Uterus

Also womb. One of the extraordinary organs whose main function is menstruation and childbearing, which are related to kidney essential qì, the thoroughfare (chōng) and controlling (rèn) vessels, and the heart, liver, and spleen.

Kidney essential qì Only when there is abundant essential qì can the female reproductive organs develop to maturity, ensuring proper menstruation and adequate conditions for conception and childbearing. In old age, the kidney essential qì grows weak and menstruation ceases; the reproductive function is then lost. Plain Questions (素问 sù wèn) states, At the age of seven, the kidney qì of the female is strong, the teeth are replaced, and the hair is long. At the age of two sevens [i.e., fourteen], the heavenly tenth tiān guǐ arrives, controlling (rèn) vessel flows, and the thoroughfare (chōng) vessel fills, the menses come according to their times, and [she] can bear offspring... At seven sevens [i.e., the age of forty-two], the controlling (rèn) vessel empties, the thoroughfare (chōng) vessel weakens, tián guǐ is exhausted, the passages of the earth are cut, the body deteriorates, and she can no longer bear children. This statement highlights the key role of the essential qì of the kidney (kidney qì) in maintaining normal menstruation and the conditions for childbearing.

The thoroughfare and controlling vessels Both these vessels start from the uterus. The controlling (rèn) vessel joins with the three yīn channels of the foot in the abdomen and regulates all the yīn channels of the body. Thus it is sometimes referred to as the sea of the yīn channels. When there is an abundance of blood and qì in the twelve channels, it flows into the thoroughfare (chōng) and controlling (rèn) vessels, which control the flow into the uterus, permitting menstruation. Menstruation begins during puberty, when the essential qì of the kidney comes to fullness and the uterus develops. It was traditionally held that before the opening of the controlling (rèn) vessel and the full development of the thoroughfare (chōng) vessel, the menses would not start. At the age of about fifty, the thoroughfare (chōng) and controlling (rèn) vessels become vacuous as a result of the gradual debilitation of essential qì, causing menstrual irregularity, and finally, menopause. This represents the natural course of development, but disturbance of menstruation may occur at other times, owing to diseases of the thoroughfare (chōng) and controlling (rèn) vessels.

The heart, liver, and spleen The blood is governed by the heart, stored by the liver, and commanded by the spleen. The role of these organs with regard to the blood explains their connection with menstruation. If the liver fails to store blood or the spleen fails to command the blood, conditions such as profuse menstrual flow (menorrhagia), shortening of the menstrual cycle, prolonged menstrual periods, or flooding and spotting may occur. Such conditions are known as the liver and spleen failing to store and command the blood. Underproduction of blood resulting from diminished assimilation of the essence of grain and water in spleen vacuity conditions, or heart blood vacuity caused by mental and emotional disturbances, may lead to reduced menstrual flow, prolongation of the menstrual cycle, or even amenorrhea, all of which fall under the general term of dual vacuity of heart and spleen. Mental depression may affect the liver’s governing of free coursing, causing liver qì depression, which may also disrupt menstruation.

Etymology

Chinese: 子 zǐ, child, infant, son; 宫 gōng, palace. Infant’s palace.