VOLUME I, SECTION I: FOUNDATIONS OF CHINESE ENERGETIC MEDICINE

THE LARGE INTESTINE:

The upper
mouth of the
~
__ ~_)J_2_~_.'_~! i(]
DACHANG
The Large Intestine is a tubular Yang organ,
Large Intestine
is situated close
to the lower
fA • * l;,' To 0 1\
:; lit ~", I. n '1 ,.
belongs to the Metal Element, and its associated mouth of the ""..t ~") 0'1 \~ I')
Yin organ is the Lungs. The Large Intestine com- Small Intestine. •• f'~~ 1.::!ffl 1:.
municates with the skin and the anus, and is re- The lees - - t... ...··~;t f:.
sponsible for controlling the departure of the Po (leftover tf' a j (/l (f')
from the anus through the "Po Men" (Gate of the substance after
a refining
Po) after the time of death (Figure 8.64).
process) enter
CHINESE CHARACTER FOR LARGE
the Large
Intestine here.
INTESTINE: DA CHANG
The Chinese character "Da Chang" translates
as "Large Intestine." It refers to a general descrip-
tion of the image of the Large Intestine organ, and
is composed of two images:
• The first character "Da" translates as "large," The lower mouth
"great," or "big." of the Large
• The second character "Chang" translates as Intestine. This
"Intestine," and is divided into two ideo- area is also
graphs. The character to the left, "Ji" depicts known as the
the Chinese ideogram for body tissue, muscle anus, the path of
grain, and the
or flesh (all of which are forms of connective bottom Yin.
tissue). The character on the right depicts the
Figure 8.64. The ancient Chinese anatomical diagram
image of the sun above the horizon, with its of the Large Intestine (LI) Organ, as it appeared in
rays shinning downward. It expresses the "Important Useful Notes on Acupuncture and
Heavenly Yang influence on this particular Moxibustion," published in Japan in 1718, by
bowel. The ideograph expresses the image of Masatoyo Hongo
the sun enriching and transforming some-
thing within the flesh and conveys the Large
Intestines digestive process. Large - - .._ . ._ _
Together, the Chinese characters "Da
Chang" can be translated as, "the large Heav-
enly transformation occurring within the
flesh." The Large Intestines command the "Jin,"
Sun
the flowing intestinal fluids (Figure 8.65).
Above
THE LARGE INTESTINE IN CHINESE the
Horizon
MEDICINE Muscle,
The functions of the Large Intestine described Flesh, - -
Sun's
in Traditional Chinese Medicine are similar to Connective
Rays
those found in Western Medicine. However, some Tissue
Shining
of the functions that are attributed to the Large Down
Intestine in Western Medicine (such as control-
ling the transformation and transportation of food Figure 8.65. The Chinese characters for "Da Chang,"
Large Intestine
and fluids throughout the digestive system) are

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 CHAPTER 8: THE TWELVE PRIMARY ORGANS, CHANNELS AND COLLATERALS

Governs Fluids

Controls Transformation Reabsorbs Fluid from

and Transportation of Indigestible Food
Solid Waste

The Main Controls Waste Removal Eliminates Indigestible

Functions and Defecation Food in the
of the Form of Semi-solid Feces
Large
Intesfine Controls the Throat and
Organ and Lower Teeth
Ctiannels
Controls Nasal Drainage
Emotional Release
Psycho-Emotional Aspects and
Introversion

Figure 8.66. The Main Energetic Functions of the Large Intestine Organ and Channels

assigned to the Spleen from a Chinese medical per- eliminating the waste as fecal matter.
spective. In Chinese Medicine, the Large Intestine 3. Controls Waste Removal and Defecation: The
also has a number of psycho-emotional compo- Lungs ability to send Qi downwards depends
nents which exert an influence on the body's func- on the Large Intestine's role in excreting waste.
tions. Consequently, the descending Lung Qi sup-
According to Traditional Chinese Medicine, plies the Large Intestine with the necessary
the main functions of the Large Intestine are to: Qi needed for defecation.
govern fluids, control transformation and trans- 4. Controls the Throat and Lower Teeth: The
portation of solid waste, control waste removal Large Intestine controls the throat and lower
and defecation, control the throat and lower teeth, teeth.
control nasal drainage, and express itself through 5. Controls Nasal Drainage: The Large Intestine
the psycho-emotional aspects of emotional release controls the drainage of the nose.
and introversion (Figure 8.66). These functions are 6. Psycho-Emotional Aspects: The Large Intes-
described as follows: tine is both energetically and physically asso-
1. Governs Fluids: The Large Intestine organ is ciated with letting go of impurity. Emotional
said to govern Body Fluids (any fluid or semi- imbalances such as unhealthy attachments, or
fluid substance in the body). The Large Intes- the inability to let go of past people, places
tine reabsorbs the fluid from indigestible food and things often have their root in the Large
and then eliminates waste from the body in Intestine. Because the Large Intestine is asso-
the form of semi-solid feces. ciated with the Lungs, it is equally affected
2. Controls Transformation and Transportation by the emotions of sadness, grief, and worry.
of Solid Waste: The Large Intestine's main func- An energetic imbalance in the Large Intestine
tion is to receive the fluid form of food essence can result in physical weakness and provoke
from the Small Intestine. After it absorbs this emotional introversion, accompanied by feel-
food essence, the Large Intestine is responsible ings of depression, irritability, discour-
for the transformation and transportation of agement, distress, and apathy. Strong emo-
solid waste in the body, absorbing water and tions of fear or panic can produce an energetic

365
VOLUME " SECTION 1: FOUNDATIONS OF CHINESE ENERGETIC MEDICINE

stool reflex reaction in the Large Intestine re- THE INFLUENCE OF TASTE, COLOR,
sulting in a spontaneous defecation. AND SOUND

THE LARGE INTESTINE CHANNELS

• The pungent taste (garlic, green onions, etc.) can
be used to tonify both the Large Intestine and
The Large Intestine Channels are Yang chan-
Lungs, though excessive use can weaken them.
nels that flow externally from the hands to the
• The color of white is used to tonify the Large
head (Figure 8.67). The Large Intestine Channels
Intestine and Lungs.
originate externally from the tips of the index fin-
• The "Shhh," "Sss," and "Shang" sounds are
gers, ascend the arms, and cross the shoulders,
used to purge the Large Intestine and Lungs.
where they connect with the 7th cervical vertebra
before splitting into two branches. LARGE INTESTINE PATHOLOGY
One set of branches (one branch from the left Dysfunctions in the Large Intestine organ and
Lung and its corresponding branch from the right channels can result in diseases of the lower part
Lung) descends internally and spirally wraps the of the face (including the nose, oral cavity, and
Lungs before flowing downwards to permeate the teeth), throat, and front part of the neck, as well
Large Intestine. The other two branches ascend as disease of the back and radial sides of the up-
externally through the neck and cheek to the gums per extremities.
of the lower teeth. Here each branch curves Tonification of the Large Intestine can be used
around the upper lip before flowing to the oppo- to eradicate eye pain, toothache, ear ache, to pre-
site side of the nose, to connect with the Stomach vent hemorrhages, and to greatly reduce exces-
Channels. sive menstrual bleeding.
CHANNELS' ENERGY FLOW
Because of its relationship to the Lungs, the
Large Intestine can be purged to treat coughing and
The Large Intestine Channels contain equally
asthma caused from excessive Heat in the Lungs.
abundant amounts of both Qi and Blood. Thus
Similarly, replenishing the vital Qi of the Lungs can
the Large Intestine Channels influence the body's
cure constipation in debilitated patients.
energetic and nervous functions, as well as affect
Patterns of energetic imbalances in the Large
the Blood and physical substances of the body.
Intestine generally relate to disturbances in bowel
At the high-tide time period (5 a.m. to 7 a.m.),
movements. Energetic dysfunctions in the Large
Qi and Blood abound in the Large Intestine organ
Intestine can be categorized as either excess or
and Large Intestine channels. At this time, the
deficient conditions, described as follows:
Large Intestine organ and channels can more eas-
1. Excess conditions of the Large Intestines can
ily be dispersed and purged. During low tide (5
result in symptoms of: Heat, Heat obstruction,
p.m. to 7 p.m.), they can be more readily tonified.
Damp Heat, or Cold invading the Large In-
The energy of the Large Intestine Channels acts
testine.
on the skin, muscles, and nerves found along the
2. Deficient conditions of the Large Intestines
channel pathways.
can lead to an invasion of Cold or Dryness,
THE INFLUENCE OF CLIMATE and in severe cases of Deficiency, to the Col-
An External Cold, Damp Cold or Dry climate lapse of the Large Intestine.
can interfere with the proper functioning of the T.C.M. PATTERNS OF DISHARMONY
Large Intestine. The Large Intestine requires a cer-
Patterns of disharmony associated with the
tain amount of moisture in order to function effi-
Large Intestine are generally related to the condi-
ciently, and is therefore easily injured by Dryness.
tions of the other internal organs of digestive sys-
The Dry climate (generally active in the autumn
tem (Spleen, Stomach and Small Intestine). The
time) can interfere with the functions of the Large
most common Large Intestine disharmonies arise
Intestine.
from deficient Qi of the Large Intestine, Damp
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 CHAPTER 8: THE TWELVE PRIMARY ORGANS, CHANNELS AND COLLATERALS

External
Channel
Flow

LI-13 ~f-----__ Internal

Channel
LI-12 Flow

LI-3--+--.
LI-2 ---\<~.

LI-1 - - - - ' 1 , .

Figure 8.67. The Internal and External Oi Flow of the Large Intestine (LI) Channels

367
VOLUME 1, SECTION 1: FOUNDATIONS OF CHINESE ENERGETIC MEDICINE

This type of Large Intestine

Deficient Qi of the Large Intestine
(Deficient Spleen Yang) - disharmony is often called Deficient
Spleen Yang Disharmony

Cold Damp in the Large Intestine

1- Sudden abdominal pain, painful
diarrhea, a cold sensation in the
abdomen, and a feeling of cold

Fever, sweating, a heavy feeling

~
in the body and limbs, abdominal
Lar~e
Intes me
Damp Heat Invading the Large Intestine
}-- pain, diarrhea with mucus and
blood in the stools, smelly stool,
and burning in the anus

Constipation, dry stool, burning

Exhausted Fluid of the Large Intestine

r- and swelling in the anus,
abdominal distention, high fever,
sweating (especially on the limbs)
thirst, and delirium

Sharp pain in the lower

Intestinal Abscess right abdominal area
I and possible fever

Figure 8.68. Chart of Large Intestine Disharmonies

Cold in the Large Intestine, Damp Heat Invading pattern. Its clinical manifestations include fe-
the Large Intestine, Exhausted Fluid of the Large ver, sweating, a heavy feeling in the body and
Intestine and Intestinal Abscess, described as fol- limbs, abdominal pain, diarrhea with mucus,
lows (Figure 8.68): blood in the stool, smelly stool, and burning
1. Deficient Qi of the Large Intestine: This type around the anus.
of Large Intestine disharmony is often called 4. Exhausted Fluid of the Large Intestine: This
Deficient Spleen Yang Disharmony. type of disharmony occurs when Heat within
2. Damp Cold in the Large Intestine: This type the Large Intestine consumes the fluids neces-
of Large Intestine disharmony often occurs in sary for the organ to function properly. This can
conjunction with invasion of the Spleen by result in constipation, dry stool, burning and
Cold and Damp. Cold invading the Large In- swelling in the anus, abdominal distention,
testine is considered to be an excess pattern, high fever, sweating (especially on the limbs),
and its clinical manifestations include sudden thirst, and delirium.
abdominal pain, painful diarrhea, a cold sen- 5. Intestinal Abscess: This type of Large Intestine
sation in the abdomen, and a feeling of cold. disharmony is similar to the Western syndrome
3. Damp Heat Invading the Large Intestine: of acute appendicitis. It can originate from ir-
This type of Large Intestine disharmony is regular (or otherwise unhealthy) eating habits,
often associated with Damp Heat accumulat- excess physical activity too soon after eating,
ing in the Spleen. Damp Heat invading the or an imbalance of Cold and Heat in the abdo-
Large Intestine is considered to be an excess men (affecting the Spleen and Stomach's abil-

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 CHAPTER 8: THE TWELVE PRIMARY ORGANS. CHANNELS AND COLLATERALS

Right Left
Colic Colic
(Hepatic) (Splenic)
Flexure Flexure

Haustrum

Ascending
Descending
Colon - - - - I
- - - Colon

Ileum
Cut Edge of
the
Mesentery
Ileocecal
Valve Tenia Coli

Sigmoid
Colon
Cecum

Internal Anal
Sphincter
External Anal Sphincter

Figure 8.69. The Large Intestine (LI) Organ (Inspired by the original artwork of Dr. Frank H. Netter).

ity to transform and transport). Symptoms in- The walls of the large intestine are also struc-
clude sharp pain in the lower right abdominal turally different from the walls of the small intes-
area and possible fever. tine, corresponding to the differing functions of
each organ. The large intestine stretches from its
THE LARGE INTESTINE IN WESTERN
connection with the small intestine (at the ileoce-
MEDICINE
cal valve) to the anus, and is shaped roughly like
Situated in the lower abdomen, the large in- an upside-down "U". The large intestine can be
testine is a tubular organ about 5 feet in length structurally divided into four parts: the cecum,
that comprises the terminal portion of the gas- the colon (ascending, transverse, descending, and
trointestinal tract. It has the name large intestine sigmoid), the rectum, and the anal canal. These
due to the fact that it has a greater diameter (2.5 four sections are described as follows (Figure 8.69):
inches) than that of the small intestine (one inch), 1. Cecum: The cecum is a small pouch about 2.5
while the small intestine actually has a greater inches in length, and is the first part of the
length (approximately 21 feet). The large intestine large intestine to receive chyme (via the ileo-
is attached to the posterior abdominal wall by its cecal valve) from the small intestine. The ileo-
mesocolon of visceral peritoneum. cecal valve (also called the ileocecal sphinc-

369
VOLUME 1, SECTION 1: FOUNDATIONS OF CHINESE ENERGETIC MEDICINE

ter) is a small fold of mucous membrane that canal. The rectum has three transverse folds,
acts as a valve between the ileum of the small called rectal valves, that serve to separate fe-
intestine and the cecum of the large intestine. ces from flatus. The nature of the location of
The vermiform appendix, a small convoluted the rectum allows for a number of lower-ab-
tube about three inches in length, is attached dominal organs to be examined digitally
at the medial portion of the cecum and ex- through its anterior wall.
tends roughly in the direction of the rectum. 4. Anal Canal: The anal canal forms the last inch
2. Colon: The colon makes up the majority of of the gastrointestinal tract. The anal canal
the large intestine, and is itself divided into contains an internal sphincter (involuntary -
four parts: the ascending colon, the transverse composed of smooth muscle) and an external
colon, the descending colon, and the sigmoid sphincter (voluntary - composed of skeletal
colon. The colon weaves itself through sev- muscle); these lie between the rectum and the
erallayers of the abdomen, though not all of anus and control the expulsion or retention
the colon is situated behind the peritoneum. of feces. Within the anal canal are longitudi-
It is anchored to the walls of the abdominal nal fold of mucous membrane (anal columns)
cavity by sheet-like layers of connective tis- that contain a number of arteries and veins. It
sue called mesentery colons. is these veins and the rectal veins that can,
• The ascending colon is attached to the open when put under excessive pressure, over-
end of the cecum and extends upwards on the stretch and cause the condition known as
right side of the abdomen. At about the height hemorrhoids or piles.
of the under-surface of the liver, the colon turns Physiology
abruptly, forming the right colic (hepatic) flex- The primary functions of the large intestine
ure that marks the end of the ascending colon can be divided into the following four basic cat-
and the beginning of the transverse colon. egories (Figure 8.70): completion of the digestive
• The transverse colon begins at the right colic process, manufacture and absorption of certain
flexure and extends horizontally across the ab- nutrients, formation of feces, and the expulsion
domen towards the left. Near the lower left of feces.
end of the spleen, there is another acute turn By the time the chyme reaches the large in-
in the colon, known as the left colic (splenic) testine, most of the available water and nutrients
flexure. This marks the end of the transverse have already been absorbed into the bloodstream.
colon and the beginning of the descending Though the large intestine possesses no villi to
colon. enable any large scale absorption of nutrients, it
• The descending colon begins at the left colic plays and important role in maintaining the bod-
flexure and extends downwards along the left ies water balance, absorbing all but 100 to 200 ml
side of the abdomen. Upon entering the pel- of the liter or so of water that it receives. It also
vis, the descending colon becomes the S- absorbs small but essential amounts of various
shaped sigmoid colon. electrolytes. The resident bacteria within the large
• The sigmoid colon begins near the iliac crest intestine serve to complete the process of diges-
of the pelvis, extends inwards towards the tion by fermenting and breaking down the pro-
midline, then joins the rectum at the level of teins and carbohydrates that are still present
the third sacral vertebrae. within the chyme. Once the bacteria have com-
3. Rectum: The rectum, roughly eight inches in pleted the process of breaking down the chyme,
length, is the next to last portion of the gas- the undigested material is now known as feces.
trointestinal tract. Situated anterior to the The process of fermenting carbohydrates re-
sacrum and coccyx, the rectum extends down- leases hydrogen, carbon dioxide, and methane
wards from the sigmoid colon to join the anal gas; while the proteins are broken down and con-

370
 CHAPTER 8: THE TWELVE PRIMARY ORGANS, CHANNELS AND COLLATERALS

Completion of Food Digestion

Manufacture and Absorption of Certain Nutrients

(a function of the intestinal bacteria)
Large
Intestine
Formation of Feces

Expulsion of Feces

Figure 8.70. Th.e Functions of the Large Intestine (Western Medical Perspective)

verted into amino acids and their fatty acid com- dent bacteria. A gastrocolic reflex, initiated by in-
ponents. Protein fermentation in the large intes- troduction of food into the stomach, causes peri-
tine also releases indole and skatole, which con- staltic waves in the large intestine. While feces
tribute to the odor of the feces. Bacteria also de- travels along the colon by peristaltic contractions
compose the bilirubin released by the liver, giv- it is also churned about by haustral churning, in
ing feces their characteristic brown color. Several which alternate sides (haustra) of the large intes-
vitamins (e.g., vitamin K and some B vitamins) tine expand and contract. Mass peristalsis, which
are also created as bacterial by-products, and are begins at the middle of the transverse colon,
absorbed into the body through the colon. De- pushes feces downwards and into the rectum.
pending on the composition of the chyme, the When the rectal wall is adequately distended,
bacteria in the large intestine may also release stretch receptors then initiate a reflex for defeca-
large or small amounts of toxic materials; once tion; in defecation, the rectum is emptied through
absorbed into the body, these are generally con- a combined contraction of the diaphragm, ab-
verted into less toxic substances by the liver and dominal muscles, and increased peristalsis in the
then released in the form of urine. other portions of the colon. If defecation is post-
The large intestine has a thick layer of mu- poned, due to the voluntary contraction of the
cosa to ease the passage of feces towards the end external anal sphincter, the feces backs up into the
of the digestive tract. This thick mucous layer also sigmoid colon. Upon the next wave of peristaltic
protects the walls of the large intestine from the contractions, the intensity of the defecation reflex
irritating acids and gases produced by the resi- increases.

371