Qi or the Breath of Life: a fundamental concept

Qi is an imperceptible, subtle substance, considered to be both single and plural. Usually translated as energy, its main characteristic is perpetual movement. This movement gives it its functions and ensures the vital functions of the organs.

Contents

• Transformation and movement of Qi
• Qi of the organs and bowels
• Production of Qi
• Functions of Qi
• Movements of Qi
• The different types of Qi

The body’s Qi has 3 origins and is made up of the following 3 elements:

1. The Earlier Heaven Qi – Xian Tian, Qi present before birth, from conception, original Qi, Qi of the parents;
2. The Qi of the natural world, the air we breathe, the 2nd^​ means of producing Qi;
3. The Qi of food.

In the body, Qi circulates constantly and makes the blood and fluids circulate. It reaches every part of the body. It is the fundamental substance that makes up the organism and maintains the vital functions. Once Qi is formed, it is distributed to the organs, the bowels, the skin, the bones, the tendons and the meridians. These different Qi of the 5 organs, the bowels and the meridians are the concrete manifestation of the functional activity of the body’s Qi in different parts of the body.

For example, Heart Qi is the action of the body’s Qi at the level of the heart. The heart’s function is to govern the Blood; it is Qi that allows the heart to push the blood through the vessels. The same goes for the Qi of a given meridian.

The forms this movement of Qi takes

The transformation of Qi – Qi Hua

This refers to all the processes of Qi transformation through which vital activities can take place.

The movement of Qi – Qi Ji

It is one of the functions of Qi, its capacity to transform and eliminate the old to produce the new: the metabolic activities (digestion, assimilation, transport of food, transformation of fluids into urine, sweating, breath) of the body to keep it alive and healthy.

• The transformation of Qi – Qi Hua
  This refers to all the processes of Qi transformation through which vital activities can take place.
• The movement of Qi – Qi Ji
  It is one of the functions of Qi, its capacity to transform and eliminate the old to produce the new: the metabolic activities (digestion, assimilation, transport of food, transformation of fluids into urine, sweating, breath) of the body to keep it alive and healthy.

In Traditional Chinese Medicine, we focus on the Qi Hua processes of Qi transformation. By regulating Qi Hua through Chinese Tuina massage, herbal medicine and acupuncture, we can restore the proper functioning of the body.
The Qi mechanism, Qi Ji, covers all the movements of Qi, which follow preferred directions: ascending (upwards), descending (downwards), entering (from the outside inwards) and exiting (from the inside outwards).
It is these complementary and opposite movements that make it possible to accomplish the process of Qi transformation, “Qi hua”, within the body and with the external environment.

• Ascending generally of Yang;
• Descending of Yin;
• Entering : receiving the new;
• Exiting : rejecting what is worn out and old.

Ascending and descending allow internal exchanges; they emphasise the body’s internal transformation processes.
Entering and exiting allow exchanges between internal Qi and external Qi, exchanges of matter (reception, elimination).

Basic rules of the movements of the Qi of the organs and bowels

The organs share the common function of storing Qi and essence. Their movement is considered to be mainly ascending.
The bowels, whose common function is to transport/transform , have a mainly descending movement.
Nevertheless, the Heart and the Lung must have Qi that descends so as to communicate with the lower organs.
The Liver and the Kidneys must have Qi that rises so as to communicate with the upper part.
The Spleen, located in the centre as a kind of pivot, has Qi that must both rise and descend.

The Liver rises and ascends from the left. The Lung descends from the right.
The bowels have Qi that is mainly descending (elimination, digestion). However, it may need to rise again.
Each organ has an ‘ascending’ aspect and a ‘descending’ aspect.

The Qi is the most fundamental matter for the functioning and constitution of the organism and for maintaining vital activities. It is the matter on which human life rests, and it is also the common name for these activities.

As the fundamental matter of the organism’s constitution, Qi structures the body.

This structure takes 2 forms:

– Condensation of Qi , which gives substance to the organs, the bowels, the skin and every component of the human body;
– Qi that disperses, spreads and circulates: this is the Qi we work with in Chinese Tuina massage and in acupuncture.

It is the matter needed to maintain the body’s functional activities.

To maintain these vital activities, human beings need to exchange with the outside world.
Air, water and food are transformed into the organism’s vital substances thanks to the Qi Hua of the organism.
Once transformed into vital substances, they are absorbed or eliminated.

Human beings and the natural environment are governed by the same theories of Yin Yang and the 5 movements.
When Qi condenses, there is life; when Qi disperses completely, there is death.
Human beings have inherited the Qi of heaven and earth, and depend on the Qi of the 4 seasons to grow.
Human beings and heaven always correspond: “Tian Ren He Yi”.

The production of Qi

Qi is made up of:

• Earlier Heaven Qi, Qi inherited from the parents, the primitive matter that forms the embryo, the Yuan Qi.
• Later Heaven Qi , which includes the nutritive substances drawn from food – Jing Qi of food – and from the air we breathe – Jing Qi of pure air.

Qi is produced by:

1. The Lung handles overall regulation through breathing – inhaling pure Qi and exhaling turbid Qi. The Lung also takes a direct part in producing Qi through the Zong Qi it produces in the chest from air (Lung) and food (Spleen). Zong Qi stimulates breathing and the circulation of Qi and Blood.
2. The Spleen – root of Later Heaven – and the Stomach – source of the transformation of Qi and Blood – are at the origin of the production of nutrients. They transform food and produce nutrients, thereby producing Qi and Blood, and they also nourish the essence of Earlier Heaven.
3. The Kidney stores essence, the matter that allows the creation of human life (Yuan Qi being essence in the form of Qi). It stores the essence of Earlier Heaven and the essence of Later Heaven.

The functions of Qi

1^​ function of Qi: activation, setting in motion

A driving effect that shows in the growth and development of the organism (in reproduction), in the functional activities of the organs and bowels, in the production and circulation of blood, and in the production, distribution and elimination of fluids.

All the organs, bowels, meridians and collaterals depend on this setting in motion to perform their functions.

The fundamental matter for the formation of the meridians is Qi. As for blood and fluids, the production and circulation of blood as well as the production, distribution and elimination of fluids depend on the combined action of the organs and bowels. Qi, for its part, stimulates the production of blood and fluids, and also stimulates their circulation.

If there is Qi deficiency, these 4 areas are affected.

2^​ function: warming

Possible thanks to the Yang aspect of Qi, the junior Fire, the ministerial Fire. Qi is a source of heat for the body.

It maintains normal body temperature. Without this warming, there is no physiological functioning: fluids and blood cannot circulate.

3^​ function: defence

Qi is also used to describe how diseases are triggered.

Zheng Qi, upright Qi: a state in which the movements of Qi are normal inside the body. It reflects the body’s capacity to resist a pathogenic factor.

Xie Qi, perverse Qi, pathogenic Qi: a state in which the movements of Qi are abnormal inside the body, which can create imbalances.

In Chinese Medicine, a disease corresponds to a struggle between upright Qi and perverse Qi. The course of a disease can be seen as a struggle waged between Zheng Qi and Xie Qi.

If upright Qi is harmonious – Zheng Qi is normal – the body can resist diseases.
If there is disharmony in the Qi, perverse Qi can attack.
In the Huangdi Nei Jing or Yellow Emperor’s Inner Classic, the oldest work of Chinese medicine, we read: “All diseases arise from Qi”.

3 areas where this can be seen:
– Defence against external pathogenic factors at the level of the skin. The Lung spreads defensive Qi as far as the skin, and this Qi prevents invasion by external pathogenic factors;
– Struggle between upright Qi and perverse Qi: the role of (upright) Qi is to fight the intruder. The body’s upright Qi fights until it expels the perverse Qi out of the body;
– Recovery after an illness: convalescence, recovery. After the illness, upright Qi restores itself and promotes the restoration of the Yin Yang balance and the restoration of physiological functions. Healing can then take place.

The state of Qi (abundant, circulating well or insufficient) determines the state of upright Qi, which in turn determines the likelihood of falling ill or being attacked by a pathogenic factor. When upright Qi is abundant, even if perverse Qi is present, it will not be able to attack, or the illness will be mild and easy to cure. If it is insufficient, the person will easily be attacked and often ill, with a recovery that is either longer or more complicated.

4^​ function: containment

This concerns the containment of the body’s fluids.

In Yin Yang theory, within the relationships of opposition and complementarity, Yang is considered to be the master and Yin to follow. Yang Qi is the master of life. If Yang is weak, Yin is consumed.

The containment function of Qi reflects the regulating function of Yang Qi over the Yin fluids.

Qi can contain the blood and keep it from leaving its regular pathways. It can contain the fluids (sweat, urine, stomach fluids…), controlling the quantities secreted and eliminated. It can contain the seminal fluid.
Qi also contains the Qi of the organs and bowels, which are thus held in place, and allows them to perform their function.

→ Setting in motion and containment must be coordinated: they are 2 complementary processes.

5^​ function: transformation

All the transformations and movements of Qi in the body.

The Qi Hua of the body: the transformation of all the movements of Qi throughout the body.

Through the movements of Qi, blood, fluids and essence transform and generate one another.

All substances transform one another (metabolism): the digestion, assimilation and transport of food, as well as the production and transformation of Qi, blood and fluids, the production and elimination of metabolic waste, and the transformation of fluids. All these activities reflect the function of Qi Hua.

→ If Qi Hua is abnormal, all metabolic processes are affected.

6^​ function: nourishment

The Qi of food is nourishing; it forms Zong Qi when it mixes with the Qi of the air.
Ying Qi is a very nourishing Qi.

The movements of Qi

The Qi Ji refers to the movements of Qi in 4 directions: entering, exiting, ascending and descending.

The function of the 5 organs is to store essence; their Qi is mainly ascending.
The bowels transport; their Qi is mainly descending.

Manifestations of Qi imbalances

Qi stagnation – Qi Zhi

When Qi stagnates, we speak of Qi stagnation – Qi Zhi / Qi Yu. Qi no longer circulates; there is a blockage.

Counterflow Qi / Rebellious Qi, Qi reflux – Qi Ni

When there is excessive ascent or insufficient descending movement, we speak of counterflow Qi – Qi Ni.

Qi collapse – Qi Xian

This is either excessive descent or insufficient ascent.

Qi escape – Qi Tuo

This is an excessive outward movement.

Qi blockage – Qi Bi

This is an obstruction of the entering and exiting movements.

The different types of Qi

We are always talking about the body’s Qi, which circulates. It is always the same Qi.

Earlier Heaven Qi, Yuan Qi, original Qi. Compared with the other types of Qi that appear after birth, Earlier Heaven Qi needs to be replenished regularly.

These types of Qi circulate throughout the body, in the organs and bowels, in the meridians.

Yuan Qi

Yuan Qi – original Qi – is the root of Qi, the vital force. It is Earlier Heaven Qi, but it cannot be considered to be made up exclusively of Earlier Heaven Qi.
The Kidney stores essence; Yuan Qi is made up of Earlier Heaven Qi and Later Heaven Qi.
Yuan Qi includes original Yin Qi and original Yang Qi.
Its role is to stimulate and activate the functions of the organs and meridians. Function: the role of beginning. It is the origin of life.
Yuan Qi is inherited from the Yin and the Qi of the parents. In terms of quantity and quality, part of it is innate, but it is entirely possible to influence this quantity and quality.

Its production: it is stored in the Kidney and depends on, and is supported by, the essence component of the Kidney. It is Kidney essence in the form of Qi. Yuan Qi is the driving force of the vital functions, whereas essence is more material. This essence and this Qi are fed by nutrients. The state of Yuan Qi is directly linked to the state of the Spleen and Stomach. If the Qi of the Spleen and Stomach is abundant, Yuan Qi will be abundant. If the Qi of the Spleen and Stomach is deficient, Yuan Qi is deficient.

Its distribution: it is the Kidney and Mingmen that store this original Qi. Yuan Qi emerges from Mingmen (between the Kidneys/from the Kidneys, on the spine – a Dumai point), passes through the whole Triple Burner and then enters all the meridians (the meridian system). It circulates everywhere: in the organs, on the skin, in the couli (the interstitial spaces). It gathers particularly at the Yuan points, located on the hands and feet, near the wrists and ankles.

• 1^​ function: Stimulating growth and development.
• 2^​ function: Warming and activating all the physiological functions of the body (organs, bowels, meridians…).

On the Yin level, Yuan Qi provides nourishment: without Yin Qi, the organs are no longer nourished or moistened. This is called Yin Yuan Qi.

On the Yang level, it provides movement: without Yang Qi, nothing circulates any more. This is called Yang Yuan Qi, or original Fire. Thus the Yin part of Yuan Qi is linked to essence, and its Yang part, Fire in nature, is linked to movement.

In clinical practice, when faced with a Qi deficiency, we first tonify the Qi of the organ concerned. If that is not enough, we tonify the Kidney and the Spleen for a more general tonification. If the treatment still has no effect, the diagnosis needs to be reviewed.

Zong Qi or Da Qi

Zong Qi is produced by the nutrients raised by the Spleen, which mix in the chest with the air entering the lungs. If there are disturbances in the nutrients or in the air, Zong Qi is affected. If the respiratory function of the Lung or the transport and transformation function of the Spleen-Stomach is disturbed, this will influence Zong Qi.
As for its distribution, Zong Qi gathers in the chest, then flows into the vessels of the heart and lung.
Upwards, Zong Qi emerges at the lung, then rises through the airways and the throat.
Zong Qi also descends, thanks to the descending function of the Lung, and gathers in the Dan Tian (cinnabar field), in the lower sea of Qi – Qihai. From the Dan Tian it heads towards the groin, then descends along the Stomach meridian to the foot. It is a Qi that circulates throughout the body.

• 1^​ function: Promoting and assisting breathing
  Zong Qi helps the Lung to stimulate breathing. The state of speech, voice and breathing depends on whether Zong Qi is abundant or not. If the voice is weak or the patient does not feel like talking, Lung Qi needs to be tonified.
• 2^​ function: Promoting blood circulation
  Zong Qi spreads inside the vessels of the heart and helps the heart to push the blood through the vessels. The state of Zong Qi influences the circulation of blood and Qi. If Zong Qi is deficient, it cannot help the heart to push the blood, which can lead to blood stasis.

Ying Qi – Nutritive Qi

It circulates inside the blood vessels and has a highly nourishing function. People often speak of nutritive blood – Ying Xue.
Ying Qi is rather Yin compared with Wei Qi.

Ying Qi is produced and transformed from the subtle substances of food. It is produced exclusively from diet/nutrients. The most refined part of the nutrients enters the vessels and forms Ying Qi.

As for its distribution, it circulates inside the vessels in a continuous, uninterrupted circuit. It circulates in the 12 main meridians as well as Dumai and Renmai, then passes through the organs and bowels.

• 1^​ function: Transforming and producing blood

From the lung, it flows into the blood and from then on becomes one of the components of blood.

• 2^​ function: Nourishing the body

By circulating in the vessels and meridians, Ying Qi reaches every part of the body and supplies them with the substances they need for their physiological activities.

Wei Qi – Defensive Qi

Wei Qi has a function of protecting the organism; it forms a barrier against external attacks.
It is called defensive Yang because it is rather Yang compared with Ying Qi.

It is produced from the subtle substances of food, from nutrients. Unlike Ying Qi, whose nature is gentler, more nourishing – the noble part of food – more moistening and more static.
The nature of Wei Qi is more impetuous, more warlike, more mobile. It is produced from a coarser part of the nutrients.
Wei Qi circulates outside the vessels and outside the meridians (Ying Qi inside the vessels and inside the meridians), mostly at the surface. It circulates continuously, faster than Ying Qi. During the day it circulates mainly in the Yang meridians, and at night mainly in the Yin meridians: 25 cycles during the day and another 25 at night, i.e. 50 revolutions a day.
Second permanent circulation system: Wei Qi.

• 1^​ function: Defence
  It can both protect the body from external attacks and help expel pathogenic factors outwards.
• 2^​ function: Warming and nourishing the organs, bowels, flesh, skin and body hair
  It can maintain normal body temperature, thus creating favourable conditions for the normal activity of the organs and bowels. The flesh will be well nourished, as will the skin and body hair.
• 3^​ function: Regulating the opening and closing of the couli, regulating the elimination of sweat
  Maintaining the balance between the inside and the outside of the body. If Wei Qi is disturbed by cold, for example, the couli may become blocked, making sweating impossible.

The circulation of defensive Qi is closely linked to sleep.
Eyes open: Wei Qi circulates in the Yang; when falling asleep, Wei Qi circulates in the Yin. If Wei Qi stays in the Yang, the body remains active (sleep disorders).

When Wei Qi is deficient, the defences weaken and external pathogenic factors are easily caught. When the functions of the organism slacken, the couli slacken too and spontaneous sweating may appear. Finally, a disturbance in the circulation of Wei Qi can lead to sleep disorders.

Nutritive Qi and defensive Qi have different functions, although both are produced from the subtle substances of food.

→ Total interdependence between Qi and the organs and bowels.

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