Brain
One of the six Extraordinary Fu organs (Qi Heng Zhi Fu), known as the 'Sea of Marrow' (Sui Hai), formed from the accumulation of Kidney Essence. It is considered the 'Residence of the Original Spirit' (Yuan Shen Zhi Fu), governing mental activity, consciousness, memory, and sensory functions.
Five Element Correspondences
Season
None
Climate
N/A (not directly assigned in Five Element theory)
Emotion
All emotions (mental activities attributed to the five Zang organs under Heart's leadership)
Color
N/A (not directly assigned in Five Element theory)
Taste
N/A (not directly assigned in Five Element theory)
Sound
Speech and language
Direction
None
Sense Organ
All five sense organs (eyes, ears, nose, tongue, skin) - receives sensory input
Body Tissue
Marrow (Sui) - including spinal cord and bone marrow
Body Fluid
Cerebrospinal fluid (related to Marrow)
Peak Hours
N/A (not assigned specific hours in Chinese clock)
Meridian
Directing Vessel
Educational content · Consult qualified TCM practitioners for diagnosis and treatment
Overview
The Brain (脑, Nǎo) holds a unique position in Traditional Chinese Medicine as one of the six Extraordinary Fu organs (奇恒之腑, Qí Héng Zhī Fǔ). Unlike the regular Zang (solid/yin) and Fu (hollow/yang) organs, the Extraordinary Fu organs share characteristics of both types—they are hollow in form like Fu organs, yet they store vital essences like Zang organs. The Brain is called the 'Sea of Marrow' (髓海, Suǐ Hǎi) because it is formed from the accumulation of Marrow, which itself is produced from Kidney Essence.
In classical TCM theory, the Brain is described as the 'Residence of the Original Spirit' (元神之府, Yuán Shén Zhī Fǔ). This means it is the central location where consciousness, thinking, memory, and sensory perception converge. However, TCM takes a unique approach: while acknowledging the Brain's importance, classical theory attributes mental and emotional functions primarily to the five Zang organs, especially the Heart which 'houses the Spirit' (Shen). The Brain's functions are thus 'distributed' among the Heart, Liver, and Kidney in particular.
The Brain has an especially close relationship with the Kidneys, as Kidney Essence (Jing) produces Marrow, which then rises through the spine to fill the Brain. When Kidney Essence is abundant, the Sea of Marrow is full, resulting in sharp thinking, good memory, clear senses, and physical vitality. When Kidney Essence is depleted, the Brain becomes undernourished, leading to symptoms like dizziness, poor memory, tinnitus, and cognitive decline.
Historical Context
The concept of the Brain in TCM dates back to the earliest medical classics. The Huangdi Neijing (Yellow Emperor's Classic of Internal Medicine) first established the Brain as an Extraordinary Fu organ and coined the term 'Sea of Marrow.' The Lingshu chapter 'On the Sea' states that when the Sea of Marrow is sufficient, one feels 'light, agile, and strong,' but when deficient, symptoms include 'dizziness, tinnitus, leg weakness, visual impairment, and desire to lie down.' The Suwen noted that 'the head is the residence of clarity and brightness.'
Despite recognizing the Brain's existence, classical TCM developed a system where mental functions were attributed to the five Zang organs—the Heart stores Spirit (Shen), Liver stores the Ethereal Soul (Hun), Lungs store the Corporeal Soul (Po), Spleen stores Intellect (Yi), and Kidneys store Will (Zhi). This 'Five Spirit Organs' theory became the dominant framework for understanding consciousness and emotion.
A significant development came in the Ming Dynasty when the great physician Li Shizhen declared in his Bencao Gangmu (Comperta of Materia Medica) that 'the Brain is the residence of the Original Spirit.' Later, Qing Dynasty physician Wang Qingren in his Yilin Gaicuo (Correcting Errors in Medical Works) boldly stated that 'the spirit of intelligence and memory resides not in the Heart but in the Brain.' These later scholars began recognizing the Brain's direct role in mental function, though clinical practice continued to focus on treating brain disorders through the Zang organs, particularly the Kidney, Heart, and Liver.
Physiological Functions
Governing Life Activities
主宰生命活动The Brain is considered essential for life itself. The Huangdi Neijing states that 'stabbing the brain causes immediate death,' indicating its role as a vital center. The Brain coordinates and regulates the functions of all organs and systems in the body.
Governing Mental Activities
主精神活动The Brain is responsible for consciousness, cognition, thinking, memory, and emotions. When functioning normally, a person has clear thinking, good memory, appropriate emotional responses, and sharp mental faculties. Though TCM attributes these functions to the Heart and other Zang organs, the Brain is the physical location where these activities take place.
Governing Sensory Perception
主感觉All five sense organs (eyes, ears, nose, tongue, and skin) are located on the head near the Brain. Sensory information from sight, hearing, smell, taste, and touch travels through the meridians to the Brain for processing. When the Sea of Marrow is full, the senses are sharp and clear.
Governing Motor Function
主运动The Brain controls and coordinates bodily movement. It sends commands through the meridians to the limbs and constantly regulates movement to ensure coordination, rhythm, and precision. Brain dysfunction can lead to sluggish movement, paralysis, or loss of motor control.
Relationships with Other Organs
Other
Brain-Kidney Connection (脑肾相济): This is the most fundamental relationship. 'Below is the Kidney, above is the Brain—when one is deficient, both are deficient.' The Kidneys store Essence (Jing), Essence produces Marrow, and Marrow fills the Brain. The Governing Vessel (Du Mai) connects the Kidney to the Brain, allowing Kidney Essence to rise and nourish the Sea of Marrow. Treating Brain disorders by nourishing Kidney Essence and supplementing Marrow is a core clinical principle.
Other
Heart-Brain Connection (心脑相通): 'The Heart and Brain communicate intimately, keeping consciousness clear and alert.' The Heart governs Blood and houses the Spirit (Shen). Heart Blood nourishes the Brain, and when Blood is abundant, the Brain functions well. The 'Spirit-bright Heart' actually refers to Brain function. Clinical treatment of Brain disorders often includes treating the Heart, or treating Heart and Brain together.
Other
Liver-Brain Connection (肝脑相维): The Liver governs the smooth flow of Qi and stores Blood. Proper Qi circulation and adequate Blood supply keep the Brain clear and alert. Liver dysfunction—whether Liver Qi stagnation, Liver Yang rising, or Liver Wind—can severely affect the Brain, causing stroke, seizures, or mental-emotional disturbances.
Other
Spleen-Brain Connection (脑脾相关): The Spleen is the source of Qi and Blood production and governs the ascending of clear Yang. When the Spleen is healthy, it sends clear nutrients upward to nourish the Brain. When the Spleen is weak, 'the nine orifices are blocked' and clear Yang cannot reach the Brain. Li Dongyuan's principle of 'raising Spleen Qi to treat Brain disorders' remains clinically important.
Other
Lung-Brain Connection (脑肺相系): The Lungs govern Qi of the whole body and assist the Heart in circulating Blood. When Lung function is normal, Qi is sufficient, Blood circulates well, and the Sea of Marrow receives adequate nourishment. Brain disorders can sometimes be treated through the Lungs.
Common Pathological Patterns
Key Manifestations
Key Manifestations
Tongue Manifestations
The Brain itself does not have direct tongue manifestations in traditional diagnosis, as tongue diagnosis primarily reflects the state of the Zang-Fu organs. However, conditions affecting the Brain manifest through patterns of related organs:
- Pale tongue: May indicate Kidney Essence deficiency leading to Sea of Marrow insufficiency
- Purple or dark tongue with stasis spots: Suggests Blood stasis affecting the Brain, common in stroke
- Thick greasy coating: Indicates Phlegm misting the mind/Brain
- Red tongue with peeled coating: Reflects Yin deficiency with empty heat rising to disturb the Brain
- Deviated tongue: Classic sign of Wind-stroke affecting Brain function
Pulse Manifestations
Brain conditions are assessed through pulse patterns reflecting the state of related organs, particularly the Kidneys (which produce Marrow to nourish the Brain):
- Deep and weak pulse: Suggests Kidney deficiency with insufficient Marrow reaching the Brain
- Slippery pulse: Indicates Phlegm, which may obstruct Brain function
- Choppy pulse: Suggests Blood stasis, potentially affecting cerebral circulation
- Wiry and rapid pulse: Indicates Liver Yang rising or Liver Fire flaring upward to the head
- Scattered or irregular pulse: May indicate serious Brain disorders affecting consciousness
Clinical Relevance
Diagnostic Approach: Since TCM attributes Brain functions to the five Zang organs, Brain disorders are diagnosed through patterns of these organs. Key relationships to assess include: Kidney Essence (for memory, cognition, developmental issues), Heart Blood and Spirit (for consciousness, sleep, mental stability), Liver Qi and Yang (for headaches, dizziness, stroke risk), and Spleen Qi (for clarity of thought, mental energy).
Treatment Principles: Brain disorders are primarily treated through the related organs. The most important principle is 'Nourish Kidney Essence to Fill the Sea of Marrow' (补肾填精益髓) for conditions like memory loss, cognitive decline, and dementia. Other approaches include calming the Heart and Spirit for mental-emotional disorders, subduing Liver Yang and extinguishing Wind for headaches and stroke, transforming Phlegm and opening orifices for confusion and mental fog, and invigorating Blood and resolving stasis for post-stroke recovery.
Common Clinical Applications: Memory decline and dementia (tonify Kidney, fill Marrow); insomnia and anxiety (calm Heart, nourish Blood); headaches and dizziness (subdue Liver Yang, nourish Kidney Yin); stroke and paralysis (extinguish Wind, invigorate Blood, open orifices); confusion and mental illness (transform Phlegm, open orifices, calm Spirit). Acupuncture points on the head, particularly along the Du Mai such as Baihui DU-20, are frequently used for Brain disorders.
Classical Sources
Huangdi Neijing Lingshu (Yellow Emperor's Classic - Spiritual Pivot)
Chapter 33 - On the Sea (海论)脑为髓之海，其输上在于其盖，下在风府
The Brain is the Sea of Marrow. Its transport point above is at its cover (vertex), below is at Fengfu.
Huangdi Neijing Lingshu
Chapter 33 - On the Sea髓海有余则轻劲多力，自过其度；髓海不足，则脑转耳鸣，胫酸眩冒，目无所见，懈怠安卧
When the Sea of Marrow is abundant, one is light, agile, and strong, surpassing normal capacity. When deficient, there is dizziness, tinnitus, weak legs, vertigo, visual impairment, and desire to lie down.
Bencao Gangmu (Compendium of Materia Medica)
Li Shizhen, Ming Dynasty脑为元神之府
The Brain is the residence of the Original Spirit.
Yilin Gaicuo (Correcting Errors in Medical Works)
Wang Qingren, Qing Dynasty灵机记性不在心在脑
The faculty of intelligence and memory resides not in the Heart but in the Brain.
Modern References
The Foundations of Chinese Medicine
Comprehensive coverage of the Brain as an Extraordinary Fu organ, its relationship to Kidney Essence and Marrow, and clinical applications.
Chinese Acupuncture and Moxibustion
Standard textbook covering acupoints for treating Brain disorders and the theoretical basis of the Brain in TCM.
TCM natural products and acupuncture intervention for Alzheimer's disease based on neuroinflammatory pathway
Modern research review on TCM approaches to brain disorders, demonstrating clinical applications of the 'Kidney produces Marrow to fill the Brain' theory.