The Five Elements of Thinking runs through all aspects of traditional Chinese medicine, whether it is physiological and pathological research, or clinical diagnosis, and prognosis, it is inseparable from the Five Elements Thinking, and the "Five Elements - Five Organs" is the backbone of all this. From the late Warring States period to the early Western Han Dynasty, the matching of the "Five Elements - Five Organs" also went through three stages.
1.Embryonic stage: Purely consider the position of the five internal organs.
The Book of Rites and the Order of the Month corresponds the five elements to the season, natural phenomena and human activities, such as "The moon of Meng Chun, the day is in the barracks, the evening is in the middle of the ginseng, and the tail of the Dan is in the middle." Its day A and B, its emperor is too white, its god sentence mang, its insect scales, its sound horn, the law in the too cluster, its number eight, its taste sour, its smell, its worship household, sacrifice first card. Carry the green flag, wear green clothes. Sidley in wood". In the book, the "Five Elements - the Organs of the Sacrifice Ancestors" are "Spleen-Wood, Lungs-Fire, Heart-Earth, Liver-Metal, Kidney-Water", and "Lü's Spring and Autumn Period: The Twelfth Period", "Huainanzi Shi Zexun" and "Taixuan Xuanshu" are all similar to them and will not be repeated.
It is easy to see that at this time, the five elements were assigned according to the "position of the five organs in the body" when standing in the south, which was mainly used for sacrifices rather than medical practice, which was very different from the "five elements - five organs" that were common in later generations.
2.Transition period: Partial consideration of the functions of the five organs.
Pipe, Water and Land" cloud: "March is like a chew, what is the chewer?" Five flavors of the day. What are the five flavors? Day Gozo. The main brand of acid, the main lung of salt, the main kidney of Xin, the main liver of bitterness, and the main heart of sweetness. The five treasures have been possessed, and then the raw meat, the brand is separated, the lungs are bones, the kidneys are brains, the liver is born, the heart is born, and the five meats have been possessed and then the nine orifices. The spleen is the nose, the liver is the eyes, the kidneys are the ears, and the lungs are the orifices."
Since the "Five Elements and Five Flavors" have been stereotyped in the Shangshu Hongfan period, we can infer that the "Five Organs-Five Flavors-Five Bodies-Five Orifices-Five Elements" here are "Spleen-Acid-Septum-Nose-Wood, Liver-Bitterness-Leather-Eye-Fire, Heart-Sweetness-Meat-(None)-Earth, Kidney-Xin-Brain-Ear-Jin, Lung-Salty-Bone-Trick-Water".
Just looking at the "Five Elements - Five Organs" in it, it is not difficult to find that the attributes of the five elements of the card and the heart are the same as those of the "Book of Rites and the Moon Order", while the liver, kidneys, and lungs have changed. This may be due to the fact that the original affiliation has been revised according to some inexplicable phenomena, such as: liver lesions, the most common symptom is depression and depression, and the normal qi of the liver should not be gold sedimentation, but fire tendency; The most common symptom of lung lesions is coughing and wheezing, and the normal qi of the lungs should not be fire, but water sedimentation. At this time, the "kidney", which was originally equipped with water, had to be relegated to "gold".
Under this idea of allocation, although the matching of the "five elements and five organs" is not the same as that prevailing in later generations, the rudiments of the common scheme in later generations can already be seen from the matching of liver, lungs and kidneys. In addition, it can be seen that at this time, the correspondence between the "five organs, five bodies, and five orifices" has been explored, and the correspondence between the liver, the eyes, and the kidneys, and ears is consistent with that of later generations.
"The Oriental Sun Star, its time is spring, its air is windy, the wind is born, the wind is born of wood and bones, its virtue is joyful, and the festival is issued." This is called Xingde; Southern Day. At that time, it was called summer, its qi was sun, yang gave birth to fire and qi, and its virtue was charity and happiness. This is called Japanese Germany; **Said soil, soil virtue and practical assistance, four o'clock in and out, with wind and rain festival, soil benefit, native skin skin, its virtue and peace with even, selfless, practical auxiliary four times, spring education, summer growth, autumn harvest, winter closure. The great cold is extreme, the country is prosperous, and the Quartet is obedient, which is called the virtue of the year; The sun in the west, its time is autumn, its qi is yin, yin gives birth to gold and armor, and its virtue is sad, quiet, and strict. This is called Chende; The sun and moon in the north are called winter at that time, their qi is cold, cold gives birth to water and blood, and their virtue is pure, gentle and thorough. This is the virtue of the month".
The "Five Elements-Five Qi-Five Bodies" in this article correspond to "Wood-Wind-Bone, Fire-Yang-Qi, Earth-Yili-Skin, Gold-Yin-Armor, Water-Cold-Blood", which is completely different from "Pipe, Water and Land" and has not attracted attention in the past. However, the medical book "Book of Fetal Birth" unearthed from the No. 3 Han Tomb of Mawangdui in Changsha is very similar to the content of this article, which believes that in the process of fetal development, water gas, fire gas, gold gas, wood gas, earth gas, and stone gas will be transferred into the womb in turn, generating blood, qi, tendons, bones, skin leather, and hair. May and fire bestow it, and it makes it angry. In June, the gold was granted, and it was made into tendons. And the wood gave it in July, and it made it into bones. In August, the earth gave it to make the skin leather. In September, the stone was granted, and it became a hair." Considering that the five qi and five modernizations of this article are relatively close to the "wind (heat) (dampness) (dryness) and cold" and "growth (transformation) collection" of later generations, our research group believes that it is of equal importance to the pipe and water, and both have laid the foundation for the final maturity of the Tibetan elephant theory. It is worth mentioning that in the process of fetal development described in the "Book of Fetal Birth", "eating qi" enters the womb in the order of the five elements, and the inner pill technique to cultivate the five internal organs and guard the qi to travel in the five internal organs at night are all in this order, which may have another profound meaning.
3.Maturity stage: Comprehensively consider the position and function of the five organs.
In addition to the "Yellow Emperor's Neijing", the earliest surviving record of the "Five Elements - Five Organs" passage and subordination scheme is the "Huainanzi Topographical Training", that is, the East - Liver - Pale - Eyes - Muscles and Qi, West - Lung - White - Nose - Leather, South - Heart - Red - Body - Blood, North - Kidney - Black - Yin - Backbone, ** Stomach - Black - Mouth - Flesh. The only difference is that the organ corresponding to "**" here is "stomach", not "spleen", which is consistent with "the stomach is yellow, and the yellow is also earthy" in the "Historical Records: Bian Que Canggong Biography", indicating that the "five elements-five organs" may have gone through the stage of "replacing the spleen with the stomach" before the final finalization.
So, how did the "Five Elements - Five Organs" evolve into the "Huainanzi Topographical Training", and finally stereotyped into the "Yellow Emperor's Neijing"? Although there is a lack of direct information, on the basis of understanding the thinking path of the ancestors, we can still work backwards from the final result and appreciate the difficult trade-offs made by the "pioneers of Chinese medicine" after considering many factors. For the sake of conciseness, the deductive method is used here.
Condition 1: Under the "Five Directions-Five Hours" model, the position of the five viscera is the natural basis for their attachment to the five elements, and is still used as an important reference, i.e., Shang-Fire, Xia-Water, Left-Wood, Right-Metal, and Middle-Earth.
Condition 2: The function of the five organs directly reflects the attributes of the five elements of "dirty qi", so when the five elements are assigned, the reference priority of the functions of the five organs is higher than the position. At the same time, the understanding of "the liver tends to go up and the lungs tend to go down" formed during the "Pipe, Water and Land" period has been preserved.
Condition 3: The meridian theory is gradually perfected, and its characteristics of left and right symmetry make the five internal organs and six organs belonging to the meridians also tend to be symmetrical.
Conclusion 1 (Hepatic Wood): The liver is located on the right side of the body and does not meet the third condition, so the spleen (today's pai viscera) and the liver (today's liver) are collectively called "liver", making it symmetrical ("The Book of Difficulties: Forty-two Difficulties"); According to condition 2, this organ can belong to wood or fire; Obviously, the liver (present-day spleen and liver) at this time did not occupy the height of the torso, and according to condition 1, the liver could only be assigned to "wood".
Conclusion 2 (Lung is gold): the lungs are one on the left and one on the left, and condition 3 has been met; According to condition two, the lungs should be filled with gold or water; According to condition one, the lungs should be equipped with fire. The two are contradictory, and a trade-off must be made, considering that the lungs and the heart are close to each other, the "highest" characteristics can be transferred to the heart, and the function and location of the lungs must be considered as "gold".
Conclusion 3 (the heart belongs to fire): the heart is close to the midline, which approximates to meet the condition three; When heart disease changes, it is mostly manifested as cold limbs, and the normal qi of the heart is upward, which should be matched with wood or fire; Since the position of the lungs and the heart are close to each other, and the lungs are already assigned to the "gold" because of their downward qi, the approximation of the heart can be regarded as "the highest", and the heart can be assigned to it by considering the function and location"fire".
Conclusion 4 (Kidney is water): the kidney is one on the left and one on the left, and condition 3 has been met; It is located at the bottom of the trunk, and the lesion is mostly manifested as abnormal water metabolism, and the normal qi of the reverse kidney is also trending downward, considering the function and location, it belongs to "water".
Conclusion 5 (Stomach Soil): Since the spleen (now the spleen) has been incorporated"liver", it is necessary to select new organs to be incorporated into the five visceral systems. According to condition three, only the stomach and pancreas, because they are close to the midline, approximately meet the requirements of left and right symmetry, because the stomach is much larger than the pancreas, and the function is intuitive, so it was first selected as a genus that matches the soil. When the stomach is diseased, it can be manifested as vomiting or diarrhea, and the normal qi is centered, and the vertical position of the stomach in the trunk happens to be centered.
Conclusion 6 (Spleen soil): With the gradual refinement of anatomy, the digestive function of the pancreas was confirmed. At the same time, medical theories have been further developed, and the definition of "viscera" has become clearer - "those who have five viscera hide essence and qi without diarrhea; Those who have six internal organs pass on the incarnation but do not hide it". Obviously, the stomach is part of the digestive tract and is no longer qualified to be called "Tibet", in which case the pancreas, which is closely adjacent to the stomach, meets all the conditions, so the pancreas is renamed Pai (now the pancreas), and finally belongs to the "earth.""。When the five internal organs are discussed in the articles such as "Su Wen Linglan Secret Classics", "Su Wen Three Nine Candidates", and "Lingshu Five Evils", it is only called "spleen and stomach" at the card place, and this transitional phenomenon of "brand stomach and stomach" may also be related to the stage of "replacing the spleen with the stomach".
In the process of the evolution of the "Five Elements-Five Organs" Division, even the organs themselves have changed, which is indeed incredible, and the detailed argument can be found in the author's previous research "From the Evolution of the "Five Elements-Five Organs" Coordination and the Position of the "Liver and Spleen"".
Standing at the end of the line, you may not think it is too much, but for the pioneers, through a large number of anatomical research and clinical practice, a new discovery or concept change was obtained, and many new discoveries or concept changes finally created the "perfect" Tibetan elephant theory. As stated in "Su Wen: The Theory of Assassination":"The liver is born on the left, the lungs are hidden on the right, the heart is on the surface, the kidneys are on the inside, the spleen is for it, and the stomach is for the city." The final structure of the five organs can also be taken as the circular motion of qi, which is in line with the characteristics of the "five directions-five hours" model.
Quality Author List 4The development of the Five Elements Doctrine in Traditional Chinese Medicine.
The classics of traditional Chinese medicine, represented by the "Yellow Emperor's Neijing", "The Book of Difficulty" and "Treatise on Typhoid Fever and Miscellaneous Diseases", have inherited the idea of the five elements of mutual growth and victory, and clearly expounded the conditions for multiplication and insulting, such as the cloud of "Su Wen: The Great Treatise on Five Operations": "If there is more qi, you will be able to control yourself and insult you will not be victorious; If it is not enough, it will be insulted by what it is not overcome, and it will be insulted by what it has won lightly."
The multiplication relationship is actually a one-way development of a two-way win. In the face of changeable clinical examples, the theory of traditional Chinese medicine has also developed "symbiosis" into a two-way relationship, such as "Treatise on Typhoid Fever and Pingmai Method": "Water travels by gold, fire travels by wood, and the name is reversed; The gold line takes the water, the wood line takes the fire, and the name is smooth". Since then, any two elements of the five elements can form a two-way relationship.
The structure of the three yin and three yang, as well as the theory of five luck and six qi, which are closely related to phenology, are also important developments in the theory of the five elements in traditional Chinese medicine, but the topic is too large and the space is limited, so it will not be discussed for the time being.
There is still controversy about the time when the Yellow Emperor's Neijing was written, and it is generally believed to be between the Warring States period and the early Western Han Dynasty. Some scholars believe that the Huainanzi, which was written in the early Western Han Dynasty, still includes the transitional scheme of the "Five Elements and Five Organs", so the Yellow Emperor's Neijing should be written in the middle and late Western Han Dynasty. However, considering the lag in the compilation of books and the fact that Huainanzi is not a professional medical book, our research group still sets the maturity time of the "Five Elements-Five Organs" matching scheme as the early Western Han Dynasty.
To sum up, this research group summarizes the third stage as: from the Warring States Period to the early Western Han Dynasty, in order to integrate the increasingly rich medical knowledge, doctors introduced the Five Elements Theory into the medical field, and gradually improved it on the basis of anatomical research and clinical practice, so that it finally became a diagnostic and first-class thinking paradigm, which is still used today.