TCM Theory: The Concept of Qi
4. Basic patterns of Qi’s movement
Qi flows throughout the whole body because of its strength and vigor. The movement of Qi is called Mechanism of Qi, which can be generalized as four aspects: ascending, descending, entering and exiting movements, which are based on directions. Ascending refers to the upward movement of Qi from a lower area; descending means the downward flow of Qi from an upper area. Exiting means the outward movement of Qi, and entry indicates the inward movement of Qi. Although the activities of the human body are multiple, they can all be summarized as these four aspects. For example, the dispersing effect of the Lung is a manifestation of the exit and ascent of Qi, while its descending effect is a manifestation of the descending and entering movements of Qi.
The physiological function of Zangfu Organs is often reflected on their Qi’s ascent, descent., entry and exit movements. Take the Spleen and Stomach for example. The food that enters the Stomach is separated as nutrients and wastes after digestion. The nutrients are then absorbed and transported to each part of the human body through the activities of Spleen Qi, which is mainly marked by ascent and exit. On the other hand, Stomach Qi functions downward to send down the wastes as well as urine and stools, indicating that it goes downward in physiological conditions. Take the Kidney for another example; the Kidney is located in the Lower Jiao, but Genuine Qi manufactured by Kidney Essence has to go upward so that It can be distributed all over the body. This is a manifestation of ascent. On the other hand, the Kidney can assist the Lung by its receiving function, so it also has the manifestation of descent.
The ascent, descent, exit and entry movements of Qi are of prime importance in human life. The Kidney Essence, the food Essence transported and transformed by the Spleen and Stomach and the fresh air inhaled by the Lung, will not be distributed over the body to perform their physiological functions if they do not make ascent, descent, entry and exit movements.
Entry, exit, ascending and descending movements of Qi must be kept in harmony. In other words, the two opposite aspects should be balanced. A free flow of Qi as well as balancing the ascent, descent, and exit and entry movements of Qi are known as the harmony of activities of Qi. Once this harmony is destroyed, disharmony of the activities of Qi will ensue, which mainly consists of five states: adverse upward flow of Qi, collapse of Qi, escape of Qi and obstruction of Qi in its outward passage. The adverse upward flow of Qi refers to excessive ascent or insufficient descent of Qi, which affects the Liver, the Lung and the Stomach in most cases. As Liver Qi tends to go up, any induction factors may cause uprising of Liver Qi; Lung Qi and Stomach Qi, in a normal case, tend to go downward, so when the pathway for descent is obstructed, their Qi will go upward instead. The former case is a result of excessive ascent of Qi, while the latter is a result of inadequate descent of Qi. Collapse of Qi results mostly from excessive descent or inadequate ascent of Qi, which occurs mainly in the Spleen. As Spleen Qi functions upward to send up nutrients, it may sink if it is deficient. Escape of Qi indicates inability of Qi to be kept within the body which leads to excessive loss of Qi, which often follows profuse sweating or severe hemorrhage. Obstruction of Qi in going outward is usually caused by an attack of noxious gases which obstruct the pathways for Qi in the Interior of the body to go out. Such a case is marked by sudden occurrence of coma or syncope. The last type is stagnation of Qi, meaning impeded flow of Qi in the whole body or in a local area.
5. Classification of Qi
As the most basic substance that constitutes the world, Qi can be used to name everything in the world, so it is hard to classify it. However, Qi mentioned here is something concrete, or Qi that is different from Blood and Body Fluids. That means, it is not a gen eral term for all the components of the body, but substance that has a certain distribution and function. Clinically, the following four kinds of Qi are most the commonly mentioned.
5-1. Primordial Qi
Primordial Qi is also named Genuine Qi. It is manufactured by Kidney Essence and functions as the primary motive force for the growth and development of the human body, as well as the functional activities of Zangfu Organs. After being manufactured, it goes through the whole body by the way of the San Jiao to promote the life activities.
The main function of Primordial Qi is to initiate and promote the vital activities. The growth and development of the human body, and the functional activities of Zangfu Organs all depend on Primordial Qi. Therefore, when Primordial Qi is sufficient, the functional activities of Zangfu Organs will be strong and the constitution will be good. However, if Primordial Qi is deficient due to a congenital defect or improper feeding after birth, the functional activities of the whole body will become weakened.
It must be pointed out that the mutability of Primordial Qi is not only determined by the congenital Essence, but also determined by the acquired Essence or the Food Essence sent down to the Kidney. So congenital Deficiency of Primordial Qi can be corrected to some extent by supplementing the acquired Essence, or by strengthening the function of the Spleen and Stomach to promote the production of Food Essence. Long-standing diseases, which often consume the Essence of the human body, may lead to Deficiency of Primordial Qi.
5-2. Pectoral Qi
Pectoral Qi is also termed Great Qi. It accumulates in the thorax where Qi of the whole body converges. So the thorax is also known as “the sea of Qi”.
Pectoral Qi is generated by the combination of the food Essence the Spleen transports and transforms and the fresh air in haled by the Lung. Therefore, the functional states of the Spleen and the Lung directly influence the formation of Pectoral Qi.
Pectoral Qi is distributed in the thorax after its formation, then to the Blood vessels and the respiratory tract. Its main functions are twofold: first, it can assist the Lung in breathing. As Lung Qi serves as the force for breathing and voice, speaking, voice and respiration are all closely related to the quality of Pectoral Qi. Usually, clear speech, a strong voice and moderate and rhythmic respiration indicate strong Pectoral Qi, while unclear speech, a feeble voice and shallow breathing or shortness of breath are signs of Deficiency of Pectoral Qi. Second, Pectoral Qi can assist the Heart in activating the flow of Blood. So, circulation of Qi and Blood and the pulsation of vessels can reflect its condition. Generally speaking, when Pectoral Qi is sufficient, the pulse will be moderate and forceful, and the Heart will beat rhythmically and evenly. If Pectoral Qi is deficient, the pulse will be swift, irregular, feeble or scattered.
Pectoral Qi is usually considered a link connecting the functional activities of the Heart and those of the Lung. In the clinic, Deficiency of Pectoral Qi in most cases indicates Deficiency of Lung Qi leading to Deficiency of Heart Qi and ensuing Blood Stasis. For example, when a patient suffering from chronic bronchitis develops pulmonary Heart disease, which is marked by shortness of breath, a low voice, palpitation, a purplish face, running or intermittent pulse, etc. , he or she can be diagnosed as having deficient Pectoral Qi.
5-3. Nutritive Qi
Nutritive Qi is the Qi flowing in the Blood vessels. It is so named because it is rich in nutrients. As it exists together with the Blood in the vessels, they are often collectively named Ying Blood (Ying means Nutritive Qi here).
Nutritive Qi is formed by the combination of the nutritious part of the food Essence transported by the Spleen and fresh air inhaled by the Lung. After its formation, Nutritive Qi is sent to the Channels to flow in the order of the Twelve Regular Channels.
The main functions of Nutritive Qi are to generate Blood and to nourish the whole body. In TCM, Blood consists mainly of two parts: Nutritive Qi and Body Fluids. The Nutritive Qi can absorb Body Fluids from refined food and carry it to the vessels to form Blood. So Nutritive Qi has the function of generating Blood. Moreover, all Zangfu Organs, Channels and tissues depend on the nourishment of Nutritive Qi for their existence and functional activities. As Nutritive Qi, compared with Defensive Qi, belongs to Yin it functions chiefly to nourish the physique of the body.
5-4. Defensive Qi
Defensive Qi is Qi that functions to defend the human body. It is also named Defensive Yang, because it belongs to Yang compared with Nutritive Qi.
Defensive Qi comes from refined food that is vigorous and flows fast, and fresh air inhaled from Heaven. Being vigorous, Defensive Qi cannot tolerate the control of the vessels, so it flows out of the vessels. The distribution of Defensive Qi has two features: the flow following Nutritive Qi and free flow. The former indicates that Defensive Qi also goes along the Twelve Regular Channels, while the latter indicates that Qi is distributed all over the body.
The main functions of Defensive Qi include three aspects: First, protecting the body surface from the invasion of external pathogens. Defensive Qi permeates the muscular striae and the skin to control opening-closing of the muscular striae, so it acts as a defense against the invasion of external pathogens. If Defensive Qi is deficient, diseases due to the attack of external pathogens are likely to occur. Second, warming and nourishing Zangfu Organs, skin and hair, muscles, etc. , to maintain the normal body temperature and ensure the normal activities of the organs and tissues. When Defensive Qi fails to warm due to its Deficiency, cold symptoms may be exhibited. On the other hand, stagnation of Defensive Qi will produce Heat and give rise to Heat manifestations. For example, when a Cold pathogen attacks the superficial areas of the body, fever and chills often occur. The fever is related to the stagnation of Defensive Qi, while the chills are due to failure of Defensive Qi to produce its warming effects. Three, controlling the opening and closing of the sweat pores. Sweat is derived from Body Fluids and Blood, but its discharge depends on the function of Defensive Qi. When the striae of muscles are tightly closed due to an attack of external pathogens, Defensive Qi will be unable to go outward, so there is fever and absence of sweating. When Defensive Qi is deficient, spontaneous sweating will occur.
Both Nutritive and Defensive Qi are mainly derived from refined food transported by the Spleen and Stomach. Nutritive Qi flows in the vessels while Defensive Qi flows out of the vessels. Coordination of the two maintains a normal sweat discharge and a normal body temperature. If this coordination is destroyed, abnormal sweating or fever with chills will ensue.
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