The Six Conformations (6C) system of pathophysiological understanding in Chinese medicine is the primary one relied upon by Zhang zhongjing, author of the Shanghan za bing lun, and originator of the received version of Chinese herbalism. It is also commonly misunderstood.
The primary mistake people make is in associating the 6C solely with their channel manifestations.
The majority of TCM students first learn (and last learn) of the 6C when they learn the full names of the acupuncture channels. For example, the Bladder channel’s fuller name is the Bladder channel of foot Taiyang (paired with the Small Intestine channel of hand Taiyang). Certainly the paths, relationships and qi dynamics of these channels have something to do with the mature concept of the 6 Conformations.
The Six conformations include the channels but also go beyond them.
Like the 5 phases, the 12 organ systems and the various tissue models used in Chinese medicine, the 6 Conformations is a way of dividing up all the structures and functions of the human body into a form that works as a guide for diagnosis and treatment. With the 5 phases, most students and practitioners readily adapt the symbolism to a variety of structures and functions, including those inside and outside of the body. We simply need to extend this flexibility to our understanding of the 6 conformations.
Each conformation is a pair of two organ systems – three yang pairs and three yin pairs.
These are in turn described with a term (listed below) that describes the orientation and functionality of that pair. There are many layers of theory that assist the practitioner in applying the basic symbolism to their patients’ treatment. Each layer is fascinating and useful! But, first, I just want to lay out the basics as best I can.
The conformations’ names and their associated organ systems
- Taiyang – 太陽 – Great Yang – Bladder and Small Intestine organ systems
- Yangming -陽明- Yang Brightness – Large Intestine and Stomach organ systems
- Shaoyang – 少陽 – Lesser Yang – Gallbladder and Triple Burner organ systems
- Taiyin – 太陰 – Great Yin – Lung and Spleen organ systems
- Shaoyin – 少陰 – Lesser Yin – Heart and Kidney organ systems
- Jueyin – 厥陰 – Reverting Yin – Pericardium and Liver organ systems
The Six Conformations are related to Six climactic factors/Qi (Liu qi).
These should be in balance in nature, but when they are out of balance we know them as the Six Evils.
- Taiyang – Cold : associated with water, contracting quality
- Yangming – Dryness : associated with metal, desiccating quality
- Shaoyang – Fire : associated with a guttering flame, like a torch
- Taiyin – Damp : associated with earth, sticky and heavy in quality
- Shaoyin – Heat : associated with a steady fire, like a hearth
- Jueyin – Wind : associated with wood, wandering in quality
The climactic factors lend their qi to the conformations. So, the pathophysiology of Taiyang is influenced in some way by cold. The particular ways in which that manifests is laid out, though not clearly, in the Shanghan lun. For now, it is fine just to know that when we’re working with one of the conformations both organ systems associated have a relationship to the climactic factor it is associated with.
The order of the conformations and the layers of the body
The specific order I keep using as I list the conformations is not without reason. While there is some discussion about the placement of Yangming, most of my teachers seem to agree on the order they are listed above. Straightforward cold damage pathology is said to transmit through these layers one at a time, passing from Taiyang to Yangming and so on. The details of this, again, are embedded within the concentrated teaching text the Shanghan lun.
Taiyang is the most outward of the conformations.
It governs the most superficial layers of the body and is associated with the Weiqi or defensive force of the human being. Think of the primary formulas associated with Taiyang – Guizhi Tang and Mahuang tang. Both strongly resolve the surface. Yangming is the next layer deep – both in some sense physically and also in terms of how external pathogens must progress in their quest to do harm. It is in the Yangming stage that we get great fevers, this is a storehouse of immense Qi and Blood force in the average person. Think how well this resonates with the Stomach and Large Intestine organ systems, both deep dealers in the most basic, primal functions of life. The last Yang conformation, and thus the last protector against a disease becoming deeply internalized, is Shaoyang. Shaoyang is said to “pivot” (a long discussion) between internal and external, and thus has a kind of oscillating quality.
Now we enter the interior of the body, going ever deeper.
Taiyin is the first of the Yin conformations and in some way exemplifies a kind of “doing without doing” — the most active of the passive organ systems. Going a layer deeper we find Shaoyin, the north and south poles of the body – Heart and Kidney, the basic axis of the functioning of the human body. When external pathogens reach this deeply, serious disease is the result. Finally, Jueyin – the deepest, but also the possibility of rebirth into the Taiyang conformations in the classic cyclic manner of Chinese philosophical systems. Jueyin is deeply involved with blood, as can be seen clearly in its encompassing of both Liver and Pericardium.
The 6 Conformations provide us with a fascinating and clinically useful way to look at the human body and its pathologies.
These basics provide a scaffolding for future posts on this important subject. If you have any questions about this essential information, or would like to offer a correction or comment – please feel free to leave it in the comments section below.
[This post has been updated during the 2020 site updates. My goal during post updates was to keep the character of the original post, but update for corrections and clarity, as well as to remove broken links.]