Yvonne Lau, President of Mayway Herbs and Dr. Skye Sturgeon take a closer look at Blood in TCM, one of the few concepts that closely parallels modern physiology. Explore how Blood and Qi work together, how the organs influence its movement, and why it’s central to overall health.
Listen to the podcast, or read the transcript (below)!
YL: Good morning, Skye. How are you today?
SS: Oh, I'm doing great. How are you doing?
YL: I'm doing pretty fantastic myself.
SS: So, today we're going to talk about Blood. And, Blood, or Xue in Chinese, it's one of the vital substances that we talk about in traditional Chinese medicine. And I find it interesting that Blood is the most similar TCM term as what we describe in modern medical physiology. So, similarly named, and their composition is similar as well.
YL: Sorry, Skye, what do you mean by composition? Are you talking about red blood cells and stuff like that?
SS: There's a concept of blood in medicine, and there's a concept of Blood in traditional Chinese medicine, and they're very similar, in many respects. As opposed to some TCM ideas, which are conceptual but there's no direct connection to modern medicine.
But in many ways, the connection in traditional medicine and modern medicine, there's a lot of overlap. Most people know about blood, and of course, people have known about blood since ancient times, because when someone is wounded, or someone has an accident, this red substance comes out, and we called that blood. And the ideas in traditional Chinese medicine, in many ways, are very, very sophisticated, and valuable to understand.
Blood is a liquid matrix, which contains cells, among other things. And it's not a solution, although there are things dissolved within it. And it's not an emulsion, even though there are immiscible things in it, like fatty acids and so on like that. The cells are suspended in this liquid, which flows.
It's actually a connective tissue. The liquid portion is called plasma, and then there's lots of different kinds of cells, which we'll get into. It includes red blood cells, which is what makes it red. And this is only one component, it's the largest component.
But there's also white blood cells, there are platelets… white blood cells are a part of the immune function, and platelets, which are a part of the clotting factor, because a problem with blood is bleeding, and sufficient bleeding will cause loss of life. So, there's a mechanism within blood for it to prevent this bleeding or deal with the bleeding in such a way that the bleeding can stop. The matrix transports nutrients and oxygen and waste throughout the body. It goes to every cell. The blood vessels are a part of the heart. And the heart is closely related to the blood. And when we say nutrients, we mean that which is obtained from the digestive system.
YL: Basically, the blood transports everything we need for life.
SS: Well, it is, in fact, the thing of life. It’s transported throughout the body, because every cell needs these items in order to function, and the way they receive these things is through the blood. The blood goes to every cell, even the vessels of the heart. They start out very large, leaving the heart, these arteries. First, it goes to the lung, where it gets oxygen, and then it comes back to the heart, and then it's sent out to every part of the body through the arteries. And eventually becomes arterioles, becomes capillaries, which are very, very tiny, literally transporting one cell at a time. And then in direct contact with every cell. So, every cell needs this nourishment, needs the oxygen, needs the nutrients, and responds to the various chemical messengers that might be transmitted in the blood.
In traditional Chinese medicine, there's certain things that are said about the Blood that are a part of the theory of Blood. And one, interestingly, even though blood is a liquid, which makes it Yin, it's also considered to be a dense form of Qi. That's because it contains Qi, and it is how Qi is moved to every cell, because every cell has to have Qi.
In fact, it's considered to be inseparable from Qi, and we're going to talk about Qi more in just a minute, what kind of Qi is in it. And then Qi moves blood. Because it is a liquid that is moved throughout the body, through the action of the Heart Qi. The Heart Qi contracts, and it pumps the liquid through the body, and then also recovers the liquid. So it's more or less a closed system. Although that's not strictly true, but it is a system where there is a going out and there's a coming back.
YL: So, in ancient times, even though people were hesitant to cut open cadavers, when it comes to Heart and the Heart Qi, they already knew that the heart was a muscle that actually pumped blood through?
SS: They did. And of course, anyone that examines someone else, you will notice this phenomena of the beat. This is not necessarily the only way you would figure this out, but if you had someone who was wounded in battle and they're dying, maybe their abdomen is cut open. Well, you can see that this heart is where the beat comes from is pushing the blood, and the person may be bleeding out, and you think, well, the heart bleeds, and the heart pumps, and it causes the blood to move, and eventually there's no more blood, and it's gone, and then the person dies, and the heart stops.
So, it's not a big leap of conjecture to figure out that's where it's coming from. And interestingly, the idea of mind, or consciousness, you had to somehow accommodate the idea that every part of the body was aware and had consciousness, because touch is all over the body, you can feel things, you know, in your feet, and how is this accomplished? Through mind, or through the consciousness of mind, they always proposed that because the vessels of the heart went everywhere, then that was how the mind got to every part of the body, and therefore, that was the location of mind was the heart. The brain was a curious, extraordinary organ. It's full of this gunk, which they called marrow, and they hadn't really discovered fine dissection yet, so they didn't know about the nerves and everything else, and so the brain later became known to be kind of the central processing unit, but still, the mind was located in the heart. The heart was the center of mind.
So, the other thing is that Blood is the Mother of Qi. You have to look at the fact that even though we say the source of Qi mainly has to do with the spleen, or the digestive system, and the lungs that provide the oxygen, and that's what Qi is, is the combination of food Qi and air Qi, and with the action of the kidneys as well.
But Blood is the Mother of Qi, because without Blood, the Spleen and the Lung and the Kidneys do not live. And it nourishes all the organs, the Blood, so it's the Mother of actually all Qi, all functions within the body are dependent on Blood in order to do that.
There are different types of Qi, as we know, the Upright Qi, or the true Qi. It has several aspects to it, one of which is the Defensive Qi. The Defensive Qi is located in the exterior, and it's under the skin, it circulates outside of the channels, but there is this idea that we know that there's an immune system that is transported by blood, and we'll get to that in a bit. But that has to be a part of the Righteous Qi, would be that aspect, and there are many, many things that go into that. Otherwise, it's Nutritive Qi that is in Blood, and the Nutritive Qi winds up coming from the Spleen, the digestive system. And so, it is under the control of the Lungs, because the Lung provides the Qi for the passage of the Qi and the digestive system, into the Blood.
So, if you think of the digestive system, including the intestines, the nutrients are absorbed by the stomach, not so much absorbed in the stomach, but prepared and, you know, we say rotted, and so on, and then it's absorbed into the small intestine, and to a lesser extent, the large intestine. So, it's believed that the Lung Qi is what pushes that nutrient into the bloodstream. So, it's the Lung Qi acting with the Spleen Qi, that does that. We say that the Spleen transforms and transports and one of the ideas about the Spleen transforming is digestion itself. For instance, we eat protein, but our bodies are not interested in the particular kind of protein. Chicken protein, pig protein, doesn't matter, because we're going to break that down into amino acids, and those amino acids are then absorbed into the bloodstream, go to various cells where they're transported into the cells, where they're assembled using the Jing, or the RNA and DNA, to make human proteins. So, that is one aspect of the Kidneys being involved, because we depend upon the Kidney Yang as a part of the transformation portion of that. And then the transportation of the Spleen is putting it into the bloodstream, and then that Nutritive Qi moves in the Blood to nourish all the cells.
But there are other things going on in Blood, that you would have to think are part of Qi as well, and those would be the immune system. The innate and adaptive immune system is transported in blood. Parts of it are also transported in the lymph, but mainly it comes in the blood. And, all of the hormones that regulate various functions of the body that are secreted by endocrine glands are in the blood. Those aren't nutritive. And they are a part of the Righteous Qi. It's how the body functions correctly - through this regulation of these chemical messengers.
There's also, in the case of there being some wound or lesion in the body, and possibly inflammation occurring, then there are other chemicals, like prostaglandins and so on, like thromboxanes that are secreted as a way of controlling the inflammation. These are also transported by blood. And I would say that those are a part of the Righteous Qi as well, because to me, the Righteous Qi is the ability of the body to function correctly, all the components that are included.
We mentioned that Qi generates Blood, Qi moves Blood, and Qi holds Blood in the vessels, and Blood nourishes Qi. But the Qi holding the Blood in the vessels is a part of the Spleen function. Because the way it's held in the bloodstream is that all blood vessels have a layer of smooth muscle around them that literally hold the vessel and keep it intact. The arteries have more layers than the veins, but the veins also have this smooth muscle surrounding them. So, if you have bleeding that is due to the Spleen not holding the blood in the vessels, you don't tonify the Blood. You tonify the Spleen, because that's the job of the Spleen. But it's definitely associated with Blood.
So, the other thing that blood does is it is a liquid, and a large portion of the plasma is actually water. And this is a source of Yin for the body. So, when we say that the Blood is a kind of Qi, but it also is a kind of Yin, because it is a liquid, it brings water to the organs so they don't dry out. I mean, moistening of the organs.
So, the Heart, the Spleen, and then the Liver have the most direct relationship with Blood among the Zhang Fu organs, because the Heart governs the Blood, it moves the Blood. The Spleen holds the Blood in the vessel, and interestingly, the Liver stores the Blood. Because the same imagination I have of someone being wounded, and you see this organ, the liver. The liver is an extremely bloody organ. And so they said, well, that must be where Blood is stored is in the Liver. So, let's just take a minute and look at each of these organs and their relationship to Blood.
We said the Heart governs the Blood. All the blood vessels are associated with the Heart. And the blood circulates within these vessels, so that's one connection to Heart. The second is that Blood is made in the Heart. It's a combination of the Heart Fire, or the Yang of the Blood, and interestingly, the Blood in the Heart cools and moderates the Heart Fire.
So the blood creates a balance in the Heart between the Fire of the Heart and keeps it from flaring up. And we've talked in the past, when we talked about Yin and Yang, we talked about the necessity of all of our metabolism and our body temperature being 98 degrees, why don't we just burn up? Well, it's because of the Yin in the body, and one of the ways this Yin is circulated is through the Blood.
The Spleen produces the Nutritive Qi which is the basis for the formation of Blood. And the Spleen keeps the Blood in the vessels. And deficient Spleen Qi, not only is the digestive function compromised in deficient Spleen Qi, but the Spleen then may not be able to hold the Blood, and you can wind up with hemorrhage or bleeding, which are two examples of Blood stagnation.
The Liver stores the Blood. And when a person is active, the Blood flows to the muscles and tendons, which are governed by the Liver. And when you're lying down, it goes back to the Liver.
And there are two kinds of Blood. We look at it as there being Heart Blood, which is the blood that circulates. But the Liver Blood is blood that moistens, and moistens the eyes, providing good eyesight. It moistens the sinews, the muscles and the tendons, and so on, and that blood, the Liver Blood, provides for the flexibility of our joints.
Importantly, Liver Blood supplies the uterus with blood. And, together with the Chong Mai, or the Penetrating Vessel which the Liver Blood is closely related to, the Liver Blood empties into the uterus and provides for the nourishment of the uterus, in case the seed is implanted. In other words, that's the source of menstruation if that seed is not implanted correctly.
The Liver Blood winds up being very closely connected to a lot of gynecological problems. And when we talk about Liver Blood in this way, we have to understand that a part of the Righteous Qi in the Blood is going to be the hormones that regulate menses. And so, the liver blood winds up being very important when it comes to the menstrual cycle and pregnancy. Also keep in mind that when we talk about Kidneys, that the Kidneys store Jing, and this is the basis, or the origin of Blood. But the Kidneys are also the Mother of the Liver in Five-Element theory. So there is that aspect of it as well. And Jing is thought to be transformed directly into Blood, and Blood then also replenishes Jing, because Blood is the source of the Nutritive Qi, which is the postnatal Jing. So that's how Jing is maintained.
And then the Kidney Jing is also in control of the reproductive function, so that, in fact, the Kidney Jing literally creates the Liver Blood and controls the Liver Blood. So if you're wanting to nourish Blood in TCM, you have to pay attention to the Spleen function, because that's the mother, and you also have to pay attention to the function of the Kidneys. And as people age, the Kidney function drops down, and Blood problems can be a result of that.
