Aging and Blood Stasis: A New TCM Approach to Geriatrics

Aging and Blood Stasis: A New TCM Approach to Geriatrics

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Yan De-xin is one of the leading 'old Chinese doctors' in the People's Republic of China today. His theories on blood stasis and aging have revolutionized 2,000 years of TCM geriatrics. Besides being a clinical manual on the treatment of all the most commonly seen geriatric diseases, this book contains the best discussion of the interrelationship of the qi and blood of any so far in the English language. Thus, no matter whether one sees elderly patients or not, this book is an important addition to the English language TCM literature.

The five types of qi
Because qi is distributed in different parts of the body and the qi in these different parts have their own characteristics, therefore one can name different types of qi. For instance, qi concentrated in the upper burner or chest is called ancestral qi. That gathered in the middle burner is called the central qi. That concentrated in the lower burner and originating from the kidneys is known as the original qi. Wei qi or defensive qi is emitted from the interstices of the skin, while ying qi or constructive qi circulates within the blood vessels. The Relationship of Qi & Blood to Senility 11

1. Original qi
This is also known as source qi, true qi, and life qi. Of the different kinds of qi in the human body, it is the most important and fundamental. Original qi is acquired prenatally and is hidden and treasured within the kidney essence. It passes through the three burners and spreads to the whole body. Internally, it spreads to the viscera and bowels, while externally it spreads to the interstices of the skin and muscles. It goes wherever it may reach. It both stimulates the functional activities of the viscera and bowels and enriches and nourishes the four limbs and the hundreds of bones. Therefore, if the original qi is sufficient, the functions of the viscera and bowels are vigorous and resistance to disease will be strong. One will be healthy and long-lived. Conversely, if original qi is insufficient, the functions of the viscera and bowels will decline and resistance to disease will be weakened. Diseases may occur one after another and may finally result in early death. Thus, we should pay attention to preserving our original qi while we are still healthy; while in treatment, one should stress the importance of cultivating and supplementing the original qi. This is very important in preventing and treating disease as well as in delaying senility.

2. Ancestral qi
This is also known as the great qi and as chest qi. The ancestral qi is composed of the clear qi inhaled into the lungs from nature and combined with the essence qi from water grain which is transported and transformed by the spleen and stomach. The ancestral qi accumulates in the chest from where it diffuses throughout the entire body. It has two great physiological functions. The first is circulation in the respiratory tract. In terms of this, ancestral qi is responsible for breathing. Language, sound, and the strength or weakness of breathing are all connected with the exuberance or decline of the ancestral qi. The second is the flow of qi and blood through the heart vessels. Thus the circulation of blood is also related to the ancestral qi. Through respiration and the circulation of blood, the ancestral qi is connected to the functional activities of the whole body. In his Du Yi Sui Bi (Notes on the Study of Medicine), Zhou Xue-hai states: The ancestral qi is the stirring qi. Respiration, speech, sound, the motion of the limbs, and the strength or weakness of sinews and bones are all due to the operation of ancestral qi. If it is vacuous, the breath will be short and scant. If it is replete, there will be panting and wheezing, distention and fullness."

3. The central qi
The central qi is also known as the stomach qi. Its chief source is from food and drink. It is produced through the rottening and ripening of the stomach and is transported and transformed by the spleen. All the viscera and bowels in the human body require their supply of central qi in order to maintain their different physiological functions. "The Treatise on the Tai Yin&Yang Ming" in the Su Wen (Simple Questions) states: The four limbs receive their qi from the stomach. Sometimes, the spleen qi does not reach the channels due to disorder of the spleen. As a result, it cannot move the fluids and humors of the stomach. The four limbs thus do not obtain qi from water and gain. Hence the qi is gradually weakened. The circulation in the vessels is not smooth, and the sinews, bones, and muscles all lack the qi to exist; so they cannot function well.

In his "Treatise on the Exuberance&Decline of the Spleen&Stomach" in the Pi Wei Lun (Treatise on the Spleen & Stomach), Li Dong-yuan also states:
The Relationship of Qi & Blood to Senility 13
When food and drink enter the stomach, the yang qi goes upward. The fluids and humors and qi enter the heart, pass through the lungs, fill and make replete the skin and hair, and scatter in the hundreds of blood vessels. The spleen receives qi from the stomach and sprinkles to the four sides, nourishing qi and blood... Humans receive the qi of water and grain and live. This is rooted in their stomach qi. Because the central qi rottens and ripens food and drink in order to obtain nutrition for the body, so it also enriches and constructs the defensive and constructive and the viscera and bowels. It upbears the clear and downbears the turbid, transports and transforms in the four directions. Hence, various masters of TCM in different generations have regarded the spleen and stomach as root of latter heaven.

4. The constructive qi
The constructive is made from the finest essence of the water and grain qi and it moves within the vessels. Thus it makes up a part of the circulation of blood. Its main function is the transformation and engenderment of the blood and body fluids and it follows the circulation of blood to construct and nourish the entire body. Because the constructive qi and blood move together within the vessels, day and night without pause they transport and move above and below, to the interior and exterior, to the viscera and bowels, and to the four limbs and the hundreds of bones in order to provide all these with nutrition. Therefore the constructive and the blood are often mentioned together.

5. The defensive qi
The defensive qi is a part of the yang qi in the human body. Therefore, it is also known as defensive yang. Its original source comes from the yang qi in the kidneys. However, it must depend on the latter heaven finest essence of water and food for constant nourishment. This essence is produced after birth in the spleen and stomach. Then the defensive qi is circulated through the body by the diffusion and emission of qi from the lungs. Therefore, it can be said that the defensive qi originates from the lower burner, is enriched and nourished in the central burner, and is opened and emitted from the upper burner. This qi is transported and moves outside the vessels and throughout the entire body. It performs the function of guarding and defending the muscles and exterior, defending these against external evils, opening and closing the sweat pores, regulating the body temperature, moistening the skin and hair, and warming the viscera and bowels.

In addition, each viscus and bowel has its own qi. For instance, the liver has its qi for growth and development. It is responsible for coursing and discharge. The heart has its qi of fire and warmth. It rules growth and nourishment. The spleen has its qi of water and grain. It governs transportation and transformation. The lungs have their qi to clear and depurate. It governs administration and discipline. The kidneys have their qi to store the essence of life. It governs the regulation of water metabolism and the control and promotion of respiration. It also determines the condition of the bones and marrow. Physiologically, each of these various types of visceral qi have their own functional characteristics. Thus, when one or another of the viscera become diseased, different symptoms appear.

Aging and Blood Stasis: A New TCM Approach to Geriatrics

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