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Part Seven: THE SIX FU-ORGANS AND THE EXTRAORDINARY FU-ORGANS

第七部分:六腑和奇恒之腑

http://www.100md.com   2006-2-7
     TCM refers the gallbladder, the stomach, the large intestine, the small intestine, the urinary bladder and the triple energizer to the six fu-organs. it is not only that, besides the functions of their own, they are characterized by their common role ofdecomposing and digesting water and food, and discharging the wastes, but that, in the process of digesting and absorbing food and excreting the wastes, they are closely related to each other both physiologically and pathologically. Their functional feather is excretion without storage and taking descending and unobstruction as their normal functional state. TCM's rational knowledge of the interrelationship of the six fu-organs is well grounded on ancient anatomical knowledge, the observation of the physiological and pathological changes of the six fu-organs and the summarization of long-term and rich medical experience.

    中医的六腑指的是胆、胃、大肠、小肠、膀胱和三焦。这不仅是因为除了其自身功能之外,它们具有腐熟、消化水谷和传化糟粕的共同功能特点,而且是因为在食物的消化、吸收及排除残渣的过程中,它们在生理和病理上是密切相关的。它们的特点是泄而不藏,以通降为合。中医对六腑关系的理性认识来自于对六腑生理和病理改变的认识和长期丰富的临床经验。

    Food entering the stomach is decomposed into chyme which after digested by the stomach, is transported to the small intestine in which it is further digested by means of bile excreted by the gallbladder. The small intestine "separates the clear from turbid".The clear, refers to food essence, is transported and distributed to all parts of the body by the spleen; while the turbid is the residues of water and food. Of them waste water goes into the kidney, and then into the urinary bladder where it is turned into uruie to be excreted from the body. And the other is conveyed to the large intestine where it is changed into feces and leaves the body via the anus. In the whole process of the transportation and transformation of water and food, the triple energizer dominates qi transformation and qi movement of the whole body.

    食物进入胃内经胃的消化变为食糜后转运至小肠,在小肠内由胆汁进一步消化。小肠有分清别浊的功能。清指的是食物精华,它有脾运送分散到人体的各个部分。而浊指的是水谷残渣。浊水经过膀胱转化成尿液排出体外。另外的部分则运送到大肠,在大肠内转化成粪便由肛门排出体外。在水谷运化的整个过程中,三焦调节气的运化和整个人体的气的运动。

    The triple energizer is one ot the six fu-organs, and among all the zang-fu organs, it is the largest fu-organ in the human body. Huangdi's Classic on Medicine holds: "The triple energizer is separated from the zang-fu organs and yet is within the body. It encloses all organs and is the largest one." And the book also advanced a viewpoint that "The triple energizer exists in name only but is not the entity". Triple energizer has no exterior-interior relationships with the zang-organs, it is therefore called "solitary fu-organ". Its main functions are to pass various kinds of qi and to serve as the pathway for body fluid. It is divided into three parts: the upper energizer, middle energizer and lower energizer. The triple energizer with the related zang-fu organs, each having its own function to perform, accomplish jointly a complicated physiological process in the digestion, absorption, distribution and excretion.

    三焦是六腑之一,在所有的脏腑器官中,它是人体中最大的腑。《黄帝内经》认为:“三焦与脏腑分离但位于体内。它围绕所有的器官,是人体最大的器官”。该书亦提出一个观点即“三焦有名无实”。三焦和脏之间没有表里关系,因此也称为“孤腑”。它的主要功能是运行各种气体并是体液运行的通道。它分为三个部分:上焦、中焦、下焦。三焦与相关脏腑,各自执行其功能共同完成消化、吸收、分散、排泄这个复杂的生理过程。

    The upper energizer refers usually to the part above the diaphragm, including the heart, lungs and head as well. Its main physiological function is to distribute essence-qi throughout the body. In other words, in combination with the heart and the lung, the upper energizer distributes essence-qi to the whole body to warm and nourish the skin and muscles, tendons and bones. This function is described in Miraculous Pivot "The upper energizer resembles a sprayer." This is a metaphor, which is used to describe the function of the upper energizer to sprinkle fog-like cereal essence.

    上焦通常指的是膈以上的部分包括心、肺和头。它的主要生理功能是散精至身体的各个部分。换言之,通过心肺结合,上焦散精至全体以温养肌肤筋骨。这个功能在《灵枢》中被喻为“上焦如雾",这是一种隐喻法,通常用于描述上焦散精的功能。

    The middle energizer refers mainly to the abdorminal part between the diaphragm and umbilicus, and includes such zang-fu organs as the spleen, stomach, liver and gallbladder. Its main physiological functions are to decompose food and transform nutrient substances into qi and blood, and to discharge the wastes and steam body fluid. This function is mentioned in Miraculous Pivot: "The middle energizer is likened to a fermentation tun." By "fermentation tun" is meant the place where food is decomposed and digested.

    中焦主要指的是位于膈和脐之间的腹部部分,包括脾、胃、肝、胆。它的主要生理功能是腐熟水谷将精微物质转化胃气血,泌糟粕、蒸津液。这个功能在《灵枢》中被喻为“中焦如沤”。“沤”指的是食物腐熟消化的地方。

    The lower energizer refers, generally, to the portion located below the stomach, including the small intestine, large intestine, kidneys, urinary bladder. etc. Its main function is to discharge food residuces and urine. So there is also a saying in Miraculous Pivot, "The lower energizer works like a sewer." Here "sewer" is used to describe the function to excrete the wastes. However, with the development of visceral manifestations (zang xiang), essence and blood of the liver and kidney as well as primordial qi are generally attributed to the lower energizer by later generations.

    总的来说,下焦指的是位于胃以下的部分包括小肠、大肠、肾、膀胱等。它的主要生理功能是排泄糟粕和尿液。所以《灵枢》将其喻为“下焦如渎”。“渎”是用于描述排泄废物的功能。然而,随之脏象学说的发展,后人多认为肝肾之精血和元气也来自下焦。

    In short, the triple energizer dominates all kinds of qi and qi transformation of the human body, and serves as the pathway for water. Therefore, Basic Questions says: "The triple energizer, as the waterways, is an organ in charge of the water circulation, flowing along the waterways."

    简而言之,三焦主司各种气体调节体内气体的运化并是水运行的通道。因此,《素问》曰:三焦者,决渎之官,水道出焉。

    While the six fu-organs transport and tranform water and food, the process of reception, digestion, transportation and excretion are also in progress. The six fu-organs are usually in a state of the alternations between emptiness and fullness. And they transform food into essence but not store it. That's why TCM believes: " the six fu-organs function well when they are unobstructruction, the unobstructed is the normal functional state for the six fu-organs; where the regular descent is their normal functional activities."Pathologically, disorders among the six fu-organs often affect each other. For instance, when body fluid is consumed because of excessive heat in the stomach, the large intestine is bound to have trouble in transportation, and, in consequence, constipation occurs. A disturbance of the large intestine in transmission and transformation not only leads to the obstruction of the large intestine itself, but also affects the regular descent of stomach-qi, causing repeated vomiting. A dominant gallbladder fire often interferes with the stomach and results in vomiting bitter fluid.Dampness and heat accumulated in the stomach and spleen burn and steam the liver and the gallbladder. This may cause the bile to overflow, and give rise to jaundice.

    六腑在运化水谷中,依次进行受纳、消化、传输、排泄的过程。六腑常处于更实更虚之中,传化物而不藏。这就是为什么中医认为六腑以通为用,以降为和。病理上六腑功能的失调会相互影响。例如,当胃实热证时,体液被消耗,大肠的传输功能也一定会出现问题而导致便秘的发生。大肠传输功能异常不仅会导致大肠气滞,也会影响胃气沉降而导致反复呕吐。胆火炽盛,常犯及胃造成呕吐苦水。脾胃实热常熏蒸肝胆,这便会导致胆汁外溢返流。

    Apart from the six fu-organs, there are the brain, marrow, bones, vessels, gallbladder and uterus termed the "extraordinary fu-organs". Like the fu organs morphology, the extraordinary fu-organs are mostly hollow but not the pathways for the digestion and excretion of cereal food and, like the zang argans functionally, they also store essence-qi. With the exception of the gallbladder, they have no exterior-interior relationships.

    六腑之外,尚有脑、髓、骨、脉、胆、女子胞称为“奇恒之腑”。它在形态上与六腑相似,大多为空,但不是水谷消化和排泄的通道;在功能上与脏相似,它们也可藏精。除了胆,其他的都没有表里关系。

    The brain is located in the skull and connects with the spinal marrow. It is the organ of spirit, consciousness and thinking. Basic Question says: "The head is the house of intelligence".(,the head is the residence of intelligence)Li Shizhen of the Ming Dynasty pointee out, "The brain is the seat of the mind", and the heart governs all funcctions of the whole body, including mental activities. In the Qing Dynasty, Wang Qingren stated: "The intelligence and memory onginate from the brain but not from the heart." And he also considered: "Thinking, memory, vision, hearing, smelling and speaking are all controlled by the brain." Although TCM has some knowledge of the brain's physiology and pathology, it still ascribes the functions of the brain to the heart, the liver and respectively to the five zang-organs, and holds that spirit, consciousness and thinking are related to the five zang-organs.

    脑位于头颅,与髓相联系。它是精神、意识、思考的器官。《素问》曰:头者,精明之府。明代的李时珍指出:脑为元神之府。心统管全身功能包括精神活动。清代王清任指出“智力和记忆来自于脑而非心”。他认思考、记忆、视力、听力、嗅觉和言语都由脑控制。虽然中医对脑的生理和病理有了一些认识,胆始终将其归于心、肝和其他的五脏的功能里,认为魂、意识、思考于五脏相关

    The uterus, or womb(wu:m), situated in the lower abdomen posterior to the urinary bladder in women, is an inverted pear-shaped organ where menstruation occurs and the foetus is bred. They are two complex physiological processes in which tiangui, a kind of refined nutritious substance transformed from the kidney-essence, plays the most important role. Both Chong and Ren meridians originate from the uterus. The uterus is also closely related to the heart, liver and spleen, because normal menstruation and the nourishment of the foetus rely on the blood dominated by the heart, stored by the liver and controlledby the spleen. Therefore the dysfunction of the above organs will affect the normal functions of the uterus, bring about menstrual disorder and sterility.

    女子胞是女性位于下腹膀胱之后的器官,是个倒置梨形的器官,是月经发生和孕育胎儿的场所。它们是两个复杂的生理过程,由肾经化生的精微物质-天暌在其中起了非常重要的作用。冲任二脉都起于女子胞。女子胞同样与心、肝、脾有着紧密的联系。因为,月经的正常和胎儿的营养要依靠心的主血、肝的藏血和脾的摄血功能。因此,以上脏器的功能失调将会影响女子胞的正常功能,造成月经鼻不调和不孕。

    It should be pointed out that according to the theory of visceral manifestation, the names of the zang-fu organs correspond to those of the modern human anatomy and refers to the substantial internal organs. However, in the physiology and patholoty, the knowledge of TCM differs greatly from that of western medicine, which has been learnt a lot from the above.

    需要指出的是根据脏象理论,脏腑器官的名字与现代人体解剖学的器官相对应指的是内脏器官的物质形式。然而,在生理和病理上,中医和西医的认识却大相径庭,这在以上的阐述中能明显体现。

 
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