Among the most commonly known concepts of Chinese medicine are yin and yang, the polarization of life in the physical world. Most fundamentally, yin is about embodiment, or substance, and the opposite of embodiment is yang, or energy.
Qi—Energetic Medicine
Qi (ch’i, pronounced “chee”) is a word used in many contexts. It can be translated as “breath,” “air,” or “gas.” Its meaning can also be expressed as our life force or the energy that animates life.
Energy itself is pure. It has no beginning and no end; it has no specific purpose. It is “shaped” by intention and belief. Anything is possible, because the energy that animates existence is limited only by our individual and collective beliefs. When we say a person or place has “good energy” or “bad energy,” what we are really describing is how our own energetic frequency resonates with the vibrational frequency of another person or place.
We can use electricity as a metaphor for Qi: Its current moves through the utility company’s electrical grid as pure energy. In our homes, though, we turn on a switch and the lamp illuminates the room, or we put a plug in the outlet and the digital face of a clock radio lights up. The “purity” of the electricity takes on the vibration and function of a light bulb, a clock radio, or whatever other appliances we are using.
Qi has a similar flexibility of function, though its source is mysterious, pervasive, and indefinable. In the context of Chinese medicine, we see the word Qi attached to many concepts. We begin to understand that Qi suggests function, not substance. It is the reason Blood and Fluids circulate, but it is not the substances of Blood and Fluids themselves. It is the reason we as human beings are able to engage in relationship, but it is not the human being.
A quality associated with Qi is that it is warm, allowing it to circulate. Like warm air, Qi tends to rise. Because of its ability to circulate it fosters the relationship between and among many things: people, physiological functions, plants, pets, and so on. Qi also allows for the larger, macrocosmic relationships of Heaven, Earth, and Humanity.
The Many Implications of Qi
Given the flexibility of Qi’s function, it can be daunting to work with the Chinese medical system, which has no absolute treatment protocols, no perfect answers. We human beings prefer clear definitions of our problems and solutions. To satisfy this need, over the course of its history Chinese medicine has developed many concepts to give “shape” to Qi.
One of the most fundamental types of Qi is Source/Yuan Qi. This is the Qi that resides in the Essence of all living beings—plant, animal, human, the magmatic core of the Earth, and the cosmos. From a Western point of view Source Qi is associated with DNA, our constitutional makeup that unfolds as we move through life. This Essence is also our connection to the “larger” Source, the Cosmic/Yun Qi, which influences our development from the time of conception. The fertilized ovum not only is the combined Essence of our parents but also contains this Cosmic/Yun Qi.
The development of the fetus is in the domain of Prenatal Qi, which is the core concept of Qi in the field of obstetrics. After birth we enter the realm of Postnatal Qi: that which allows us to engage with the circumstances we encounter after we are born. For health practitioners working to reverse or manage illness, this is a concept of Qi that provides a large umbrella under which many other concepts function.
Some of these other concepts include Gu Qi, literally “Grain Qi,” which describes the function of digestion, and Zhong Qi, the general functioning of the chest, especially the Lungs. There is Da Qi/Great Qi, that which we breathe in to bring light and inspiration into our lives, and Zheng Qi, or Upright Qi, the overall function of health and well-being. There is also Xie Qi/Pestilent Qi, which can be the contagion of an epidemic, or perhaps the effects of poison from a venomous insect.
A very broad understanding of Qi is that it represents our capacity to live our lives. If we feel that a task is too much for us or a concept is too difficult to comprehend, these are signs that we are deficient in Qi.
Among some of the common descriptive terms for health conditions related to Qi are Deficient Qi, Excess Qi, Rebellious Qi, and Stagnant Qi.
The Humours of Chinese Medicine
While Qi relates to function, or yang, the humours relate to physical substance, or yin. As long as we are alive, there is inseparable interaction between these two aspects of life.
Blood and Fluids—Nourishment for the Essence and Conductors of Qi
In the context of its ability to foster relationships, Qi requires a medium in which to circulate through our bodies. It needs a substance with conductivity that moves through our bodies and supports our physical existence. Returning to the analogy of electricity, the conductivity of the copper wiring in our homes brings electricity’s potential to the appliances that require it to function. In our bodies, the media of conductivity for the Qi to circulate are the Blood and Fluids.
Blood
Blood represents the internal terrain of the body. Relative to Qi it is yin, or substance. Its substance is, however, less dense than Essence/Jing. According to the Chinese, our Blood contains our Spirit/Shen. It has a major involvement with our mental and emotional functioning. It plays a critical role in gynecology and conception.
The Blood records and holds on to our experiences in life; adequate Blood is required for the proper functioning of memory. This relationship to the past and to memory gives us the ability to observe what has gone before and, with reflection, to make choices concerning our future. The Heart continually pumps the Blood through the vessels, and our experiences and emotional responses move with it, allowing past experiences and emotional attachments to linger in our consciousness.
There are three Organs that influence the Blood. The Spleen produces the “red substance” that becomes Blood and maintains the integrity of the channels through which it flows. The Heart “finishes” and circulates the Blood. The Liver “stores” the Blood and makes decisions about its management: Does it need to send more Blood to the Heart, or to the Uterus for conception or menstruation?
Conditions related to the Blood include deficiency, whether in production by the Spleen, storage by the Liver, or the strength of movement as reflected by Heart Qi. Symptoms of Blood deficiency may include declining memory, poor sleep, fatigue, or pallor.
Heat is a potential pathology. We develop Heat in the Blood when a very serious condition comes on acutely and the body is unable to quickly eliminate it. Human immunodeficiency virus (HIV) and Lyme disease are examples of acute pathologies that penetrate to the Blood level. Or, perhaps more likely in modern times, we create Heat in the Blood through emotional stress or habitual dietary “indiscretions.” The Su Wen mentions the consumption of alcohol several times with regard to creating Heat in the Blood.
Imagine cooking a sauce on the stove. With the initial boil the liquid begins to move quickly, but as the sauce thickens the movement becomes heavier and more sluggish. The same is true with Blood. At the initial stages of Heat in the Blood, its exuberant movement can produce symptoms such as nosebleeds, broken blood vessels in the eyes, or a menstrual cycle with a lot of blood loss. If the pathology of Heat continues to linger it can damage the Blood, Fluids, and Qi. The Blood and Fluids become thick and sluggish, and since Qi moves with these substances, the Qi becomes stagnant.
Fluids
The Fluids are less dense than Blood. Generally they are carriers that either nourish all the tissues of our bodies or cleanse and flush out toxicity. The Fluids are capable of more movement throughout the body than the Blood.
There are two qualities of Fluids in the body—the Thin Fluids/Jin and the Thick Fluids/Ye. Both of these have two aspects: the Clear and the Turbid. Collectively they are called the Jin-Ye.
The Clear Fluids are those that in some way nourish the body. The Clear Thin Fluids moisten the skin, the sinews, and the sensory orifices. The Clear Thick Fluids nourish the Internal Organs.
There are also two categories of Turbid Fluids. The Turbid Thin Fluids are those that help excrete toxins via sweat, urine, and saliva. The Turbid Thick Fluids affect a deeper anatomical level in the body. The Turbid Thick Fluids are the foundation of our hormonal system, and they include the cerebrospinal fluid. They mobilize to the bone and marrow, the joints, and the brain. While the Turbid Thick Fluids do not actually have a route for excretion, they bring pathology that has not been eliminated deeper into the anatomy, to be held latent.
Adequate hydration is crucial to health. Hydration is defined by how well the water we drink is absorbed, not by how much is consumed. Our Fluids are the major conductor of Qi in the body. They nourish the mucous membranes of the respiratory and digestive systems. Fluids help us flush out and eliminate the toxins we breathe in or ingest. They keep our skin supple and strong to protect against external factors. There is a priority for distributing fluids in the body: when we drink water, the first place it goes is to the blood, giving it sufficient volume to fill and travel through the vessels of the body. Only if there is adequate hydration at this first step of distribution can the fluids go on to nourish the cells, the fluids of the joints, and the brain.
Jing-Qi-Shen—The Three Treasures of Humanity
The concept of Jing-Qi-Shen does not appear frequently in the classical writings of Chinese medicine. It is a concept discussed more in the martial arts and alchemical traditions.
The Jing is our physical body. It is the gross matter of our being. It is associated with our genetics—what we have inherited from our parents and ancestors—and with our own ability to reproduce. If we cultivate our bodies through practices such as qigong and taiji, we begin to refine and strengthen our bodies by opening physical blockages and allowing the Qi and Blood to move more freely. With such practice our bodies become relatively strong and healthy. We are not burdened as much by serious illness and we are able to live our lives productively. As martial artists or qigong practitioners, our physical movements and postures are correct according to the principles of the system we practice, and the postures become so natural that they require little attention. We call it our Essence, and it is associated with Earth and the lower abdominal region.
The Qi is our ability to engage in relationships. These relationships give us the opportunity to examine our attitudes and beliefs. With this examination we can let go of the attitudes and beliefs that limit us and begin to move more freely in the world. As martial artists we can respond spontaneously and naturally to force that is directed toward us and redirect it so that it becomes harmless. As qigong practitioners or healers we can direct the Qi to benefit other people. We call it Energy, and it is associated with Humanity and the chest and middle abdominal region.
The Shen is our connection to the Divine, which abstains from any judgment. Shen has no relationship to duality. It loves all things equally and impersonally. We call it Spirit, and it is associated with Heaven and the head.
This trinity is humanity’s treasure. Our Essence/Jing is inspired by the Spirit/Shen to function in the physical world, and the relationships we make because of our Energy/Qi enable us to know ourselves better. The Three Treasures offer us the possibility of bringing Spirit and Essence together as we negotiate the many experiences of life.
Jing, Qi, and Shen are associated with three anatomical regions of the body: the lower abdomen, the chest and middle abdomen, and the head. These are the three dantian, or Elixir Fields, a term popularized by alchemists who were working to “redeem Spirit from matter.” The character for tian illustrates a cauldron, an important tool for the external alchemists who attempted to transform gross matter into a refined substance that could promote longevity, or even immortality. During the process of cooking in the cauldron, the correct “firing time” in which the transmutation could occur was crucial. The same is true in qigong practices.
With its strong orientation toward cyclical movement, Chinese philosophy operates from the belief that since we come from Spirit/Shen, we return to Spirit/Shen. This process will happen automatically at death, but the ancient practitioners considered that it was possible to accomplish this transformation while still living in the physical body, thus evolving to become a more refined human being.
This concept is fundamental to the practices of both internal alchemy, where practitioners make a transformation through the effort of mind and body, and external alchemy, where (historically) practitioners consumed substances that were fundamentally toxic in order to trigger responses in the body that would lighten the physical load, as it were, and bring about heightened awareness and spiritual realization.
The Three Coming Together as One
There is a saying in taiji circles: the Essence/Jing transforms into Energy/Qi, and the Qi transforms into Spirit/Shen. It may be that the Jing does not actually transform into Qi, but that through dedicated practice the Jing becomes so developed and natural that we are able to devote our full attention to the cultivation of Qi, to developing more awareness of the subtle relationships occurring within our own bodies and the other stimuli with which we come into contact. With continued practice the Qi also becomes so developed and natural that we are able to commit our attention to the Shen.
From another point of view, if by virtue of our Qi—that is, our relationships—we take the opportunity to examine our attitudes, we can transmute our Jing to become more refined. We live in a society full of deeply held beliefs. One fundamental belief is that aging requires the degeneration of bodily and mental functioning. To the degree that we “buy into” this societal indoctrination, we will degenerate in our process of aging. If we challenge our beliefs and begin to move more freely in the world, we become more spontaneous, “lighter” as we shed our emotional baggage, and more spirited. With this process Qi transmutes to become Shen. Aging is only the accumulation of experience, not a prescription for degeneration.
In the practice of meditation the goal is that the Shen transmute into emptiness, or the Void. If we can transmute Spirit we realize impermanence, while at the same time knowing that Spirit is the only thing that is permanent. It is a paradox. This is the state of nonassertive action famous in Daoist philosophical writings.
Interaction and transformation constantly occur between the Blood and Fluids, Essence and Spirit, and Qi. With the warmer environment of the surface anatomy, Fluids evaporate to become Qi. With the cooler environment of the interior, Fluids condense to become Blood. At the deepest level of the Essence, the Blood and Fluids condense even more and become part of the Bone.
The Energetic Anatomical Terrains—Wei Qi, Ying Qi, and Yuan Qi
Our capacity to relate to the environment, other beings, and ourselves is defined by three levels of energetic relationship. These are:
Wei Qi (Defensive Qi): unconscious/instinctual (physically associated with the skin and the sinews)
Ying Qi (Nourishing Qi/Blood): conscious/cognitive/intelligent (physically associated with the flesh and blood vessels)
Yuan Qi (Source/Essence Qi): the blueprint of life/fate/destiny (physically associated with the bone)
Wei Qi—Instinctual Response
Wei (pronounced “way”) Qi is the energy that circulates through the most superficial terrain of our bodies: the Skin and the Sinews, or in Western parlance, the nerves, muscles, tendons, and ligaments. Wei Qi is often translated as Defensive Qi, and it equates in some ways to the immune system. Wei Qi is our instinctual response to external influences. We sweat because it is hot, get goose bumps because it is cold, have the allergic reactions of red eyes and a runny nose, or perhaps jerk away from a hot surface. All of these are Wei Qi responses, and none of them involves conscious intention.
From an emotional point of view, Wei Qi is associated with our moods. When we cannot assign a reason for feeling the way we do, this is Wei Qi. It is like the weather that surrounds us.
Every day, at the moment we awaken and open our eyes, Wei Qi is brought to the external anatomy via the acupuncture point Bright Eyes/Jing Ming, located at the inner corner of the eyes. During the course of the day it circulates sequentially through the channels associated with external tendinomuscular activity. At night as we fall asleep, however, Wei Qi penetrates deeply into the body, entering at a point about one hand’s width below the armpit, Armpit Abyss/Yuan Ye/GB-22, and then passes through a point at the center of the chest, Central Altar/CV-17. Hence the phrase “Wei Qi homes in to the chest.” As it moves inward it brings with it the energetic messages it has encountered during daily activities. These messages might influence our dreams as we try to work out our various challenges. Or perhaps during the course of the day we are exposed to a cold or flu. If we have difficulty falling asleep after exposure to an external pathogenic factor, it can be the result of Wei Qi’s reluctance to return inward when it still has its defensive work to do on the exterior.
During the night Wei Qi circulates through an internal, autonomic terrain. Mingling with the Fluids, it bathes the musculature of the heart and encourages the peristaltic action of the intestines, among the many actions our bodies perform that are not governed by intention or choice.
Wei Qi is heavily involved with our ability to be alert to the external environment, a very necessary component for survival. Indeed, Wei Qi’s resources are rooted in Kidney Yang, with its primitive drive for life. While the ability to be alert is a Wei Qi attribute, when Wei Qi is excessive we focus our attention on too many things, which can lead to attention deficit disorder.
The Responsible Organs
The Internal Organs most responsible for the proper functioning of Defensive/Wei Qi are the Lungs and Liver. The Lungs, by virtue of the breath, have the most direct access to the external environment. The skin, the part of our anatomy that directly senses and adjusts to the outside world, is associated with the Lungs. The Liver is responsible for muscular activity and for the smooth flow of Qi. The reasoning behind the folk medicine recommendation that we go to sleep before midnight has basis in the Chinese medicine “clock.” The Liver is strongest in its function from 11:00 p.m. until 3:00 a.m. As the Liver works to mobilize and direct its resources, it is best if we do not interfere with this function by engaging in too much thinking and activity.
Fundamental to the circulation of energy is adequate hydration. We can see from some of the Wei Qi responses, such as sweating and runny eyes or nose, that fluids play an important role in its proper function. Wei Qi brings moisture to the skin, to the anatomical organs, and to the mucous membranes of the respiratory and gastrointestinal tracts. When we have enough energy combined with sufficient hydration, Wei Qi makes our skin glow.
If we describe Wei Qi as Defensive, there is an implication that the world is something against which to defend. Wei Qi is, however, simply the Qi that allows for contact with the postnatal world. At the instant of contact there is no judgment: it is primitive, instinctual contact. Our experience is not yet at the cognitive level. The Lungs and the Metal element represent the external world, and the clearest example of this primitive contact with the world is the breath. In other words, we are always in contact with the world at large even though we might be distracted by other tasks. We are always in contact through the breath.
Ying Qi—Conscious Interaction
Usually translated as Nourishing Qi, Ying Qi is contained in the Blood and Flesh. It is also associated with the production of Jin-Ye, the Thin and Thick Fluids. Ying Qi is intimately involved with the functions of digestion and emotional health. It has a particular relationship to the chest and abdomen and to the mid-back. When treating a patient, a practitioner should focus on the Ying Qi level when the patient presents with signs and symptoms related to digestion and assimilation of food.
Ying Qi also pertains to the emotions. How well “digested” are our relationships? Do we digest our food efficiently so that we are able to absorb and utilize the available nutrients, or do we suffer from heartburn, sluggish digestion, or constipation? Do we feel nourished by our relationships with other people and circumstances, or are they painful and stagnant? Do they cause anxiety? In Chinese medical thinking, the Blood is said to contain the emotions. If we are stuck emotionally we will have stagnant Blood. The Blood is also said to contain the Spirit. If our Blood is not moving smoothly our relationship to Spirit will also stagnate. We become dispirited. To engage in life fully we need to move the Qi, move the Blood, and thereby allow the Spirit to animate our lives.
The Responsible Organs
The most important Organs associated with Ying Qi are the Spleen, Stomach, Heart, Small Intestine, and Pericardium. Ying Qi is the level at which we take something and make it our own, either through the process of digesting food and drink or through the assimilation of life’s experiences. The Stomach is the basis of Postnatal Qi. Our capacity to feel nurtured begins with the ability to receive food. The Spleen’s responsibility is to transform and transport, in order to make food into a usable substance for the body. Together, the Stomach and Spleen “separate the clear from the turbid” of what we ingest. The Small Intestine receives what the Spleen and Stomach pass on to it, providing a second opportunity to further separate the clear from the turbid.
The Heart seeks to fulfill its curriculum through experience, and the Pericardium/Heart Protector, in its efforts to protect the Heart from the pain and suffering of human experience, transforms a difficult and unwanted experience into something that is purposeful and usable. Nothing is accidental, and so-called negative events can be transformative if only we have the humility to recognize the lesson we are confronting.
In contrast to the Defensive/Wei Qi level, where our responses are without conscious intent but are rather based on autonomic actions and instinct, Nourishing/Ying Qi carries the responsibility of bringing to consciousness the choices that support or limit our ability to transform. These choices apply to the quality of the foods we eat as well as to our emotional responses to the relationships and circumstances in our lives. Unlike Wei Qi and its moods, Ying Qi knows why we are angry or sad. It can assign an object to these feelings.
A Bridge between the Internal and the External
Ying Qi is our capacity to find meaning for our existence in the world. In addition to its function to support our ability to be nourished by the food we eat, Ying Qi allows us to discover purpose and validation in our lives. Ying Qi is influenced from the exterior by our families, friends, and lifestyle choices. It is also influenced from the interior, as the constitutional level reveals its temperament and nature by its response to external stimuli. Ying Qi makes the bridge between our constitutional tendencies and the exterior world.
Key words for Ying Qi are cognition, choice, and commitment. With cognition, that is, knowing why we are responding in any particular way to the various stimuli we encounter, either we can choose to perpetuate old routines—the habitual responses of our individual life stories—or we can make a different choice that generates momentum toward a more conscious life. Nourishing/Ying Qi offers us the opportunity to separate the things that are meaningful to us from those that are not. We have a level of commitment in either case, whether to our old way of being or to the willingness to experience life continually anew.
Yuan Qi—Unfolding Destiny
Our Yuan Qi, translated as Source Qi, circulates with our Essence/Jing at the deepest, densest level of our bodies: through the bones and the marrow, delivering the subtle messages of the hormones and other deep biochemical interactions in our body. Yuan Qi allows the seeds of our destiny to germinate. Our temperament, the deepest level of our emotional expression in life, is stored in the Essence.
From a Western medical point of view, the Yuan Qi is our DNA. Our genetic unfolding contains our “curriculum” for this life, and the curriculum is assigned from two different sources. We receive the genetic imprint of our physical attributes and emotional tendencies from our parents and, through them, our ancestors. Other aspects of our personalities come from the energetic dynamics of the cosmos at the time of our conception and subsequent birth.
The Responsible Organs
Our curriculum is stored with our Essence in the Kidneys. A key concept for how our Essence is distributed to fulfill our curriculum is called the Triple Heater. This refers to a mechanism whereby energy circulates among the three anatomical regions of the lower abdomen, the middle abdomen, and the chest. The Triple Heater can be referred to as the Tree of Life.
The right and left kidneys communicate with each other at the spine (a process known as the Moving Qi of the Kidneys), at a point located slightly above the waist called Gate of Life/Mingmen. At this point the dense quality of the Kidneys’ Essence meets Mingmen Fire and is combusted to become lighter in quality, like steam (fig. 3.1). This steam, which contains the inherent knowledge of the lessons we need to accomplish, ascends upward along the spine via a group of points known as the Bladder Shu/Transporting points (see table at “Urinary Bladder Shu/Transporting Points” in appendix 2). These points have a direct line of communication to specific Internal Organs. The Triple Heater mechanism deposits the “steam” as it reaches the points associated with the Organs that will be involved in fulfilling our destiny.
The Triple Heater process gives us our temperament. If our curriculum requires that we be decisive go-getters, the Triple Heater brings Essence to the Organs that will support that quality. If our purpose includes making beautiful things in the world, Essence is delivered to the appropriate Organs to help us fulfill that purpose.
Figure 3.1. The Triple Heater process: The left kidney contains Kidney Yin, the essence of our physicality. The right kidney contains Kidney Yang, the basis for the energy to live life. These two qualities continually interact through the Moving Qi of the Kidneys. As they meet at the spine, they are combusted by Mingmen Fire and turned to steam. The energetic movement called the Triple Heater mechanism transports the steam upward along the spine and deposits it into the points that nourish the Internal Organs responsible for developing our constitutional tendencies.
Cycles of 7 and 8
Beyond our individual curriculum, we share with all other beings the cycle of birth, growth, maturity, and death. Our lives are stories: we have an origin and we have a destination. How we journey from the beginning to the end is described in the earliest texts of Chinese medicine as the cycles of 7 and 8 (the Su Wen), or of 10 (the Ling Shu). The cycle of 7 refers to females, the cycle of 8 refers to males, and the cycle of 10 is general. The cycles define childhood, adolescence, adulthood, and the elder years. The cycles of 7 and 8 refer to the years of our lives (the ages of 14 and 21, or 16 and 24, on up to 40, 56, 64, and beyond), because major changes often accompany multiples of these periods. Each cycle brings different responsibilities: the increasing household duties of an older child, providing for the needs of one’s family as an adult, or bringing the wisdom of age to the community as an elder.
These cycles are governed largely by the hormones, which are distributed by our Source/Yuan Qi. In modern times life moves more quickly than during the time of the classics, and the actual years described in the cycles of 7 and 8 are not so pertinent. Nevertheless, we all share, to one extent or another, the process of life experience and aging.
The levels of Defensive/Wei, Nourishing/Ying, and Source/Yuan Qi are constantly interacting with each other, continually accommodating the environmental and emotional challenges our Essence encounters.