The Basic Concept of Visceral Manifestation (Zang-Xiang)

Visceral manifestation (Zang-Xiang) primarily refers to the internal zang-fu organs and the physiological and pathological signs they manifest externally; it also encompasses the anatomical images of the internal organs and their corresponding natural phenomena in the external environment. The term “Zang-Xiang” first appeared in the Suwen · Liujie Zangxiang Lun (Basic Questions: Treatise on the Six-Juncture Visceral Manifestations): “The Emperor asked: What of the visceral manifestations? Qibo replied: The heart is the root of life and the seat of spirit. Its bloom is manifest in the face, its fullness in the blood vessels. It is the great yang within yang, and it communicates with the qi of summer.” The Huangdi Neijing's definition of Zang-Xiang focuses primarily on the physiological functions of the zang-fu organs and their associated psychological activities, body and sensory orifices, and natural phenomena. The Ming dynasty scholar Zhang Jiebin, in his Leijing (Classified Canon), annotated: “Xiang means image or form. The zang are stored within; the form is visible on the outside. Hence it is called Zang-Xiang.”

Thus, “Zang” refers to the organs stored within the body, including the five zang (liver, heart, spleen, lung, kidney), the six fu (gallbladder, stomach, small intestine, large intestine, bladder, sanjiao), and the extraordinary fu organs (brain, marrow, bone, vessel, gallbladder, uterus). “Xiang” primarily refers to the physiological and pathological phenomena manifested externally, and also involves the anatomical images of the internal organs and the natural phenomena they resonate with. Among these, Xiang is the external reflection of Zang, and Zang is the internal essence of Xiang. Therefore, the term Zang-Xiang not only reveals the organic connection between the body's internal organs and their external manifestations, but also objectively reflects Chinese medicine's cognitive method of “measuring the zang from their manifestations” (yi xiang ce zang) — that is, by observing external signs to study the activity patterns of internal organs and understand their essence. As stated in the Lingshu · Ben Zang (Spiritual Pivot: On the Viscera): “Observe the external correspondences to know the internal organs.”