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

1.
2.
3.
4.

According to the sources, functions and

distributions, Qi is divided into four types:
congenital Qi (yuan Qi)
pectoral Qi (zong Qi)
nutrient Qi (ying Qi)
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)

1.

2.
3.
4.

5.

like nutrient Qi, comes from cereal essence,

but, unlike nutrient Qi, it runs outside the blood
vessels.
Defensive Qi has the following functions:
Protect the body surface against exogenous
pathogens,
Control the opening and closing of the pores,
Adjust the excretion of sweat,
Warm and nourish the Zang-Fu organs, muscles and
the skin with hairs, etc.,
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.
2.
3.
4.
5.

Propelling action
Warming action
Defending action
Containment action
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:

Ascending

entry

center issue

Descending

When this movement of Qi stops,

the body dies.

Disorder of Qi
1.
2.
3.
4.

Deficiency of Qi
Prolapse of Qi
Stagnation of Qi
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.


1.
2.
3.

Cause: depletion of Qi due to

over consumption in lingering diseases
over fatigue
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

Ginseng
Korea

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

1.
2.
3.

In normal state, the circulation of Qi in human body

is actively and freely.
Reasons for it has three aspects:
internal blockage by pathogens,
depression of Qi due to emotional disturbances,
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 syndrome
1.

2.

3.

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.
Lung: everything that impairs the lungs function in
descending, causing it to ascend,and thus cough,
asthma result.
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.
2.
3.

Deficiency of blood
Stagnation of blood
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

1.

2.

3.

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 syndrome
Pathogenic cold: causing congealing and
stagnation of blood
Depletion of Qi: impairing the free flow of the
blood, the velocity of Qi and blood become slow
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
Tibet
safflower

3. Blood heat

1.

2.

3.

4.

Refer to a syndrome of superabundance of fire and heat

in the viscera and invasion of heat into the blood aspect.
Main manifestation:
hemoptysis due to impairment of lung vessels by
superabundance of heat and fire.
hematemesis due to impairment of stomach vessels by
superabundance of heat and fire.
hematuria due to impairment of bladder vessels by
superabundance of heat and fire.
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.
2.

Insufficiency of body fluids

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

1.
2.
3.
4.

Qi and blood are closely related.

Qi engenders blood
Qi moves blood
Qi contains blood
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

1.
2.

3.

Blood circulation depends on the promoting

action of Qi.
Pumping action of heart Qi
Dispersing and descending functions of lung
Qi
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

1.
2.

Blood is referred to as the mother of Qi

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

1.
2.

3.
4.

The relationship between Qi and body fluids

is rather similar to that between Qi and
blood.
This is shown in the following four aspects.
Qi produces body fluid
Qi promotes the transportation of body
fluids
Qi controls body fluids
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.
2.
3.
4.

congenital Qi (yuan Qi)

pectoral Qi (zong Qi)
nutrient Qi (ying Qi)
defensive Qi (wei Qi)

General functions of Qi
1.
2.
3.
4.
5.

Propelling action
Warming action
Defending action
Containment action
Production and transformation action

Disorder of Qi
1.
2.
3.
4.

Deficiency of Qi
Prolapse of Qi
Stagnation of Qi
Adverse flow of Qi

1.
2.
3.

Physiologic function of blood

Disorder of blood
Deficiency of blood
Stagnation of blood
Blood heat

1.
2.

Physiologic function of body fluids

Disorder of body fluids

Insufficiency of body fluids

Abnormal accumulation of fluid