considering what I just said about Earth and the Spleen! That’s the way of Chinese medicine philosophy sometimes. The hexagram of the Triple Burner is #2 - Kun 坤, often translated as
the receptive, Earth and sometimes, simply as Yin. It is made of 6 Yin lines and is the most Yin hexagram of the Yijing. Unlike the Spleen, this makes a lot of sense for the mysterious and seemingly immaterial Triple Burner organ system.
It’s easy to see the relationship between these two hexagrams - they are opposites and create the dynamic Yin-Yang tension that characterizes the fundamental state of the entire Universe. I’ll briefly explore the Triple Burner-Spleen relationship, but certainly there is much more to say about the shared symbolism of these two important organ systems.
The Spleen and Triple Burner are both responsible for aspects of fluid metabolism, in a way they help to keep a balance between wet and dry in the body. Another organ with a relationship with wet-dry balance is the Lung, which is united to the Spleen in its 6 conformation assignment as Tai Yin. Wet and dry are two obvious manifestations of Yin and Yang, respectively. Another Yin/Yang symbol within Spleen and Triple Burner is the relationship between being in the world and being removed from it. The Triple Burner is the mysterious organ system of deep darkness and in-between-ness. The Spleen is more straightforward, and engaged in the vital business of getting things done in the world, despite it’s passivity that I discussed before.
Extending these analogies, I found myself considering the vital importance of balancing two categories of intellectual activity. First, the more “Yang” activities of memorization, reading and listening to lectures, and studying explicitly for tests. On the other hand, the more “Yin” activities of contemplation, creative thinking, and experiencing Chinese medicine principles as they operate in nature. When I don’t achieve a balance between these two types of activity, pandemonium results.
I was experiencing strange digestive and mental symptoms all this week, and found myself really perplexed by it until I thought of Spleen. It is often said that student life harms the Spleen and Heart the most. The Heart because of the incessant use of the mind, which is related with the Heart in Chinese Medicine. The Spleen because of its association with pensiveness/overthinking and worry. When we find ourselves thinking something to death or being obsessively concerned with some event - our Spleen suffers. This was certainly happening to me and I definitely noticed. As a solution, I have decided to look at my schedule again and find a way to incorporate more straightforward “study” (memorization, reading and rewriting notes, etc) with more contemplative creativity. Although the latter may not help me on tests, it will definitely help me as a practitioner and help keep my Spleen from suffering overmuch.
Archetype : The Great Yu - Channel things away instead of damming them up
One of the archetypes we learn about being related to the Spleen is the Chinese folk hero the Great Yu. It is said that he was able to stem the great flood when his father failed. His father’s strategy was to create huge earthen dams to hold back the floodwater, which inevitably broke. Yu took a different perspective, creating great ditches to lead the water away to the ocean. We are often taught in Chinese medicine school that the Spleen does something similar in water metabolism of the body - guiding dampness away from the body at a steady clip, instead of trying to create barriers to keep it away from vital organs and processes.
I learned this Spleen lesson gradually through the week. A number of projects dumped on to my lap and it was only listening to David Allen’s Getting Things Done Fast on audiobook that jolted me into healthy Spleen mode. One of the things that Mr. Allen recommends is to look at every project/action you have in front of you and figure out whether it actually BELONGS to you. Many times we take on projects that are not properly or best left with us. Delegate! Delegate! Delegate! Lead the floodwaters away. :)
There’s plenty more to say about all of these symbols, as usual - I’ve only just scratched the surface of the surface. Noone knows this stuff like Heiner Fruehauf, my esteemed teacher. Be sure to visit his website at Classicalchinesemedicine.org if you’re interested in learning this kind of information in more depth from someone who actually knows what they’re talking about! Also be sure to visit the Year of Sagely Living page and consider joining us in our quest to be the best human beings we can be.
Eric
Tags: academics, balance, Character, chinese-medicine, classical-chinese-medicine, etymology, habits, hexagram, Learning, Organ systems, snake, spleen, study, studying, symbolism, Year of Sagely LivingRelated posts
7 keys to understanding the Classical Chinese Medicine concept of organs
I’d like to piggyback off of the organ clock post and introduce the Chinese medicine theory of organs in a little more
depth. It’s important to understand that there is not just one right way to view the body. There is no more validity in viewing it in the Western medicine manner than there is in viewing it in the Chinese medicine manner. Each system (and many others) have taken different features of the human being to be primary, each system has used their own conceptual understanding to render a viable picture of the body and its interactions. Perhaps most importantly, each system uses their vision of the human being to craft effective treatments. It seems that different systems will create different spheres of effectiveness - a topic for a future post. With no further ado, here are seven things you need to know to enhance your understanding of Chinese medicine organ systems.
- There are twelve organ systems in Chinese medicine: Heart, Small Intestine, Bladder, Kidney, Pericardium, Triple Burner, Gall Bladder, Liver, Lung, Large Intestine, Stomach and Spleen. The typical convention is to capitalize when we are talking about Chinese organ systems and not to capitalize when we are referring to the anatomical organ known to Western medicine. Another convention is to refer to the in the singular. So, for instance, the Lung organ system includes the Lungs, but we don’t say - for example - The emotion of the Lungs is grief.
- They’re not ORGANS. Probably the most important thing to understand is that the Classical Chinese view is not based on materialism. Although the ancient Chinese did investigate the inside of the body and were clearly aware of the physical structures that Western medicine now names “organs” this is not primary for the medicine’s understanding. The organ is included in a larger concept that is often called the “organ system,” which you have already seen me use many times. This organ system includes the physical organ, it’s associated channel(s), the tissues, surfaces, functions and other bodily features associated with that organ and other more rarefied aspects of the system.
- The organs work together as a dynamic whole. While each system has specific functions and can be talked about in isolation, the beauty of the Chinese medical view of the body only becomes truly apparent when you focus on the interconnections. No system is complete without seeing its relationship to the rest. This can make it a little confusing to study because our brains seem to find it simpler to focus on one mono-dimensional thing at a time. TCM has largely lost its understanding of the physiological interactions of the organs except where those interactions are extremely simplified.
- The organs are a reflection of the macrocosm. This principle relates back to Chinese philosophical understanding of the holographic nature of reality. For a complete review of the holographic worldview, see Michael Talbot’s The Holographic Universe. The basic gist of this philosophy is that the fundamental nature of reality is reflected in its smallest pieces just as much as in its largest. The small reflect the large, and the large reflect the small - they’re both reflecting something much deeper than themselves. In Chinese medicine we study this principle all the time. On one level, each organ is a reflection of all the others - the parts reflect the whole. On another level, the total complex of organs and each organ individually reflect some aspect of nature. For example, the Heart reflects the nature of our Sun and acts as such within the body. Understanding these layers of meaning help us to fully comprehend the human body, and studying the human body through this lens helps us to gain a greater understanding about the Universe. It’s funny like that.
- Following from that, then, the organ systems can be understood using natural and governmental symbolism. For me personally, learning about the Chinese concept of the body was much easier once I learned to think about it as an ecosystem or as a country. With the former, I could simply walk in nature in a mindful way and reflect on the various features I found there. IS the Heart like the Sun? What would that mean if it were? How does that bear out in diagnosis? In treatment? I think this practice does its work on more subtle levels as well - it must be why we are constantly urged to spend time in nature as CCM students. Using metaphors about the government helped me a great deal in understanding the functional relationships between organ systems. If the Heart is like the Emperor (or the King, possibly the President) then what relationships should I see between it and the Lung, which is said to be like the Prime Minister (or Presidential Cabinet?).
- The organs’ interrelationships are therapeutically useful. Far from being a simple intellectual exercise, understanding the organ systems as networks of interrelationship bears out in treatment. An example: imagine we are looking at some kind of problem that - through the intake process, including tongue and pulse taking - we come to understand as being centered in the Heart organ system. A TCM process of differentiation would then focus on the Heart, most likely, only adding other organ systems in limited circumstances (such as adding Lung if there are breathing difficulties). A more nuanced approach will consider the interrelationships using various systems, such as five-element or six conformation. Using a five element approach, we might wonder whether fire is failing to be generated by wood, or whether it is being over-controlled by water. We would search for symptoms that might suggest this, we would recheck the pulse to see whether we had missed something. There are specific systems to use when doing these investigations, but the key is simply to dive deeply into the physiology in order to comprehend pathology. It will yield excellent treatment.
- Even with this complex understanding - the organ systems are not PRIMARY. In a sense, the organ systems are simply a useful way of organizing the overwhelming amount of information we can get from studying the human body. It is a convenient way because it has clear physical correlates. But we must also consider the fluids of the body (Qi, Blood, Jing, Shen, JinYe) as well as any more subtle aspects of the human being. We must also keep in mind that the body is not just a jumble of parts, but a integral functioning whole - when we treat we are not “tonifying the Kidney” but instead having a specific kind of impact on an infinitely complicated system using a particular technique. Maybe that’s splitting hairs, but it seems an important distinction.
There’s a lot more to know - but that’s a good start. Please put any questions or thoughts in the comments!
Eric Grey
Tags: classical-chinese-medicine, exercise, five phases, flu, focus, health, Learning, liver, lung, materialism, nature, organ system, Organ systems, organizing, overwhelm, pericardium, philosophy, pulse, rest, spleen, students, study, studying, symbolism, tea, Theory, traditional-chinese-medicine, visionRelated posts
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