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The relationships between the five zang-organs are rather complicated; for instance, the heart is the monarch of the five zang-organs, so the life activities of the five-zang organs are dominated by the heart; the kidney yin and kidney yang are the root of the yin and yang of the five zang- organs and the excess and deficiency of the kidney essence is the key to the exuberance and debilitation of yin and yang of the five zang-organs; the spleen and stomach is the source of qi and blood, so the functions of the spleen and stomach are of great significance to the volume of qi and blood of the five zang-organs. Besides, traditional Chinese medicine also explains their relations in terms of the five elements. The specific relation- ships between them are introduced as follows:

The Relationships Between the Heart and the Lung

The relationships between the heart and lung are mainly manifested as the coordination between the heart governing blood and the lung governing qi as well as the interaction between the heart governing blood circulation and the lung governing respiration.

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1. The coordination between the heart governing blood and the lung governing qi is, as a matter of fact, a specific manifestation of the inter- dependence and inter-promotion between qi and blood, which will be further discussed in the following chapter of qi, blood, fluid, and liquor.

2. The interaction between the heart governing blood circulation and the lung governing respiration can be generalized into “qi commanding blood” and “blood carrying qi.” The dispersion-descent function of the lung and the feature of all vessels converging in the lung can facilitate the heart to promote blood circulation; conversely, only when the heart pro- pels blood normally can respiration functions properly. The ancients believed that the key link to blood circulation and respiration is thoracic qi, which permeates throughout the heart vessels and manages respiration, thus reinforcing the coordination and balance between blood circulation and respiration. For this reason, the deficiency of lung qi and the dysfunc- tion of the lung in ascent and descent can both affect blood circulation, leading to chest distress, alteration in heart rate, cyanic lips and purple tongue, etc. Conversely, if the heart qi is deficient, or the heart yang is weak, or the heart vessels are blocked, the respiration function of the lung will be affected, leading to adverse rising of lung qi, with such signs as coughing and panting, etc.

The Relationships Between the Heart and Spleen

The relationships between the heart and spleen can be discussed in terms of blood production and circulation. The heart governs blood while the spleen controls it; besides, the spleen is the source of qi and blood, so the relation between the heart and spleen is very close. If the spleen is normal in transportation and transformation, there will be abundant blood for the heart to govern; and only when the spleen qi is vigorous and controls blood normally without extravasation can the heart perform its function of governing blood. So pathologically, there will be simultaneous deficiency of the heart and spleen. For instance, excessive thinking may both con- sume the heart blood and affect the digesting function of the spleen; weak- ness of spleen qi will lead to insufficiency of qi and blood and then to deficiency of heart blood; moreover, dysfunction of the spleen to control

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blood will lead to loss of blood and insufficiency of heart blood. Therefore, clinically there will be symptoms of simultaneous deficiency of heart blood and spleen qi, such as dizziness, palpation, insomnia, dreaminess, abdominal pain, poor appetite, lassitude, and pale complexion, etc.

The Relationships Between the Heart and Liver

The relationships between the heart and liver can be discussed in terms of blood circulation and emotional activities.

1. Blood is produced by the spleen, governed by the heart, and stored by the liver. So only when the heart functions properly in blood circulation can the liver has adequate blood to store; if the liver fails to store blood, the heart may have nothing to govern. Therefore, clinically “blood defi- ciency of both the liver and heart” is very common.

2. The spiritual, mental and emotional activities, though dominated by the heart, are closely associated with the liver in promoting free flow of qi. Emotional disorders may stagnate the liver qi, which eventually trans- forms into fire and impairs yin-fluid; hence clinically “hyperactive fire of the heart and liver” and “deficient yin of the heart and liver” are very common.

The Relationships Between the Heart and Kidney

The relations between the heart and kidney can be discussed in terms of yin-yang and water-fire. The heart, located above the kidney, pertains to fire and yang, while the kidney, located below the heart, pertains to water and yin. From the ascent-descent theory of yin-yang and water-fire, the heart fire must descend to reach the kidney and the kidney water must ascend to arrive at the heart. Only by doing so can they maintain the balanced physi- ological functions. That is why we say “coordination between heart and kidney” and “inter-promotion between water and fire.” Pathologically, if the heart fire cannot reach the kidney and the kidney water fails to arrive at the heart, there will be imbalanced conditions such as “disharmony between the heart and kidney” and “discordance between water and fire,” clinically marked by insomnia, palpation, vexation, weak loins and knees, nocturnal emission in males and dreamed coitus in females, etc.

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The Relationships Between the Lung and Spleen

The relations between the lung and spleen can be discussed in terms of the production of qi and the metabolism of body fluid.

1. The lucid qi inhaled by the lung and the cereal nutrients transformed by the spleen and stomach are basic materials for the production of qi. Hence, the production of qi relies chiefly on the respiratory function of the lung and the transportation-transformation function of the spleen and stom- ach. They are mutually affected. For instance, deficiency of spleen qi often leads to insufficient lung qi; conversely, prolonged lung disease may also involve the spleen, leading to malfunction of transportation and transfor- mation or deficiency of spleen qi.

2. The metabolism of body fluid is actually a coordinated process involving the lung with the functions of dispersion-descent and dredging waterways and the spleen with the function of transporting, transforming and distributing water and fluid. The aforementioned functions of the lung is conducive to the spleen in transporting and transforming water and fluid, thus preventing internal dampness from accumulating in the body; similarly, the function of the spleen in transporting body fluid is the pre- requisite to the function of the lung in dredging waterways, and the spleen can also distributes nutrients to the lung, thus providing essential nourish- ment for the lung.

Daily Exercises

1. Concisely describe the relations between the heart and lung. 2. Concisely describe the relations between the heart and kidney.

The Relationships Among the Five Zang-Organs

The Relationships Between the Lung and Liver

The relationships between the lung and liver are mainly reflected by the regulation of qi activities. The lung is in charge of ascending while the liver is in charge of ascending, the coordination of which is essential to the regulation of qi. If the liver qi ascends excessively or the liver qi descends insufficiently, there will adverse rising of qi and fire, marked

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by cough with dyspnea or even hemoptysis. This is called “liver fire invading the lung.” Conversely, if the lung fails to purify and causes internal heat and dryness, the liver may be involved and becomes stag- nated in qi activity, marked by cough, distension and radiating pain in the chest and hypochondria, dizziness, headache, reddened complexion and eyes, etc.