The Basic Substances Constituting the

Human Body: Qi, Blood and Body Fluids

The concept of Qi
Formation of Qi
Functions of Qi
Basic patterns of Qi's movements
Classification of Qi
Blood
Body Fluids
Conection between Qi, Blood and Body Fluids
Disscussion of difficult points

Qi, Blood and Body Fluids are the most basic substances
that constitute the human body and maintain its functional
activities. They are, on the one hand, the products of the
functional activities of the Zang and Fu Organs of the body,
and on the other hand, the material basis of these functional
activities. As TCM holds that the life process is, in fact, a
process of the metabolism of these substances, this is
regarded as the true meaning of the Zang and Fu Organs. In
other words, the viscera are produced and maintained by
the activities of these substances. Therefore, disorders of
the viscera can be generalized as those of these substances.
Generally speaking, Qi is an essential substance that is full
of vigor and flows fast. Blood is the red liquid circulating in
the vessels and nourishing the whole body, and Body Fluids
are a general term for all the water necessary for life. Qi is
attributed to Yang, because it is mobile and functions to
move and warm; while the Blood and Body Fluids are
attributed to Yin because they are motionless and function
to nourish and moisten the human body. In this sense, Qi is
also named Yang Qi and the Blood and Body Fluids, Yin
Fluids of the body.

1. Qi
Concept of Qi Qi was originally a philosophic concept. The
ancients believed that the world changes and things in the
world can transform from one to another, so when they tried
to explain the world with a common substance, they
determined that the substance must have two properties:
invisibility and motion. As it is invisible or has no certain
shape, it can create various kinds of things; and as it is
moving, things in the world are always changing and may
transform from one to another. Air, the original meaning of
Qi, is just such a substance which cannot be seen but the
movement of which, as wind, can be felt. This was extended
to mean that the most basic substance of the world, and its
movement and change can explain the generation,
development and change of all things in the world.
The ancient Chinese philosophy holds that Qi is this most
basic substance constituting the world. Accordingly, TCM
also believes that Qi is the most fundamental substance in
the construction of the human body and in the maintenance
of its life activities. As a whole, Qi in the cosmos takes two
patterns of existence, diffused Qi and coagulated Qi. The
former is more vigorous, cannot be detected directly and
exists everywhere. The latter is manifested as various kinds
of things that can be seen or that have certain shapes. In
order to survive, coagulated Qi must communicate with
diffused Qi and its generation as well as its ending results
from movement of the diffused Qi. That means, when the
diffused Qi coagulates, it creates substantial matter, while if
it separates, the matter disappears. Therefore, any
substantial matter can be regarded as a special process of
the movement of Qi, and life, in essence, is the course of
Qi's ascending, descending, exiting and entering movements
in given conditions.
Man depends on nature for his production and growth and
must observe the common laws of the world. As everything

in the world comes from the interaction of Heaven Qi and

Earth Qi, man must breathe to absorb Heaven Qi and eat to
absorb Earth Qi. The food Essence transformed and
transported by the Spleen must be sent up to the Lung to
combine with fresh air to produce the nutrients necessary
for man's life activities.
Qi of the human body also has two patterns of existence.
The coagulated Qi is manifested as various visible or
structural components of the body, such as viscera, body
figure, sense organs, Blood, Body Fluids and Essence; the
diffused Qi is manifested as the Qi that flows in the body,
but takes no certain form, such as Nutritive Qi, Defensive Qi,
Primordial Qi and Pectoral Qi.
2. Formation of Qi
Qi of the human body comes from the combination of three
kinds of Qi, Primordial Qi inherited from parents, the fresh
air inhaled by the Lung and the refined food Essence
transformed by the Spleen. Primordial Qi is derived from the
Congenital Essence of the parents and is the primary
substance to produce an embryo. So it forms the basis of
the human body and its life activities. Without Congenital
Essence, there can be no human body. After birth, the
congenital Essence is stored in the Kidney to promote
development and to control the reproductive activity of the
human body. The refined food Essence is generated by the
food which is taken in after birth and is distributed all over
the body to produce nutrients and Qi and Blood under the
action of the Spleen and Stomach. Fresh air is inhaled by the
Lung after birth and is the main source of Qi of the human
body.
From the process of formation of Qi, we can see that Qi of
the human body is closely related to the functional activities
of the Kidney, the Spleen and Stomach, and the Lung, in
addition to the congenital constitution, food and nutrients,

and the environment. Only when these organs function

properly can the Qi of the body flourish. Conversely,
dysfunction of any of these organs will influence the
formation of Qi and the physiological function of Qi. For
example, dysfunction of the Lung will weaken respiration,
leading to failure of fresh air to be inhaled and the turbid Qi
of the body to be exhaled, with the resultant inadequate
formation of Qi.
The transformation and transportation of the Spleen and
Stomach play a particular role in the formation of Qi, for
man relies on the nutrients transformed and transported by
the Spleen and Stomach for his life after birth. On the one
hand, the Spleen sends up nutrients to the Lung to be
dispersed, on the other, it sends down nutrients to the
Kidney to supplement Kidney Essence. So, hypofunctioning
of the Spleen and Stomach influences all three elementary
substances that produce Qi.
3. Functions of Qi
Generally speaking, Qi of the human body has five
functions: pushing, warming, defending, controlling and
steaming.
1)Pushing Qi is a vigorous substance that flows fast in the
human body. So it promotes the growth and development of
the body, the movement, distribution and discharge of Blood
and Body Fluids, and the functional activities of Zangfu
Organs.
After birth, the Genuine Qi generated from Kidney Essence
determines the growth and development of the human body.
After middle age, Genuine Qi gradually declines, so a person
grows old. If his Genuine Qi is deficient, a person's
development will be poor.
The physiological functions of Zangfu Organs and Channels
and Collaterals of the human body all depend on the pushing
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of Qi as well as the nourishing of Blood. The vigor and the

ascending, descending, entry and exit movements of Qi play
a very important role in promoting the functional activities of
Zangfu Organs and Channels and Collaterals. Any organ is a
place where the activities of Qi take place, so the
physiological effect is in fact, the manifestation of Qi's
movements. For example, the respiration of the Lung is
actually carried out by the dispersing and descending effects
of Lung Qi. Therefore, when Qi is deficient, hypofunctioning
of Zangfu Organs will ensue. For instance, deficient Lung Qi
often leads to feeble breathing, a lower voice, lassitude,
weak pulse, etc.
Qi also promotes the generation, distribution and discharge
of the Blood and Body Fluids. As Yin substances, Blood and
Body Fluids depend on Qi's activities to be generated. In
other words, generation of these substances relies on the
activities of Qi of the Spleen and the Stomach, the Lung and
the Kidney. Besides, Qi is a vigorous substance, so it can
activate the flow of Blood and Body Fluids, as well as
transform them into various secretions and excretions. For
this reason, Qi Deficiency often leads to an impeded flow of
Blood or stagnation of Blood, or retention of Body Fluids in
the body, which, in turn, causes Phlegm or edema.
2)Warming Qi, as a Yang substance, is rich in heat, which
can warm Zangfu Organs, Channels, skin, and muscles and
tendons, to maintain normal body temperature and the
normal functional activities of these organs and tissues.
Motion produces heat, so the heat carried by Qi is in fact, a
result of the constant movement of Qi, and the body
temperature is maintained by the constant movement of Qi.
In addition, Qi's warming function contributes to the
movement of Blood and Body Fluids. The ancients observed
that water in a river would flow in warm weather and freeze
in cold weather, so they drew the conclusion that the
warming effect of Qi must be an imperative condition for the
free flow of Blood and Body Fluids within the body.
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Pathologically, disorders of Qi in its warming function are

mainly manifested as two kinds: one is a cold manifestation
due to Deficiency of Qi, which results mostly from the
deficient Qi failing to produce adequate Heat to warm the
body, marked by aversion to cold and a desire for warmth,
cold limbs, lower body temperature and sluggish flow of
Blood and Body Fluids. The other is the manifestation of
Heat due to stagnation of Qi, which is usually caused by
sluggish flow of Qi in a local area.
3)Defending
The defensive ability of the body results from the combined
action of a number of physiological functions, of which the
function of Qi plays a particularly important role. The
defensive effect of Qi mainly indicates that Qi can prevent
the invasion of external pathogenic factors into the body.
Generally speaking, external pathogens invade the body
through either the skin or the nose and mouth. Defensive Qi
functions to protect the body surface, and control the
opening and closing of the pores, so it can prevent the
invasion of external pathogens. If the defensive function of
Qi is deficient, the resistance of the body against the
invasion of these factors will be weakened, and as a result,
susceptibility to such diseases as the common cold are likely
to occur.
4)Controlling Qi has the function of controlling the flow of
Blood and Body Fluids to prevent extravasation or
unnecessary loss of Body Fluids. Qi can keep the Blood
flowing within the vessels to avoid extravasation, control the
amount and time limit of such secretions as sweat, urine,
gastric juice, and saliva to prevent their excessive loss, and
control emission to avoid its excessive discharge. When Qi is
deficient, Yin Fluids will be profusely lost. For example,
failure of Qi to control Blood will cause various kinds of
bleeding; inability of Qi to control Body Fluids will cause
spontaneous sweating or profuse sweating, incontinence of

urine or profuse urine; and failure of Qi to control emission

will cause nocturnal emission, premature ejaculation, or
seminal emission.
The controlling effect of Qi and the pushing effect of Qi are
opposite and supplement each other. On the one hand, Qi
promotes the distribution and discharge of Blood and Body
Fluids; on the other, Qi controls the flow of these Yin
substances to prevent their unnecessary loss. Only when
these two opposite aspects are harmonized can the normal
flow and discharge of the Yin substances and the
metabolism of Blood and water be maintained.
5)Transforming
This refers to various conversions occurring along with the
movement of Qi. It includes the changes of Qi during its
movement and the generation and metabolism of Essence,
Blood and Body Fluids and their transformation. That is to
say, any changes of substances can be considered the result
of the transforming effect of Qi, such as transformation of
Food into nutrients and wastes, that of wastes into feces,
that of nutrients into Qi and Blood, that of Body Fluids into
sweat and urine, and the discharge of urine and feces. As
the transforming effect of Qi in the human body is a process
in which the metabolism of the substances take place, it
forms the essence of life.
Although the above mentioned five functions of Qi differ
from each other, they are all based on the basic property of
Qi, or the vigorous and nutritive nature 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.
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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.
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
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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.
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).

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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.
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

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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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