|Home|

How TCM Kidneys Affect Other Organs

In traditional Chinese medicine (TCM), the kidneys are the most important organs of the body; they are viewed as the root of life activities and the origin of our congenital (inherited) foundation. The TCM understanding of the kidneys is more extensive than the Western anatomical kidneys. They perform reproductive, urinary, endocrine, skeletal, blood, and central nervous functions as well as store primordial yin and primordial yang (known as the inherited kidney yin and kidney yang). The kidneys work closely with the other "zang or fu organs" to carry out physiological functions. The kidneys' relationships with the other organs are ones of mutual generation and restriction with states of constant motion and change. TCM uses the five elements theory as a tool for analyzing the phenomena, to explain the physiology and pathology of the organs and to guide clinical diagnosis and treatment.

The cycle shows how the five elements restrict and generate one another.

The cycle shows how the five zang organs restrict and generate one another.

Generates

Restricts

I. The kidneys' relationship with the lungs

According to the five elements theory, the relationship between the kidneys and the lungs is like a bond between a mother and child. The kidneys belong to water and the lungs belong to metal; the metal and water elements mutually generate each other. They depend on each other physiologically, and influence each other pathologically.

The lungs are the respiratory organs. By inhaling clear qi from natural air and exhaling turbid qi out of the body, it exchanges the qi between the interior and the exterior of the body. Depending on the regulation of lungs, the qi (vital energy) can circulate smoothly throughout the body, and therefore, a normal state of internal metabolism is ensured. However, respiration does not merely depend on the lungs functioning; the kidneys also coordinate it. In order to keep the qi exchange effective, the inhaled and refined qi must flow down and be absorbed by the kidneys properly. The astringent or grasping and holding function of the kidneys ensures the lungs to receive and circulate downward the qi. In this way, the former helps coordinate respiration while the latter controls respiration.

Normal respiration from a TCM perspective

Normal respiration depends on mutual regulation by the kidneys and the lungs. The relationship is clearly stated in Leizheng Zhicai (Differential Diagnosis and Treatment of Diseases): "the lungs are the master of qi and the kidneys are the root of qi; the lungs exhale qi and the kidneys absorb refined qi; smooth respiration is the result of the harmony between yin and yang." In order to have smooth respiration and a clear airway, the kidney-qi must be strong and their astringent grasping and holding functions must be intact. When a kidney deficiency develops and fails to grasp the qi, the qi does not flow down to the kidney. It can lead to respiratory problems like difficulty inhaling with longer exhalation times. Conditions worsen during exercise. In TCM, this is called failure to retain the breathing qi in the kidney. Clinically, diseases like severe chronic bronchitis, emphysema and pulmonary heart problems that affect the right side of the heart are all due to the result of kidney deficiency and a reversed flow of qi.

II. The kidneys' relationship with the spleen

The kidneys are regarded as the congenital foundation and the spleen is regarded as the acquired foundation of life.

While the kidneys are regarded as the "congenital foundation" and origin of life, the spleen is regarded as the "acquired foundation" and source of blood and qi production. The two organs mutually nourish and promote each other.

The spleen rules transformation and transportation. That means it is the primary organ for digestion, absorption and distribution of nutrient essences to the entire body. The nutrient essences are the material basis for fundamental substances like blood, qi and body fluids. That is why the spleen is regarded as the "acquired foundation" and source of blood and qi production. In order to work properly, the spleen depends on the warming and propelling activities of kidney-yang. Yimen Banghe (Medical Alarms) states: "The transformation and transportation functions of the spleen and stomach are actually motivated by the kidney yang's warming and propelling energy." The statement implies that the congenital foundation supports the acquired foundation, which enables the spleen and stomach to work properly. As a result, food and drink are digested and nutrient essences are produced, ensuring the replenishment and nourishment of the body.

Formation of acquired jing (essence) that is used to support life functions.

Once the kidney yang is deficient and fails to warm and propel the spleen, the transformation and transportation processes become abnormal, and problems such as diarrhea may occur. In the Chinese medicine classic Jingyue Quanshu (Jingyue's Complete Works), it notes: "The kidneys act as the gate of the stomach; they open into the anterior and posterior orifices; therefore, urination and defecation processes are controlled by them. If a kidney yang deficiency is present, then the fire of the vital gate is diminished...... the body's yin energy will be in extreme, which leads to uncontrollable diarrhea." Clinically, in cases of senile degeneration or long-term illness, individuals usually suffer from a kidney yang-qi deficiency and the spleen loses warmth. Diarrhea is a common symptom among them. For those people who present with constant diarrhea before daybreak, a common TCM therapeutic approach is to warm the kidneys and spleen.

III. The kidneys' relationship with the heart

According to the five elements theory, the heart belongs to fire and the kidneys belong to water. They are categorized as possessing yang and yin properties respectively. The heart and the kidneys are closely related, with a mutually dependent and restrictive correlation within each other. If this functional relationship is abnormal, that is to say, if a dynamic equilibrium is disrupted between the body's yin and yang or water and fire properties, the morbid condition is termed as "non-coordination between the heart and the kidney".

The following concrete presentations describe their relationship:

1. Water and fire coordinate with each other mutually.

From a TCM viewpoint, the heart is located in the upper part of the body. It is categorized as yang and presides over water, which has a quiet property. While the kidneys are situated in the lower part of the body, they are categorized as yin and preside over fire, which has a dynamic property. Under normal physiological conditions, the heart fire descends to the kidney and joins with the kidney-yang to warm and propel kidney-yin. On the other hand, kidney water ascends together with heart-yin to nourish heart-yang and prevent it from becoming hyperactive. There are Chinese medicine sayings such as "when the kidneys lack heart fire, then water is cold; when the heart lacks kidney water, its fire becomes hyperactive." When water and fire are in harmony, a relative balance between the yang above and the yin below is maintained ensuring a healthly condition.

Coordination between the heart and the kidneys is necessary for each organ to work properly.

Once there is disruption between heart fire and kidney water with yin ascending and yang descending, pathological conditions will occur. For example, when kidney yin is exhausted, the kidney water fails to restrict the heart fire and leads to a hyperactive heart fire. Meanwhile, the hyperactive heart fire cannot be directed downwards to warm the kidney water. Therefore, the upper part of body is suffering from hyperactive heart fire, whereas the lower part of body is suffering from coldness and coagulation of kidney water, leading to problems like insomnia, night involuntary semen emissions and in severe cases, mental confusion such as delirium.

2. Essence and blood transform each other mutually.

The physiological function of the heart is to govern the blood, and the physiological function of the kidney is to store essence. Blood and essence are important elements inside the body; they form the essential substances in maintaining life activities. The kidney essence can transform into blood, and the blood can transform into essence. The mutually transforming and breeding actions provide the material basis for the functional correlations of the heart and the kidney.

3. Essence (jing) and spirit (shen) employ each other mutually

Accumulating essence can make the spirit full and complete, which ensures emotion and / or sentiment.

According to TCM, the heart houses the spirit (shen). It dominates all life activities and replenishes the essence. The kidneys store the essence (jing), which transforms into bone marrow and the sea of marrow. The marrow gathers and fills up the brain. That is why TCM believes essence also shelters emotions or sentiments. Accumulating essence can make the spirit full and complete so that it can be on guard internally. Our spirit, which defines our individuality, is the manifestation of essence. That is to say, our mental activities are not only controlled by the heart, but also are influenced by the kidneys intensively. A well-established close relationship between the kidneys and the heart ensures that the kidney essence (categorized as yin) ascends and consoles the heart's spirit. In contrast, it also ensures that the heart qi (categorized as yang) descends and consoles the kidneys' emotions. There are Chinese sayings such as: "essence is the material basis of the spirit; spirit is the outer manifestation of essence." Spirit arises from essence and will power arises from the heart. These activities are also influenced by interactions between the heart and the kidney. When there is a yin deficiency in the lower part of body and yang hyperactivity in the upper part of body, the heart cannot contain the spirit and essence fails to house our emotions. Under these conditions, diseases such as mania, depression and dementia can occur.

IV. The kidneys' relationship with the liver

The liver stores blood and the kidneys store essence. The liver promotes flowing and releasing movements, while the kidney promotes storing and sealing up actions. The two organs both belong to the lower burner (part of the triple burner), which is said to be from the same origin. They are correlated with each other both in physiology and pathology.

1. Water can nourish wood.

According to the five elements theory, the liver belongs to wood and kidneys belong to water. The liver promotes flowing and releasing qi movements, and its other function is to store the blood and regulate the supply, which ensures proper blood circulation and bodily adjustment. The water element generates the wood element in the five elements theory. This is sometimes referred to as a mother-child relationship because only a mother can give birth to a baby.

The kidneys can nourish the liver.

The kidneys enhance and nourish the liver so it can function normally. One of the related illustrations is the relationship between kidney-yin and liver-yin. Kidney-yin nourishes liver-yin so it makes the liver-yang unlikely to be hyperactive, and therefore, creates unrestrained conditions for flowing and releasing movements. On the other hand, liver-yin contributes to the regeneration of kidney-yin. Among them, kidney-yin is predominant. Abundance in kidney-yin is crucial in retaining the dynamic balance between them. If kidney-yin is deficient, then the water element fails to nourish the wood element and leads to a yin deficiency in both of the liver and the kidneys and also hyperactivity of liver-yang. Then, excessive fire evils accumulate inside the body. Symptoms like headaches and pain on the sides of the ribs will occur.


2. Essence and blood transform each other mutually.

Acquired essence and blood come from the same source. They are transformed from the nutrient essence that is produced during digestion and absorption by the stomach and the spleen. The blood is then stored in the liver and the essence is stored in the kidneys. Under normal biological conditions, blood stored in the liver relies on the nourishment of kidney essence; on the contrary, kidney essence also depends on persistent complement from the liver blood. They mutually transform and nourish each other.

3. Both of them possess prime minister-fire.

The prime minister-fire has its origin from the vital gate, which is located in the liver and kidneys. It is relative to the monarch-fire(heart fire) and the two work together to coordinate functioning of all the organs like a kingdom that promotes healthy functioning of the whole body.

4. Their functions are opposite but complementary.

The liver promotes the flowing and releasing movements while the kidneys promote storing and sealing up actions. Proper flowing and releasing in liver-qi movement ensures that kidney-qi works within its normal capacity so it does not become hyperactive. On the other hand, proper storing and sealing up actions of kidney-qi restrict the liver so it does not hyper or under function. Those actions are opposite but complementary. This special relationship is illustrated when looking at male ejaculation. For example, if the liver fails to regulate flowing and releasing movements and the kidneys cannot store essence, the liver-yang will become hyperactive and the fire elements cannot be contained. When the excessive fire overwhelms the leaked out essence, it will give rise to nocturnal emission or spermatorrhea (involuntary discharge of semen without orgasm).

The liver promotes the flowing and releasing movements while the kidneys promote storing and sealing up actions.

V. How TCM kidneys affect the "fu-organs"

Among the "fu-organs", the kidneys are most intimate with the bladder. The kidney meridian communicates with the bladder creating an exterior and interior relationship. Moreover, according to the five elements theory, both of them belong to the water element, so not surprisingly they play an important role in water movement of the whole body.

TCM representation of "fu" organs, kidneys and orifices.

The kidneys rule water by regulating its distribution and excretion, traditionally described as vaporization by the kidney. The bladder stores and excretes urine, which is also part of the vaporizing process. From a TCM understanding, they do this through processes similar to opening and closing of different water gates. The propelling function of the kidney-qi is crucial for normal bladder function. When the kidney-qi is sufficient and its astringent function is proper, the bladder opens and closes regularly so as to maintain normal storage and excretion of urine. When there is a kidney-qi deficiency, it leads to an irregular opening and closing of the bladder. Problems like general swelling (edema), incontinence and frequent urination will occur. Pathological changes in the storage and discharge of urine, therefore, are often related to both the bladder and the kidney.

Similarly, the propelling and warming functions of the kidney ensure the normal actions of the following "fu-organs":

	Receiving and ripening of food and fluids in the stomach.
	Containing and transforming food in the small intestine. It refers to receiving the semi-digested materials from the stomach that are further differentiated into nutrients and wastes.
	Transmitting the impure materials and stool excretion in the large intestine.

Generally speaking, the kidneys are the most important organs of the human body from a TCM viewpoint. They should be viewed as the congenital foundation and root of life. As we grow older, kidney function naturally declines. On a daily basis, it is crucial to pay attention to the protection and nourishment of the kidneys as they are fundamental to our long term health.

<To Top>