feature Regarding the Lower Origin of the Wei Qi I am quite conscious that the quotations from the old texts are sometimes translated in a slightly choppy style and may lack grace. The reason for this is that I wanted to remain as close as possible to the Chinese language in order to avoid distortions of meaning. A small effort on the reader!s part! however! should make it possible to understand the sense of a phrase. I am also perfectly aware that the repeated use of quotations of the traditional texts weighs down the rate and rhythm of this article. But for me it is fundamental that the assertion of any essential theory draws its justification from the works that built the Chinese medical system. T o BETTER COMPREHEND THE RELATIONS between the Bladder and the defensive qi, it is necessary to agree on the main func- tion of the Bladder: it stores the fluids, not the urine. After establishing this point, we will proceed to the main topic. The Bladder stores the liquids (Pang Guang cangjin ye) According to the Huang Di Nei ling (Yellow Emperor's Inner Classic) the Bladder stores the fluids: "The Bladder is in charge of the provinces and capitals" ; it stores fluids." 1 And: "The Bladder is the palace of the fluids."2 In fact, it is necessary to examine this idea within its context. First of all, it should be remembered that the Bladder receives liquids from two different origins: from the Kidneys and the Small Intestine. When the clear fluids distributed by the Lungs have impregnated, humidified and nourished the organs and tissues of the entire body, the surplus or turbid fluid, the part that was not assimilated, is recovered by the Kidneys and sent to the Bladder. In addition, when the Small Intestine receives the shi mi (food pulp), it separates the liquids and evacuates the surplus turbid part of those liquids towards the Bladder. Thus, according to ancient Chinese medicine, the first function of the Bladder is to store the turbid or excess fluids waiting to be transformed, excreted or re-used. It is only when these liquids are discharged that they are named niao ye (urine). This is the reason why the Huang Di Nei ling and a. The exact expression is Zhou Du. In the old imperial administration, Zhou indicates an administrative territory, which initially was a province, whereas Du indicates the capitals of these provinces. www.sionneau.com - [email protected]
Transcript
feature
Regarding the Lower Origin of the
Wei Qi
I am quite conscious that the quotations from the old texts aresometimes translated in a slightly choppy style and may lack grace.The reason for this is that I wanted to remain as close as possibleto the Chinese language in order to avoid distortions of meaning.A small effort on the reader!s part! however! should make itpossible to understand the sense of a phrase. I am also perfectlyaware that the repeated use of quotations of the traditional textsweighs down the rate and rhythm of this article. But for me it isfundamental that the assertion of any essential theory draws itsjustification from the works that built the Chinese medical system.
To BETTER COMPREHEND THE RELATIONSbetween the Bladder and the defensive
qi, it is necessary to agree on the main func-tion of the Bladder: it stores the fluids, notthe urine. After establishing this point, wewill proceed to the main topic.
The Bladder stores the liquids(Pang Guang cangjin ye)According to the Huang Di Nei ling (YellowEmperor's Inner Classic) the Bladder stores
the fluids: "The Bladder is in charge of theprovinces and capitals" ; it stores fluids." 1
And: "The Bladder is the palace of thefluids."2
In fact, it is necessary to examine thisidea within its context. First of all, it shouldbe remembered that the Bladder receivesliquids from two different origins: from theKidneys and the Small Intestine. When theclear fluids distributed by the Lungs haveimpregnated, humidified and nourished theorgans and tissues of the entire body, thesurplus or turbid fluid, the part that wasnot assimilated, is recovered by the Kidneysand sent to the Bladder.
In addition, when the Small Intestinereceives the shi mi (food pulp), it separatesthe liquids and evacuates the surplusturbid part of those liquids towards theBladder. Thus, according to ancient Chinesemedicine, the first function of the Bladder isto store the turbid or excess fluids waiting tobe transformed, excreted or re-used.
It is only when these liquids are dischargedthat they are named niao ye (urine). This isthe reason why the Huang Di Nei ling and
a. The exact expression is Zhou Du. In the old imperialadministration, Zhou indicates an administrative territory,which initially was a province, whereas Du indicates thecapitals of these provinces.
many other traditional sources claim thatthe Bladder stores the jin ye (fluids) ratherthan the urine. "The Bladder remains in thelower part, in a hollow inside [of the body],this is why it stores the fluids jin ye. If theyobtain transformation of the qi by the seaof qi,b then the urine empties."3
Of course, there are certain classics thatsay the liquids stored in the Bladder arethe urine, such as for example the ZhuBing Yuan Hou Zong Lun (Discussion ofthe Origins of the Symptoms of Disease:"The fluids jin ye are in surplus, they enterthe Bladder, this is the urine."4 But thesesources are a minority. Moreover, the factof admitting that fluids and not urine arestored in the Bladder makes it possible toinclude and understand the other functionsof the Bladder. In order to comprehendthe following complex explanation, it isimportant to keep in mind: what is stored bythe Bladder are the liquids of the Kidneys;what is excreted by the Bladder is the urine.For liquids to be discharged, they mustundergo the transformation into urine,which is accomplished as part of the wholeqi hua mechanism: the qi transformation.
Thus, the Bladder is not satisfied onlyto store the fluids, it excretes them too.However, this action is only done underthe influence of the Kidneys, which controlthe two lower openings. One can say thatthe metabolism of the liquids depends onthe Spleen, the Lungs, the Small Intestine,the Large Intestine, the Triple Burner, theKidneys and the Bladder. But the yang qiof the Kidneys supports the action of allthese zang fu (organs) to assimilate andexcrete the liquids. And thanks to the qihua, the Kidneys direct the turbid liquidsinto the Bladder and transform them intourine at the time of their discharge. It is theKidneys that give, via the qi hua, the orderto the Bladder to excrete or retain the urine."The liquids are stored in the Bladder, theycannot leave spontaneously. One needs themechanism of the qi hua, which transmitsand transforms, then the liquids exit, theyare the urine."s
b. The Kidneys regain the clear from the turbid andvaporises to the Lungs which redistribute throughoutthe system.
A case of qi hua: transformation of theBladder qi (Pang Guang zhi qi hua)To refine our understanding of the relation-ship between qi transformation and theBladder, it is necessary to recall that the termqi huac describes a different phenomenadepending upon the context in which itappears.
First of all, at its most basic, "qitransformation" indicates all of the changesthat result from the ceaseless movementsof the qi. The transformations of the qi canbe regarded as the source and the engine ofthe metamorphoses of all the phenomenaof the universe. In the context of the humanbody, qi transformation refers to all ofthe changes that allow the organism tomaintain balance and living. This preciseapplication appears in various fields suchas the qi hua to generate qi, blood, jingand fluids. It also means that these varioussubstrates transform one another and allowthe waste disposal that is born from theseperpetual transformations.
In a narrower sense, the term qi huaindicates the capacity of the ministerialfire6 to vaporise and transform the waterof the Kidneys. Fire transforms water intoqi. This transformation of water is calledtransformation of the qi because it generatesa particular qi, which is none other thanthe original qi: yuan qi. "The water thatdisperses is qi, the qi that accumulatesis water."7 To understand this conceptprofoundly, it should be remembered thatthe water of the Kidneys is an aspect of yinand jingoIn other words, the ministerial firetransforms jing of the Kidneys into yuanqi, which is itself the source for any othertransformation of qi around the body.
Eventually, in a more restricted sense, theterm qi hua indicates the transformation ofthe fluids of the Triple Burner, particularlyat the level of the Bladder and thanks toyang qi of the Kidneys. Chen Nian-Zud inone of his works points out this fact: "TheBladder is in charge of the provinces and
c. Context is all, as it is often the case for any essentialconcept of the Chinese medical thinking.d. Chen Nian-Zu (ca 1753-1823) was a famous doctorof the Qing dynasty who wrote 16 books that helpedpopularise this art. He was also a brilliant commentatoron the Nei ling (Yellow Emperor's Inner Classic), the ]inGui Yao Lue (Essentials from the Golden Cabinet) andthe Shang Han Lun (Discussion of Cold Damage).
• This article was previouslypublished in French, and isbased on the seminar "Zang-Fu" during the internationalacupuncture congress held inQuebec in 2003. It was trans-lated by Brigitte Linder.
• Philippe Sionneau is oneof the most active research-ers and teachers in thefield of Chinese medicine inEurope, with a score of bookspublished on the subject inFrench, English, and Spanish.He is one of the fewWesterners who thoroughlystudied Chinese medicinein a Chinese university andbecame a graduate (OfficialState degree from thePeople's Republic of China).He reads medical Chinesefluently and his researchis based exclusively uponoriginal Chinese texts. Heteaches regularly in France,Switzerland, and Spain, as wellas in Canada (Montreal) andthe U.s. (New-York).
,It is commonly acceptedthat perspiration from theBladder is generated bythe clear part of the turbidfluids, whereas the urinaryfluid is considered the'turbid of the turbid:
the capitals, it stores fluids from wherethe transformation of the qi can emanate.Yet if the qi of the Kidneys is sufficientthen there is transformation, if the qi ofthe Kidneys is insufficient there will notbe transformation." In this context theqi hua is expressed in the transformationand the regulation of the liquids by theqi of the Kidneys. Another quote speaksmore precisely about the function ofvaporisation of the liquids. "What is calledthe transformation of the qi, is the qi inthe centre of the Kidneys, it is fire in thecentre of yin. [If] yin is without yang in itscentre, then the qi can not transform, withthe result that the way of water does notcirculate, overflows and becomes oedema."sAnd from the Lei ling (Classified Classic):"The source of the transformation of the qiis in the dan tian (cinnabar field) which iscalled lower sea of the qi ... If the original qiis sufficient, transport and transformationare normal and the pathway of water isnaturally free."gTo avoid any confusion, onemust remember that when speaking aboutthe water of the Kidneys, it refers either tothe liquids stored by the Bladder, or jingstored in the Kidneys. It is always necessaryto know the context. Here, it refers preciselyto the transformation of the jin ye (fluids)of the Kidneys which are localised in theBladder.
The qi hua that impacts on the Bladderallows the generation of two types of fluids.The first is quite simply the urine, whichonly becomes urine once it is evacuated.The second is perspiration. Indeed, theliquids of the Kidneys that are stored in theBladder are vaporised to the Lungs, whichsends them outwards to the skin and thehair, partly in the form of perspiration."When the cold qi of the water of tai yang(greater yang) follows hand shao yang (tripleburner) and ascends, it exits via the skinand hair as perspiration; when it followshand shao yang and descends, it flows intothe Bladder as urine."l0 Here the authorutilises the Triple Burner, a large envelopein which the whole of the transformationtakes place. Furthermore, as we know; theministerial fire transforms jing into qi, and
it too is associated with the Triple Burner.In another work, the same author, Cao]ia-Da, again insists on the relationship ofperspiration and the Urinary Bladder: "Thecold water of tai yang (greater yang) followsthe Triple Burner descending to the Bladder,it is the urine. Due to the vaporisation ofKidney yang, which transforms the Bladder,it (ie. the water of tai yang) exits via skinand hair, it is perspiration. Thus the urineand perspiration come from the sameorigin."il Tang Zong-Hai confirms this pointof view: "Perspiration is the water at thelevel of qi, its origin is in the Bladder."12It iscommonly accepted that perspiration fromthe Bladder is generated by the clear part ofthe turbid fluids, whereas the urinary fluidis considered the "turbid of the turbid':
The fact that perspiration comes partlyfrom this source does not contradict thefact that this fluid is also associated withblood and the Heart. In fact, perspirationhas two sources: fluids of the Bladder andblood (in particular that of the Heart). Thefirst is related to the defence of the bodyand the second deals with nutrition as wellas temperature control of the body.
Certain Chinese authors agree that thewater that is transformed by the Kidneysdoes not generate urine or perspirationonly. Indeed, the transformation of thefluids of the Bladder gives birth to aparticular qi: the wei qi or defensive qi.Although many classics, including Su Wenchapter 43 and Ling Shu chapter 71, statethat the defensive qi comes from the qi offood originating in the middle burner, theLing Shu chapter 18 evokes the lower originof this qi: "The defensive [qi] originates inthe lower burner." Subsequently, other textsappear to confirm this point of view: "Thetransformation of the qi in the centre of thewater of the Bladder tai yang (greater yang)ascends and is spread towards the outside,it is the yang [of qi], the exterior defence."eD
The qi transformed in the centre of theBladder tai yang (greater yang), followsthe sea of qi (qi hai), circulates through theqi jie/ skirts the (fatty) membranes at the
e. Wei yang (Yang defensive) is synonymous with wei qi(defensive qi).f. The expression Qj lie (qi avenues) corresponding to thepathways through which qi circulates throughout the
top, the chest and the diaphragm, entersthe Lungs, exits at the nose and becomesthe qi of expiration. At the same time, theqi of the transformation of the Bladder,traverses the interior of the membranes,exits at the muscles and flesh, disperseswithin skin and hairs, it is the external qiof defence.14
The Ben Cao Wen Da states: "In thehuman body, the Kidneys and the Bladderbelong to water. Yang in water is thetransformation of the qi that ascends. Thetransformation of the qi that raises the qiexits at the mouth and the nose, it is thusthen breath. It fills the skin and the hairs, itis thus then the defensive qi."15
Chen Nian-Zu confirms: "The qi of thetai yang meridian that remains outsideis the qi of defensive yang.e And this qiemerges from the centre of cool water ofthe Bladder."16
In fact, the yang of the Kidneys is at theorigin of this production of defensive qi,starting from the fluids contained in theBladder. And, like any transformation, thisis the result of the transformation of the qihua. There are thus, according to the ancientclassics, two sources of wei qi: one from themiddle and one from the lower part of thebody. The origin in the middle comes fromthe qi of food at the level of Spleen andthe Stomach. The lower origin comes fromthe fluids at the level of the Bladder. Thisexplains why; according to the Shang HanLun, the tai yang meridian of the Bladderis the defence of the body and the placeof battle between the normal qi (zheng qi)and the evil qi (xie qi). Tang Zong-Hai says:"The Bladder corresponds to tai yang, it isyang in the centre of water, it spreads thedefensive qi outwardly."17
The water of the Bladder vaporises and isagitated, then it is transformed into qi,it spreads towards the outside and is the
body lie means junction, specifically the junction of thefour avenues. Howevet, accotding to the Huang Di Neiling Ling Shu chaptet 52 the crossroads of qi (Qj lie) atefour: the chest, abdomen, head and lower limbs.
defensive qi. The transformation of the qiof yang of the Kidneys is the [qi] defensive,it follows the tai yang meridian to bedisseminated towards the outside. 18
Chen Nian-Zu,Shang Ran Lun Qian Zhu
Still more explicitly, Jing Ri-Zhenstates: "The jin ye fluids are the source ofperspiration, the transformation of the qi ofthe Bladder allows perspiration to emerge,this is why Zhang Zhong-Jing inducesperspiration using the tai yang."19
One can say that the Bladder stores thefluids that will be used for the productionof wei qi and with its meridian tai yangassists the transport of the defensive qitowards the outside of the body. Moreover,it seems that there exists a close linkbetween the perspiration produced bythe qi hua on the level of the fluids of theBladder and the defensive qi: "The yang ofthe Bladder transforms water into qi, it exitsvertically on top of the mouth and nose,it exits horizontally through the internalmembranes, it spreads into muscles andthe flesh and is diffused in the skin and thehairs, it is then perspiration. Perspiration isa transmutation/transformation of waterinto defensive qi; it belongs to the layer ofthe qi.,,2o
Endnotes
1.~%'~j{;~ 1+1t~z'§, $4'~~~ o(Pangguang zhe,zhoudu zhi guan,jinye cang yan.) Huang Di Neiling Su Wen (Yellow Emperor's Inner Classic BasicQuestions), chapter 8.2. ~ ~j{;~$4'~zMJill o (Pangguang zhe, jin ye zhi fuye). Huang Di Nei ling Ling Shu (Yellow Emperor'sClassic Divine Pivot), chapter 2.3 Liu Wan-Su.1186. Su Wen Bing]i Qj Yi Bao Ming]i (Collection of Writings on the Mechanism ofDisease, Suitability of Qj and the Safeguarding ofLife as Discussed in the Basic Questions). In thisbook Liu explains his theories on heat and fire. Itdevelops various themes such as prevention, dia-gnosis, attacks of cold, materia medica, diseasescaused by external pathogenic factors, mechanismof diseases, internal medicine, gynaecology; pae-diatrics. This book completes his major work: SuWen Xuan]i Yuan Bing Shi (Mysterious Mechanismat the Origin of Pathology in Basic Questions).Liu Wan-Su (also known as Liu He-Jian) lived(1120-1200) during the Jin dynasty He is the firstof the four great masters of Jin and Yuan, andis the founder of the "School of cool and cold"
,The lower origin comesfrom the fluids at thelevel of the Bladder. Thisexplains why, according tothe Shang Han Lun, thetai yang meridian of theBladder is the defence ofthe body and the place ofbattle between the normalqi (zheng qi) and the evilqi (xie qi).
,One can say that theBladder stores the fluidsthat will be used for theproduction of wei qi andwith its meridian tai yangassists the transport of thedefensive qi towards theoutside of the body.
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(Han Liang Pail, which argues that disease ismainly due to heat. He named the six pathogenicfactors as wind, heat, cold, dampness, drynessand heat. Among them, he gave heat the place ofhonour, hence the use of cool and cold medicinalsubstances that names his school. This theoryis called Zhu Huo Lun (:Ex i~), the idea thatall the six qi transform into fire, and thus fire isa primary pathological agent. He developed theidea that yang is in excess because of the principleof similar transformation: the body whichundergoes a sequence of transformations willinduce heat sooner or later, the metamorphosisof any evil heat. For internal heat, therapeuticstrategies often aim to drain the fire of the Heartand nourish the Kidney water. Legend has it thatLiu Wan-Su refused a high rank position as animperial official several times in order to devotehimself to the practice of medicine.
4. Chao Yuan-Fang. 610. Zhu Bing Yuan Hou Lun(Discussion of the Origins of the Symptoms ofDisease). This book is considered the first tosubmit a systematic aetiology, pathogenesis andsymptoms of disease, and has been extremelyinfluential for over a thousand years. ChaoYuan-Fang (550-630 AD) was a doctor from theImperial Academy of Medicine during the Suidynasty and wrote this book by imperial decree.5 Wu Kun. 1594. Wu Zhu Huang Di Nei ling SuWen (Commentaries ofWu [Kun] on the BasicQuestions). Wu Kun (1552-1620) was one of thegreatest commentators on the Nei ling (YellowEmperor's Inner Classic). The book is also knownas the Huang Di Nei ling Su Wen Wu Zhu whichgives an identical translation or simply Su WenWu Zhu which means the comments ofWu [Kun]on the Su Wen.6. The ministerial fire is the original yang, thetrue yang from the previous heavens (earlierheaven). Its role is to enable the transformationof jing (Kidney water) into yuan qi to support allfunctions of the zang fu and the meridians. It iscalled ministerial because it aims to carry out theorders of the imperial fire, the fire of the Heartthat is in relation with the shen (spirit, psychicaspect). If the emperor presides, the ministerperforms. So its functions are fundamental to thephysiological balance of the body7. Pan Ji. Yi Deng Xu Yan. (G[:kHi£:ks TheContinued Blaze in the Lamp of Medicine). Thisbook was written during the Ming dynasty by astudent of Wang Shao-Long (1565-1624), namedPan Ji (Jlri!: 1591-1664). Pan Ji was an experton pulses and the classics, while also beinginfluenced by Liu Wan-Su, Zhu Dan-Xi and LiDong-Yuan.8. Chen Nian-Zu. 1896. YiXue Cong Zhong Lu(Records of Popular Medicine). Chen Nian-Zu(ca 1753-1823) is also known as Chen Xiu-Yuanand Chen Liang-You. This book consists of sevenparts on internal medicine and various diseasesand an eighth part that speaks about gynaecology.
Vol 6-3
9 Zhang Jie-Bin (1563-1640) also known as ZhangJing-Yue is one of the great figures of Chinesemedicine, one of the most famous commentatorsof the Nei ling (Yellow Emperor's Inner Classic)who has explained many difficult subjects. Hisessential work is the Lei ling (Classified Classic),published in 1624. His other fundamental workis the ling Yue Quan Shu (Collected Treatisesof [Zhang] Jing-Yue) also published in 1624.His personal theory is the famous saying thatyang is never in excess. On the contrary, as thebasis of life, it is rather empty, hence the need tostrengthen it. He is therefore a main proponent ofthe "school of tonifying the warm".
10 Cao Jia-Da. 1933. Shang Han Fa Wei(Elaborating on the Subtleties of Cold Damage).11Cao Jia-Da. 1933.lin Cui Fa Wei (Elaboratingon the Subtleties of the Golden Cabinet).12 Tang Zong-Hai. 1884. Xue Zheng Lun(Discussion of Blood Patterns). This book isconsidered a masterpiece on the subject ofimbalances of the blood. It is also a fantasticbook on physiology and pathology of Chinesemedicine.13 Chen Nian-Zu. Qing. Shang Han Lun QjanZhu (Simple Annotation of the Discussion ofCold Damage).
14 ibid.15 Tang Zong-Hai. Ben Cao Wen Da. 1894. TangZong-Hai (aka Tang Rong-Chuan, 1847-1897), isthe famous author of Xue Zheng Lun (Discussionof Blood Patterns) and Zhong Xi Hui Tong YilinglingYi.16. Chen Nian-Zu. Qing. Shang Han Lun QjanZhu (Simple Annotation of the Discussion ofCold Damage).17.Tang Zong-Hai. Xue Zheng Lun (Discussion ofBlood Patterns).18. Chen Nian-Zu. Qing. Shang Han Lun QjanZhu (Simple Annotation of the Discussion ofCold Damage).19 Jing Ri-Zhen. 1696. Song Ya Zun Sheng QuanShu (Complete Treatise on Respecting Life fromthe Lofty Precipice) Jing Ri-Zhen (zi-nameDong-Yang) was an early Qing medical scholar.His name of honour expressing his membershipin Confucian movement is Song Ya. Being aConfucian scholar and doctor, he based hisstudy on the Yiling and comprehensive classicalliterature. In his book he developed many theorieson the mechanisms of qi, diagnosis, materiamedica, therapeutic principals, mechanisms ofdisease, pathology classified according to differentregions of the body, gynaecology, obstetrics, andpaediatrics. The work of the author is not wellknown in the West, and sadly underrated. It has,I believe, valuable information particularly suitedto our modern practice.20. Chen Nian-Zu. Qing. Shang Han Lun QjanZhu (Simple Annotation of the Discussion ofCold Damage).
