Lec 2 (Liver, Kidney, Gallbladder) PDF

Yin and Yang organs II Prof. Dr. Samy Abdel Samad Nasef Dean , Physical Therapy, ECU liver  ▪ It is extremely common to find Stagnation of Liver Qi in clinic. Liver ensures smooth flow of Qi throughout all the Liver Ensures body, in all directions. Smooth...

Yin and Yang organs II Prof. Dr. Samy Abdel Samad Nasef Dean , Physical Therapy, ECU liver  ▪ It is extremely common to find Stagnation of Liver Qi in clinic. Liver ensures smooth flow of Qi throughout all the Liver Ensures body, in all directions. Smooth Flow of ▪ Any activity that depends on Qi relies on the Liver's "flowing and spreading". Qi ▪ The Smooth Flow of Liver Qi Affects Three Main Areas  ▪ The emotional state is seriously affected by the Liver's function of "Flowing and Spreading" Qi ▪ When the spreading of Qi impaired or the circulation of Qi restrained, there will be emotional depression, frustration, repressed anger, and physical symptoms. Emotions ▪ There is a relationship between emotional state and Liver Qi. "Anger makes Qi rise and Blood stagnate in the chest." ▪ Stagnation along channels related to Liver: hypochondriac and costal pain, "plum pit Qi", chest oppression, swollen/tender breasts and genitals, lower abdominal pain.  ▪ Digestion and the Liver - Five element: Wood controls Earth. ▪ The Liver's function of spreading Qi aids the Spleen and Stomach's digestive functions, and is important to ensure harmonious Qi movement in Middle Burner. Digestion , and ▪ But Stagnant Liver Qi can "invade" or "attack" the Bile Secretion Stomach or Spleen (Wood overacts on Earth). ▪ Smooth flowing of Liver Qi affects bile flow. ▪ Stagnant Liver Qi can obstruct bile flow (bitter taste, belching, or jaundice)  ▪ Regulates volume of Blood according to physical activity ▪ When at rest, Blood returns to Liver (Liver contributes to restoring energy). ▪ When body is active, Blood nourishes muscles to enable them to perform. Stores Blood ▪ Blood regulation function influences energy level: ▪ if this function impaired, lack of Blood (= nourishment) where needed, hence easily tired. ▪ If Liver Blood is deficient, there can be muscle cramps, tics and twitches or tremors/shaking in muscles. (Liver Wind from Blood Deficiency)  ▪ Liver is very important in gynecology. ▪ If Blood storage function is abnormal, e.g. Liver Blood is deficient, menstrual problems e.g. amenorrhea, oligomenorrhea. Regulates ▪ If Liver is Hot or Excess, menorrhagia or metrorrhagia can occur. menstruation ▪ If Liver Qi stagnant, Liver Blood can stagnate (dysmenorrhea, PMS, dark clots). ▪ Liver malfunction influences energy of Ren Mai & Chong Mai which are closely related to uterus.  ▪ Blood & Liver function reciprocally affect each other. ▪ Where Blood is Deficient or Hot, Liver function can be affected. Blood & Liver ▪ If Liver function abnormal, can affect quality of Blood. function ▪ For example: If Liver is Hot, Blood can become Hot (causing skin eruptions, eczema, etc").  ▪ Sinews (tendons) depend on Liver Blood to moisten and nourish them so(smooth movement of joints and good muscle action). ▪ Deficient Liver Blood leads to lack of nourishment in the tendons, which leads to spasms, impaired extension/flexion, numbness of limbs, cramps, tremors, muscle weakness, etc. Controls Sinews ▪ The Liver controls the Sinews (tendons), or the (tendons) contractile aspect of the muscles. ▪ The Spleen controls the muscles, or the mass or bulk. ▪ Liver imbalances are more likely to affect movement, ▪ and Spleen weakness more likely affects flaccidity, atrophy, etc.  ▪ The finger and toe nails are the outgrowth of sinews and are influenced by Liver Blood. Manifests in the ▪ When Liver Blood is deficient, the nails will lack Nails nourishment and become dark, indented, dry, cracked, brittle, etc  ▪ Liver Blood nourishes and moistens eyes and gives Opens to the capacity to see. Eyes ▪ Liver Blood deficient: blurred vision, myopia, "floaters" color blindness, dry "sandy" eyes. If heat in Liver, eyes bloodshot, sore and burning.  ▪ The Hun is also called the ethereal Soul. ▪ Hun is related to ability to be resolute, to plan and have Houses the Hun creative drive and assertiveness. ▪ When the Liver is out of balance in excess for instance, this becomes anger.  ▪ Energy moves up and out like tree (Wood element). ▪ The liver also relates to growth in the sense of personal Influences Rising growth, ability to change. and Growth ▪ People who feel stuck in life or a situation usually have Liver Qi Stagnation.  ▪ Liver gives capacity to plan. Said to be like General of Controls an army (Gall Bladder gives ability to make decisions, Planning hence very closely linked)  The liver is the largest glandular organ in the body and performs multiple critical functions to keep the body pure of toxins and harmful substances. An average adult liver weighs about three Liver in western pounds. Located in the upper-right portion of medicine the abdominal cavity under the diaphragm and to the right of the stomach, the liver consists of four lobes. It receives about 1.5 quarts of blood every minute via the hepatic artery andportal vein.  ▪ The liver is considered a gland—an organ that secretes chemicals— ▪ because it produces bile, a substance needed to digest fats. ▪ Bile’s salts break up fat into smaller pieces so it can be Liver in western absorbed more easily in the small intestine. medicine ▪ In addition to producing bile, the liver: Detoxifies the blood to rid it of harmful substances such as alcohol and drugs  Stores some vitamins and iron Stores the sugar glucose Converts stored sugar to functional sugar when the body’s sugar (glucose) levels fall below normal Liver in western Breaks down hemoglobin as well as insulin medicine and other hormones Converts ammonia to urea, which is vital in metabolism Destroys old red blood cells (called RBC’s) Kidney  ▪ Kidney Yin and Kidney Yang are the foundation of the Yin and Yang of the whole body. ▪ Kidney Yin and Kidney Yang rely on each other for their existence. Kidney Yin provides material basis for Kidney Yang. Kidney Yang provides necessary Heat for all Kidney functions. ▪ Store the Jing and rule birth, development, and reproduction Function of ▪ Jing is the (material and immaterial) substance most kidney in TCM intimately connected to life itself. ▪ The Kidneys are sometimes referred to as the "Root of Life" because Jing is the basis for reproduction, growth, and development. ▪ The Kidneys are said to govern these processes at it stores the Jing.  ▪ Jing (Essence) the precious substance has two types: ▪ Prenatal Jing: Inherited from parents ▪ Postnatal Jing: Partly replenished from food and fluid ▪ Prenatal Jing determines our basic constitution, vitality, and strength. ▪ It is the basis of sexual life and the formation of sperm and egg. Function of ▪ It is the foundation for differentiation into Yin and Yang. kidney in TCM ▪ Insufficient Jing can cause infertility, impotence, problems relating to growth, reproduction, premature senility, etc. ▪ Postnatal Jing is the refined essence extracted from the food by the internal Organs, particularly the Spleen. ▪ Kidney Jing provides material basis for both Kidney Yin and Kidney Yang.  ▪ Produces Marrow, Fill up the Brain and Spinal Chord, and Control the Bones ▪ Jing is also the organic foundation for production of marrow. ▪ Marrow is the common substance of bones, bone marrow, brain and spinal cord. ▪ Kidney Jing produces Marrow, which generates spinal cord Function of and "fills up" brain: therefore Kidney has relationship with brain. kidney in TCM ▪ Strong Jing nourishes brain and memory/concentration, etc. will be good. ▪ Jing inadequate to nourish the brain: poor memory and concentration, dull thinking. ▪ Therefore Kidneys also govern bone marrow and bones (and teeth, which are said to be the outgrowth of bones).  ▪ Kidneys Governs Water and Water Passageways ▪ Kidneys belong to Water element ▪ They govern the transformation and transportation of body fluids in many different ways. ▪ The correct balance of Kidney Yin and Kidney Yang produces normal regulation of the opening and closing Function of of the "gate" of urination. kidney in TCM ▪ In disease, Kidney Yin and Yang imbalanced (not enough Yang or not enough Yin). Where Yang is deficient, "gate" stays open: profuse and pale urination. Where Yin is deficient, "gate" stays closed: scanty and dark urination  ▪ Control inspiration and the grasping of Qi ▪ While the Lungs govern respiration, the Kidneys play an important role in normal breathing. ▪ The Kidneys assist the Lungs during inhalation by Function of "Grasping the Qi". ▪ In this relationship, the Lungs are called the "Foundation kidney in TCM of Qi", and the Kidneys are called the "Root of Qi". ▪ When the Kidneys fail to Grasp the Qi, respiratory illnesses can occur, such as chronic asthma  ▪ Opens into the Ears ▪ Ears related to Kidneys: Kidney Jing nourishes ears and Function of enables proper functioning. kidney in TCM ▪ Weak Jing, weak hearing or tinnitus.  ▪ Manifest in the head hair ▪ Abundant Kidney Jing nourishes hair: hair then grows well and is healthy and shiny. ▪ Weak Kidney Jing: thin brittle, dull, or falling hair, Function of premature graying. kidney in TCM ▪ NOTE: Liver Blood also has to do with hair color and shine, but Kidney Jing is instrumental in production of Liver Blood  ▪ Controls the Two Lower Orifices ▪ The Kidneys control the front orifice, which is the urethra (and spermatic duct in males), and the rear orifice, which is the anus. ▪ Urethra related because Kidney provides the Bladder with the Qi necessary to transform urine (weak Kidney Function of Qi produces leaking of urinary incontinence). kidney in TCM ▪ Deficient Kidney Qi or Kidney Jing can cause spermatorrhea or nocturnal neuroses. ▪ Anus anatomically related to Large Intestine but functionally related to Kidney. If Kidney Qi is weak, there may be diarrhea or prolapsed anus.  ▪ Houses the Will Power Function of ▪ Will Power (Zhi), including concepts of:- ▪ staying power and motivation, depend on Kidneys kidney in TCM  1. Removing Wastes from the Blood. The main job of nephrons is to filter the blood to remove waste products. A metabolic waste is a waste substance produced by the body. Nitrogenous wastes (such as urea and uric acid) are examples of metabolic wastes. 2. Urine formation is the process by which the kidneys prepare waste products, filtered from the blood, for Function of elimination from the body. kidney in Western 3. Regulating the body's water volume is another important function of the kidney. medicine Maintaining the correct volume of water in the body is an extremely important function of the kidney. If the kidneys are unable to perform this crucial function, the result could be serious illnesses, such as high blood pressure and pulmonary edema.  ▪ Regulating pH Balance ▪ Regulating the body's pH balance is another important function of the kidney. If the blood is too acidic, meaning that there is an excess of hydrogen ions, the kidneys remove these excess ions into the urine. Function of ▪ Bacteria (which cause many serious degenerative kidney in Western diseases) flourish in an acidic environment. The kidneys help to maintain the blood plasma at a neutral medicine pH 7.4. By regulating the body's pH, the kidneys help to maintain an environment that prevents diseases and promotes the efficient functioning of all bio-systems within the body.  ▪ Production of Hormones is Another Function of The Kidney ▪ Some important hormones are produced in the kidneys. One such hormone is erythropoietin (eh- RITH-ro-POY-eh-tin). It plays a key role in the Function of production of red blood cells in the bone marrow. kidney in Western ▪ When the kidneys detect a decline in the red blood medicine cells in the body, it produces erythropoietin. This hormone is released into the bloodstream and goes to the bone marrow, which triggers the production and release of more red blood cells.  ▪ Processing Vitamin D ▪ Not many people are aware that processing vitamin D is a function of the kidney. Here's what the kidneys do to help process vitamin D: Function of kidney in Western The kidneys convert calcidiol to calcitriol, which is an active form of vitamin D. In this active form, vitamin D medicine promotes calcium absorption by the small intestine and makes it available for bone development  4. The Kidneys Regulate The Body's Salt Content. By regulating the amount of salt and water in the blood, the kidneys ensure that the concentration and volume of the blood stay at the correct level at all times. 5. Regulating blood-pressure is another crucial function of the kidney. This is done by hormonal reactions and regulating the volume of water in the body. Renin (REE- nin) is an enzyme secreted by the kidneys, which helps to Function of control blood pressure and regulate electrolyte balance kidney in Western 6. This enzyme converts blood protein into a hormone called angiotensin. medicine 7. Angiotensin then induces the adrenal gland to release another hormone called aldosterone. 8. This hormone causes sodium and water to be reabsorbed into the blood, thereby increasing blood-volume and blood-pressure ▪ Gall bladder  ▪ The Gall Bladder is unusual among Yang Organs, because it does not receive, transform or transport digestate and waste products, but it stores bile. Bile is a Functions of the pure (refined) substance, unlike the digestate and its products, which are impure substances. Gall Bladder ▪ Hence, since the Gall Bladder stores a pure substance, it Gall bladder resembles a Yin Organ. For this reason the Gall Bladder is included in the "Curious Organs".  ▪ The Gall Bladder Stores and Releases Bile ▪ It receives bile from the Liver and stores it, releasing it when needed during digestion (same as in Western biomedicine). Functions of the ▪ Smooth flow of bile aids Stomach and Spleen digestive Gall Bladder functions. ▪ When Liver Qi stagnates and bile does not flow smoothly, digestive signs such as nausea and belching occur.  ▪ Gall Bladder Controls Judgment ▪ (Liver controls planning), ▪ Gall Bladder controls ability to make decisions. Functions of the ▪ These two functions are interdependent. ▪ Gall Bladder gives a person courage and initiative, i.e., Gall Bladder courage to make decisions, act, make changes: positive and decisive action. ▪ Deficient Gall Bladder can result in indecision, timidity and easily becoming discouraged.  ▪ Controls the Sinews (Tendons), With the Liver ▪ Wood element (Gall Bladder and Liver) control sinews. Functions of the Liver nourishes tendons with Blood, Gall Bladder provides Qi to ensure correct movement and flexibility Gall Bladder of tendons. The influential point for tendons is Gall Bladder 34, i.e., on Gall Bladder channe  ▪ The gallbladder serves as a reservoir for bile while it’s not being used for digestion. ▪ The gallbladder's absorbent lining concentrates the stored bile. ▪ When food enters the small intestine, a hormone called Gallbladder in cholecystokinin is released, signaling the gallbladder western to contract and secrete bile into the small intestine through the common bile duct. medicine ▪ The bile helps the digestive process by breaking up fats. ▪ It also drains waste products from the liver into the duodenum, a part of the small intestine.  ▪ An excess of cholesterol, bilirubin, or bile salts can Gallbladder in cause gallstones to form. western ▪ Gallstones are generally small, hard deposits inside the gallbladder that are formed when stored bile medicine crystallizes