Guangwen Xu

Abstract: Huang Di’s Inner Classic (also known as The Yellow Emperor’s Inner Canon) and other classic medical works included extensive theories on the regulation of physiological functions, activities, and movements of the human body This paper mainly summarizes and discusses the regulation of reproduction, body temperature, sleep, spirit mind, affect mind, respiration, digestion and absorption, blood circulation, qi transformation, body fluid metabolism, the qi dynamic, the five sensory organs, physical movement, and defense.

Key words: TCM theory; Living Human Body; Physiological Regulation.

In The Yellow Emperor’s Inner Canon (also known as Huang Di’s Inner Classic), the physiological activity of the living human body is regulated by dynamic balance. The physical energy and physiological functions of the living human body manifest in life activities and movements.

Physiological regulation of reproduction

Human growth and development includes the maturation of sexual function and the reproductive organs. Women menstruate, men ejaculate, and when men and women copulate (the union of yin and yang) this leads to pregnancy and birth. When the five viscera are debilitated, women enter menopause, while men no longer produce sperm, and they are no longer fertile. This whole process of human physiology is first seen in the first chapter of the Inner Canon, “Discourse on the True ［Qi Endowed by］ Heaven in High Antiquity”, which states:

“In a female, at the age of 7, the qi of the kidneys abounds. ［…］ With 2 times 7, the heaven gui ［heavenly tenth or tiangui］ arrives, the controlling vessel is passable and the great thoroughfare vessel abounds ［with qi］. The monthly affair moves down in due time and, hence, ［a woman］ may have children. ［…］ With 6 times 7, the 3 yang vessels weaken ［…］ With 7 times 7, the controlling vessel is depleted and the great thoroughfare vessel is weak and ［its contents are］ diminished. The heaven gui is exhausted. The way of the earth is impassable. Hence, the physical appearance is spoilt and ［a woman can］ no ［longer］ have children. In a male ［…］ With 2 times 8, the qi of the kidneys abounds; the heaven gui arrives and the essence qi flows away. Yin and yang find harmony. Hence, he can have children.… With 7 times 8, the qi in the liver weakens; the sinews can no longer move. The heaven gui is exhausted. The ［remaining］ essence is diminished. The kidney is weak. With eight times eight ［…］ ［at this age］ now the 5 viscera are all weak. ［…］ The heaven gui is used up entirely. ［…］ no ［longer］ has children.”^［1］

There is a particularly close relationship between reproductive physiological regulation and the heart, liver, kidneys, essence, life gate fire, the thoroughfare vessel (Chong Mai) and the conception vessel (Ren Mai), the liver meridian of foot reverting yin, the sinews, the uterus, and the testicles. This is described in the following excerpts:

1. The essence of the kidneys regulates reproduction:

The Inner Canon states: “The kidneys store essence”. “The 5 depots are responsible for storing the essence.”^［2］“The kidneys rule the water; they receive the essence from the viscera and 6 bowels and they store it.”^［1］“At the beginning of a person’s life, the essence is the first to form. Once the essence has formed, brain and marrow are generated.”^［2］“Now, the essence, it is the basis of the body.”^［1］“When two spirits strike at each other, their union results in the formation of a physical appearance. That which usually precedes the generation of a human body is called ‘essence’”^［2］ This explains that the kidneys store the essence of the 5 viscera; kidney essence is the foundation (substance and energy) that promotes growth and reproduction. Therefore, the kidney essence regulates reproduction.

2. The channel vessels regulate reproduction

The Inner Canon says:

a.“The’uterine vessel’ is connected with the heart and forms a network inside the uterus.”^［1］

b. “The network［vessel］ of the uterus is tied to the kidneys.”^［1］

c. “The liver governs the tendons.” ^［1］

d. “The liver and the sinews constitute one unit. The sinews meet in the yin organ ［penis］.” ^［2］

e. “The ceasing yin ［qi］ conduits of the liver ［…］ enter the ［pubic］ hair. They pass the yin organ ［genitals］. ［…］ A branch ［…］ ascends into the testicles and links up with the penis.” ^［2］

f. “The ceasing yin vessels move along the yin organ ［genitals］ and enclose the liver.“^［1］

g. “The front yin ［pudendum］ is where the basic sinews come together.”^［1］

h. “The sinew of the foot major yin ［conduit］. ［…］ Its straight course wraps. … Meets with the yin organ.”^［2］

i. “The sinew of the foot ceasing yin connects with the yin organ.” ^［1］

j. “Both the Chong Mai ［thoroughfare vessel］ and the Ren Mai ［controlling vessel］ start from the ［uterus］ bladder. … They constitute a sea that supplies the channels and network ［vessels］.” “［They emerge］ out of the pudendum.”^［2］

k. “The thoroughfare vessel is the sea of the 5 viscera and bowels. All the 5 viscera and 6 bowels receive their supplies from there.” ^［2］

l. “The controlling vessel emerges from the ［uterus］ bladder, comes out of the pudendum below, and pass the mons pubis.” ^［2］

The channel vessels and channel sinews are internally ascribed to the heart, liver, and kidneys; they connect to the uterus and the genital area in women, and to the testicles and penis in men. The thoroughfare and controlling vessels start at the uterus, and are nourished and regulated by essence and blood from the 5 viscera. Therefore, the channel vessels regulate reproductive physiology.

3. Regulatory role of the life gate fire

The life gate fire regulates sexual desire and promotes fertility; it is the root and foundation of life. The regulation and arousal of sexual desire depends on the energy of the life gate fire. It is the driving force that promotes healthy conception, growth, and development.

4. The heart and liver regulate sexual desire

Chapter 44 of Elementary Questions, entitled “Discourse on Limpness”, states: “When pondering is without limits, when one does not get what one had longed for, when ［lewd］ sentiments flow unrestrained to the outside and when one enters the ［women’s］ chambers excessively, ［then］ the basic sinew slackens. This develops into sinew limpness. It also causes white overflow. Hence, the Lower Classic states: “sinew wilting is generated by the liver sending inwards.”^［1］ Because “the heart stores the mind”, the heart spirit controls thinking and mental activity. If one indulges in delusions, thereby damaging essence and blood, the heart will be deprived of nourishment, which then leads to impotence, and affects sexual desire and fertility. This explains how the liver and heart regulate sexual desire and reproduction.

According to passages from the Inner Canon regarding the reproductive physiology of men and women, the physiological regulatory axis of female menstruation, reproduction, and sexual desire is composed of: the 5 viscera—kidneys—tiangui—the controlling vessel, the great thoroughfare vessel and the reverting yin liver channel—the ovaries and uterus (internal genitalia) and the external yin organ (external genitalia).

The physiological regulatory axis of male sexual desire and reproduction is composed of: the 5 viscera—kidneys—tiangui—the reverting yin liver channel, the controlling vessel and the great thoroughfare vessel—the testicles and the penis.

Temperature regulation

The body’s normal dynamic temperature is collectively controlled by mutual action, transformation, engendering, and regulation among yin and yang, construction and defense qi, original qi, qi and blood, and fluids.

1.The warming function of qi

“Qi warms the body”. This refers to the fact that qi transformation engenders heat, thereby warming the body. In particular, original qi is the driving force for the body’s heat energy. Qi has a warming and promoting effect on the physiological activities of the viscera and bowels, the channels and network vessels, the interstices, and the triple burner, as well as the movement and distribution of blood and fluids.

2. Yin and yang regulate body temperature

The Inner Canon says: “When the yang dominates, then there is heat; when the yin dominates, then there is cold.” ^［1］ “When the yang is depleted, then the outside is cold, when the yin is depleted, then the inside is hot. When the yang abounds, then the outside is hot, when the yin abounds, then the inside is cold.” ^［2］ “In the case of yang ［qi］ domination, heat results. In the case of yin ［qi］ domination, cold results.” ^［1］ The relative exuberance or vacuity of yin and yang can cause changes between heat and cold. Thus, yin and yang can regulate body temperature.

3. Defense qi regulates body temperature

The Inner Canon says: “The defense qi serve to warm the partings of the flesh. They fill the skin, fatten the skin structures, and are responsible for their opening and closing,” ^［2］ “The upper burner releases qi (defense qi). It isto them to supply the partings of the flesh with warmth, and to nourish the bones and the joints, as well as to penetrate the interstices.” ^［2］ This indicates that the defense qi helps to warm, moisten, and aid in nourishing the skin and muscles. It can also adjust the interstices and regulates body temperature by opening or closing the pores.

4. Lung qi diffusion regulates body temperature:

“The lung governs qi” and “the lung governs the skin and ［body］ hair”. ^［1］ Ye Tianshi’s text On Warm Heat says: “The ［fact that the］ lung governs qi pertains to defense ［qi］, ［while the fact that］ the heart governs blood pertains to construction ［qi］.” Lung qi diffuses and transports defense qi and fluids to warm and moisten the muscles, skin, and body hair. The lung regulates the defense qi, controlling the opening and closing of the pores to regulate the appropriate excretion of sweat and thereby adjust body temperature. At the same time, the lung controls respiration; the clear qi inhaled by the lung, along with the essence of grain and water absorbed by the spleen and stomach, transforms and engenders defense qi. The lung exhales turbid qi and hot qi to regulate body temperature.

5. The function of the pores, interstices, and triple burner to regulate body temperature

The interstices connect to the triple burner; the interstices and triple burner are the site of qi transformation and the passageway for fluids, defense qi, and original qi^［3］. The interstices and triple burner regulate the movement of fluids and defense qi, with fluids coming out of the sweat pores in the form of sweat. Thus, the defense qi of the interstices adjusts the opening and closing of sweat pores and the excretion of sweat, functioning to regulate body temperature.

6. The sweat can regulate body temperature

The Inner Canon says:“That which is released to flow out of the skin structures, when sweat leaves profusely, that is what is called’ jin liquid’” ^［2］ “The fluids are transformed by the 5 viscera. The heart generates sweat.” ^［2］ Therefore, in later times, it was said that “The sweat is regarded as the fluid of the heart”. The sweat is transformed from body fluids; “when yang is added to yin, this is called ‘sweat’.” ^［1］ “When one is hot, then the interstice structures open and the construction［qi］ and defense［qi］ pass through. Sweat flows out profusely. Hence, qi flows out.” ^［1］ “When one was frightened and has lost essence, the ［resulting］ sweat originates from the heart. When one bears a heavy load and walks over a long distance, the ［resulting］ sweat originates from the kidneys. When one runs fast and is in fear, the ［resulting sweat originates from the liver. When one agitates the body and works hard, the ［resulting］ sweat originates from the spleen.”^［1］

The above description explains how sweat can regulate body temperature. Sweating is mostly due to yang and heat causing the interstices and sweat pores to open; body fluids leak out and expel hot qi, which can reduce the body temperature. As for the opening and closing of the interstices and sweat pores, the regulation of sweat is closely linked to the 5 viscera, as well as the overall regulatory function of yin and yang, construction and defense, original qi, qi and blood, and fluids. Normal body temperature can only be guaranteed when yin and yang are balanced, construction and defense are harmonized, original qi is sufficient, fluids and blood are abundant, the 5 viscera are harmonized, the interstices are regulated, and the sweat pores open and close appropriately.

Physiological regulation of sleep

The physiological regulation of normal sleep requires the normal regulatory functions of the 5 viscera, as well as abundance and harmony of construction, defense, qi, blood, essence and marrow. When the brain, heart, and spirit are effulgent, and yin and yang are in balance, there will be normal sleep.

1. Yin and yang regulate sleep

The Inner Canon says:“When the yang qi are exhausted, while the yin qi abound, vision is dimmed ［i.e. one falls asleep］. When the yin qi are exhausted, while the yang qi abound, one wakes up.”^［2］This simply and clearly describes the important function of the waxing and waning of the human body’s yin and yang in the regulation of sleep.

2. Construction and defense regulate sleep

The Inner Canon states: “The defense ［qi］ move through the yang ［conduits］ during daytime. At midnight they move into the yin ［conduits］. The yin ［qi］ dominate during the night. During the night, ［the people］ are asleep.” ^［2］The Classified Canon says: “All people go to bed or get up due to the defense qi. The defense qi move through the yang during the daytime, so their activity makes ［one］ awake; they move through the yin at night, so their calm makes ［one］ go to sleep.” ^［2］“The defense qi must not enter the yin and generally stay in the yang. When they stay in the yang, the yang qi are full, and when the yang qi are full, the yang springing ［vessel］ is exuberant. They must not enter the yin, or else ［there will be］ yin qi vacuity ［and］ thus the eyes will not sleep.” ^［2］ “Now, the defense qi, during daytime they always pass the through the yang realm; during night they pass through the yin realm. The fact is: When the yang qi are exhausted, then one falls asleep. When the yin qi are exhausted, then one is awake.” ^［2］

“The defense qi ［…］ in daytime move through the yang, ［and］ in nighttime move through the yin, ［…］ when they move through the yang, the yang qi are full, and when the yang qi are full, the yang springing ［vessel］ is exuberant. They must not enter the yin; ［if there is］ yin vacuity, then the eyes will not sleep.”［2］ “The movement of their construction and defense ［qi］ never loses its regularity. Hence they are of a clear ［mind］ during daytime, and they close their eyes at night.” ^［2］

3. The liver regulates sleep

The liver governs free coursing and regulates emotions; if one is in a good mood, then one will have high quality sleep. The liver yin and liver blood nourish and moisten the liver yang, thereby preventing the liver yang from rising excessively to disturb the heart spirit and affect sleep. People’s sleeping and waking habits regulate the liver blood: the Inner Canon states that “the liver stores blood,” which Wang Bing explains as: “The liver stores the blood and the heart moves ［the blood］. When the body moves, blood circulates in the channels; when at rest, it flows back to the liver.” Thus, when one sleeps, the blood returns to the liver for storage, and when one wakes, the blood moves in the channels. When one sleeps, the liver blood is abundant and liver blood can transform into kidney essence. When blood and essence are sufficient, the heart spirit will be nourished, ensuring tranquil sleep and exuberant energy upon waking.

4. The heart spirit regulates sleep

The heart plays a key role in sleep regulation. The Inner Canon says: “The heart stores the spirit” and “the heart holds the office of monarch, from which the spirit light emanates”.［2］ If the heart spirit is calm, then one can sleep easily; when the heart spirit becomes active, one starts to wake up. Heart blood and heart yin are the material support for the heart spirit. When heart qi and blood are sufficient and their movements are smooth, the heart spirit is nourished. The heart yin restrains the heart yang so the heart spirit can be calm. When the spirit is calm, it is easy to fall asleep.

5.T he heart and kidneys regulate sleep

(1) When the heart fire and kidney water help each other, they enable interaction between the heart and the kidneys; thus the heart spirit will be calm and when one lies down at night, it will be easy to fall asleep. During the daytime, the heart spirit is active, so one will wake up.

(2) When the heart and kidney yin and yang are harmonized, at night the heart yang will enter the kidney yin and one will lie down to sleep.

(3) The kidney essence engenders marrow to fill the brain, and essence and marrow nourish the brain. When the brain is fortified, the spirit will be calm, and when the spirit is calm, it is easy to fall asleep when one lies down at night.

The 5 viscera regulate the spirit mind

The Inner Canon says: “The 5 viscera, they serve to store the essence spirit, as well as the ethereal and corporeal souls.” ^［2］“The heart stores the spirit. The lung stores the corporeal soul. The liver stores the ethereal soul. The spleen stores reflection ［or the intellect］. The kidneys store the will.” ^［1］ “When the qi can ascend and descend, the 5 viscera are calm and stable, the blood vessels are harmonized and uninhibited, and the essence and spirit are sedentary.” ^［2］ This shows how the 5 viscera store the spirit in order to regulate the spiritmind. There is a close relationship between the activities of the spiritmind and the 5 viscera, primarily the heart and kidneys. This is because the heart stores the spirit and the kidneys store the will.

1. The production of spiritmind activity is rooted in the kidneys

The Inner Canon states: “The mind serves to reign over the essence spirit. It controls the ethereal and corporeal souls.” ^［2］ Wang Bing commented on chapter 62 of Elementary Questions, entitled “Discourse on Regulating the Channels”, saying: “The mind generally refers to the 5 spirits ［of the 5 viscera］.” “At the beginning of a person’s life, the essence is the first to form. Once the essence has formed, brain and marrow are generated.” ^［2］ The marrow of the brain is produced from the earlier heaven (or prenatal) essence of one’s parents. The brain is the hub of the spirit light, which is the central regulator of spiritmind activities. The essence of grain and water absorbed by the spleen and stomach transform into later heaven (or postnatal) essence, which is stored in the kidneys. “The kidneys store the essence. The essence hosts the will.” The will is a highlevel overview of the activities of the spiritmind; it is a concentrated expression of mental activity, possessing the function of regulating and controlling various mental and psychological activities.^［4］ Because “the kidneys generate the bones and the marrow,” spinal marrow is connected to the brain, “the brain is called the sea of marrow,” ^［1］ and “the marrow is ruled by the brain,” the kidneys are connected to the brain. The kidney essence generates marrow, which connects to the brain. The brain consists of essence, marrow, and spirit light, while the kidneys govern the will. The spirit and will are unified as one, so the brain and kidneys regulate the mind. When essence is sufficient and marrow is abundant, the spirit will be effulgent.

2. The heart governs spiritmind activity

The Inner Canon says: “The heart stores the spirit” and “the heart holds the office of monarch, from which the spirit light emanates”. ^［2］ “That which controls things is called the heart.” ^［2］ This shows that the heart spirit governs and coordinates the viscera and bowel functions of the whole body, as well as people’s spiritmind activities. It enables people to make correct judgments about and responses to things in the external environment, and sets off a series of “spirit” activities to adapt to those things.

3. The liver governs free coursing and regulates the spirit mind

The Inner Canon says: “The liver stores the ethereal soul.” “That which comes and goes following the spirit, that is called the ethereal soul.” ^［2］ “The liver stores the blood. The blood hosts the ethereal soul.” ^［2］ “The liver holds the office of general; it is responsible for making strategies.” The heart spirit primarily regulates the mind and emotions through the liver’s adjustment of the qi dynamic. The heart controls the spirit mind and the liver governs free coursing, so they mutually reinforce each other to regulate the spirit mind. They coordinate people’s spirit mind activities, enabling the normal function of the spirit mind.

The regulation of respiratory movement

According to the Inner Canon, the lung governs qi and is in charge of respiration. The lung is the main organ involved in respiratory movement, and is the place where air is exchanged in and out of the body. The kidneys and the ancestral qi are also important for respiratory regulation.

1. The lung controls respiration

The Inner Canon states: “The lung governs qi.” “All qi is tied to the lung.” ^［1］ ”The lung is the basis of the qi.“^［1］ ”The qi of heaven communicate with the lung. ^［1］

2. The ancestral qi is responsible for exhalation and inhalation

The Inner Canon says: “The ancestral qi collect in the chest, they leave ［the chest］ through the windpipe. They penetrate the heart vessels, and they are responsible for exhalation and inhalation.” ^［2］ “In the case of a mutual beating of massive qi and their failure to move on, accumulations in the chest result. The ［place where they accumulate］ is called the ‘s ea of qi.’ ［The qi］ emitted by the lung, they follow the throat. The fact is: When one exhales, then they are emitted. When one inhales, then they enter.” ^［2］

3. The lung and kidneys regulate respiration

According to Jing Yue’s Complete Compendium:“The lung exhales qi and the kidneys absorb qi; therefore, the lung is the master of qi and the kidneys are the root of qi.” The Inner Canon says: “The minor yin ［vessels］ are associated with the kidneys. Upward, the kidneys are linked with the lung. Hence ［the minor yin vessels］ control 2 viscera ［lung and kidneys］.” ^［2］ This shows that the lung is connected to the kidneys and both regulate respiration.

4. The 5 viscera regulate respiration

The kidneys govern qi absorption; the clear qi inhaled by the lung depends on the kidneys’ containment and absorption to prevent shallow respiration. “The lung acts as the controller of qi and the kidneys are the root of qi. The lung governs respiration and the kidneys govern qi absorption. ［When］ yin and yang interact, respiration is harmonious.”(Systematized Patterns with Clear Cut Treatments). The liver governs free coursing and regulates the qi dynamic. The liver qi upbears on the left, while the lung qi downbears on the right. When there is appropriate upbearing and downbearing, the qi dynamic moves smoothly and respiration is unhindered. The spleen upbears the essence and qi of water and grain that is moved and transformed by the stomach and spleen; when this meets with the qi from the lung’s respiration, it engenders ancestral qi. Ancestral qi moves through the respiratory tract to drive respiration; it penetrates the heart vessel to move qi and blood. “The heart governs blood”, providing blood to nourish the lung in order to aid in respiration. Therefore, the 5 viscera and ancestral qi collectively regulate respiratory movement.

The 5 viscera regulate digestion and absorption

The Inner Canon states:a. “The regular qi of a normal person is supplied by the stomach. The stomach ［qi］ is the regular qi of the normal person. ［…］ Man requires water and grain as his basis.” ^［1］

b. “The 5 viscera are supplied with qi by the stomach. ［Hence］ the stomach is the basis of the 5 viscera.” ^［1］

c. “That from which man receives his qi, that is the grain. Where the grain flows, that is the stomach. The stomach is the sea where water and grain, the qi and blood gather. ［…］ The qi and the blood leaving the stomach, they follow the channels. These channels constitute the big network ［vessels］ linking the 5 viscera and 6 bowels.” ^［2］

d. “The qi of food enters the stomach. ［The stomach］ spreads essence to the liver. ［…］ The qi of food enters the stomach. The turbid qi returns to the heart. ［…］ Beverages enter the stomach. Overflowing essence qi is transported upward to the spleen. The spleen qi spreads the essence.” ^［1］

e. “The spleen and the stomach are the officials responsible for grain storage. The 5 flavors originate from them. The large intestine is the official functioning as transmitter along the Way. Changes and transformations originate in it. The small intestine is the official functioning as recipient of what has been perfected. The transformation of things originates in it.” ^［1］

f. “The spleen and the stomach, the large intestine, the small intestine, the triple burner, and the urinary bladder are the basis of grain storage. They are the location of the construction ［qi］. They are named containers. They are able to transform the dregs. They are ［the places］ where the substances are turned and enter and leave.” ^［1］

g. “Man receives his qi from the grain. The grain enters the stomach, and from there ［its qi］ are transmitted to the lung. This is how all the 5 viscera and 6 bowels receive qi.” ^［2］

h. “The center burner is like foam.”

i. “The ［qi of the］ center burner also merge with the center of the stomach. ［…］ The qi received there are discharged as dregs, steamed as body fluids, and transformed to refined essence. ［The latter］ pours upward into the lung vessel where it is transformed to blood, which in turn is supplied to the entire body.” ^［2］

j. “The fact is: Water and grain are regularly present together in the stomach. There they are transformed to dregs and together they descend into the large intestine. Where they constitute the lower burner, where its liquids seep in, a separate juice is secreted along the lower burner and seeps into the urinary bladder.” ^［2］

“The lower burner discharges into the curved intestine and pours into the urinary bladder, where its liquids seep in.” ^［1］

k. “The 5 flavors enter through the mouth and are stored in the intestines and in the stomach. When the flavors have a place where they are stored, this serves to nourish the 5 qi. When the qi are generated in harmony and when the body liquids complete each other, then the spirit will be alive by itself.” ^［1］

The Inner Canon provides a clear understanding of the physiological process of digestion and absorption. The center burner includes the spleen, stomach, liver, gallbladder, large intestine, and small intestine. The spleen and stomach govern digesting and absorbing the essence of water and grain, and transform them into qi, blood, and body fluids, transmitting them up to the heart and the lung. At the same time, the stomach qi descends, and the small and large intestines separate the clear from the turbid by conveying food dregs to the anus to be excreted from the body and letting turbid water seep down to the kidneys and bladder.

Regulation of blood circulation

Over 2000 years ago, the Inner Canon already included a definite understanding of blood circulation. The text states: “The qi of food enters the stomach. ［The stomach］ spreads essence to the liver. ［…］ The turbid qi turns to the heart. Excessive essence ［flows］ into the vessels. The qi in the vessels flows through the conduits. The qi in the conduits turns to the lung. The lung invites the 100 vessels to have an audience with it. They transport essence to the skin and the body hair. The hair vessels unite the essence and they move qi to the palaces. The essence of the palaces and the spirit brilliance remain in the 4 viscera.”^［1］

The text notes that the spleen and stomach move, transform, and absorb the essence of water and grain, which is transformed to engender qi and blood. This qi and blood then move through the liver into the heart. Blood flows through the channels and vessels, and returns to the lung, as the lung invites the 100 vessels to have an audience with it. The lung qi assists the heart to promote blood circulation, so that the blood, essence, and qi are transported to all the channels, the skin, and the body hair, as well as to the viscera and bowels. It then flows back to the heart and lung by means of the blood vessels, viscera, and bowels. Blood returns to and leaves the heart in an endless cycle. Blood circulation mainly relies on the heart, but the lung, spleen, liver, and kidneys are very important to help with its regulation.

The heart governs blood; the Inner Canon says: “All blood is tied to the Heart.” “The Heart governs the blood vessels.” ^［1］ “The Heart stores the qi of the blood and the vessels.” ^［1］ Thus, the heart qi drives blood circulation throughout the whole body. “The Liver stores blood”. Wang Bing commented: “The liver stores the blood and the heart circulates ［the blood］. When the body moves, blood circulates in the channels; when at rest, it flows back to the liver.” So the liver regulates the amount of blood in the whole body to help the heart regulate blood circulation.

“The spleen controls blood”; this refers to the fact that the spleen controls blood circulation inside the vessels and prevents it from flowing out of the vessels. Therefore, “the blood of the 5 viscera and 6 bowels, they all rely on the spleen qi,s control and containment.” (From Shen Mingzong’s commentary on Essential Prescriptions of the Golden Coffer)

“The camp ［qi］ are in the vessels. The guard ［qi］ are outside the vessels.” “In the blood vessels the camp and guard ［qi］ flow without cease.” ^［2］ Qi and blood regulate each other and circulate throughout the body.

Therefore, normal blood circulation is primarily related to the heart, the lung, the spleen, and the liver. The heart qi is the fundamental motive power that propels blood circulation. The lung is in charge of the qi of the whole body, as the lung faces the hundred vessels and the ancestral qi enters the vessels of the heart to promote the movement of qi and blood. The spleen controls and contains the blood of the whole body, thereby keeping the blood circulating normally within the vessels and preventing it from extravasation. The liver stores blood and regulates the volume of blood in the body. The kidneys store essence, which can transform into blood. At the same time, the essence engenders marrow, which can transform into blood, ensuring an abundance of blood and normal circulation. The channels and network vessels move and regulate qi and blood. These collectively coordinated functions ensure normal qi and blood circulation.

Circulation and regulation of body fluids and waterways

Regarding the formation, distribution, and excretion of body fluids, chapter 21 of Elementary Questions, entitled “Further Discourse on the Conduit Vessels”, gives the following overview: “Beverages enter the stomach. Overflowing essence qi is transported upward to the spleen. The spleen qi spreads the essence, which turns upward to the lung. ［The latter］ frees and regulates the paths of the water, it transports ［the water］ downward to the urinary bladder. The essence of water is spread to the 4 ［cardinal points］, it moves through all the 5 conduits simultaneously.” ^［1］

“The triple burner is the official functioning as opener of channels. The paths of water originate in it.”^［1］ “The lower burner discharges into the curved intestine and pours into the urinary bladder, where its liquids seep in. The fact is: Water and grain are regularly present together in the stomach. There they are transformed to dregs and together they descend into the large intestine. Where they constitute the lower burner, where its liquids deep in, separate juice is secreted along the lower burner and seeps into the urinary bladder.” ^［2］

These passages from the Inner Canon describe how:

1. Body fluid is formed from the essence of water and grain that is moved and transformed by the spleen and stomach, separated into the clear and the turbid by the small intestine, and spread as essence by the spleen qi. 2. The distribution and excretion of turbid body fluid are accomplished by the joint action of the 5 viscera, 6 bowels, interstices, and triple burner, including the moving, transforming, upbearing, and downbearing functions of the spleen, the diffusing and depurative downbearing functions of the lung, and the functions of the kidneys to regulate the waterways, as well as the kidney yang’s function of steaming effusion that upbears the clear and downbears the turbid. 3. The interstices and triple burner are the passageways for the distribution and excretion of body fluid, so that “the essence of water is spread to the 4 ［cardinal points］, it moves through all the 5 conduits simultaneously.” The fluids are distributed throughout the body to enrich, moisten, and nourish the viscera, bowels, sinews, bones, muscles, skin, and body hair. They also engender and transform into qi and blood, and regulate yin and yang.

Channels and network vessels regulate the movement of body fluids: “The foot major yang ［conduits］, externally they link up with the clear waters of the Qing ［river］; internally they are tied to the urinary bladder.” ^［2］ “The hand major yang ［conduits］, externally they link up with the water of the Huai ［river］; internally they are tied to the small intestine, and the paths of water originate in it.” ^［2］ Thus, the channels and network vessels circulate and regulate body fluid distribution.

About the Author:

Xu Guang wen was born into a family of TCM practitioners ,graduated from ShanHai University of TCM in China ,and holds a Master’s degree. Xu is a chief of hief TCM, ph.and British registered practitioner of Chinese medicine.