Section 1 Qi
CHAPTER THERR
QI,BLOOD,BODY FLUID AND VITALITY
Qi, blood and body fluid are the fundamental substances which make up the human
body. They are the material basis for the physiological functions of viscera, meridians,tissues and organs.
Qi is the substance of vitalism. It flows constantly and energetically. Blood refers to the blood in the body. Body fluid is a general term for all normal liquids in the body. According to the properties of qi, blood and body fluid, qi pertains to yang for its promoting and warming function; while blood and body fluid pertain to yin for their liquidity and nourishing function.
I. Concept of Qi
Qi is an naive understanding of the natural phenomena in ancient time. Early in the Spring and Autumn Period and Warring States, the materialist philosophers regarded that qi is the fundamental substance to make up the world, and every thing in the cosmos is produced by the movement and changes of qi. This naive understanding was introduced into medical theory and became a basic concept of qi in TCM.
Qi is the basic substance which makes up the human body. When qi gathers, it
forms the organic body; when it disperses, the organic body dies.
Further, qi is the essential material which maintains the life activities, life activity needs to be supported by nutrients. Only the body gets nutrients from the external world including the fresh air (clear qi) inhaled by the lung from the nature, essential qi transformed by stomach and spleen from the essence of drink and food, can the physiological activities be maintained normally. From this sense, the qi is the essential material which maintains the life activities.
II. Formation of Qi
Qi in the human body comes from three sources: the congenital essential qi inherited from the parents; the food essential qi from the essence of drink and food; the clear qi(fresh air) inhaled by lung from the atmosphere.
The congenital essential qi inherited and derived from the reproductive essence of parents stores in the kidney. The food essential qi is formed by the transforming action of stomach and spleen. The clear qi in the atmosphere is received through the respiration of the lung. From the origin and formation of qi, we can see that the wane and wax of qi is not only related to the inheritance, acquired nutrition and the condition of environment,but also closely to the function of the kidney, spleen, stomach and lung. When the function of these organs are normal,the qi in the body can keep prosperous. Conversely,if they function abnormally, the formation of qi will be affected and, then, pathological changes ,such as qi deficiency will occur.
It should be pointed out that after birth, the maintenance of normal life activities depends on receiving nutrition from the food ,which ,in turn,should depend on the function of intake, digestion, transportation and transformation of the stomach and the spleen. Thus, the functions of the stomach and the spleen play an important role in the formation of qi.
III. Physiological Functions of Qi
1. Promoting Function
The development and growth, the physiological function of viscera and meridians,
the circulation of blood and body fluid ,all these depend on the activating and promoting action of qi to maintain normal. For example ,primordial qi can activate and promote the physiological functions of the viscera so that the viscera can produce new qi ,blood and body fluid constantly to meet the needs of consumption and growth. Pectoral qi flows the heart and vessels ,so as to keep qi and blood circulating. As it is said : "The qi is the commander of blood"," When qi flows ,the blood circulates. "If the qi is deficient, the promoting action of qi becomes weak,the development will be retarded ,the functions of viscera becomes disordered. In severe case, the blood flows slowly and diseases of blood stasis occur.
2. Warming Function
Problem 22 in Classic on Medical Problems says : "Qi has warming action". That is to say qi is the source of body-heat. The constant temperature of the body is maintained by the warming function of qi. The normal circulation of blood and body fluid is maintained by warming function of qi, too. As the saying goes: "Blood flows when getting warm,but coagulates when getting cold. " If the warming function of qi is abnormal ,it will appears not only such cold symptoms as aversion to cold and preference for warmth, cold limbs and low body temperature, but also the pathological changes as slow-down of blood circulation and disturbance of fluid metabolism.
3. Defending Function
The defence function of body is very sophisticate. It consists of the comprehensive functions of qi, blood, body fluid, meridians, viscera and various tissues. Among these the defending function of qi plays a major role. Defending function of qi is mainly manifested in defending the body surface against the invasion of exogenous evil. In 33 Chapter of Plain Questions, it is said: "The evil qi will invade when the qi is deficient". That is to say when the defending function of qi is weakened, the body resistance against disease will decline, the body is easily invaded by the exogenous evil, and illness occurs.
4. Consolidating Function
This function refers to prevent the liquid substance (blood, body fluid) from leaking. It is reflected by : keeping the blood flowing in the vessels ; controlling the amount of secretion and excretion of the sweat, urine, saliva, gastric juice, intestinal juice, sperm,so as to prevent abnormal loss of them. If this function declines, it may result in abundant body liquid running off. For example, if qi fails to keep blood flowing in the vessels,it may lead to bleeding. Failure of controlling body fluid may cause spontaneous perspiration, polyuria, salivation. If qi fails to consolidate sperm, it may result in spermatorrhea,premature ejaculation and the like.
5. Transforming Function
This function is that various changes take place due to the movement of qi, namely,the metabolism of the essence, qi, blood, and body fluid and their mutual conversion.For example, in the process for formation of qi, blood and body fluid, it needs to transform the food stuff into essential qi, then to transform essential qi into qi, blood, body fluid and so forth. The body fluid changes into sweat and urine through metabolism. The residues of the food digested and absorbed convert into feces. All these process are the manifestations of the transformative function of qi. If this function is disturbed, it will affect the metabolism of qi, blood and body fluid, the digestion and absorption of the food,the excretion of sweat, urine and feces, which may result in various pathologic changes by disordering of metabolism. Thus, we can say, the transformative function of qi is the process of material metabolism in the body or the process of conversion of material and energy.
In the process of life activity, the above five functions of qi coordinate and cooperate closely, none of which can exist alone.
IV. Movements of Qi and Their Patterns
The qi in the body is an essential substance which circulates constantly with strong energy. It flows in every viscus, meridian, tissue and organ to motivate various physio logical activities in the body.
The movement of qi is called 'the functional activities of qi'. Though there are various kinds of movements of qi, theoretically they can be divided into four basic patterns: ascending, descending, exiting and entering.
The viscera, meridians tissues and organs are the places for qi to perform movement. The movement is the basis for the life activity. Once the movement stops, the life comes to an end.
The four basic movements not only motivate various physiological activities in the body but also only manifest themselves in the physiological activities of above structures. For example, exiting is exhaling and entering is inhaling in respiration. Dispersing of lung qi is ascending,the depurative descending of lung qi is descending. The stomach and spleen command digestion. The spleen is responsible for sending up the clear so that it is healthy when the qi is ascending. The stomach is responsible for sending down the muddy so that it is in harmony when its qi is descending.
The ascending versus descending, exiting versus entering are contradictory movement of opposite unification. It is not necessary for every physiological activity to have all patterns of qi movement equally. For example,the liver and the spleen command ascending while the lung and the stomach command descending. Systematically, in order to have normal physiological activities, there must be a coordination and balance between the ascending and the descending, the exiting and the entering. So the movements of qi are an important links to coordinate and balance the various physiological functions.
The coordination and balance between the four basic movements is called"harmony
of qi activities". When the four movements are imbalanced ,it is the morbid state of "disorder of qi activities". There are various disorders of qi activities. For instance, when four movements of qi are impeded,it is called "dysfunctional activities of qi";local obstruction of qi flow is called "stagnation of qi" ;over-ascending or inadequate descending of qi is called "rebellion of qi";inadequate ascending or over-descending is called "collapse of qi";qi being unable to keep qi or qi running out from the body is called "collapse of qi";qi being unable to spread but accumulated is called "condensation of qi".
V. Classification of Qi
As a whole,qi is formed by the essential qi of the kidney,the essential qi from the foodstuff transported and transformed by the spleen and stomach,and the fresh air inbaled by the lung from the atmosphere, under the joint actions of the physiological functions of the kidney,spleen,stomach and lung. Qi flows in all parts of the body. Because of their different Compositions, location and functions, each qi has its own name. Theyare as follows
1. Primordial Qi
Primordial qi is also called original qi or genuine qi. It is the most fundamental and important qi of the body,and the primary motive force for the life activities.
1) Composition and Distribution
The primordial qi mainly consists of the essential qi stored in the kidneys. Its formation depends on the essence of the kidney. After its formation, it flows through-out the body via the triple-jiao. It goes inward to the viscera and outward to the muscle and skin and functions to each part of the body.
2) Physiological Functions
The main functions of the primordial qi are promoting growth and development,warming and motivating physiological activities of the viscera, meridians, tissues and organs. Therefore, the primordial qi is the primary motive force for the life activities, and is the most fundamental substance to maintain life. Sufficient primordial qi always goes with vigor activities of viscera, meridians and organs, and good health. If the primordial qi is congenitally insufficient, or lack of proper care after birth, or exhausted by consuming disease, then there will be deficiency of primordial qi and various pathological changes
will occur.
2. Pectoral Qi
1 ) Composition and Distribution
The pectoral qi is mainly composed of clear qi inhaled by the lung and the essential qi transformed by stomach and spleen from the essence of drink and food. After its formation, it accumulates in the chest which, hence, is called "the upper sea of qi" where is the starting place for qi movement.
The spleen and stomach play important roles in the formation of the pectoral qi. Theexcess and deficiency of the pectoral qi is related to the physiological functions of the lung, spleen and stomach, especially the lung.
The pectoral qi gathers in the chest, and comes out of the throat, runs through the heart vessel by the dispersing action of the lung. It goes down to the Dan Tian (elixir field) which likes a reservoir, then via Qijie point (St. 30) pours into the Stomach Meridian of Foot Yangming then goes to the feet by the purifying descending action of the lung.
2) Physiological Functions
There are two main functions of the pectoral qi. One is to promote the respiration of the lung by moving through the respiratory tract, which is also related to the strength of voice and breath. The other is to run in the heart and blood vessels to move the qi and blood including motivating the heart beat, regulating heart rate and rhythm. Therefore, the circulation of qi and blood, body temperature and movement, perceptive ability of hearing and vision, strength and rhythm of heart beat and so forth, are all related to the strength of pectoral qi.
"Xuli", located below the left nipple, is a point to observe the strength of pectoral qi by the ancients. Clinically doctors usually detect the pulsation of Xuli to evaluate the strength of pectoral qi.
3. Nutritive Qi
Nutritive qi is one kind of qi which flows together with blood in vessels. It has the function to nourish so that it is also called "thrifting qi. " Nutritive function is closely related to blood. They are different but inseparable so that they are called together as"nourishing blood". Nutritive qi is opposite to defending qi. It pertains to yin. Therefore, it is also called "nourishing yin"
1) Composition and Distribution
The nutritive qi mainly comes from the essential qi from the essence of drink and food by the transforming action of the spleen and stomach. It derives from the essential part of essential qi. It exists in blood vessels and is an mportant part of blood. It circulates in the body.
2) Physiological Functions
Nourishing and hemopoietic actions are two main physiological functions of nutritive qi. Its main ingredient is the essential substance from food stuff which is the nutrient for the activities of viscera and meridians. At the same time, when nutritive qi flows in vessels, it is one composition of the blood.
4. Defensive Qi
Defensive qi is a kind of qi which flows outside the vessels. It is the opposite to nutritive qi and, thus, pertains to yang. Therefore, it is also called "defensive yang".
1). Composition and Distribution
The defensive qi is mainly from essential qi of essence from drink and food. Its character is vigorous and smooth. It has strongest strength and flows fast. It is not restricted by vessels so that it flows between the skin and flesh to smoke the Huang rnembranae and distribute in the chest and abdomen.
2) Physiological Functions
Defensive qi has three functions: the first is to defend the surface of the body to prevent the attack from exterior evil. The second is to warm and nourish the viscera, muscles, skin and hair etc. The third is to control the opening and closing of the interstitial space, the excretion of sweat and, thus, to maintain a stable body temperature. Both nutritive qi and defensive qi generate in the middle-jiao and mainly comes from the essential qi of the essence from drink and food. However, the nutritive qi is in the vessels and the defensive qi is outside the vessels. In order to have normal function of them the circulation of them have to be harmonized.
In addition to the above-mentioned four kinds of qi, there are "viseera-qi", "meridifan qi" etc. Actually all these qi are derived from the primordial qi. When the primordial distributes in certain viscus or meridian, viscera-qi or meridian-qi and the material basis for the activities of the viscus and meridian.
