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
1. That Qi was the fundamental
substance constituting the
universe
2. 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)
Is 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.
Functions is to maintain life
acrivites.
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.
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, hypofunction 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,
1. can all Zang-Fu organs,
meridians and other structures
perform their normal functional
activities,
2. 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."
"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:
1. Keeping the blood flowing within
the vessels to prevent it from
extravasating without reason.
2. Controlling and regulating the
secretion and excretion of sweat,
urine, sperm, saliva,
gastrointestinal juices, etc, to
maintain a relative balance of
water metabolism.
3. 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
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,
after digestion and absorption, the
residues of food 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:
center issue entry
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
1. In normal state, the functions of
Zang-Fu organs and body tissues
depend on the condition of Qi.
2. If Qi is strong and well reserved,
the physiologic function of body
may become properly active.
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 manifestations
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 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 manifestations
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 internal 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 manifestations
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. 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
lungs 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,
Send 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.

Physiologic function of blood
has the functions to 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
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 Animal liver
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 syndrome
1. Pathogenic cold: causing
congealing and stagnation of
blood
2. Depletion of Qi: impairing the free
flow of the blood, the velocity of
Qi and blood become slow
3. Trauma: resulting in extravasation
of the blood and stagnation of
blood.
Main manifestation
1. 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.
2. Abdominal mass: Accumulation of
stagnation blood in the local area
forms abdominal mass which have
fixed positions and are firm when
palpated.
3. Hemorrhage: 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.
4. Purple: Stagnation of blood may also
give rise to bluish purple face and
lips, dark purple tongue.
5. Unsmooth pulse: 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
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
chrysanthemum
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.
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: Nourish and moisten the
body.
Is also one of the essential
substances for constituting the
human body and maintaining life
activities.
Disorder of body fluids
1. Insufficiency of body fluids
2. 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.
Normal: body are nourished,
lubricated, and moistened by
body fluids,
Abnormal: when 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 rapid pulse appear.
Treatment
Replenish body fluids
bird's nest
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 the next class.
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,
1. Qi is the motive power for blood
formation,
2. Qi produces blood.
Blood is formed from nutrient Qi
and body fluid, both of which
come from food and water.
All these can not 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 spleen 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. blood is a carrier of Qi;
2. 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 fluid
2. Qi promotes the transportation of
body fluids
3. Qi controls body fluids
4. body fluids are carrier of Qi
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 an
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."
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 fluids
1. Insufficiency of body fluids
2. Abnormal accumulation of fluid