Chapter 3_The Theory of Essence, Qi, Blood and Body Fluids

Section 1. Essence Section 2. Qi 1. The Classification and Generation of Qi 2. Function of Qi Section 3. Blood 1. Formation and Circulation of Blood 2. Functions of Blood Section 4. Body fluids 1. Formation, Transportation and Dissemination of Body Fluids 2. Functions of Body Fluids

Chapter 3 The Theory of Essence, Qi, Blood and Body Fluids The four basic substances of life are essence, Qi, Blood and body fluids, they are the material bases which maintain the normal acti ities of the human body.

Section 1.
1.

Essence !Could "e thou#ht of as $%&'

Essence !(in#' is a fundamental material of the human body and the material basis for arious physiolo!ical functions of the human body. "#lain Questions" says, " $ssence is essential to the body." #ractitioners of past !enerations assumed there were two types of essence% the con#enital or innate essence and the ac)uired essence. &n functional terms, the two types are defined as the reproducti*e essence and the essence of the +an#,Fu or#ans.

The con#enital essence is recei ed fro- one.s parents, and is stored in the 'idney( it is also 'nown as "the prenatal essence", ser in! to promote the !rowth, de elopment maturity, and reproduction of the body, thus the con!enital essence is also called the "reproducti e essence." The ac)uired essence is deri ed throu!h the functions of the )an!*Fu or!ans from the nutriti*e su"stance of food and drin/ to nourish the body. &n turn, it ser es as the material basis for the functional acti ities of the )an!*Fu or!ans. Conse+uently, it is called 0the essence of the +an#,Fu or#ans.0 The essence stored in the 'idney includes both the con!enital essence and the ac+uired one. The t1o are interdependent on and pro-ote each other. Before birth, the con#enital essence prepares the material basis for the ac)uired one( and after birth, the ac)uired essence continues to replenish the con#enital one. ,ealthy con!enital essence facilitates the formation of the ac+uired essence, while the !rowth, de elopment and reproduction are all based on the replenishment of the con!enital essence by the ac+uired essence.

Section 2. Qi
-hat is Qi. /ccordin! to the ancient Chinese thou!ht, Qi is described as the basic particles which constitute the uni erse and produce e erythin! in the world throu!h their mo ements and chan!es. &n traditional Chinese medicine, Qi in its physiolo!ical sense refers to the moti e force or ener!y 0which is produced by the basic particles1 re+uired for arious functional processes. 2ince Qi is in isible, and what can be percei ed is the result of ener!y, Qi often connotes the acti ity itself. For e2a-ple, deficiency of the 'idney Qi means the deficiency of the ener!y re+uired for the functional processes of the 'idney( it actually implies the status of the hypofunction of the 'idney.

1. The classification and !eneration of Qi

Certain +ualitati e terms differentiate Qi in the human body accordin! to its source, function, and distri"ution. The ter-s are #rimary Qi 03uan Qi1 0con#enital Qi'

#ectoral Qi 0)on! Qi1 0ac)uired Qi' 4utrient Qi 03in! Qi1 0ac)uired Qi' Defensi e Qi 0-ei Qi1. 0ac)uired Qi'

&n terms of their source they may be further classified into con#enital Qi and ac)uired Qi.

3ri-ary Qi, which is deri*ed fro- con#enital essence and inherited fro- the parents, is referred to as the con#enital Qi. #rimary* deri ed from con!enital essence 0inherited from parents1 5 con!enital Qi &fter "irth, pectoral Qi, nutrient Qi, and defensi*e Qi are all deri ed from the refined essence of food, and are therefore 'nown as the ac)uired Qi. #ectorial, nutrient, and defensi e* deri ed from food essence 5 ac+uired Qi Con#enital Qi and ac)uired Qi are dependent on each other for their production and nourishment. 3ri-ary Qi stimulates and promotes the functional acti ities of the )an!*Fu or!ans and the associated tissues of the body, which in turn produce the ac+uired Qi. Thus pri-ary Qi is the material foundation for the production of the ac)uired Qi. 6n the other hand, the ac)uired Qi continuously nourishes and supplements the con!enital Qi. Therefore there is an interdependent relationship "et1een the t1o% the con#enital Qi pro-otes the ac)uired Qi, which in turn nourishes the con!enital Qi. Qi may also be described as the functional acti ities of the )an!*Fu or!ans and meridians. &t is then referred to, for e7ample, as Qi of the heart, li er, lun!, spleen, stomach, 'idney and that of arious meridians. They are discussed further in other rele ant chapters.

1.1. #rimary Qi 03uan Qi1

Deri ed from the con!enital essence, primary Qi needs to be supplemented and nourished by the Qi obtained after birth from the essence of food and water. 3ri-ary Qi ta/es root in the /idney and spreads to the entire "ody *ia the triple ener#i4er !San (iao'. &t stimulates and promotes the functional acti ities of the )an!*Fu or!ans and the associated tissues. The more a"undant the primary Qi is, the more i!orously the )an!*Fu or!ans and the associated tissues will function. The human body will then be healthy and rarely suffer from disease. 5n the other hand, the con!enital insufficiency of primary Qi may lead to arious patholo!ical chan!es.

1.2. #ectoral Qi 0)on! Qi1

#ectoral Qi is for-ed "y the co-"ination of the clean Qi 0Qin! Qi1 which is inhaled by the lun!, and the essential Qi of the food and drin' which is transfor-ed "y the spleen and sto-ach.

#ectoral Qi is stored in the chest.

6ts -ain functions are 5ne is to promote the lun!8s function of controllin# respiration, so the stren#th or 1ea/ness of speech and respiration are related to the +uality of pectoral Qi The other is to pro-ote the heart.s function of do-inatin# the "lood and *essels, so the circulation of Qi and "lood, and the coldness and 1ar-th and the -otor a"ility of the four li-"s and "ody trun/ are all closely associated 1ith the pectoral Qi.

1.9. 4utrient Qi 03in! Qi1

$eri*ed from the essential Qi of the food and drin' transformed by the spleen and stomach, nutrient Qi circulates in the essels. &ts pri-ary function is both to produce "lood and to circulate 1ith it to pro*ide further nourish-ent.

/s nutrient Qi and blood are so closely related, 07in#,"lood0 is the term commonly used to refer to their :oint functions.

1.;. Defensi e Qi 0-ei Qi1

Defensi e Qi is also deri*ed from the Qi of food essence, but unli'e nutrient Qi it circulates outside the essels. Defensi e Qi functions to protect the -uscular surface, defend the "ody a#ainst e2o#enous patho#enic factors, control the openin# and closin# of the pores, -oisten the s/in and hair, read8ust "ody te-perature, and 1ar- up the +an#,Fu or#ans.

$efendin# the "ody a#ainst e2o#enous patho#enic factors is its principal function, hence the na-e defensi*e Qi. /s mentioned abo e, the +an#,Fu and -eridians possess their o1n Qi( 5ri#inatin# from primary Qi, pectoral Qi, nutrient Qi, and defensi e Qi, the Qi of the -eridians is a co-"ination of the essential Qi of food, the clean Qi inhaled by the lun!, and essential Qi stored in the 'idney. The Qi of the -eridians, therefore, is referred to as +hen# Qi !*ital Qi' flowin! in the meridians. &s the "asis of the functions of the -eridians , the Qi of the -eridians !reatly influences the functions of the Qi, blood and )an!*Fu or!ans of the entire body.

2. Function of Qi

Qi acts e7tensi ely in the human body by permeatin! all the parts. /bundance of Qi is the basis of !ood health. -ea'ness of Qi may lead to diseases.

Qi, distri"uted to *arious parts of the "ody, characteristically functions as follo1s

2.1. #romotin! function

The followin! are all dependent on the promotin! and stimulatin! effect of Qi%

The !rowth and de elopment of the human body the physiolo!ical acti ities of the )an!*Fu and meridians the circulation of blood distribution of body fluid

$eficiency of Qi impairs the blood circulation, causes the dysfunction in transformin! and distributin! body fluid, and !i es rise to the production of damp*phle!m in the interior.

2.2. -armin! function

The normal temperature of the body is maintained and read:usted by Qi.

The "Classic on <edical #roblems" says% "Qi has a warmin! action." / deficiency of Qi can cause the lowered body temperature, intolerance to cold, and cold limbs.

2.9. Defendin! function

The defendin! function of Qi is embodied in two aspects% 1. 6ne is to !uard the surface of the s'in a!ainst e7o!enous patho!enic factors 2. The other is to combat the in adin! e7o!enous patho!enic factors so as to ward it off.

-hen the defensi e function of Qi is normal, the e7o!enous patho!enic factors ha e difficulty in in adin! the body, e en thou!h it may obtain the entry, it is not certain to cause any disease.&f it does cause a disease, this disease is easy to be cured. -hen the defensi e function of Qi becomes wea'er, i.e. the ability of the human body to fi!ht the e7o!enous patho!enic factors is lowered, the body is easily in aded and diseases are caused. /nd what is more, these diseases are hard to be cured.

2.;. Consolidatin! and !o ernin! function

By "consolidatin! and !o ernin! function", it is meant that Qi has the ability to command, control and consolidate the li)uid su"stances and or#ans in the a"do-inal ca*ity. This is done by% 2.;.1. =eepin! the blood flowin! within, not e7tra asatin! out of, the essels(

2.;.2. Controllin! and ad:ustin! the secretion and e7cretion of sweat, urine and sali a, and pre entin! the body fluid from escapin!( 2.;.9. Consolidatin! and storin! sperm and pre entin! emission and premature e:aculation( 2.;.;. Consolidatin! the or!ans so as to pre ent them from descendin!.

The wea'enin! in the abo e functions of Qi may cause arious 'inds of hemorrha!e, spontaneous perspiration, polyuria, sali ation, spermatorrhea, premature e:aculation, prolapse of the stomach, 'idney and uterus. The consolidatin# and #o*ernin# action and the pro-otin# action of Qi oppose yet also complement each other. 6n one hand, Qi has the function of promotin! the circulation of blood, and the transportation and distribution of body fluid, on the other hand, it also has the function of controllin! and ad:ustin! the mo ement, secretion and e7cretion of li+uid substances in the body. The coordination and balance of these two functions are essential for maintainin! the nor-al "lood circulation and 1ater -eta"olis- 1ithin the "ody.

2.>. #romotin! the metabolism and transformation

0Qi 9ua0 is a specific term in the science of TC<. &t refers, in !eneral, to arious 'inds of chan!es ta'in! place in the body under the action of Qi. 2pecifically, it refers to the metabolism of fundamental substances, ital Qi, blood and body fluids are formed in the followin! manner% in!ested food is chan!ed into food essence, and food essence is, in turn, transformed into ital Qi, blood or body fluids, and these can then be chan!ed into any one of the others accordin! to the physiolo!ical need of the body. The waste from the eaten food and the products produced in the course of metabolism are chan!es, separately, into feces, urine and sweat which are ready to be remo ed from the body. /ll of these are the specific manifestations of the actions of the acti ity of Qi. The dysfunction of Qi in performin! its action will affect the whole metabolism of the body. That is to say, it will

affect the di!estion, absorption, transformation and transportation of food and drin'( the formation, mo ement and transformation of ital Qi, blood and body fluids( and the e7cretion of feces, urine and sweat(

thus causin! arious symptoms due to the abnormal metabolism. &n short, the process in which Qi performs its functions is the process in which the substances in the body are metaboli?ed, and in which the substances and ener!y are transformed.

2ection 9. Blood
Blood is a red li+uid circulatin! in the essels, and is a ital nutrient substance in the body.

1. Formation and circulation of blood

/s the fundamental substances re+uired in blood formation ori!inate from the essence of food and drin' produced by the spleen and sto-ach, these two or!ans are re!arded as the source of Qi and blood. The "<iraculous #i ot" holds that 0:hen the essence of food and drin/ is recei*ed in the -iddle ener#i4er it 1ill "e transfor-ed into red fluid 1hich is called "lood,0 and 0nutrient Qi flo1s into the *essels to "e transfor-ed into "lood.0 Essence and "lood may also transfor- into each other. The boo' 0+han#.s ;eneral <edicine0 states% "&f blood is not consumed, it turns into essence in the 'idney( if essence does not lea' out, it is transformed into blood in the li er." Ta'in! the essence of food and drin' and the essence stored in 'idney as the material basis, blood is formed by the functional acti ities of )an!*Fu or!ans such as the spleen, stomach, heart, lun!, li er and 'idney. &fter "ein# for-ed, "lood normally circulates in the essels throu!hout the body, and is ta/en char#e of :ointly by the heart, li*er and spleen.

The heart do-inates the "lood and *essels, and propellin! force of heart Qi is the basis of the blood circulation. The spleen Qi has the function of controllin# "lood and pre*entin# "leedin# . The li*er pro-otes the free flo1 of Qi, stores "lood and re#ulates its *olu-e in circulation.

The coordination of the three or!ans ensures the continuous blood circulation in the essels throu!hout the body. $ysfunction of any of the three may cause abnormal blood circulation. $eficiency of heart Qi, for instance, may lead to the sta!nation of heart blood.

$ysfunction of the spleen in controllin! blood may lead to the blood*tin!ed stools, uterine or subcutaneous bleedin!, and ecchymoses.

2. Functions of blood
Blood circulates throu!hout the body, passin! throu!h the fi e )an! and si7 Fu or!ans in the interior, and the s'in, muscles, tendons and bones on the e7terior. &n this way blood nourishes and moistens the arious or!ans and tissues of the body. 0The Classic on <edical 3ro"le-s0 !enerali?es this function of blood, sayin!% 0Blood do-inates nourish-ent and -oisture.0 The nourishin! and moistenin! function of blood manifests clearly in the mo ement of the eye and four limbs. /ccordin! to the 03lain Questions0, "-hen the li er recei es blood, it !i es rise to ision( when the feet recei e blood they are capable of wal'in!( when the palms recei e blood they are capable of holdin!( and when the fin!ers recei e blood they are capable of !raspin!." 6nsufficiency of "lood may lead to

impairment of ision dryness of the eyes motor impairment of the :oints numbness of the four limbs dryness and itch of the s'in

Blood is the material foundation for the -ental acti*ities. / sufficient "lood supply ensures clear consciousness and a i!orous spirit. The 03lain Questions0 states% "Qi and Blood are the foundation for human mental acti ities." /nd the 0<iraculous 3i*ot0 says% ",armonious circulation of blood ensures a i!orous spirit." These +uotations could illustrate the close relationship between the blood and the mental acti ities. $eficiency of "lood, therefore, may lead to the -ental disorders. /n e2a-ple is deficiency of heart or li er blood resultin! in the mental restlessness, with symptoms such as palpitation, insomnia and dream*disturbed sleep.

2ection ;. Body fluid

Body fluid is a collecti e term for all the normal fluid of the body, includin! sali a, !astric :uice, intestinal :uice and the li+uids in the :oint ca ities, as well as tears, nasal dischar!e, sweat and urine.

1. Formation, transportation and distribution of body fluid

Body fluid is formed from food and drin' after its di!estion and absorption by the spleen and stomach. The transportation, distribution and e7cretion of body fluid principally rely on the

spleen8s function of transportation the lun!8s function of dispersin! and descendin! and re!ulatin! water passa!es the 'idney8s function of controllin! urination and separatin! the clear and the turbid. 6f the three, the 'idney is the most important. The 03lain Questions0 e7plains the formation and distribution of body fluid by the sayin! that

1. "/fter food enters the stomach, the refined nutrient essence of the food and drin' is
transmitted to the spleen, which will send it to the lun!. 2. The lun! re!ulates the water passa!es and transmits the Qi of water to the bladder below. 3. The Qi of water then spreads in four directions and tra els alon! the meridians of the fi e )an! or!ans.@ -hen depictin! the triple ener!i?er as the pathway of body fluid, the 03lain Questions0 states% 0The triple ener#i4er is the irri#ation official 1ho "uilds 1ater1ays.0

&n addition, the fluid sent downward from the stomach continues to be absorbed by the small and lar!e intestines. / part of the fluid, after passin! throu!h the spleen, lun! and triple ener!i?er, is e7creted from the s'in and hair as sweat. /nother part of the fluid is sent downwards to the bladder ia the waterways of the triple ener!i?er, and e7creted from the body as urine, with the assistance of the Qi of the 'idney and bladder. By means of the actions of all these )an!*Fu or!ans, body fluid reaches the s'in and hair on the e7terior, and penetrates the )an!*Fu in the interior, thus nourishin! all the tissues and or!ans throu!hout the body.

6n short, the formation, distribution and e7cretion of body fluid is a complicated process fulfilled by the coordinated acti ities of many )an!*Fu or!ans, especially the lun!, spleen, and 'idney. #atholo!ical chan!es of these or!ans may conse+uently affect the formation, distribution and e7cretion of body fluid. For e2a-ple, if there is the insufficient formation or e7cessi e loss, body fluid may be dama!ed or consumed.

/ disturbance in distribution of body fluid may lead to its accumulation, resultin! in retained fluid and edema, or the formation of phle!m. #atholo!ical chan!es of body fluid may, in turn, impair the functions of many )an!*Fu or!ans. For e2a-ple, in asion of the heart by retained water would cause palpitations( retention of fluid in the lun! may result in cou!h with asthmatic breathin!( dryness of the lun! due to consumption of body fluid brin!s on the unproducti e cou!h( dryness of the intestines leads to constipation.

2. Functions of body fluid 0Ain 3e1

Body fluid moistens and nourishes arious parts of the body. There are noticeable differences, howe er, in the nature, form and location of different types of body fluid. Clear and thin fluids are referred to as 0(in0, "Ain" is distri"uted on the -uscular surface, and has the function of 1ar-in# and nourishin# the -uscles and -oistenin# the s/in.

Thic/ and hea*y fluids are 'nown as 07e". "3e" is stored in the 8oints and orifices 0openin! such as nostril, ear, or anus1 and has the function of -oistenin# the 8oints, stren#thenin# the "rain and -arro1 and nourishin# the orifices. /s both "Ain" and "ye" are normal fluids in the body and are deri ed from the same source***the refined essence of food and drin' ***they may be transformed into each other. Generally they are referred to to!ether by the term 0(in 7e0 !"ody fluid'.