QI, Blood and Body Fluid

Qi, blood and body fluid have something in common with each other, despite their differences in nature, form and function.

They are the basic materials that constitute the human body and maintain life activities;

They all derive from cereal essence.

Physiologically They depend on each other for existence and

restrict and utilize each other;

Pathologically They also act upon each other.

Qi

Original meaning of Qi

Qi is a concept signifying a rudimentary understanding of the natural phenomena in ancient times in China.

It was believed that Qi was the fundamental substance constituting the universe and that all phenomena were the results of the changes and movement of Qi.

TCM gradually absorbed the concept and has come to assume that Qi is also the basic substance that constitute the human body.

The concept of Qi in TCM

Characterized by its vigor and constant motion, which represents physiologic activities of human body.

It vitalizes, propels and warms the body, and is Yang in nature.

It is the fundamental substance on which all life activities depend.

Formation and distribution of Qi According to the sources, functions and

distributions, Qi is divided into four types:

1. congenital Qi (yuan Qi)

2. pectoral Qi (zong Qi)

3. nutrient Qi (ying Qi)

4. defensive Qi (wei Qi)

1. Congenital Qi (yuan Qi)

the primary motive force of life activities. derives from the congenital essence stored in the

kidney, and depends on the acquired essence regenerated by the spleen and stomach.

The Essential Question says, " congenital Qi is inherited from the parents and combined with cereal essence to nourish the body."

Function: promote growth and development of the body, as well as warm and stimulate the physiological functions of the viscera and meridians.

2. Pectoral Qi (zong Qi)

is formed from a combination of the fresh air inhaled by the lung and the cereal essence conveyed by the spleen and stomach.

Pectoral Qi performs two main functions. One is traveling through the respiratory tract to

promote respiration. The other is running through the heart-meridian to

promote the circulation of Qi and blood.

3. Nutrient Qi (ying Qi)

is the Qi that circulates together with blood in the vessels.

Nutrient Qi originates from the pure part of cereal essence transformed by the spleen and stomach and bears responsibility for the blood production and the nutrition of the whole body.

Nutrient Qi is considered as Yin, so it is also called Nutrient Yin (ying-Yin) .

Function: nourish and produce the blood, and join the blood, it flows in the vessels and helps the blood to nourish the whole organism.

4. Defensive Qi (wei Qi)

like nutrient Qi, comes from cereal essence, but, unlike nutrient Qi, it runs outside the blood

vessels. Defensive Qi has the following functions: 1. Protect the body surface against exogenous

pathogens, 2. Control the opening and closing of the pores, 3. Adjust the excretion of sweat, 4. Warm and nourish the Zang-Fu organs, muscles

and the skin with hairs, etc.,5. Maintain a relatively constant body temperature.

It is given the name "defensive Qi" precisely because of its anti-exogenous pathogenic action.

Defensive Qi belongs to Yang, so it has another name defensive Yang ( Wei-Yang)

General function of Qi

1. Propelling action

2. Warming action

3. Defending action

4. Containment action

5. Production and transformation action

1. Propelling Action

Qi, as a sort of refined substance full of vigor, plays a promoting and activating role in the growth

and development of the human body, the physiological activities of the Zang-Fu organs and meridians, the production and circulation of blood, as well as the production, distribution and excretion of body fluid.

Abnormal changes

If the above functions are weakened due to Qi deficiency, the following pathologic changes will occur:

Tardy growth and development of the human body, hypo-function of the Zang-Fu organs and meridians, stagnation of blood, fluid retention, etc.

2. Warming Action

Whether man's body temperature is normal or not depends on the warming action of Qi.

Essential Question says: "Qi is responsible for warming."

Only through the warming action of Qi, can all Zang-Fu organs ， meridians and other structures perform their normal functional activities, and can such liquid substances as blood and body fluid circulate normally.

Abnormal changes

As the saying goes, “Blood flows in warmth, while it coagulates in cold.”

For example, the insufficiency of Yang-Qi may impair the warming action of Qi, causing cold syndrome such as aversion to cold, cold limbs, lowered body temperature and so on.

Conversely, Qi excess may result in the failure of Qi to disperse heat and lead to heat syndrome such as aversion to heat, preference for cold, fever, etc.

Essential Question states, "Qi excess produces heat, while Qi deficiency produces cold."

3. Defending Action

Qi has defending function to defend the body surface against the exogenous pathogens and to combat with the invaded exogenous pathogens to drive them out of the body.

Essential Question states, "When congenital Qi exists in the body, the exogenous pathogens can not attack the body."

And "If the pathogenic factors will invade the human body when the defending action of Qi is weakness." Thereby leading to illness.

4. Containment Action

Qi also has containment action, is meant that Qi has the ability to control the liquid substances and fix the internal organs in the body.

This is shown in the following aspects: Keeping the blood flowing within the vessels to

prevent it from extravasating without reason. Controlling and regulating the secretion and

excretion of sweat, urine, sperm, saliva, gastrointestinal juices, etc, to maintain a relative balance of water metabolism.

Firming the internal organs in their normal positions.

Abnormal changes

If this action is impaired, hemorrhage, premature ejaculation, spontaneous sweating, urinary incontinence, and spermatorrhea will occur.

If this action fails to work normally, such prolapses as gastroptosis, nephroptosis will happen.

5. Production and Transformation Action Qi transformation may be defined as various

kinds of changes brought about by the movement of Qi.

Concretely speaking, it refers to the respective metabolism of essence, Qi, blood and body fluid and their reciprocal transformation. For instance,

food is transformed into Qi, blood and body fluid; body fluid are converted into sweat and urine by

metabolizing, and the residues of food,after digestion and

absorption, are turned into feces to be discharged from the body.

All these processes are all the specific manifestations of the action of Qi transformation.

If Qi transformation is out of order, it will affect the digestion, absorption of food, the metabolism and transformation of essence, blood and body fluid, the excretion of sweat, urine and feces and so on.

To put it briefly, Qi transformation is actually the process in which

the substances in the body are metabolized and inter-transformed.

Although the above five actions of Qi differ from one another, they are indispensable to maintaining human life.

Their harmonious cooperation and mutual support ensure that the physiological activities are completed smoothly.

Basic rules of movement

Qi is highly active, it reaches and penetrates to every parts of body.

However, the dynamic of Qi acts according to the four principles:

When this movement of Qi stops, the body dies.

center issueentry

Ascending

Descending

Disorder of Qi

1. Deficiency of Qi

2. Prolapse of Qi

3. Stagnation of Qi

4. Adverse flow of Qi

1. Deficiency of Qi

In normal state, the functions of Zang-Fu organs and body tissues depend on the condition of Qi.

If Qi is strong and well reserved, the physiologic function of body may become properly active.

But in abnormal state, the depletion of Qi may lead to organic hypofunction and reduce resistance to pathogens, giving various signs of deficiency syndrome.

Cause: depletion of Qi due to

1. over consumption in lingering diseases

2. over fatigue

3. old age The organic hypofunction is the main point

in diagnosing Qi deficiency syndrome.

Main manifestation Insufficiency of the Congenital Qi and hypofunction of

the Zang-Fu organs result in short breath, disinclination to talk, fatigue and weakness, vertigo.

Weakness of the defensive Qi fails to protect the body surface, thus giving rise to spontaneous sweat.

Deficiency of Qi fails to ascend to nourish the head and face, resulting in pallor, dizziness, and blurring of vision.

Because exertion further consumes Qi, it will aggravate the above mentioned symptoms. And profuse sweat coming out with slight exertion

Pale tongue with white coat is the sign of the deficiency of Qi.

Weak and feeble pulse is due to weakness of Qi in propelling the blood circulation.

Principle treatment: reinforce Qi

GinsengKorea

2. Prolapse of Qi

In normal state, the internal organs are fixed in a proper place by the strength of health Qi.

But in abnormal state, Qi is too weak to elevate and hold the organs.

So prolapse of Qi will happen It is the development from deficiency of Qi

Main manifestation

Hypofunction due to deficiency of Qi leads to short breath and lassitude.

Failure of clear Yang in ascending results in dizziness and blurring of vision.

In case where the clear Qi descends, instead of ascends, frequent urination, chronic diarrhea appear.

Once the holding ability is weakened due to deficiency of Qi, the bearing-down and distending sensation in the abdomen, prolapse of inner organs such as rectum or uterus occur.

pale tongue with white coat, feeble pulse are the signs of deficiency of Qi.

The syndrome is characterized by prolapse of internal organs.

Principle treatment: strengthen Qi, elevate organ prolapse.

3. Stagnation of Qi

In normal state, the circulation of Qi in human body is actively and freely.

Reasons for it has three aspects:

1. internal blockage by pathogens,

2. depression of Qi due to emotional disturbances,

3. depletion of Yang Qi, the ability of warming and moving lessened.

Make the velocity of Qi slow down, thus result in Stagnation of Qi

Main manifestation

Stagnation of Qi in the local area leads to distention,

While obstruction of Qi results in pain The syndrome is characterized by distention

and pain, distention is more severe than pain.

Principle treatment: promote the circulation of Qi.

dried orange peel

4. Adverse flow of Qi

In normal state, the basic rules of movement of Qi has four types, ascending, descending, entry, issue.

Circulation of Qi is smooth If any pathogenic factors impair the

circulation of Qi, the adverse flow of Qi will happen.

There are three organs are influenced by this syndrome1. Liver: the injury of the liver by anger leads to excessive

ascending of the liver Qi and further, to upward disturbance of Qi and fire of the liver, causing headache, vertigo, flushed face, tinnitus, deafness, distention and pain in the chest and hypochondriac region, or even giving rise to such signs as hematemesis, and syncope.

2. Lung: everything that impairs the lung’s function in descending, causing it to ascend,and thus cough, asthma result.

3. Stomach: everything that impedes the descending function of the stomach, thus causing belching, hiccup, nausea, vomit, and regurgitation.

Principle treatment: improve functional activity of organs, sending down the adverse flow of Qi.

Blood

Formation of blood

circulating in the vessels, is a red liquid substance rich in nutrients. It is one of the indispensable substances that

constitute the human body and maintain life activities.

Blood originates from cereal essence transformed by the spleen and stomach.

Physiologic function of blood

has the functions of nourish and moisten the whole body.

The blood circulates inside the vessels internally to the viscera and externally to skin and organs and tissues to maintain the normal life activities.

Disorder of blood

1. Deficiency of blood

2. Stagnation of blood

3. Blood heat

1. Deficiency of blood

Refer to a syndrome marked by general weakness due to consumption or insufficiency of blood and malnutrition of the whole body.

Like anemia

Main manifestation Deficiency of blood deprives the head, eyes, and face of

nourishment,causing withered yellow or pale complexion, pale lips, dizziness, blurring of vision, and pale tongue with white coat.

Deficiency of blood fails to nourish the heart and then causes disturbance of the mind, thus palpitations, insomnia.

Numbness of limbs are due to an insufficient nourishment of the meridians and skin.

Deficiency of blood leads to an insufficient source of menstruation blood, therefore, scanty light colored menses, or amonorrhea result.

Deficiency of blood fails to nourish the blood vessels and so produces a weak pulse.

Analysis: the main function of blood is to moisten the whole body, inadequate nutrition supply to the organism as a result of blood deficiency causes general weakness of the body, and gives rise to many signs as listed above.

Treatment: replenish blood

jujube Transfuse blood

2. Stagnation of blood

Refer to a syndrome caused by internal retention of blood due to blood coagulation, Qi stagnation, Qi deficiency and trauma, etc.

The reasons for this syndrome1. Pathogenic cold: causing congealing and

stagnation of blood2. Depletion of Qi: impairing the free flow of the

blood, the velocity of Qi and blood become slow3. Trauma: resulting in extravasation of the blood and

stagnation of blood

Main manifestation Pain, which is the main symptom, occurs as a result of the

obstruction of blood circulation. The pain has a fixed location and is throbbing in nature. Accumulation of stagnation blood in the local area forms

abdominal mass which have fixed positions and are firm when palpated.

Obstruction of vessels by stagnant blood prevents blood from circulating along the normal courses, thus hemorrhage, ecchymosis, stasis macules on the skin or tongue result.

Stagnation of blood may also give rise to bluish purple face and lips, dark purple tongue.

Impeded circulation of blood creates an unsmooth pulse.

It is characterized by stabbing pain with certain location and aggravated by pressure.

Treatment: activate blood circulation to eliminate stasis

safflower

Tibet

3. Blood heat

Refer to a syndrome of superabundance of fire and heat in the viscera and invasion of heat into the blood aspect.

Main manifestation: 1. hemoptysis due to impairment of lung vessels by

superabundance of heat and fire.2. hematemesis due to impairment of stomach vessels by

superabundance of heat and fire. 3. hematuria due to impairment of bladder vessels by

superabundance of heat and fire. 4. Bleeding (epistaxis, dental bleeding) due to impairment

of collaterals by superabundance of heat and fire.

Common symptom: deep-red-dish tongue, taut and rapid pulse.

It is characterized by hemorrhage and heat signs

Treatment: eliminate heat, cool blood

root bark of tree peony

Body fluids

Body fluids

Is a general term here referring to all normal fluid substances of the organism.

Includes fluids flowing within the human body, and digestive juices, saliva, sweat, tear, urine, and some other liquids properly secreted by or discharged from the body.

Is also one of the essential substances for constituting the human body and maintaining life activities.

Formation and physiologic function of body fluids The formation, distribution, consumption, and

discharge of the body fluids involves complex processes in which the lung, spleen, stomach, intestines, bladder, and other organs.

Function: Nourishing and moistening the body.

Disorder of body fluids

1. Insufficiency of body fluids2. Abnormal accumulation of fluid

1. Insufficiency of body fluids

Refer to an endogenous dryness syndrome caused by insufficient moistening of the whole body or certain viscera and tissues.

Cause: inadequate production or excessive loss.

Analysis: body are nourished, lubricated, and moistened by body fluids, since it is insufficient, dryness becomes most remarkable.

Main manifestation Body fluids are distributed over the whole body to

nourish the muscles, skin, and pores externally and Zang-Fu organs and tissues internally. Insufficiency of body fluids causes failure to nourish them and causes dryness of the mouth, throat, lips, skin, and nose.

Loss of body fluids makes it impossible to produce urine, thus scanty urine results.

Once large intestine is deprived of nourishment by body fluids, its function in transmitting is impeded, resulting in constipation.

Deficiency of body fluids reduces the production of blood, causing internal heat, so red tongue with less moist, and thready rapid pulse appear.

Treatment: replenish body fluids.

2. Abnormal accumulation of fluid Abnormal accumulation of fluid in the body

indicates the impediment of fluid distribution and discharge caused mainly by dysfunction of lung, spleen, and kidney.

Edema Phlegm retention More knowledge in see Book II, chapter

three.

Relationship among Qi, blood and body fluids

Relationship between Qi and blood Qi and blood are closely related.

1. Qi engenders blood

2. Qi moves blood

3. Qi contains blood

4. Blood is the mother of Qi

1.Qi engenders blood

Qi as the commander of blood, for one thing, Qi is the motive power for blood

formation, for anther, it produces blood. Blood is formed from nutrient Qi and body

fluid, both of which come from food and water.

All these cannot be separated from the functions of Qi.

2.Qi moves blood

Blood circulation depends on the promoting action of Qi.

1. Pumping action of heart Qi

2. Dispersing and descending functions of lung Qi

3. Discharging and free-flowing function of liver Qi

3.Qi contains blood

Qi controls blood and keep it flowing in the blood vessels without extravasation.

This function of Qi is performed by splenic Qi. When Qi is deficient, it fails to control blood,

thus leading to hemorrhage.

4.Blood is the mother of Qi

Blood is referred to as the mother of Qi

1. on the one hand, blood is a carrier of Qi;

2. and on the other, blood provides adequate nutrients for Qi.

Therefore, it is impossible for Qi to exist without its "mother", blood.

Pathologic changes

1.Qi stagnation and blood stasis Cause: depression of liver Qi due to emotional

disturbances. Main manifestations: uncomfortably distension in

hypochondriac region, may be with tenderness or even formation of mass, pain aggravated by pressure, irritability, in women, amenorrhea or dysmenorrhea, dark purplish tongue, choppy pulse.

Treatment: promote Qi circulation, activate blood Such as safflower, dried orange peel

2.Deficiency of both Qi and blood Cause: Qi and blood are damaged by

lingering illness, or a great loss of blood leads to deficiency of Qi and blood.

Main manifestations: vertigo, disinclination to talk, shortness of breath, lack of strength, lassitude, spontaneous sweating, pale or withered yellow complexion, palpitation, insomnia, pale tongue, weak pulse

Treatment: reinforce Qi, replenish blood Such as ginseng, jujube

Relationship between Qi and body fluids The relationship between Qi and body fluids

is rather similar to that between Qi and blood.

This is shown in the following four aspects. 1. Qi produces body fluid2. Qi promotes the transportation of body

fluids3. Qi controls body fluids4. body fluids are carrier of Qi

1. Qi produces body fluid.

The formation, distribution and excretion of body fluids depend on all the movements of Qi and its warming, promoting and controlling functions.

The existence of Qi in the body not only depends on blood, but on body fluids which are formed from food essence by the functions of the stomach and spleen.

So, whether body fluids are adequate or inadequate depends on the conditions of spleen Qi and stomach Qi.

2. Qi promotes the transportation of body fluids. The movements of Qi are the motive for the

transportation and distribution of body fluids, and the excretion of sweat and urine.

Therefore, in case of deficiency of Qi or dysfunction of Qi, disturbance of body fluids in transportation, distribution and excretion will occur.

Thereby leading to the stagnation of body fluids.

3. Qi controls body fluids.

Qi may control the excretion of body fluids and maintain the balance of the body fluids metabolism,

In case Qi fails to control the excretion of body fluids, some of body fluids will run off.

4. body fluids are carrier of Qi Qi resides in body fluids, body fluids serve as carrier

of Qi, that is, body fluids carry Qi. Qi cannot exist without body fluid. This is the reason why the loss of body fluids often

damage Qi. If Qi fails to attach to body fluids, Qi-deficiency and

even Qi prostration will ensue. Examples in point are: enormous vomiting and

diarrhea cause great loss of body fluids, which, in turn, gives rise to Qi prolapse.

Relationship between blood and body fluids Blood and body fluids are liquids what's more, they both perform the nourishing and

moistening functions. Body fluids will become and important component of

blood when infiltrating into the blood vessels. As blood and body fluids originate from the essence

of food and water, they are known as "body fluids and blood are derived from a common source."

Pathological change

Recurrent or severe bleeding may do damage to body fluids, resulting in thirst, scanty urine and dry skin.

And severe consumption or loss of body fluids will affect the source of blood, leading to the exhaustion of both blood and body fluids.

Review

The concept of Qi in TCM Characterized by its vigor and constant

motion, which represents physiologic activities of human body.

It vitalizes, propels and warms the body, and is Yang in nature.

It is the fundamental substance on which all life activities depend.

Types of Qi

1. congenital Qi (yuan Qi)

2. pectoral Qi (zong Qi)

3. nutrient Qi (ying Qi)

4. defensive Qi (wei Qi)

General functions of Qi

1. Propelling action

2. Warming action

3. Defending action

4. Containment action

5. Production and transformation action

Disorder of Qi

1. Deficiency of Qi

2. Prolapse of Qi

3. Stagnation of Qi

4. Adverse flow of Qi

Physiologic function of blood Disorder of blood

1. Deficiency of blood

2. Stagnation of blood

3. Blood heat

Physiologic function of body fluids Disorder of body fluids1. Insufficiency of body fluids2. Abnormal accumulation of fluid