Chinese medical theory names its internal organs heart, liver, spleen, lung and kidney, and gives each functions that do not always match those of the anatomical organ with the same name. The WHO’s International Standard Terminologies on Traditional Medicine in the Western Pacific Region (2007) calls the theory of the organs visceral manifestation (zangxiang): the study of “the physiological functions and pathological changes of the internal organs as well as their interrelationship and external manifestation”. An organ is known by what shows on the outside. This page sets out the organs as the theory describes them, quoting the WHO’s definitions unless another source is named. Where the two need telling apart, Spleen with a capital is the organ of the theory and spleen the organ under the left ribs, as in the pattern names further down.
Zang and fu
The WHO terminology defines a zang, or viscus, as “an internal organ where essence and qi are formed and stored”, and a fu, or bowel, as “an internal organ where food is received, transported and digested”. Britannica’s history of medicine puts the same division as organs that “store up but do not eliminate” and viscera that “eliminate but do not store up”. In Robin Wang’s account of the Huangdi Neijing in the Internet Encyclopedia of Philosophy, storage is a yin function and transport a yang one, so the five zang are yin and the six fu are yang; Yin and yang covers that classification. Each zang is paired with a fu, and each has a channel; The channel system, counted lists the channels.
The five zang
| Zang | Where the WHO places it | What the theory says it does | Paired fu |
|---|---|---|---|
| Heart | in the chest above the diaphragm | controls blood circulation and mental activities | small intestine |
| Liver | in the right upper abdomen below the diaphragm | stores blood and keeps qi moving freely; closely related to the sinews and eyes | gallbladder |
| Spleen | in the middle energizer below the diaphragm | transports and transforms food, sends the clear upward, keeps the blood within the vessels; closely related to the limbs and flesh | stomach |
| Lung | a pair, in the chest above the diaphragm | controls breathing, governs qi, disperses and sends downward, regulates the waterways; closely related to the nose and the skin | large intestine |
| Kidney | a pair, in the lumbar region | stores essence; promotes growth, development, reproduction and urination; affects bone, marrow, the brain, hearing and breathing in | bladder |
The pericardium, in the WHO’s definition “the outer covering of the heart”, is not one of the five zang but has a channel of its own among the twelve. The qi, blood and fluids each zang stores or moves, and the colours, tastes and seasons assigned to it in The five phases, belong to the same scheme.
The six fu
- Gallbladder: connected with the liver, it stores and discharges bile.
- Stomach: receives food and begins its digestion.
- Small intestine: receives food from the stomach, digests it further and absorbs nutrients and water, separating “the clear” it keeps from “the turbid” it passes on.
- Large intestine: receives waste from the small intestine and forms it into stool.
- Bladder: stores and discharges urine.
- Triple energizer (san jiao), also triple burner: “a collective term for the three portions of the body cavity, through which the visceral qi is transformed”. The upper energizer is the chest, housing the heart and lung; the middle energizer runs from the diaphragm to the navel and houses the spleen, stomach, liver and gallbladder; the lower energizer lies below the navel and houses the kidneys, bladder and intestines.
Britannica counts the triple energizer, with the twelve channels, among the hypothetical structures that traditional Chinese anatomy postulates.
The extraordinary fu
A third group, the extraordinary fu (qiheng zhi fu), comprises the brain, marrow, bones, blood vessels, gallbladder and uterus. The WHO terminology calls them extraordinary “because their morphological and physiological properties are different from the ordinary bowels and viscera”. The brain is where “the marrow converges, and the spirit, mental activities as well as thinking take place”; marrow, both bone marrow and spinal marrow, is nourished by kidney essence. The gallbladder appears in both lists.
Why the Spleen is not the spleen
MedlinePlus, the US National Library of Medicine’s health encyclopedia, describes the spleen as a fist-sized organ above the stomach and under the left ribs. It belongs to the lymphatic system, contains white blood cells that fight germs, helps control the amount of blood in the body and destroys old and damaged cells. None of those functions appears in the WHO definition of the Spleen in the table above. The WHO’s Spleen transports and transforms food, and the terminology describes the formation of qi and blood from food as closely related to the spleen function.
The historian Lan Li, in a 2024 article in Chinese Medicine and Culture, reports that medical researchers in China have debated over the past decade whether the Pi (脾), the character translated Spleen, corresponds to the biomedical spleen or to the pancreas, and that many hold it was mistranslated. Li lists the competing origin stories for the translation: Jesuit translators of the 17th century; Benjamin Hobson (1816–1873), who rendered the pancreas as tian rou (甜肉), “sweet flesh”; and Wang Qingren (1768–1831), who in his Correcting Errors in Medicine identified the spleen as yi (胰) and the pancreas as pi. Britannica records that Wang drew his anatomy from the bodies of children torn by dogs after a plague epidemic in 1798.
Li calls the effort to settle the Pi as one modern organ or the other “anatomical retrofitting”, the imposition of present-day categories on historical objects. The article argues that the Pi shared characteristics with the humoral spleen of European medicine, which Galen counted among six organs related to nutrition, and that the spleen of anatomy is itself a historical object that changed as the humoral spleen became the biomedical one. Li concludes that the Pi and the spleen are neither mutually exclusive nor irreconcilable.
What research has tested
The organ scheme is used to diagnose, and the consistency of that use has been measured. In a
2001 study by Hogeboom, Sherman and Cherkin in Seattle, six Chinese medicine
acupuncturists each examined the same six patients with chronic low back pain on the same day. Between
them they used 20 diagnoses and 65 points. Most of the acupuncturists diagnosed qi and blood stagnation
with Kidney deficiency in every patient and used BL23
(Shenshu), the back-shu point of the Kidney, for every patient. Beyond that, agreement on the details of
the diagnosis and on the other points was poor, and some diagnoses depended more on the practitioner than
on the patient. Yin and yang reports a 2019 systematic review of
21 studies of this kind of agreement.
What the sources cannot tell you
The WHO definitions are the standard English agreed in 2007, one reading of a theory with a long textual history, and Li’s article shows how much of the modern reading of a single organ depends on translation choices made in the 17th to 19th centuries. AcuiQ’s index holds organ patterns such as Spleen qi deficiency, Kidney yang deficiency and Liver qi stagnation because published prescriptions name them. Each records what a study’s authors called the condition they treated; Patterns, symptoms and what you can look up explains the difference, and Back-shu and front-mu points covers the points named after the organs.