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Source｜China Traditional Chinese Medicine News
Author｜Jiao Yi, Beijing University of Chinese Medicine
The author has observed in clinical practice that the pulse of women is particularly slippery on the day before menstruation and on the first and second days of the menstrual period. It is not only smooth like a rolling pearl but also the width of the pulse vessels and the amplitude of the pulse increase. By the third, fourth, and fifth days, the slippery pulse weakens significantly, although the menstrual flow is not heavy. This phenomenon suggests that the essence of slipperiness is the Qi stimulating the blood to surge within the vessels; Qi is the main force, and only when Qi flows like the wind can it be smooth.
Qi is the commander of blood. A woman’s menstruation is similar to a man’s ejaculation, where Qi leads the way as the “general,” guiding the “soldiers” of blood or semen to the critical point of overflow, after which blood or semen is released. The initial surge of Qi is strong, but it diminishes over time. This explains why the slippery pulse is very pronounced at the beginning of menstruation, and although the bleeding may not be heavy later, the slippery pulse weakens due to the depletion of Qi.
Blood is the mother of Qi. Even if the bleeding or semen is not abundant, it can lead to a weakened slippery pulse, and Qi becomes more even, because blood is the mother of Qi; even a small amount of blood, semen, or bodily fluids contains a significant amount of Qi.
The relationship between Qi and blood has been clarified above. Extending this to the relationship between Qi and bodily fluids, we can consider the following case: A 29-year-old male presented with premature ejaculation, dampness in the scrotum, yellow urine, and foul-smelling stools. The pathogenesis was damp-heat descending, but the initial diagnosis with Long Dan Cao (Gentian) Decoction was ineffective. In the second diagnosis, the original formula was combined with Chai Hu Shu Gan San (Bupleurum Powder to Spread the Liver), which was very effective. This indicates that Qi carrying damp-heat was ineffective when only addressing damp-heat, while regulating Qi and addressing damp-heat together was highly effective, highlighting the importance of Qi.
Furthermore, Qi carrying blood, semen, bodily fluids, water Qi, phlegm, and other tangible substances can cause issues, and Qi should flow smoothly. Qi is Yang; it should operate like the sun, rising and setting. Yang is active, and Yin follows Yang, allowing blood, bodily fluids, urine, phlegm, and water Qi to flow smoothly, circulate, or dissipate naturally, preventing chaos. If one stays up late, causing Qi to rise without descending, it is like the sun scorching the earth, leading to irritability.
Qi is Yang, and protecting Yang Qi does not mean warming Yang, but rather maintaining the normal operation of Qi, which is to sustain the normal process of Qi transformation, similar to the formation of clouds and rain, where earth Qi rises to form clouds and heavenly Qi descends as rain. The unity of heaven and man is akin to maintaining the natural formation of clouds and rain, ensuring the normal operation of Qi transformation within the body. Therefore, in terms of Qi, smoothness is precious, while chaos is worthless. For a healthy person, as long as blood and bodily fluids are not lost in large quantities, and Qi transformation is normal, everything is normal.
Regardless of whether the medicine is cold, hot, warm, or cool, it is all aimed at maintaining normal Qi transformation. For example, when a woman’s menstruation is delayed for several months, the common approach among practitioners is to use Gui Zhi (Cinnamon Twig) and Ai Ye (Mugwort) to warm the uterus. This is naturally effective for cold in the uterus and stagnant blood. However, if damp-heat is obstructing, using Gui Zhi and Ai Ye is like adding fuel to the fire; even if warming Yang provides the impetus for Qi to break through the vessels, it can scorch the blood, leading to scanty and dark menstrual flow. If damp-heat is addressed using Bai Jiang Cao (Patrinia) and Sheng Yi Yi Ren (Job’s Tears), it may lead to loose stools, decreased Qi, and subsequently reduced menstrual flow.
Why does warming Yang initially have good effects but later diminish? Because warming Yang is akin to adding fire to steam buns, accelerating the formation of steam, which has the power to impact phlegm, water Qi, and stagnant blood, and can also provide momentum to chaotic Qi, helping it return to normal. However, prolonged use of warming Yang can scorch Yin fluids, leading to a decrease in Yin fluids and a shortage of steam, thus reducing subsequent momentum. Warming Yang only addresses one condition, which is Yang deficiency without fluid depletion. Warming Yang generates fire to produce steam, facilitating the flow of Qi.
We can also refer to Cao Yingfu’s “Shang Han Fa Wei” to analyze Ma Huang Tang (Ephedra Decoction) and Gui Zhi Tang (Cinnamon Twig Decoction) from the perspective of Qi.
In the case of cold damage, Qi is constrained by cold on the surface, initially without fever. The temperature of the blood inside gradually rises, while the pores on the outside are closed, leading to stagnation and fever. The reason for the fever is entirely due to the closure of the pores. Therefore, Ma Huang Tang (Ma Huang, Gui Zhi, Xing Ren (Apricot Kernel), Gan Cao (Licorice)) is used, where Gui Zhi provides the impetus for steam, Ma Huang opens the pores, Xing Ren opens the lung Qi, and Gan Cao nourishes the stomach. This allows the stomach Qi to rise and promotes sweating, resolving the cold damage with a sweat.
In the case of wind stroke, sweating occurs but there is still fever and aversion to cold. If sweating does not resolve the fever, it indicates that the evil Qi is deeper (the evil Qi is in the muscles, deeper than the pores). Here, the fever is due to muscle heat, and sweating does not resolve it. Therefore, Gui Zhi Tang (Gui Zhi, Shao Yao (Peony), Sheng Jiang (Ginger), Gan Cao, Da Zao (Jujube)) is used, where Shao Yao drains muscle heat and gathers Qi to prevent it from dispersing outward, Gui Zhi provides the impetus for the surface, promoting the remaining wind evil to exit through the pores. Since the pores are already open, Ma Huang is not needed. Continuous sweating weakens stomach Qi, so ginger, licorice, and jujube are used to replenish bodily fluids in the stomach to nourish the source of sweat.
From the above analysis, it can be seen that both Ma Huang Tang and Gui Zhi Tang work to maintain normal Qi transformation.
In clinical practice, some tumor patients show no symptoms and are only discovered during examinations. Patients often choose surgical removal for a permanent solution, which can turn a previously asymptomatic high-quality life into one filled with vomiting, diarrhea, insomnia, and other symptoms that lower quality of life. From the perspective of Qi and blood, asymptomatic tumor patients may have formed tangible tumors within, but their Qi transformation state is normal, allowing them to maintain normal eating, drinking, and sleeping. The above discussion demonstrates that even a small amount of blood contains a significant amount of Qi; surgical removal directly damages the flesh and blood, leading to Qi disorder and preventing normal Qi transformation. Qi cannot operate regularly like the sun, illuminating the earth, resulting in various discomfort symptoms. Therefore, for asymptomatic tumor patients, maintaining the normal operation of Qi is essential for sustaining a high quality of life. Using traditional Chinese medicine can subtly alter the living environment of the tumor based on the original Qi dynamics. Coexisting with tumors while maintaining a high quality of life is the ultimate goal of tumor treatment, and in some cases, it can even lead to tumor shrinkage or disappearance.
Editor｜Xu Jing
Reviewed by｜Ma Jun Li Xiu Yun
