The Basics of Qi


In traditional Chinese medicine, the body and mind are inseparable. Composed of a number of vital substances -- qi (pronounced chee), blood, essence, and body fluids -- the body and mind express their qualities through the functions of the internal organs.

Ranging from tangible, visible substances to subtle, intangible forces, these basic elements of the body and mind are responsible for all aspects of human life -- physical, mental, emotional, and spiritual.

Their intimate involvement in human activity makes them an essential part of physiology, and recognition and understanding of

them are an essential part of diagnosis.

Defining "Qi"

Defining "Qi"

Although qi plays a central role in traditional Chinese medicine, it is extremely difficult to define. It is best to understand it in terms of its functions and activities, where it is more readily perceived.

Situated somewhere between matter and energy, qi has the qualities of both. It has substance without structure, and it possesses energy qualities but can't be measured. It is the fundamental power underlying all the activities of nature as well as the vital life force of the human body.

For example, the force of a thunderstorm can be understood in terms of its qi: The power of qi can be observed in the fallen trees and buildings in the storm's aftermath.

Similarly, the strength of the digestive organs can be determined in relation to their qi by evaluating the appetite, color of the tongue, strength of the pulse, and the body's response to nutrition.

The Meridians

The flow of qi through the body occurs within a closed system of channels, or meridians. There are 12 major meridians, and they correspond to the 12 organ systems: six yin organs and six yang organs. Traditional organ theory pairs yin and yang organs according to their structure and function and the interconnection of their meridians.

In addition, eight extra meridians are interconnected with all the channels. This network of meridians allows the qi, or life force, to reach all the tissues and organs, providing nourishment, warmth, and energy to all parts of the body.

The flow of qi travels from channel to channel, passing through all the meridians every 24 hours. For example, the flow of qi in the heart meridian is strongest between the hours of 11 a.m. and 1 p.m. From there, the qi flows into the meridian of the small intestine, staying there until 3 p.m., at which time the flow passes into the bladder meridian.

In this way, qi passes through all the major meridians and their corresponding organs every day. Although the meridians are deep within the body, points along them are accessible from the surface of the skin.

It is the manipulation of these points by means of pressure, heat, or needles that is the basis for acupressure, moxibustion, and acupuncture, respectively.

The qi that flows through the meridians can be manipulated at the acupuncture points, bringing healing energy to organs that need it and moving energy away from areas that are impaired due to stagnation of qi.

Qi works in conjunction with the other vital substances to keep your body healthy. See the next section of this article to learn about the functions of qi.

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Functions of Qi

One of the functions of spleen qi is to transform                                      food into qi and blood.
One of the functions of spleen qi is to transform food into qi and blood.

Although many types of specialized qi exist in the body, such as those associated with a particular organ, all varieties share some basic functions. These functions are as follows:

  • Transformation: Qi transforms one type of substance into another. Spleen qi transforms food into qi and blood the body can use; kidney qi transforms fluids into pure essence and waste water; lung qi transforms air into the energy to sustain life.
  • Movement: All movement is accompanied by its own qi, including growth and development and even walking, breathing, and thinking. Qi moves the blood through the vessels, giving rise to the saying, "Qi is the commander of the blood."
  • Protection: Qi protects the body from attacks by disease-causing organisms. Therefore, if a person's qi is weak, that person may experience frequent illnesses.
  • Retention: Qi keeps the organs in their proper place, keeps blood within the vessels, and keeps body fluids inside the body. Deficiency of qi can lead to sagging organs (prolapse), bleeding disorders, and excessive sweating or urination.
  • Warming: The yang aspect of kidney qi keeps the entire body warm; when it is deficient, chronic cold extremities and decreased function in all activities that require warmth, such as digestion, can occur.

The source and function of qi determines the type of qi. Learn about the different types of qi in the next section of this article.

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Types of Qi

Prenatal qi reflects your                              heritage, including your                                            prenatal experience.
Prenatal qi reflects your heritage, including your prenatal experience.

Chinese medicine traditionally divides qi into various types, depending on its source and function. The original source of this life force is a person's parents, and the qi inherited from them is known as prenatal qi.

Prenatal Qi

Prenatal Qi

Prenatal qi, the basic constitution of a human being, depends on genetics and the quality of the parents' lives at the time of conception and during pregnancy.

This qi is the person's heritage, and it cannot be replenished; however, healthy lifestyle, diet, and breathing practices can conserve prenatal qi and slow down its depletion.

Preservation of prenatal qi is one of the most important contributions of traditional Chinese medicine. It enables a person who is sickly and weak to live a life of health and vitality. The process involves a simultaneous conservation of prenatal qi with practices that enhance the formation of postnatal qi.

Postnatal Qi

Postnatal Qi

Postnatal qi, or acquired qi, is derived from the digestion of food and extracted from the air we breathe. Combined with prenatal qi, it forms the totality of the body's power to perform all the vital processes of life.

Lung Qi: One of the functions of the lungs is to extract qi from air and incorporate it into the storehouse of postnatal qi. The strength of postnatal qi depends on a number of factors: the strength of lung qi, the quality of the air, and the performance of breathing exercises such as qi gong, which enhances the lungs' ability to extract qi from air. When lung qi is deficient, a person can experience symptoms of fatigue, shortness of breath, pallor, and frequent colds.

Spleen Qi: The other factor in building strong postnatal qi is the quality of the food we eat and the strength of our digestive organs, especially the spleen. When spleen qi is weak, symptoms of fatigue, lack of appetite, sluggishness, and loose stools can occur. When the diet lacks essential nutrients and variety, the extraction of qi is impaired even if spleen qi is strong.

People accustomed to eating fresh organic fruits, vegetables, and whole grains will often experience this when circumstances force them to eat denatured, refined, pesticide-laden foods: Inevitably, they notice their energy level drops. Recent research has confirmed that organically grown produce has significantly higher levels of nutrients.

When both spleen qi and lung qi are strong, and the quality of our air and food are high, postnatal qi can grow. Herbs that tonify lung and spleen qi, along with breathing practices such as qi gong, further increase the accumulation of postnatal qi. In this way, even a person with a weak inherited constitution (prenatal qi) can experience a life of health and vitality.

True Qi

True Qi

The totality of qi that results from the combination of prenatal and postnatal qi is known as true qi. Responsible for all the functions of the body, true qi takes different forms. From the clinical perspective, two of these forms of qi are especially significant: nutritive qi and protective qi.

Nutritive Qi: Nutritive qi circulates in the meridians and nourishes the organs. Acupuncture manipulates this qi to affect organ function. Specific points along the meridians are needled, pressed, or warmed (by means of moxibustion) to achieve specific effects in the organs.

For example, a point below the knee is manipulated traditionally to treat appendicitis, often eliminating the symptoms when the condition is caught before infection sets in.

When a Chinese surgeon performing appendectomies needled this point on his patients, he found that the intestines contracted rhythmically on either side of the appendix. This demonstrates how the power of qi can be observed, even when it is difficult to understand exactly how it is working.

Protective Qi: The other important subdivision of true qi is protective qi, or wei qi. Believed to flow between the skin and muscles, wei qi is responsible for defending the body from external pathogens that attack the body.

Although first described thousands of years ago, wei qi accurately describes the body's immune system. Research has confirmed that herbs traditionally used to tonify wei qi, such as Astragalus root (huang qi), have a powerful effect in strengthening the body's resistance to disease and increasing immune function.

Certain acupuncture points, such as Stomach 36 (Zusanli) and Large Intestine 4 (Hegu), have similar effects on immune function.

Changes in the levels, direction, or flow of qi in the body can cause health problems. Learn about disorders of qi in the next section of this article.

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Disorders of Qi

Chinese medicine seeks to ensure that the levels, direction, and flow of qi are all appropriate for their particular organs. The various disorders of qi that can occur involve deficiency, sinking, stagnation, or incorrect movement of qi.

Qi Deficiency

The symptoms of qi deficiency are common to all the types of qi disorders: fatigue, pallor, and lethargy. When the qi of an organ is deficient, the specific functions of that organ are also impaired.

For example, the spleen is responsible for appetite and digestion; spleen qi deficiency produces poor appetite and loose stools. Lung qi is responsible for the strength of respiration; when it is deficient, a person experiences shortness of breath and a chronic cough. Treatment focuses on strengthening, or tonifying, the qi of the affected organs.

Sinking Qi

In disorders of sinking qi, the qi that holds organs in place has insufficient strength to do its job. The result is sagging, prolapsed organs, such as the uterus, transverse colon, or rectum. Specific acupuncture points and herbs can correct this type of imbalance.

Stagnant Qi

Stagnant Qi

When qi is stagnant, the functions of an organ are impaired due to a blockage in its qi flow. The liver is the organ most often affected by qi stagnation. Since the liver is in charge of the smooth flow of emotion, stagnant liver qi frequently results in irritability and anger. Because there is sufficient qi, tonifying in these cases would make the situation worse, so treatment focuses on moving qi away from the area.

Rebellious Qi

Rebellious Qi

In rebellious qi, the normal direction of organ qi is reversed. Each organ has a normal direction of qi flow; for example, the lungs and stomach move qi downward, while the spleen moves qi upward. Rebellious lung qi results in coughing or wheezing; rebellious stomach qi produces symptoms of nausea, belching, or vomiting; and rebellious spleen qi produces diarrhea.

Qi is just one aspect of the body's functions that traditional Chinese medicine addresses. Learn more about the other vital substances considered during treatment in the next section of this article.

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Other Vital Substances in Chinese Medicine

Prenatal essence is inherited but can be                                      supplemented with postnatal essence from nutrition                                      to help ensure a child enjoys good health.
Prenatal essence is inherited but can be supplemented with postnatal essence from nutrition to help ensure a child enjoys good health.

Qi is only one of the vital essences that traditional Chinese medicine considers important to one's health and wellbeing. The blood, as well as the other body fluids, the essence, and the spirit all play essential roles as well.

Blood

In traditional Chinese medicine, blood has some parallels to its Western counterpart, such as its function of circulating through the body and nourishing the organs.

However, it also has some very subtle functions in traditional Chinese medicine, such as providing a substantial foundation for the mind and improving sensitivity of the sensory organs.

In other words, a deficiency of blood causes an impairment in mental function, leading to poor memory, anxiety, and insomnia.

Blood deficiency can also impair the senses, especially the eyes, causing blurry vision. Closely aligned with qi, blood has a complementary relationship with it. The saying, "Blood is the mother of qi, and qi is the leader of blood," refers to the fact that without blood, qi has no fundamental nutritional basis; without qi, the body cannot form or circulate blood, and the blood would fail to stay within the vessels. The two are considered to flow together through the body.

Disorders of Blood

Blood's main function is to circulate throughout the body, providing nourishment and moisture to the organs, skin, muscles, and tendons. When blood is deficient, symptoms such as dry skin and hair, inflexible tendons, and various emotional and reproductive imbalances can occur, depending on the organs involved.

Since qi and blood are so closely related, a deficiency or stagnation of one of the substances often leads to the same type of imbalance in the other one.

The organs that have the most intimate relationship with blood are the spleen, heart, and liver. The spleen creates qi and blood from food; it also helps keep blood within the vessels. When spleen qi is deficient, blood deficiency or bleeding disorders can occur.

The heart is said to "rule the blood and vessels." When it is qi or yang deficient, energy to move blood through the vessels is insufficient, resulting in poor circulation and feelings of coldness in the extremities.

Since the heart blood is also the resting place for the mind and spirit, deficient heart blood leads to symptoms of insomnia, palpitations, restlessness, and poor memory.

Finally, the liver stores the blood during times of rest or sleep. This function is a process of regeneration, and it is also intimately involved with menstrual flow and fertility. A deficiency of liver blood can lead to scanty menstruation or infertility.

Stagnant liver blood may lead to menstrual cramping and discomfort. Since the liver opens into the eyes, this deficiency can also produce such symptoms as blurry vision, floaters, and dry eyes.

Body Fluids

Body fluids refer to all the fluids in the body, such as sweat, tears, saliva, and various secretions and lubricants. The spleen and stomach regulate the formation of fluids, which are considered byproducts of digestion, while the intestines and bladder are involved in their excretion.

The lungs regulate body fluids from above, and the kidneys are in charge of their metabolism throughout the body.

Fluids consist of two basic types: clear thin fluids known as jin, and thick viscous fluids known as ye. Jin is distributed mostly to the muscles and skin, keeping them moist and nourished.

Ye acts as a lubricant to the joints and nourishes the brain. Jin ye is the collective term for all the body fluids.

Because of the relationship between the organs and body fluids, a traditional Chinese medicine practitioner can extrapolate a wealth of information about organ function from the condition of the jin ye.

For this reason, the initial interview includes questions about thirst, urination, color of fluids, and the amount and timing of sweating.

Sweat is ruled by the heart. Excessive sweating during the day is considered a sign of yang deficiency; night sweats, on the other hand, are a sign of yin deficiency.

Tears relate to the liver; dry eyes are a sign of liver blood and yin deficiency. Sputum is ruled by the spleen; excessive sputum is a symptom of yin excess in the spleen.

The lungs are the storage area for mucus; a runny nose or wet cough is a sign of yin excess in the lungs. Since the kidneys control the moisture of the entire body, a dry mouth can indicate kidney yin deficiency.

The body fluids also have an intimate relationship with qi. Since qi is involved in the transformation of fluids, deficient qi can lead to fluid retention or excessive sweating.

Conversely, fluid stagnation can impair qi circulation, and profuse loss of body fluid can lead to a severe deficiency of qi. For this reason, herbs that induce sweating are used cautiously in people who are qi deficient.

Essence and Spirit (Jing and Shen)

Essence and Spirit (Jing and Shen)

Stored in the kidneys, essence (jing) is the subtle substance that is responsible for growth, development, and reproduction.

Prenatal essence is inherited from the parents, and it is the original substance of life. It cannot be increased, but it can be conserved through a healthy lifestyle and moderation. It can be supplemented with postnatal essence, which is derived from nutrition.

When the essence is strong, a child grows and develops normally and enjoys healthy brain function and strong immunity and fertility as an adult.

Conversely, birth defects, mental retardation, and a child's failure to thrive are considered signs of a deficiency of essence. In adults, essence deficiency can cause infertility, low immunity, and premature aging.

Spirit (shen) is a person's innate vitality. It can be considered the soul, but it also has a material aspect. When an individual has healthy shen, the eyes have the glow of life and the mind is clear.

Since the heart is the resting place for the spirit, disturbances in shen are typically diagnosed as heart imbalances.

A mild shen syndrome appears with a heart blood deficiency, with signs of forgetfulness, insomnia, fatigue, and restlessness.

In a more serious shen syndrome, "heat phlegm confusing the heart," the individual may be violent, with red face and eyes; the Western diagnosis of this condition might be psychosis.

A person who is in a coma as a result of a stroke or a person who experiences epileptic seizures may receive a diagnosis of the shen disturbance known as "phlegm blocking the heart opening."

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ABOUT THE AUTHORS:

Bill Schoenbart has been practicing traditional Chinese medicine (TCM) since 1991, when he earned a Masters degree in TCM. He teaches TCM medical theory and herbalism at an acupuncture school in California, and also maintains a clinical practice.

Ellen Shefi is a licensed massage technician, licensed acupuncturist, and registered dietitian. She operates a private acupuncture practice, has assisted in developing acupuncture protocol, and has contributed to a national research project funded by the National Institutes of Health Office of Alternative Medicine. She is a member of the American Association of Acupuncture and Oriental Medicine, the American Herb Association, and the Oregon Acupuncture Association.