The Vital Substances: Qì, Xuè, Jīn-Yè, Jīng and Shén

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Chapter 4 The Vital Substances:,, Jīn-Yè, Jīng and Shén Goals of this chapter Explain the concepts and functions of the Vital Substances. Learning Goals After this chapter you have to be able to: explain the following concepts: Blood Jīn-Yè Fluids Jīng Essence Shén Spirit Xiān Tiān Jīng earlier heaven essence Hòu Tiān Jīng later heaven essence Yuán- source Qi Gŭ- food Qi Kōng- Air Zōng- chest Qi or gathering Qi Zhēn- true Qi Wèi- defensive Qi Yíng constructive Qi or nutritive Qi Hún ethereal soul Pò corporeal soul Yì thought Zhì will power explain functions of, Wèi-,, Jīn-Yè, and Jīng explain how,, Jīn-Yè, Jīng and Shén are formed explain the relationship between and explain the relationship between Jīn-Yè and the organs, Jīn-Yè and, and Jīn-Yè and explain the different forms of Shén and their relationship with organs Introduction Traditional Chinese Medicine (TCM) describes the human body completely different than Western Medicine (WM) does. The point of view of TCM is one of correspondences, mutual relationships, and different levels of energies in the body. WM has a biochemical view. The vital substances describes in this chapter are used in TCM for describing the functioning of our body in detail. Assignment Read chapter 3 and 4 of The Foundations of Chinese Medicine (G. Maciocia). Study the different models below and write in your own words what this model tells you. Add comments of your teacher to the models. 1

in Chinese Philosophy vapour, steam, gas (uncooked) rice as steam produced by cooking rice Qi has different densities. when it disperses then is basis of in Phenomena Discontinuous form of matter Continuous form of matter Universe Organic Inorganic when condenses then is Physical shape (Xing) in Chinese Medicine Heaven- union Earth- manifests in Different forms 2

Two aspects relevant to medicine: Qi is an energy which manifests simultaneously on a physical and spiritual level; Qi is in a constant state of flux and in varying states of aggregation. When Qi condenses, energy transforms and accumulates into physical shape. changes Form different hats according to Locality and Function Two major aspects of : = refined essence produced by internal organs. Function(nourishing body and mind) indicates functional activity of internal organs. e.g. Gān- portion of residing in Gān. Gān- = complex of functional activities. ensuring smooth flow of. Various forms of Hòu Tiān Jīng is Motive Force functional activity of all organs as Yuán- nourishes has Functions basis for Shèn- provides heat (Yuán- closely related to Shèn functions) derived from comes out at Source points Xiān Tiān Jīng facilitates transformation of Zōng- to Zhen- (Shèn participate in the production of ) facilitates transformation of Gŭ- to (in Xīn) Gŭ- means: " of food", " of grains". as Gŭ- transformed from Food by sends upwards (to the chest) First stage of transformation of Food into Qí. 3

originates from nourishes Xīn as Zōng- assist Yuán- Functions enhances and promotes influences affects and promotes : Xīn: Speech and strength of voice Blood circulation to extremities controls and respiration governs and Blood Vessels Throat area. Area where Zōng- collects in chest is called Sea of. The controlling point is Shānzhōng CV-17 (Ren-17). Zōng- is also treated via Heart and Lung channels and by breathing exercises. Zōng- affected by emotional problems. Zōng- flows downwards to aid Shèn-Kidneys. Yuán- flows upwards to aid respiration. Zōng- is also called: Chest-Qi (Xiōng-) or Big-Qi (Dà ). as originates from Zhēn- controls. as Yíng- This is activated by acupuncture. It is interior and it nourishes. It flows in blood vessels and channels. as Wèi- protects Body Exterior pathogenic factors. controlled by regulate circulation regulates Pores Open/Close warms, moistens Skin and Muscles by regulates Body Temperature 4

spread outwards Shàng Jiāo () Wèi- nourished by Zhōng Jiāo (, Wèi) has root Xià Jiāo (Shèn) Relationship between the various forms of Food transformed to by sends upwards (to the chest) Gŭ- combine to form Zōng- Air transformed into Zhēn- has form Yíng- In Blood Vessels and Channels. under catalytic action of Yuán- has form Wèi- Outside the Channels. Under skin. Zhōng- - Is of and Wèi, or Hòu Tiān derived from food. If - Xū gives rise to prolaps of an organ, then can be due to Zhōng- Xū. Zhèng - is the active aspect of all components including Zàng-Fŭ,, Jīn-Yè, Jīng and various forms of in maintaining health and resisting disease (protecting the body from invasion by exterior pathogenic factors). It indicates the body's resistance to pathogenic factors. Xié- different types of evils. For example exterior pathogenic factors. These attack the body. Basis functions of The basic functions of are: transforming transporting protecting holding raising warming 5

Transforming function - transforms into Food Xīn- transforms Gŭ- into Shèn- transforms Fluids Páng Guāng- transforms Urine Transporting function - - Shèn- Gān- - transports transports transports transports transports to Skin Gŭ- Qi downwards Qi upwards Qi in all directions Fluids Protecting function - protects from Exterior pathogenic factors Body 6

Holding function Lung-Qi holds Sweat Shèn- Páng Guāng- holds Urine - holds in Blood Vessels Raising function - raises (strengthen) Organs Shèn- rises Upwards Warming function A function of Yáng-. -Yáng Shèn-Yáng warming Body Direction of movement of among Zàng-Fŭ Normal physical function of Zàng-Fŭ and various types of rely on Complex balance Yīn-Yáng character of Direction of movement The various types of have to flow in the appropriate directions. This is called "Ascendingdescending and exiting-entering" in Sù Wèn chapter 68. Examples are: 7

Xīn Shèn Xīn-Huo rises to meet flows downwards to meet Water of Shèn Shèn-Shui Wèi sends upwards Clear sends downwards Impure Wèi controls to controls Transforming Receiving Xīn Ascending clear Descending impure depends on depends on Ascending of - Descending of Wèi- controls descending of directs downward inhale Clear exhale Impure to Shèn, Páng Guāng 8

Gān Gān controls smooth flow of flows in All directions Upwards Gān- a balance - Shèn descends to (+ Xīn) balance ascends to Shèn (+ Gān) send down receive controls controls Exhalation Inhalation Pathology of Xū deficiency: mainly,, and Shèn. Xiàn sinking: sub type of Xū. Applies mostly to -. Zhì stagnation: cannot/does not move and stagnates. Mainly Gān-. Nì counterflow: a reversal of the normal direction of the flow of. Blood is a denser form of. 9

Air (Kōng ) pushes to Xīn transforms into 80% Food + drink Wèi Gŭ- upwards Yuán- Yuán- Shàng Jiǎo Zhōng Jiǎo Impure part of Shèn Jīng produces Suĭ-Marrow generates Gŭ Suĭ-Bone Marrow 20% Xià Jiǎo Function of nourishing Body moistening Eyes + Sinews Gān- moistening Tongue Xīn- material foundation of (anchors) Shén-Mind is Yīn in nature. and Zàng-Fŭ It is important to understand what the relation is that has with different organs. The following organs are discussed: Xīn Gān Shèn 10

Xīn governs Xīn makes Xīn-Huŏ with help of Blood Vessels responsible for regulation of Fire = Yáng transforms into cools down = Yīn origin of keeps in Blood Vessels produces Gŭ- basis for formation of Gān Gān stores regenerates in Gān stores has relation with physiology and pathology of menstruation. 11

Gān supplies with Zĭgōng-Uterus Shèn and Gān have a common origin: Jīng transformed into nourishes & replenishes stores stores Shèn Gān sends Gŭ- transforms into to send to Xīn infuse controls controls Channels Blood Vessels into Assist pushing function of Xīn 12

Shèn Yuán- assist in transformation of Gŭ- to Jīng can be transformed in To summarize Xīn governs Gān holds delivers basis for production of stores Shèn determines quality of The - relationship = Yáng and = Yīn. Yíng- circulates with in Blood Vessels There are four aspects to the - relationship. These are: generates moves holds nourishes 13

The first three aspects of this relationship are often expressed in the saying: " is the commander of." generates Gŭ- basis for - essential for production of If Xū Xū. It is often necessary to tonify in order to tonify. moves - infuses into Blood Vessels When moves, follows. If stagnates, congeals. holds function( ) holding in Blood Vessels Primarily done by -. nourishes prevents from 'floating'. This aspect is often expressed in the saying: " is the mother of." 14

Prevents from floating is the Mother of Material and dense basis to provides relies on for Nourishment -Jīng relationship transforms into nourishes and replenishes affect assists in formation of Jīng pathology 1. Xū mostly caused by - Xū. 2. -Rè mostly due to Gān-Rè. 3. Yū caused by Zhì, Rè and by Hán. Jīn-Yè Body Fluids Assignment Read the section on Body Fluids of The Foundations of Chinese Medicine (G. Maciocia). 15

Types of Jīn-Yè Actually there is Jīn and there is Yè. The table below shows the main differences. Jīn (fluids) Clear Light Thin-watery Circulates with Wèi- (defensive) on exterior Moves relatively quickly Under control of (spreads under skin). Under control of Shàng Jiăo for transformation and movement towards skin. Function: moisten and nourish skin and muscles. Sweat, tears, saliva, mucus. Component of fluid part of. Yè (liquids) Turbid Heavy Dense Circulates with Yíng- in the interior Moves relatively slowly Under control of Pì and Shèn for transformation. Under control of Zhōng and Xià Jiăo for movement and excretion. Function: moisten spine, joints, brain and bone marrow. Lubrication of orifices of sense organs (eyes, ears, nose, mouth). Jīn Sense organ Fluid of Tears eyes Gān Sweat pores Xīn Watery saliva (xian) mouth Nasal mucus nose Mucoid saliva (tuo) - Shèn Source: S. Clavey, Fluid physiology and pathology in Traditional Chinese Medicine. Source and Transformation of Jīn-Yè Persperation (sweat) Refined Fluids circulate around body by action of Sān Jiāo,, and channel Food + drink clear portion of fluid transports clear fluid [2] Shàng Jiǎo Wèi impure [1] impure + Wèi- yáng Zhōng Jiǎo impure Xiǎo Cháng Fluid impure thru Sān Jiāo impure from Sān Jiāo Shèn Dà Cháng Re-absorbtion Páng Guāng [3] pure Xià Jiǎo Faeces Urine [1] by s spreading + descending function [2] via Sān Jiāo and Shèn channel [3] Steaming action does separation 16

Jīn-Yè and Zàng-Fŭ Jīn-Yè and controls transformation and separation into controls direction Pure & Impure part Pure upwards Impure downwards All stages of Jīn-Yè production! Most important in relation to physiology and pathology of Jīn-Yè. Disorders of Jīn-Yè treat. Jīn-Yè and Wèi Source of Jīn-Yè. Wèi likes to be moist. likes dryness. Dry-foods for a long time may damage Wèi-Yīn. Jīn-Yè and from controls dispersion of Pure part of Jīn-Yè to Space under skin Regulate Water Passages sends Fluids down to Shèn Páng Guāng 17

Jīn-Yè and Shèn This is a very important relationship. 1. Shèn-Yáng controls Many stages of fluid transformation provides Heat for function (transform Jīn-Yè) 2. Shèn-Yáng assists Xiao Cháng function (separation of Jīn-Yè in pure and impure) 3. Shèn-Yáng provides to Páng Guāng function ( transformation) i.e. send pure upwards, urine downwards with help of Shèn-Yáng. 4. Shèn-Yáng assists Sān Jiāo function (transformation + excretion of fluids) 18

Jīn-Yè and Páng Guāng fluids Páng Guāng pure impure excretes urine Qi transformation Jīn-Yè and Sān Jiāo Sù Wèn chapter 8: The Sān Jiāo is the official in charge of irrigation and it controls the water passages Shàng Jiao assists in directing Pure fluids upwards assists in dispersing Pure fluids under skin Zhōng Jiao assists Wèi in function Churning fluids, directing impure downwards 19

Xià Jiǎo assists assists assists Xiǎo Cháng Páng Guāng Shèn function of transforming, separating, excreting fluids Relationship and Yīn-Yè transforms + transports holds in Jīn-Yè produces Shèn- Xū incontinence, enuresis. - Xū spontaneous sweating. - Xū chronic vaginal discharges. Profuse sweating Xū, loss of Wèi-, injures Yáng. Persistent vomiting depletes. Xū sweating. Relationship and Yīn-Yè Does not coagulate or stagnate replenishes & makes thinner Jīn-Yè Yīn nourish & supplement Yīn Excessive use of saunas Xū. Chronic blood loss Jīn-Yè Xū. Pathology of Jīn-Yè 1. Jīn-Yè Xū 2. Jīn-Yè Xū accumulation in the form of oedema or Tán-Yĭn (Phlegm-Rheum). 20

Jīng Essence in context of passed through by Parents Xiān Tiān Jīng determines fixed Person s basic constitution: - strength - vitality Is unique! Quantity vitalizes of positively affected by Quality Tàijíquán & gōng Jīng in context of Hòu Tiān Jīng extracted from Food & fluids by & Wèi interacts with replenishes Growth, reproduction, development in context of Shèn-Jīng Functions Jīng produces Sui- Marrow Brain, fills Spinal Cord, Bone marrow. Jīng as basis of Shèn- See next model Jīng as the basis of constitutional strength Resistance to exterior pathogenic factors. Jīng as basis of Shèn- Shèn- (the steam) Shèn-Yīn, Shèn-Jīng (soup in cauldron) Shèn-Yáng (and Míng Mén) (fire under cauldron) Result of the heating of Shèn-Yīn by Shèn-Yáng. Shèn-Jīng = fluid-like = Yīn = aspect of Shèn-Yīn. Shèn-Jīng is the material basis for this soup. Heating function Differences between and Jīng 21 Jīng

Formed after birth Energy like Everywhere Easy to replenish Short cycles (yearly or shorter) Changes quickly from moment to moment Derived from parents Fluid like Mostly in Shèn Difficult to replenish Long cycles (7 or 8 years) Changes gradually and slowly. Problems when Jīng Xū Growth, reproduction, development Jīng as basis of Shèn- Jīng produces Sui-Marrow Jīng as basis of constitutional strength Poor bone development, stunted growth in children, infertility, habitual miscarriage, mental retardation in children, bone deterioration in adults, loose teeth, hair falling out or greying prematurely. Impotence, poor sexual function, weakness of knees, nocturnal emissions, tinnitus, deafness. Poor memory, poor concentration, dizziness, tinnitus, feeling of emptiness in head. Constantly prone to colds, influenza, other exterior diseases, chronic rhinitus, allergic rhinitus (hay fever). Shén spirit, mind Currently under development. Sān Bāo three treasures In Daoism Jīng, and Shén are called the Sān Bāo the three treasures or the three gemstones. These three determine the internal world of every individual. The Sān Bāo are unique for every individual and are a constitutional micro cosmos which forms a natural opposite of the creative forces of the universe: earth, human, heaven. Knowledge test 1. Compare the main functions of and. What are the important differences and similarities? 2. what is the function of Yuán? 3. What is the role of Shèn-Kidneys in the transformation process? Indicate which aspect or which manifestation of Shèn-Kidneys is responsible for what process. 4. What is the difference between Zōng- and Zhōng-? 5. What is the difference between Zhēn- and Zhèng-? 22

References Sù Wèn chapter 1, 3, 4, 5, 8, 23, 68. Líng Shū chapter 28, 30, 36. Nàn Jīng chapter 4. Bibliography G. Maciocia; The Foundations of Chinese Medicine, Churchill Livingstone, 1989 S. Clavey; Fluid physiology and pathology in Traditional Chinese Medicine, Churchill Livingstone, 1989 C. Larre and E. Rochat de la Valée; Essence spirit blood and qi, Monkey Press, 1999 N. Wiseman, Feng Ye; A Practical Dictionary of Chinese Medicine, Paradigm Publications, Brookline, Massachusetts 1998 Maoshing Ni, Ph.D.; The Yellow Emperor's Classic of Medicine, Shambala, 1995 23