By Eric Brand

All first-year TCM students have memorized that the liver governs the tendons according to Chinese medicine. This original statement of fact, laid down in the Nei Jing about 2000 years ago, is generally accepted without question. However, the ancient method of differentiating the body's various tissues is somewhat different than our modern biomedical understanding, and the precise tissue type referred to in the Nei Jing is a bit more complex in nuance than the biomedical term tendon suggests. In fact, one could argue that the translation of the Chinese word "jin" as “tendon” represents a true error in translation, and it is one that has permeated the Western TCM community.

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Jin tissue is governed by the liver, and it is associated with agility, flexibility, and strength. In pathology, the contractions seen in epilepsy are associated with contraction of the jin, and hypertonicity of the sinews is widely treated with methods that involve liver-wood. The texture of jin tissue is stringy and ropy. If you look at red meat, the gristle and white tissue surrounding and joining the red part is all described as jin. In Tui Na, any ropy tissue that you can grab and “pluck” is generally associated with jin.

In biomedicine, tendons attach muscle to bone. This is much narrower in scope than the Chinese tissue type. Chinese medical dictionaries often describe jin as encompassing tendons, ligaments, and connective tissue, though in fact many muscle bellies are also categorized as jin tissue. Examples include ropy muscles like the SCM on the neck or the aptly-named gracilis muscle, which just happens to traverse the liver channel area. The upper trapezius muscle is also quite ropy and is described as jin tissue in Tui Na; this region is coincidentally associated with the gallbladder (wood).

Chinese medicine divides the body’s tissues differently than biomedicine, and we must endeavor to understand Chinese medicine on its own terms. The translations of sinew (jin) and flesh (rou) are far more accurate than the words tendon and muscle. When people hear that the liver governs the tendons and the spleen governs the muscles, their understanding often ends right there. In actuality, the liver governs the tendons, ligaments, connective tissue, and ropy muscle bellies, while the spleen governs the thick, meaty, fleshy part of the body. This has major implications for the treatment of our patients, since understanding how the body’s tissues are grouped is essential for proper diagnosis.

In my opinion, it is essential to study Chinese medicine as it actually is, without trying to fit it into our own cultural box. There is plenty of room to bring our own culture’s contributions to Chinese medicine after we learn the foundation well, but at the moment the foundation of many students remains somewhat shaky. Having more accurate, consistent, and professional terminology would do wonders for future generations of students. It takes time and education to correct ingrained habits like the use of the word “tendon” to describe the tissue of the liver, but our patients will thank us for taking the time to learn TCM concepts correctly.