中医基础理论 之 精气血津液 授课者：梅志刚 Basic Theory of Traditional Chinese Medicine:

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2 中医基础理论 之 精气血津液 授课者：梅志刚 Basic Theory of Traditional Chinese Medicine:
Essence, Qi, blood and body fluid 授课者：梅志刚

3 【教学目的与要求】 掌握精的基本概念、分类、代谢及功能。 掌握气的基本概念、生成、运行、功能及其分类。 掌握血的基本概念、生成、运行和功能。
掌握津液的基本概念、代谢和功能。 掌握神的基本概念、生成和作用。 了解精气血津液神之间的关系。

4 精（essence）的概念 天地之精 人体之精气 精是人体生命的本原； 精是由禀受于父母的生命物质与后天水谷精微相融合而形成的一种精华物质；
取象比类 精是人体生命的本原； 精是由禀受于父母的生命物质与后天水谷精微相融合而形成的一种精华物质； 精是构成人体和维持人体生命活动的最基本物质。 狭义之精：藏于肾的、具有繁衍后代作用的精微物质，即肾精 广义之精：人体之内的血、津液、髓以及水谷精微等一切精微物质。 （精的生成禀受于父母，充实于水谷）

5 （一）精的生成（generation of essence）
人体之精的代谢 metabolism of essence （一）精的生成（generation of essence） 先天之精（congenital essence） ——禀受于父母，是构成生命的原始物质。 “以母为基，以父为楯”， “两神相搏，合而成形，常先身生，是谓精” 后天之精（acquired essence） ——来源于水谷，是人出生后赖以维持生命 活动的精微物质。（“脾主为胃行其津液者也” ） 来源

6 （二）精的贮藏 (storage of essence)
剩余部分藏于肾，补先天 先天之精藏于肾 部分分藏于他脏腑 后天之精经脾气转输至各脏腑，化为脏腑之精—→供给脏腑生理活动之需 （三）精的施泄 (excretion of essence) 分藏于各个脏腑之中，濡养脏腑，并化气以推动和调控各脏腑的机能。 形式 化为生殖之精而有度地排泄以繁衍生命。

7 《内经》对人类生命发展过程的论述 男了以八岁为一个生理阶段 丈夫八岁，肾气实，发长齿更 二八肾气盛，天癸至而精气溢泻，阴阳和，故能有子
三八肾气平均，筋骨强劲，故真牙生而长极 四八筋骨隆盛，肌肉满壮 五八肾气衰 ，发堕齿槁 六八阳气衰于上，面焦发始白 七八肝气衰，筋不能动 八八天癸竭，精少，形体皆极，则齿发去

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9 人体之精代谢示意图 生殖 之精 繁衍 生命 先天 之精 精 脏腑 之精 濡养 脏腑 后天 之精 化气 化血 化神 生成 贮藏 施泄

10 人体之精的功能 function of essence
一、繁衍生命 Breeding life 二、濡养 Nourishment

11 Haematogenous function
人体之精的功能 function of essence 三、化血 Haematogenous function 四、化气 Turn into Qi 五、化神 Maintain spirit

12 classification of essence
人体之精的分类 classification of essence 来源： 先天之精与后天之精 (congenital and acquired essence) 部位： 脏腑之精 (essence in viscera and organ) 特殊功能：生殖之精 (essence for procreation)

13 气、血、津液是构成人体和维持人体生命活动的基本物质。是脏腑、经络等组织器官功能活动的产物，又是脏腑功能活动的物质基础。
In TCM books, qi is always mentioned in the same breath with blood and body fluid, for they are all the fundamental substances constituting the human body and maintaining its life activities. However, among them qi is particularly important for the human body. That is why TCM often explains the life activities of the human body in the viewpoint of qi. For this reason, Zhang Jingyue said: “Man‘s life relies entirely upon this qi.” Classic on Medical Problems(难经) states:“qi is the root of the human body; once the root is damaged, the stem and leaves would turn withered” 气者，人之根本也；根绝则茎叶枯矣. And, also, Basic Questions（素问） points out : “One’s life is the combination of qi of heaven and earth”（天地合气，命之曰人）

14 Qi is the root of the world
气是构成世界的本原 Qi is the root of the world 《庄子·知北游》：“人之生也，气之聚也，聚则为生，散则为死……通天下一气耳。” 《论衡》：“万物之生，皆禀元气。” 《素问·保命全形论》：“天地合气，命之曰人。”王冰注：“气者，生之母也。” 精与气的关系 精为脏腑功能活动的物质基础(substance)，气是推动和调控脏腑生理活动的动力（power & impetus） “人始生，先成精” “精化为气”

15 气的概念 Concept of Qi 气是一种具有很强活力的、在人体内不断运动着的、构成人体和维持人体生命活动的最基本物质。
气是人体生命的原动力，它代表脏腑组织的生理功能，如心气、经气。 The classic chinese philosophy believes that the primary state of the universe is qi,the constant movement of which produces all the things in the univese,including life.thus people in ancient china thoutht that the accumulation of qi would produce life while the dispersion of qi would put an end to life. Qi is very active and in constant motion.qi is also extremely fine and invisible.

16 气的生成 黄芪养颜汤： 人参10g， 黄芪15g， 松子仁20g， 黑芝麻50g， 花生100g， 糙米300g， 白糖适量

17 肾为生气之根 先天 之精 元气 一身 之气 后天 之精 谷 气 宗气 自然界 清气 脾为生气之源 肺为生气之主

18 The production of Qi Qi exists right after the formation of individual life. This kind of qi is inherited from kidney-qi of the parents during pregnancy. So it is called “congenital qi”which is the foundation of the development of new life After birth ,the human body keeps absorbing nutrients from the external world to nourish the congenital qi. This is the acquired source of qi,also known as “acquired qi”. Acquired qi originates from food nutrients and fresh air inhaled into the body. In fact, the congenital qi and acquired qi are just two material sources of qi. The process of qi production also involves the other viscera. The inter-transformation among essence,qi,blood and body fluid influences the production of qi.

19 人体之气的运动与气化 1.气机的含义：气的运动称为气机 2.气运动的 基本形式 主升：肝脾 主降：肺胃 升：自下而上的运动
降：自上而下的运动 出：自内而外的运动 入：自外向内的运动 2.气运动的 基本形式 气机调畅 主升：肝脾 主降：肺胃 肝阳上亢、泄泻、内脏下垂或 咳嗽、呕吐 气的运动畅通无阻 气的升降出入协调平衡

20 脏腑之气的运动规律 在上者降，在下者升，阴阳二气交感。 心 肺 脾 胃 脾胃为气机升降的枢纽 肝 肾

21 Basic patterns of Qi's movement
Qi flows throughout the whole body because of its strength and vigor. The movement of Qi is called Mechanism of Qi, which can be generalized as four aspects: ascending, descending, entering and exiting movements, which are based on directions. Ascending refers to the upward movement of Qi from a lower area; descending means the downward flow of Qi from an upper area. Exiting means the outward movement of Qi, and entry indicates the inward movement of Qi. Although the activities of the human body are multiple, they can all be summarized as these four aspects. For example, the dispersing effect of the Lung is a manifestation of the exit and ascent of Qi, while its descending effect is a manifestation of the descending and entering movements of Qi. The ascent, descent, exit and entry movements of Qi are of prime importance in human life. The Kidney Essence, the food Essence transported and transformed by the Spleen and Stomach and the fresh air inhaled by the Lung, will not be distributed over the body to perform their physiological functions if they do not make ascent, descent, entry and exit movements.

22 气运动的意义 “出入废则神机化灭，升降息则气立孤危。故非出入，则无以生长壮老已，非升降则无以生长化收藏。是以升降出入，无器不有！

23 脏腑之气运动规律

24 气 化 含义：是气的运动而产生的各种变化，是指由人体之气的运动而引起的精气血津液等物质与能量的新陈代谢过程，是生命最基本的特征之一。
形式：精的生成、精化为气、精化为髓、精血同源互化、津液与血同源互化血的化生与其化气生神、津液的化生与其化汗化尿、气的生成与代谢等 体内精气血津液各自的代谢及相互转化是气化的基本形式！

25 Qi-transformation Qi-transformation means changes caused by the movement of qi, which is the essential cause of the conception,development,growth and decline of life. Life activities concerned with qi-transformation can be divided into three categories. Firstly,through food and respiration the body absorbs nutrients from the external world and transforms them into essence,qi,blood and body fluid essential to the body. Secondly,inter-promotion among the refined substances is the process of automatic regulation,improvement and balance of life. Thirdly,waste substance and turbid qi are excreted out of the body in the process of life. If qi-transformation is weakened,the whole process of life will be in disorder or decline,leading to various diseases. The declination of qi-transformation even leads to death.

26 人体之气的功能(一)

27 人体之气的功能(一)

28 人体之气的功能（二）

29 人体之气的功能（三、四）

30 人体之气的功能（五）

31 Functions of Qi 1. Promoting function of qi Just as wind (highly active air) provides energy to push the sails of a boat or turn the turbine of a windmill, qi provides the active, vital energy necessary for the growth and development of the human body and to perform the physiological functions of the organs, meridians and tissues. In addition, qi promotes the formation and circulation of blood and supports the metabolism of body fluid. If there is a deficiency of qi, its promoting functions are weakened. As a result, growth and development can be affected or delayed, the organs and meridians cannot function properly and blood formation is hampered, leading to a series of health problems

32 Functions of Qi 2. Warming function In a gaseous state, air contains more kinetic heat energy than in its liquid state. Like air, qi also contains heat energy for the body. Being a heat source, qi warms the body and keeps it at a constant temperature so normal physiological functions can take place. Deficiency of qi can lead to a lowered body temperature, intolerance of cold and cold hands and feet. 3. Defending function In TCM, one of the main causes of disease is the invasion of "Evils"."Evils" are environmental factors that lead to illness. They are classified as wind, summer heat, dampness, dryness, cold and fire. By resisting the entry of ' illness evils" into the body, qi defends against their attack and maintains healthy physiological functions. In western terms, this qi defending function acts like the immune system.

33 Functions of Qi 4. Consolidation and retention function Qi consolidates and retains the body's substances and organs by holding everything in its proper place. First, qi keeps the blood flowing within the vessels and prevents it leaking out into the tissues. Secondly, qi controls and adjusts the secretion and excretion of sweat, urine and saliva, and keeps body fluids from escaping the body. Thirdly, qi consolidates and stores sperm to prevent premature ejaculation. Lastly, qi consolidates the organs and stops them from descending into a position where they cannot function properly. If qi is deficient, the consolidating function is weakened, leading to various kinds of health problems such as haemorrhage; frequent urination, premature ejaculation and stomach or kidney prolapses (where the organ sinks). The promoting and consolidating functions work in a complementary manner. For example, qi promotes blood circulation and the distribution of body fluids, but it also controls and adjusts the secretion of fluid substances. The balance between these two functions is essential for maintaining a healthy blood circulation and water metabolism.

34 Functions of Qi 5. Transforming functions
Qi also possesses vaporization or transformation functions, which are important for the metabolism of fundamental substances. As suggested by these words, qi may "vaporize" substances in the body and transform them into essence or vital energy. For example, certain actions of qi allow food to be changed into food essence, which is in turn transformed into different types of qi and blood. Indigestible food and waste are also transformed by qi into urine and stools for excretion.

35 人体之气的分类 元气、宗气、营气、卫气

36 宗气的分布与功能示意图 呼吸道 助肺司呼吸 宗气 心脉 助心行血气 丹田 资助先天元气

37 人体之气的分类

38 营气与卫气的区别 营 气 卫 气 概念 营气是行于脉中而具有营养作用的气。 营气属阴，又称营阴。 卫气是行于脉外而具有保卫作用的气。
营 气 卫 气 概念 营气是行于脉中而具有营养作用的气。 营气属阴，又称营阴。 卫气是行于脉外而具有保卫作用的气。 卫气属阳，又称卫阳。 生成 分布 营者，水谷精气精纯柔和部分 行于脉中 卫者，水谷之慓疾滑利部分。 行于脉外 功能 化生血液 营养全身 温养脏腑 护卫体表

39 营气与卫气的联系 营卫二气都源于水谷之精的化生，来源相同。营气与卫气之间又可相互化生，相互资助。营气在脉中，若游出脉外则为卫气；卫气行脉外，若进入脉中则为营气。营气与卫气分之为二，合二为一。 营卫和调，才能维持正常的体温和汗液分泌，人体才能有旺盛的抗邪力量和脏腑的正常生理活动。若营卫二者失和，则可能出现恶寒发热、无汗或汗多，昼不精夜不瞑，以及抗病能力低下而易于感冒等（参见伤寒的麻黄汤、桂枝汤、桂枝加龙骨牡蛎汤等方证）。 营气与卫气的运行 营气与卫气的运行应是：相偕而行，昼行于阳，夜行于阴。昼则卫气起主导作用，夜则营气起主导作用

40 Types of Qi 1. Inborn qi （primordial qi，元气） Inborn qi is the most original, essential and vital type found in the human body. It possesses prenatal and congenital properties. After conception, "congenital essence" (an essential vital substance inherited from parents) is stored in the kidney, the place from which inborn qi originates. Inborn qi is further nourished by "acquired essence" (food essence derived from digestion) of the spleen and stomach. After this process is complete, inborn qi is ready to travel to the entire body to exert its effects. Starting from the portion between the two kidneys, known as the "vital gate", the qi moves through the triple burner and circulates through the organs, muscles, skin and meridians providing the power source for all of life's activities.

41 2. Pectoral qi （宗气） Pectoral qi is stored in the chest. It is formed by combining fresh air inhaled by the lungs and food essence derived from the spleen and the stomach. Because pectoral qi concentrates in the chest, it can penetrate the blood vessels of the heart and lungs and move outward during expiration and inward during inspiration. By flowing through the respiratory tract, pectoral qi supports the breathing function of the lungs and affects how loud the voice can be. Its ability to flow through the blood vessels and the heart is important in regulating the heartbeat and supporting the circulation of other types of qi and blood. Pectoral qi also plays a role in keeping the body warm and influences the activities of the limbs

42 3. Nutritive qi （营气） Nutritive qi, as its name suggests, supplies nourishment to the body. It mainly circulates through the blood vessels with the blood. Sometimes this combination of nutritive qi and blood is referred to collectively as "nutritive blood". Nutritive qi mainly comes from food essence derived by the spleen and stomach's transformation and transportation properties. Starting from the middle burner, nutritive qi goes to the lungs where it enters the main circulation. Nutritive qi has yin properties so it can form into materials needed by other parts of the body. For example, its close relationship with blood allows it to provide some of the necessary substances needed to produce new blood. Nutritive qi also provides the needed nutrients to support the physiological functions of the organs.

43 4. Protective qi (defensive qi，卫气) Protective qi protects against evils. As previously mentioned, evils are environmental factors that lead to illness. In western terms, protective qi functions like the immune system, which helps prevent disease from occurring or spreading. Unlike nutritive qi, protective qi has yang properties, because it has more functional characteristics. Protective qi also comes from the food essence derived by the spleen and stomach. It moves outside the blood vessels and circulates in different areas from nutritive qi. Internally, it will be distributed to the diaphragm and scattered around the chest and abdominal cavities. Externally, it moves between the skin and muscles providing protection. Protective qi not only guards against illness and disease but also regulates the sweat glands and pores and provides nourishment for the skin, hair and muscles. Although nutritive and protective qi share the same origin, their flow directions, as previously described, are opposite to one another. By balancing their nutritive (yin) and protective (yang) functions, healthy sweating, temperature control and defence functions are maintained.

44 中医学中精与气概念的区别 精是构成人体的最基本物质，也是维持人体生命活动的基本物质。《灵枢·经脉》说：“人始生，先成精。”“夫精者，身之本也” 气是由精化生的极细微物质，《素问·阴阳应象大论》说：“精化为气。” 精为脏腑功能活动的物质基础，气是推动和调控脏腑生理活动的动力。 精属阴，藏于脏腑而有形；气属阳，运行全身而无形。

45 血的概念 血的生成 血 是循行于脉中·而富有营养的红色液态物质 脉 为血府；
离经之血：因外伤等原因，血液不在脉中运行，而逸出脉外则形成出血，称之。 血的生成

46 血液化生示意图 饮食 水谷 精微 脾胃之气 营气 津液 肾精 肝 心脉 血 清气 肺气 肾气 中焦受气取汁 髓 心气

47 The basic concept of blood
Blood, mainly composed of the nutrient qi and body fluid,circulates inside the vessels. It is red in color and sticky in texture. Blood functions to nourish and moisten the body. It is vital to the maintenance of life.

48 血的运行 循行方式：血液运行于脉道之中，循环不已，流布全身 影响血液运行的因素

49 各脏腑调节血的功能 血液的正常运行，主要与心、肺、肝、脾等脏腑的功能密切相关

50 The circulation of blood
The vessels in the whole body form a relatively close circulatory for blood circulation. Such a system is known as blood vessels in TCM included in the concept of meridians and vessels. The minute capillaries are called blood collaterals

51 Blood regulation function of viscera
Blood is propelled by the heart to circulate in the vessels. Apart from the heart, other internal organs are also involved in the circulation of blood,including the lung,the spleed and the liver. Structurally the lung is connected with all the vessels in the body,known as “the lung facing all the vessels”. The spleed commands blood,making the vessels compact,directing blood to circulate normallu in the vessels and preventing it from flowing out of the vessels. The liver stores blood and regulates the volume of blood. Besides, the liver also governs dredging and dispersing,thus smoothing the activity of qi to promote blood circulation.

52 血的功能

53 The physiological functions of blood
The physiological functions of blood are to nourish and moisten the body as described in Nanjing. Since blood contains the nutrient qi.it can nourish all the organs in the body. It should be noted that blood is also the important material base for mental activities. If blood is sufficent,there will be dispiritedness;if blood is deficient,there will be dispiritedness;if blood is in disterbance, there will be mental disorder. Since blood contains fluid,it can moisten the viscera and the body. When the fluid flows out of the vessels,it moistens the orifices and lubricate the joints.

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55 第四节 津液 含义：是体内一切正常水液的总称。包括各脏腑形体官窍的内在液体及其正常的分泌物。是构成人体和维持生命活动的基本物质之一。 同：同源于水谷精微，均赖脾胃运化而生成 津液的异同点 1.二者在运行代谢过程中可相互补充，相互转化、津液并称 2.病理上相互影响 3.伤津与脱液程度不同 性状：质地较清稀、流动性大 作用：体表皮肤肌肉和孔窍、血脉 分布：滋润 津 异 性状：质地较稠厚、流动性小 作用：骨节、脏腑、脑、髓 分布：濡养 液

56 津液的代谢

57 津液的代谢 津液的排泄 尿 粪 汗液 呼气 肺气宣发，输精于皮毛，经气蒸腾激发 形成汗液排出 肺主呼吸，呼出水气 肾气蒸化，生成尿液
肾气推动激发作用下排出体外 肾气的固摄作用，使尿液不致逸出 尿 粪 大肠传化糟粕，带走一部分水分 1.津液的排泄主要与肾、肺、脾生理功能有关 2.肾为水脏 3.肾者，胃之关也 4.汗孔为气门

58 津液的功能 津 血 津液的功能 滋润 濡养 充养血脉 同源 布散于体表——滋润皮毛肌肉 渗于体内——濡养脏腑 输注于孔窍——滋润官窍
渗注骨、脊、脑——充养骨髓、脊髓、脑髓 流注关节——滋润骨节，屈伸自如 滋润 濡养 津液的功能 充养血脉 津液为血液的重要组成部分，注于脉中，化生为血液，滋润濡养全身 津液可调节血液浓度，滑利血脉，津血互化 调节体内外环境的阴阳相对平衡 随外环境的改变，通过津液代谢所化之汗尿的排泄以适应之，从而保持正常体温 同源 津 血

59 The basic concept of body fluid
Body fluids refer to the different kinds of physiological fluids found in the body, including fluids in the organs and tissues, gastric fluid, intestinal fluid, semen and tears. Classified as one of the fundamental substances, body fluids are essential to life‘s activities . Body fluid is also a component of blood when it flows inside the vessels. However, body fluid also flows outside the vessels in the viscera and the body. If secreting or excreting from the five sensory organs and the nine orifices,body fluid becomes urine,sweating,tears,snivel,saliva and drool,ect. (若津液从五官九窍中分泌或排泄出来就成为了尿、汗、泪、涕、唾、涎)

60 Functions of Body Fluids
1. Moistening and nourishing Body fluids are mainly responsible for providing moisture and nourishment to the tissues. When distributed to the surface of the body, body fluids moisten the skin and hair and maintain the smooth and elastic texture of the skin. Body fluids also moisten, nourish and protect different orifices in the body. For example, body fluids allow the eyes to blink smoothly, the nasal cavity to maintain an open airway without blockage and the lips and mouth to remain moist without becoming dry. Internal body fluids also penetrate different organs, tissues and even bone marrow to provide moisture and nourishment. The spinal cord and brain are examples of organs surrounded by body fluid that protects and nourishes them.

61 Functions of Body Fluids
2 the transformation of blood body fluid not only flows outside the vessels,but also inside the vessels to participate in the production of blood. Blood is composed of two parts:body fluid and the nutrient qi. If body fluid is insufficent, the production of blood will be reduced,leading to blood deficiency. Disharmony of body fluids is manifested in two ways. When body fluids can no longer nourish and provide moisture to the body, symptoms such as dry skin, flaccid muscles, brittle hair, dry eyes, parched lips and a dry nose or throat occur. When there is dysfunction of distribution or excretion of body fluids symptoms can present as swollen eyelids, edema (retention of fluid in the tissues), obesity or other conditions

62 Flow chart for formation of body fluid

63 第五节 神 神是人体生命活动的主宰及其外在总体表现的统称 精气血津液充足——脏腑功能强健——神旺 精气血津液亏耗——脏腑功能衰败——神衰
狭义之神---精神、意识、思维活动。 广义之神---一切生理活动、心理活动的主宰， 生命活动外在的体现 神的生成：精气血津液是产生神的物质基础 五脏藏五神：心藏神，肺藏魄，肝藏魂，脾藏意，肾藏志 精气血津液充足——脏腑功能强健——神旺 精气血津液亏耗——脏腑功能衰败——神衰 有神 失神 无神

64 神的作用 得神者昌，失神者亡

65 神的作用示意图 精 血 气 津液 神 驭 生，行，控 生，行，固 生，行，摄 脏腑之气 脏腑功能 推动和调控 分化 主宰生命活动

66 精气血津液神之间的关系 气为血之帅

67 精气血津液神之间的关系 血为气之母

68 气与津液的关系 气能生津 气能行津 机理：气是津液生成的动力，津液的生成依赖于气的推动作用 生理：气充则津足
病理：气亏虚则津液不足，气阴两虚 治疗：补气生津 气能行津 机理：气是津液在体内正常输布运行的动力 生理：气行则水行 病理：气虚、气滞则水停，即“气不化水” 治疗：行气与利水并用

69 气与津液的关系 气能摄津 津能生气 机理：津液受到各脏腑阳气的蒸腾温化，可化生为气。 生理：津充气旺 病理：津液亏耗则气衰少 治疗：气阴两补
机理：气通过对津液排泄的有节控制，防止津液无故流失于体外 维持体内津液量的相对恒定。 生理：维持体内津液代谢平衡。 病理：气虚，固摄力量减弱则津液外泄。 治疗：补气固津 津能生气 机理：津液受到各脏腑阳气的蒸腾温化，可化生为气。 生理：津充气旺 病理：津液亏耗则气衰少 治疗：气阴两补

70 气与津液的关系 津能载气 机理：气的运行须依附于津液而存在 生理：津液是气的载体 病理：气随津脱 治疗：益气固脱、补液养津

71 精血津液之间的关系 精血同源

72 精血津液之间的关系 津血同源 病理传变：夺血者无汗，夺汗者无血

73 精血津液之间的关系 同源 精 血 互化 同源 充养 互化 津液

74 之间的关系

75 之间的关系

76 之间的关系

77 精气神关系示意图 生 血 神 调 化养 生 行摄 气 同源 互化 驭 生 精 摄 生 摄

78 小 结

79 Connections Between Qi, Blood and Body Fluids
Connection between Qi and Blood The relation of Qi and Blood can be generalized as having two aspects: Qi as the commander of Blood, and Blood as the mother of Qi. As the commander of Blood, Qi has three main functions. First, generating Blood. This means that the generation of Blood depends on Qi's activities for its production. Blood is composed of Body Fluids and Nutritive Qi, which is produced by food through the functional activities of Spleen Qi and Stomach Qi. During this process, it is Qi's activities that transform the food into food Essence, then into Nutritive Qi and Body Fluids and ending in the formation of Blood. Without Qi's activities, there would be no Blood. So Qi can generate Blood. When Qi is vigorous, it can generate adequate Blood. On the other hand, Deficiency of Qi will cause Blood Deficiency due to decline of its action of generating Blood. Clinically, Qi-invigorating drug are often added to Blood-nourishing formulas to promote the generation of Biood.

80 Connections Between Qi, Blood and Body Fluids
Second, propelling the circulation of Blood. This means that Blood, a Yin substance which is motionless in nature, depends on Qi for its movement. To be exact, Heart Qi moves Blood by maintaining the beating of the Heart, Lung Qi pushes Blood outward through its dispersing effect and sends down Blood through its descending effect, and the Liver's dispersing and discharging effects help to regulate the free flow of Blood. When Qi is deficient and hasn't enough power to propel, the Blood flow will become sluggish or Blood Stasis will occur. If Qi's ascent, descent, or entry and exit movements are destroyed, Blood Flow will also be disturbed. For example, adverse upward flow of Qi will cause Blood to flow upward excessively, giving rise to distending pain of the head, blood, shot eyes, red face, or even hematemesis and coma. Therefore, Blood flow disorders are usually treated both with drugs regulating Blood and drugs regulating flow of Qi. Third, controlling the flow of Blood. This means that Qi functions to keep Blood flowing within the vessels to prevent extravasation, which is mainly performed by Spleen Qi. If Qi fails to control Blood flow, various kinds of bleeding will occur. Clinically, bleeding due to Qi Deficiency must be treated by strengthening the Spleen so that Blood flow can be controlled. Blood as the mother of Qi has two meanings: Qi attaching to Blood and Blood supplying Qi. Qi is a vigorous substance and prone to flee easily, so it must attach itself to Blood so that it can reach all of its distribution points to perform its normal function. This is also a manifestation of mutual restriction of Yin and Yang, or the motionless nature of Blood restricting the moving nature of Qi. By Blood supplying Qi is meant that Blood nourishes Qi or serves as the material basis of Qi. Clinically, a severe hemorrhage often gives rise to escape of Qi due to the failure of Blood to carry Qi, and Blood Deficiency often leads to Qi Deficiency.

81 Connections Between Qi, Blood and Body Fluids
Relationship between Qi and Body Flulds The relations of Qi and Body Fluids is very similar to those of Qi and Blood. The generation, distribution and discharge of Body Fiuids depend on Qi and its activities. On the other hand, Qi also relies on Body Fluids to be carried, and Body Fluids are where Qi exists, moves and changes. Qi can generate Body Fluids. Body Fluids comes from food and drink, which are transformed into both refined and waste material through the activities of the Spleen and Stomach. The liquid that has been refined, or Body Fluids, is then distributed to each part of the body by the Spleen. When the Spleen and the Stomach function properly, Body Fluids can be adequately generated on the other hand, Deficiency of Spleen Qi or Stomach Qi will lead to inadequate formation of Body Fluids, causing Deficiency of both Qi and Yin Fluids. Qi can distribute and transform Body Fluids. Body Fluids are substantial and motionless in nature. So their distribution and discharge depend on the propulsion of Qi and the activities of Qi. As a result of the ascent, descent, and entry and exit movements of Qi of the Spleen, the Lung and the Kidney, Body Fluids are distributed all over the body to perform their moistening effect. All the metabolized Body Fluids must be transformed into sweat, urine or steam to be discharged, so the transforming effect of Qi plays an important part in the discharge of Body Fluids. Failure of Qi to propel and transform due to its Deficiency or to stagnation of Qi can give rise to retention of Body Fluids, leading to edema, Damp or Phlegm, which is known as inability of Qi to propel and transform Body Fluids.

82 Connections Between Qi, Blood and Body Fluids
Qi can control Body Fluids. This means that Qi can control the flow and discharge of Body Fluids to prevent their excessive loss. For example, Defensive Qi can prevent excessive sweating by controlling the closing and opening movements of the sweat pores. If Defensive Qi is deficient, spontaneous sweating will occur as a result; Kidney Qi controls the opening and closing of the Bladder, so Deficiency of Kidney Qi often leads to profuse and frequent urine, enuresis and incontinence of urine. For such cases, drugs consolidating Qi must be adopted to obtain effectiveness. Body Fluids carry Qi. Qi is also attached to Body Fluids. When too much Body Fluids are lost, Qi will escape. Excessive vomiting or diarrhea, for example, will impair Qi, leading to Deficiency of Qi, which is often accompanied by lassitude, a symptom of Qi Deficiency

83 Connections Between Qi, Blood and Body Fluids
Relationship between Blood and Body Fluids Blood and Body Fluids are from the same source and their functions are similar. So they can be transformed into each other and are closely related to each other. Both Blood and Body Fluids are derived from food Essence, hence they are said to have "a common source'. Body Fluids are an important component of Blood, and Body Fluids in the vessels can go out of the vessels to make up Body Fluids of the body and vice versa, so Blood and Body Fluids usually influence each other under pathologic conditions. When excessive loss of Blood occurs, Body Fluids that are out of the vessels can enter the vessels to compensate for the loss in the same way, when there is excessive consumption of Body Fluids, the Fluids in the vessels can also go out of the vessels to increase those Body Fluids. Therefore, for patients with excessive bleeding, diaphoretic should be avoided; while for patients with Deficiency of Body Fluids, the practice of removing Blood Stasis with drastic drugs is not indicated.

84 习 题 1.积于胸中、上走息道、下注气街的气是： A.元气 B.宗气 C.营气 D.卫气 E.肺气
习 题 1.积于胸中、上走息道、下注气街的气是： A.元气 B.宗气 C.营气 D.卫气 E.肺气 2.激发整个脏腑经络生理活动的功能是气的： A.温煦作用 B.推动作用 C.防御作用 D.固摄作用 E.中介作用 3.脏腑之气和经络之气的物质基础是： A.元气 B.宗气 C.营气 D.卫气 E.中气 4.推动人体生长发育及脏腑机能活动的气是： A.元气 B.宗气 C.营气 D.卫气 E.动气 5.具有温煦脏腑、润泽皮毛、控制汗孔开合等功能的气是： 6.易于感冒，是气的什么功能减弱的表现： A.推动作用 B.温煦作用 C.防御作用 D.固摄作用 E.中介作用 7.生命最基本的特征是： A.推动功能 B.温煦功能 C.固摄作用 D.气化 E.营养作用 8.机体内物质转化和能量转化过程实际上是指： A.气的推动作用 B.气机 C.气的防御作用 D.气的固摄作用 E.气化 9.体内液态物质的运行、输布和排泄，主要依赖气的哪些功能的配合： A.推动与温煦 B.防御与固摄C.推动与固摄 D.中介与推动E.温煦与凉润 10.临床上，常从“虚里”处的搏动状况可以察其盛衰的气是： A.中气 B.营气 C.卫气 D.元气 E.宗气

85 习 题 11.与人的睡眠有密切关系的气是： A.卫气 B.宗气 C.中气 D.元气 E.营气 12.构成脏腑经络的最基本物质是：
习 题 11.与人的睡眠有密切关系的气是： A.卫气 B.宗气 C.中气 D.元气 E.营气 12.构成脏腑经络的最基本物质是： A.中气 B.营气 C.卫气 D.水谷精气 E.脏腑经络之气 13.与视、听、言、动的强弱关系最密切的气是： A.元气 B.卫气 C.宗气 D.谷气 E.营气 14.元气运行的主要通道是： A.十二经脉 B.奇经八脉 C.血脉 D.三焦 E.肝 15.气的运动受阻，运动不利时，称为： A.气机不畅 B.气结 C.气闭 D.气逆 E.气虚 16.具有司腠理开合功能的气是： A.元气 B.宗气 C.营气 D.卫气 E.中气 17.与气的生成密切相关的脏是： A.心肝脾 B.肺肝肾 C.肺脾肾 D.心肺肾 E.肝脾肾 18.人体生命活动的原动力是： A.营气 B.卫气 C.元气 D.宗气 E.谷气 19.与肺主一身之气密切相关的是： A.宗气 B.谷气 C.卫气 D.元气 E.营气 20.一身气机的枢纽为： A.脾胃 B.心肾 C.肺肝 D.脾肾 E.以上均非

86 习 题 21.出现恶寒喜暖，是气的哪一项功能失常： A.推动与调控作用 B.温煦作用 C.防御作用 D.固摄作用 E.中介作用
习 题 21.出现恶寒喜暖，是气的哪一项功能失常： A.推动与调控作用 B.温煦作用 C.防御作用 D.固摄作用 E.中介作用 22.临床出现自汗、多尿、出血、遗精等症，是气的哪一项功能减退： 23.“气有余便是火”是气的哪一项功能失常： A.推动作用 B.温煦作用 C.防御作用 D.固摄作用 E.中介作用 24.影响人体的生长发育或出现早衰，是气的哪一项功能失常： A.推动与调控作用 B.温煦与凉润作用 C.防御作用 D.固摄作用 E.中介作用 25.形成多种代谢异常的病变，是气的哪一项失常： A.推动作用 B.温煦作用 C.防御作用 D.气机 E.气化 26.机体精神活动的主要物质基础是： A.精 B.气 C.血 D.津 E.液 27.血的生成与哪个脏腑的关系最密切： A.肝 B.心 C.脾胃 D.肺 E.肾 28.充养脑髓、滑利关节的主要是 A.精 B.气 C.血 D.津 E.液 29.津液输布的主要通道是： A.脉管 B.经络 C.腠理 D.三焦 E.分肉 30.“吐下之余，定无完气”的理论根据是： A.气能生津 B.气能行津 C.气能摄津 D.津能载气 E.以上均不是

87 答 案 1.B B 3.A 4.A 5.D 6.C D 8.E 9.C E 11.A 12.E 13.C 14.D 15.A 16.D 17.C 18.C 19.A 20.A 21.B 22.D 23.B 24.A 25.E 26.C 27.C 28.E 29.D 30.D

88 Question 1.Which qi is derived congenital essence?
A.Yuan qi B.Wei qi C.Zong qi D.Ying qi 2.Which qi is to promote the lung’s function of controlling respiration and to promote the heart’s function of dominating the blood and blood vessels? 3.Which qi is derived from the qi of food essence produced by the spleen and stomach,and circulates inside the vessels? 4.Blood normally circulates in the vessels throughout the body,and is acted jointly by the following organs EXCEPT: A.heart B.kidney C.spleen D.liver 5.Which statement is NOT correct about blood stagnation and qi stagnation?Which statement is NOT correct about blood stagnation and qi stagnation? A.qi stagnation:fixed pain B.blood stagnation:severe and stabbing pain C.both have wiry pulse D.both have pain symptoms 6.Blood stagnation does NOT have A.bleeding B.ecchymoses C.wandering pain D.resistance to touch

89 Question 7.A female patient has thirst with desire to drink,dryness in the skin and throat,constipation,scanty urine,red tongue with crack,rapid pulse. Your diagnosis is deficiency of: A.Yin B.Yand C.Blood D.Jin and Ye(fluids) 8. Which statement is correct about body fluid(Jinye) A.Clear and thin fluid are referred to as “Ye” B.Thick and heavy fluid are known as “Jin” C.Jin warms and nourishes the muscles and moistens joints D.Ye strengthens the brain and marrow and nourishes the orifices. 9.Which statement is NOT correct about blood deficiency and fluids insufficency? A.Both lost body fluids B.Both have thin pulse C.Blood deficiency:produces internal heat easily D.Fluids insufficiency:dryness in mucus

90 Answer 1.A 2.C 3.D 4.B 5.A 6.C 7.D 8.D 9.C

91 Thank You !