以上是中医书上说的“五脏”，本编所引用的中医说法，不及十分之一，大略尚能与西医之说相合。这种合拢起来讲中西医的生理学，似乎尚非胡扯乱拉，恐怕内中真有抉出这两种学问的精义的地方，也未可知。现在我再把中医讲的“六腑”说一说。
六腑六腑，中医以（一）胃，（二）大小肠，（三）胆，（四）膀胱，（五）命门（三焦附），（六）心包络（膻中附），为六腑，兹分述于下：（一）胃经云，脾胃者，仓廪之官，五味出焉。又云，胃者，水谷气血之海。又云，水谷入口，则胃实而肠虚，食下，则肠实而胃虚。又云，胃者，水谷之海，六腑之大源也。又云，五味入口，藏于胃，以养五脏。又云，．脾合胃，胃者五谷之府。以上诸说，总不外乎胃主腐熟五谷的道理。与西医之说吻合，不过中医无胃液之说，其论胃之妙用，多连脾（中医言睥包括胰脏在内）而言。所以二者总以连带讲述为宜。盖胃主纳食，脾主运化，脾气宜升（所谓健睥），胃气宜降（所谓胃以通为补也），张仲景治伤寒的三承气汤（就是泻药），叫作急下存津，就是知道胃中不宜存留着好多腐败东西，免去它在肠胃内作祟，所以把它泻下来。再轻一点的胃病，也是注意这种见解，所以又有胃柔润，以通为补的说法，就是缓缓的叫它往下运动，不愿大泻的说法，这与西医的清凉药、缓泻药，用意相同，这全是偏于实证的治法。若是李东垣的补中益气、调中益气、升阳益胃等汤，全然用着大补的药品，来治睥胃，这就是治的脾胃的虚证，较之西医的治法，圆妙的多。中医是主张脾脏之阳（就是热气，，若是不能上升，蒸动胃气，那是不行的。所以这些补药，往往有起死回生的妙用。总一句来说，就是胃宜下降，脾宜上升，这就是最可信的经旨。
（二）大小肠经云，小肠者受盛（音成）之官，化物出焉。大肠者传导之官，变化出焉。按中医书，小肠上口，即胃之下口，名曰幽门，而无十二指肠之名。小肠下口即大肠上口，名曰阑门，亦无盲肠之名，此是中医的解剖未精的缘故，无庸讳言。然中医对于大小肠之生理，则言之甚详。其言小肠为心之腑一语，即是说的小肠对于食物吸收后，由乳糜淋巴而造成血液，以入于心脏（参看前章肺之生理）之理。中医说小肠所受盛者，只是食物。饮主化气，食主化血，食物在小肠内，皆化为液，以出于油膜（此指中焦说），此油暎二字，即-西医书之乳糜淋巴等组织。不过中医书分不清楚这种东西的构造，可是早巳参透了食物变成血液的道路（由肠壁吸收之营养质，其输送之道路有二，一由门脉经肝脏，以达于心脏，一经肠淋巴管，及胸管，混入血液中，以达于心脏，所以血液中仍有脂肪，即中医所称之“营”是也。）所以它说小肠能化物，化物就是指着气血这两种东西说。至于气的化出，中医是离不了三焦的说法。而肠子周围的东西，统统名为三焦。这个道理，我在后边三焦节下，叙述之。食物在小肠，吸收去的成分极多，到了大肠，吸收力就少了。可是大肠能特别吸收水分，使粪便浓厚，所以中医书说大肠是传导之官，变化出焉。变化出，这三个宇，就是说由小肠送来的东西，到了大肠，精汁大部分早已化去了，到了此处，就变为糟粕而出。其言大肠为肺之腑一语，就是说的大肠何以能传导，必赖肺气下达，它才能致其功用。若是肺气闭塞住，不甚活泼（例如表实及里热等），那么它那传导（道与导同）的力量，也就小了。这个说法，也与血之运行有极微妙的关系，参看上节肺之生理就明白了。所以心合小肠，肺合大肠，这两句的经旨，乍一看好象荒谬之至，我经过若干年的实验，才知道此中真有至理，而且与西医的说法，不谋而合。
（三）胆经云，胆者中正之官，决断出焉。又云，肝合胆，胆者中精之腑。又云，胆气郁为怒。可见中医论胆，已知其与肝有连带关系，但不知胆汁入十二指肠，以助消化之理。然其推阐肝郁，则胆气抑遏，令人暴怒之理，颇觉圆通。盖肝之血行，若有障碍，势必肝汁存留，输送停顿，不但消化受其影响，即神经亦必不能安静。所以郁怒的现象，中西医是公认的。在西医书所称加答儿性黄疸症，皆有神经抑郁，食欲不振，及肝脏胆囊之肿大。若在胆石症，胆部更有剧烈的疼痛、恶寒等，粪便之失色（多为白色）等等主要的症侯。可是中医说胆病，亦有黄疽、忿怒、胁疼、胁胀等等之重要主症。至于胆主决断一语，似系从经验中得来的，证以科学的注重实际，自然不能强合。然而中医之治惊惧和忿怒，大半离不了肝胆二经。它那理论，总是说胆气太过则暴横专断；胆气不足，则惊惧无决断，本此立论，而处方治病，是确实有效的。这大约与神，经上有微妙的关系，只以此系偏于精神方面立论，无有真凭实据的东西，所以我不能下断语。可是中医论胆，证以它的治法有效，就不能把它的理论，一笔抹煞。这是我的主张，说不定若干年后，就可以研究出它这一点的道理来啊。
（四）膀胱经云，膀胱者州都之官，津液藏焉，气化则能出矣。又云，肾合膀胱，膀胱者津液之府也。中医解剖未精，看不清膀胱与肾脏联络的东西（输尿管），却是知道尿是存注于膀胱。惟对于尿之来路，则说不明白，于是有气化的说法，这不能不说是中医的疏漏，可是关于气化这种理想上的创造，证以中医治水病的灵验，真是有它独立的价值，不可不加以阐明。中医说入气不化则水归大肠，而为泄泻；出气不化，则闭塞下窍，而为瘾肿，这两句话，隐然与经旨论肾气化能出的道理相合。它那理论，是把膀胱的上口、下口、撂开不讲。它的精义，就是不论膀胱口是何如，若是气不能化，简直的喝下水去-，到不了膀胱，就得出来（泄泻），或者全聚到膀胱，小便不容易出来（尿闭），或者全留到体内（浮肿）。水是一点也化不了气，或是一点也排泄不出来，此可证明膀胱并非无口，何以水的道路，忽然发生了变化呢？在这种现象之下，是用着气化二宇，来神其功用的。西医是除了利尿药之外，就是抽水或用器械的排尿，在当时未尝不立见效验，可是根本上，今天放了腹水，明天就须再肿起来。今天用加的儿排了尿，明天仍然又不通。除了尿石的外科手术，那是对尿石症再好不过的法子以外，我认为中医治水症，它那气化二字的神妙，可以补西医治水病的缺点，这是我经验了若干年，才敢下这几句断语。现在我举一个例子于下：我的老友李勋卿的太太和张松泉的太太，年龄全在五十以上，她那病象，全是水肿。先是四肢肿，后来腹肿，而且肿的极厉害，肚脐全肿的很高，而且往外出水，两腿肿的发亮，主要的症候是这样，我的用药是党参、黄芪、山药、白芍、白术、茯苓皮、姜皮、补骨脂、熟附子，这是主要的药，分量每味五六钱，附子二三钱，大约二三十剂，此二症就痊愈了，刻下均健在。此症已经多医诊治，她那以前的药方，我已记不清，大约是药味太多，分量太少的毛病，所以未能收效。记得张松泉的太太，还有出虚汗的毛病，所以重用白芍，后来我不在家了，他还写信来问我，说是汗早已不出了，吃药未断，因而汗出不来，又难过，以后减去白芍，就痊愈了。
The above refers to the "Five Zang Organs" described in traditional Chinese medicine (TCM) books. The TCM theories cited in this book account for less than one-tenth of the total, yet they generally align with Western medical concepts. This approach of integrating TCM and Western physiology does not appear to be arbitrary or forced; it is possible that there are indeed insights into the essence of both disciplines. Now, I will discuss the "Six Fu Organs" as explained in TCM.
The "Six Fu Organs" in TCM include: (1) Stomach (Wei), (2) Small Intestine (Xiaochang) and Large Intestine (Dachang), (3) Gallbladder (Dan), (4) Bladder (Pangguang), (5) Mingmen (Gate of Life, associated with Sanjiao/Triple Burner), and (6) Pericardium (Xinbaoluo, associated with Danzhong/Chest Center). These are described below:
(1) The *Meridian of the Stomach* states: "The Spleen and Stomach are the officials of the granary, from which the five flavors emerge." It further states: "The Stomach is the sea of water and grain, the source of Qi and Blood." It also says: "When food and drink enter, the Stomach becomes full and the Intestines empty; when food descends, the Intestines become full and the Stomach empties." Additionally: "The Stomach is the sea of water and grain, the great origin of the Six Fu Organs." And: "The five flavors enter the mouth and are stored in the Stomach to nourish the Five Zang Organs." Finally: "The Spleen harmonizes with the Stomach; the Stomach is the residence of the five grains." All these statements essentially convey the principle that the Stomach is responsible for rotting and ripening the five grains. This aligns with Western medicine, although TCM lacks the concept of gastric juice. TCM descriptions of the Stomach's functions often link it with the Spleen (in TCM, the Spleen includes the pancreas). Therefore, it is appropriate to discuss them together. The Stomach governs the reception of food, while the Spleen governs transformation and transportation. Spleen Qi should ascend (known as "strengthening the Spleen"), and Stomach Qi should descend (known as "tonifying the Stomach through unblocking"). Zhang Zhongjing’s use of the Three Chengqi Decoctions (purging formulas) in treating Cold Damage diseases, termed "urgent purging to preserve fluids," reflects the understanding that the Stomach should not retain excessive decayed matter to prevent disturbance in the gastrointestinal tract. Thus, purging is employed. For milder stomach conditions, this perspective leads to the saying "the Stomach prefers moistening and softness, tonification through unblocking," meaning to gently promote downward movement rather than using harsh purgatives. This intent is similar to Western cooling and mild laxative drugs, representing treatment methods primarily for Excess syndromes. In contrast, formulas such as Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Tiaozhong Yiqi Tang (Regulate the Middle and Augment the Qi Decoction), and Shengyang Yiwēi Tang (Raise the Yang and Benefit the Stomach Decoction) by Li Dongyuan use strong tonifying herbs to treat the Spleen and Stomach. This addresses Deficiency syndromes of the Spleen and Stomach and is more sophisticated than Western treatments. TCM advocates that Spleen Yang (heat energy) must ascend to steam and activate Stomach Qi; otherwise, it is ineffective. Hence, these tonifying herbs can have miraculous effects in reviving critical patients. In summary, the Stomach should descend, and the Spleen should ascend; this is the most reliable classic principle.
(2) The *Meridians of the Small and Large Intestines* state: "The Small Intestine is the official of reception and transformation, from which changes emerge." "The Large Intestine is the official of transmission, from which transformations emerge." According to TCM texts, the upper opening of the Small Intestine is the lower opening of the Stomach, named the Pylorus (Youmen), without a term for the duodenum. The lower opening of the Small Intestine is the upper opening of the Large Intestine, named the Lanmen, without a term for the cecum. This is due to the imprecision of TCM anatomy, which needs no concealment. However, TCM describes the physiology of the intestines in detail. The statement "the Small Intestine is the Fu organ of the Heart" implies that after absorbing food, the Small Intestine converts chyle and lymph into blood, which then enters the Heart (see the previous chapter on Lung physiology). TCM holds that what the Small Intestine receives is merely food. Drinks mainly transform into Qi, and food mainly transforms into Blood. Food within the Small Intestine turns into fluid, exiting via the "oil membrane" (referring to the Middle Jiao). The term "oil membrane" corresponds to chyle and lymph tissues in Western medicine. Although TCM texts cannot distinguish the specific structure of these substances, they had already comprehended the pathway of food transforming into blood (nutrients absorbed by the intestinal wall have two transport pathways: one via the portal vein through the Liver to the Heart; the other via intestinal lymphatic vessels and the thoracic duct, mixing into the blood to reach the Heart. Thus, blood still contains fat, known in TCM as Ying/Nutritive Qi). Therefore, it says the Small Intestine can "transform substances," referring to the generation of Qi and Blood. Regarding the generation of Qi, TCM relies on the concept of Sanjiao (Triple Burner). Everything surrounding the intestines is collectively called Sanjiao. This principle is discussed in the following section on Sanjiao. Food absorbs many components in the Small Intestine, but absorption decreases in the Large Intestine. However, the Large Intestine specifically absorbs water, thickening the feces. Hence, TCM says the Large Intestine is the "official of transmission, from which transformations emerge." "Transformations emerge" means that by the time material arrives from the Small Intestine, most of the essential juices have been transformed, leaving only dregs to be excreted. The statement "the Large Intestine is the Fu organ of the Lung" explains that the Large Intestine requires descending Lung Qi to perform its transmission function. If Lung Qi is blocked or inactive (e.g., in Exterior Excess or Interior Heat syndromes), its transmission power diminishes. This theory has a subtle relationship with blood circulation, as understood in the previous section on Lung physiology. Thus, "the Heart harmonizes with the Small Intestine, and the Lung harmonizes with the Large Intestine" may seem absurd at first glance, but years of practice have revealed profound truth in this, aligning with Western medicine.
(3) The *Meridian of the Gallbladder* states: "The Gallbladder is the official of uprightness, from which decision-making emerges." It also says: "The Liver harmonizes with the Gallbladder; the Gallbladder is the organ of pure essence." And: "Stagnation of Gallbladder Qi leads to anger." This shows TCM knew of the connection between the Gallbladder and Liver, though it did not know that bile enters the duodenum to aid digestion. However, its deduction that Liver Qi stagnation suppresses Gallbladder Qi, causing sudden anger, is quite logical. If Liver blood flow is obstructed, liver juice accumulates and transport stops, affecting digestion and causing nervous instability. Both TCM and Western medicine acknowledge symptoms of depression and anger. In Western medicine, catarrhal jaundice involves nervous depression, loss of appetite, and enlargement of the liver and gallbladder. In cholelithiasis, severe pain, chills, and pale stools are main symptoms. TCM also identifies jaundice, anger, hypochondriac pain, and distension as key symptoms of Gallbladder disease. The phrase "the Gallbladder governs decision-making" seems derived from experience. Scientifically focusing on practicality, it cannot be forcibly aligned. However, TCM treatment for fear and anger largely involves the Liver and Gallbladder meridians. The theory posits that excessive Gallbladder Qi leads to tyranny and decisiveness, while deficient Gallbladder Qi leads to fear and indecision. Prescriptions based on this theory are effective. This likely relates subtly to the nervous system. Since this theory leans towards the mental aspect without empirical proof, I cannot make a definitive judgment. Nevertheless, given the efficacy of TCM treatments, the theory cannot be dismissed entirely. This is my view; perhaps in years to come, the rationale behind this will be elucidated.
(4) The *Meridian of the Bladder* states: "The Bladder is the official of the capital, storing fluids; Qi transformation allows their exit." It also says: "The Kidney harmonizes with the Bladder; the Bladder is the residence of fluids." Due to imprecise anatomy, TCM could not see the connection between the Bladder and Kidneys (ureters), but knew urine was stored in the Bladder. Lacking clarity on urine's origin, TCM proposed "Qi transformation," which is an oversight but represents an idealistic creation with independent value, proven by the efficacy of TCM in treating edema. TCM states: "If entering Qi fails to transform, water goes to the Large Intestine, causing diarrhea; if exiting Qi fails to transform, the lower orifices close, causing swelling/abscess." These implicitly align with the classic principle that Kidney Qi transformation enables urination. Ignoring the bladder's openings, the core idea is: regardless of the bladder's state, if Qi cannot transform, ingested water either exits directly (diarrhea), accumulates preventing urination (urinary retention), or stays in the body (edema). Water cannot transform Qi, nor can it be excreted. This proves the bladder has openings, yet water's path changes. Here, "Qi transformation" mystifies this function. Western medicine uses diuretics, aspiration, or catheterization, which work temporarily but fail fundamentally (ascites returns, urinary obstruction recurs). Except for surgery for calculi, I believe TCM's "Qi transformation" compensates for Western medicine's shortcomings in treating water disorders, a conclusion drawn from years of experience. Example: My old friends' wives, Li Xunqing's wife and Zhang Songquan's wife, both over fifty, suffered from edema starting in limbs, progressing to severe abdominal swelling, umbilical protrusion with leakage, and shiny legs. I prescribed Dangshen (Codonopsis Radix), Huangqi (Astragali Radix), Shanyao (Dioscoreae Rhizoma), Baishao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Fulingpi (Poria Cocos Exocarpium), Jiangpi (Zingiberis Recens Cortex), Buguzhi (Psoraleae Fructus), and Shu Fuzi (Aconiti Lateralis Radix Praeparata). Main herbs were 15-30g each, Fuzi 6-9g. After 20-30 doses, both recovered and remain healthy. Previous treatments failed likely due to too many herbs with insufficient dosages. Zhang Songquan's wife also had spontaneous sweating, so I used heavy Baishao. Later, she reported sweating stopped but became uncomfortable without it; removing Baishao cured her.