Basic Concepts I: Microcosms to Networks
Chinese medicine is based on particular modes of knowing (epistemology), beliefs about the nature of reality (metaphysics), theories about the nature of human behavior (physiology, psychology), as well as instrumental means of being helpful (methods of therapeutic intervention). Because the concepts of Chinese medicine differ from Western pathological categories of disease, familiarity with its unique vocabulary is a stepping-stone to the theoretical framework within which health and disease are understood.
Every human being is a world in miniature, a garden in which doctor and patient together strive to cultivate health.
The Human Body: A Microcosm of Nature
The human body is a microcosm, a universe in miniature. Just as Nature includes air, sea, and land, so the body is a matrix comprised of Qi, Moisture, Blood, Jing, and Shen. Life is characterized by a coherent, transformative dynamism known as Qi (pronounced chee). Qi is responsible for and manifest by movement, rhythm, and warmth. Everything that pulsates, wiggles, changes, cogitates and radiates is Qi. Blood (Xue) is more than red fluid – it is the material from which the body grows itself. While tissue arises from Blood, the distribution and transformation of substance are governed by Qi.
Together Qi and Blood maintain the body’s form and composition. Qi and blood in turn arise from Jing, translated as essence, the original primal substrate responsible for and manifested by growth, development, and maturation. Jing is the body’s reproductive and regenerative substance, while Shen is mind, responsible for perception, sensation, expression, and self-awareness. An integrated sense of identity that coheres in space and endures over time is conveyed by the concept of Shen-Jing, the inextricable unity of psyche and soma, mind and body. Together the three treasures known as Qi, Jing, and Shen maintain shape, function, and identity – the self-transforming, self-making, and self-actualizing human capacity.
Five Body Constituents
The five constituents – Jing, Blood, Moisture, Qi, Shen – exist on a continuum of greater and lesser density and materiality. Qi is unseen and insubstantial, Moisture (Jin Ye) (body fluid) is more dense than Qi but less dense than Blood, and Blood is more substantial still. Relative to each other, Qi is more dynamic, while Blood is more stable. Yet of greater density than Blood is Essence, from which Blood itself is formed; and Shen (mind), ephemeral and entirely lacking in substantiality, arises as personhood emerges from the body's life.
Unlike the mechanistic model, the Chinese medicine model does not divide the body into individual organs, but treats networks.
Concept of Qi
Qi is also an overarching concept – it is everything that exists and occurs. In the body, it is both a single constituent as well as the aggregate of all constituents. Scholar Nathan Sivin writes that in early manuscripts about nature, Qi meant basic stuff, simultaneously “what makes things happen in stuff” and “stuff that makes things happen.” Qi is often the material basis of activity, but the activity itself is often also described as Qi.
All substances and functions are part of a continuum called Yin-Yang. The dynamism known as Qi is the emanation of the unceasing interplay and co-generation of polar and complementary forces known as Yin-Yang. The light Qi of heaven rose upward to become heaven (Yang), and the heavy Qi bore down to become earth (Yin). Between heaven and earth, human beings appear as the fruit of this union. Yin-Yang represents dynamic balance, intrinsic relativity and the tension of duality: contraction–expansion, wet–dry, visible–invisible, internal–external, depleted–congested, dark–light, chronic–acute, weak–strong, empty–full, lower–upper, deep–superficial, quiescent–active, cold–hot, dense–porous, concentrated–dilute, inhibited–excited, slow-fast, hypoactive-hyperactive.
The constituents and functions of the body can be delineated along the Yin-Yang continuum: Essence, Blood, and Moisture (Yin) are relatively dense and tangible compared to Qi and Shen (Yang), which are relatively light and intangible. The storage of Blood and Moisture is Yin, while their circulation is Yang. The process of digestion and assimilation is Yang, while the acquisition of flesh and the deposition of fat is Yin. While catabolism is Yang, anabolism is Yin. Yin and Yang inextricably depend upon one another: where the mind leads, the Qi follows, where Qi goes, blood flows, and Blood is the mother of Qi.
Five Organ Networks
Five Organ Networks
The body is governed by five Organ Networks (Zang Fu) – the Heart, Kidney, Liver, Spleen, and Lung – whose function is to organize, regulate, store, and distribute the five constituents (Shen, Jing, Blood, Moisture, Qi). These Zang Fu assume primary responsibility for the tasks of the organism. Although these organs bear Western anatomical names, their meaning differs. In Chinese medicine these organs represent broad functional networks rather than strictly distinct physical structures. Each Organ Network governs visceral organs, associated structures, tissues, and functions, as well as the pathways of Qi, known as the acupuncture channels (Jing Luo). A blueprint of the relationship between these networks and the life processes of the organism is like a map charting the relationship between the oceans and the continents. Currents and landmasses meet and flow together, yet each occupies its own territory. Similarly, the body is seen as a structural and functional whole with mutually engendering patterns of interconnectedness.
For example, the Kidney stores the Jing (essence), while the Heart houses the Shen (mind). The Kidney includes but extends beyond the job of managing fluid metabolism – it governs the will, growth, development, reproduction and regeneration, the bones and marrow, the brain being considered the sea of marrow, the lumbar region, ears, and teeth. Problems such as retarded growth, ringing in the ears, infertility, low back pain, apathy or despair are viewed as dysfunctions of the Kidney Network. In addition to propelling the blood, the Heart sustains the higher functions of the central nervous system, including internal and external perception and communication. The Liver stores and governs the blood, tendons, and nerves, the volume, pressure, and evenness of circulating Qi and Blood, temperament and judgment. The Lung governs respiration, circulation, and distribution of Moisture and Qi, maintaining the skin and other defensive boundaries of the body. The Spleen assumes responsibility for digestion, assimilation, distribution of fluids, maintains stability, density, and viscosity of tissue and fluid, generates muscle and flesh, and holds the blood within the vessels.