Qi, Blood, and Fluids: The Complete Guide—The Very First Framework for Viewing the Body in Kampo

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Hello everyone. This is Yuyu Kampo.

Have you ever felt overwhelmed by the sheer number of prescription names when trying to learn Kampo? There are just as many names for crude drugs, and it's hard to know where to start. I myself stopped at the same place.

However, the framework for viewing the body in Kampo is actually not that extensive. The first things to grasp are the three elements: 'Qi,' 'Blood,' and 'Fluids.'

This article is a definitive guide that brings those three together. I hope you will keep it on hand and open it whenever you need it.

What the three elements mean

In Oriental medicine, it is believed that three things circulate within the body.

Qi is the invisible force that moves the body. The beating of the heart, the digestion of food, the healing of wounds, and the maintenance of body temperature are all considered to be the work of Qi. In terms of a house, it corresponds to electricity. It is invisible, but if it stops, nothing will move.

Qi is said to have four roles: warming the body, protecting it from external cold, heat, and the causes of illness, pushing Blood and Fluids along, and supporting internal organs and Blood so they do not fall from their proper places.

Blood is the flow that delivers nourishment and moisture to every corner of the body. While it overlaps with blood in Western medicine, Oriental medicine considers it to have an additional role of calming the mind. This is why shallow sleep and unexplained anxiety are viewed as a deficiency of Blood. Blood reaches the extremities such as the skin, hair, nails, eyes, and muscles, and when it is insufficient, changes appear there first.

Fluids are all moisture in the body other than Blood. Sweat, tears, saliva, and the fluid that lubricates joints are all included in Fluids. They play the role of moisturizing the body and cooling down heat.

Disorders occur because of 'deficiency' or 'stagnation'

Each of the three elements can become disordered in two ways: either they are insufficient or they are stagnant. Just these two.

If there is not enough electricity in a house, the lights will be dim. If the wiring is clogged, even if there is enough electricity, that room will not have light. Both look like the same result, but the causes and the ways to fix them are opposite.

Three elements and two states. That makes six. The entrance to Kampo is sufficient with just these six for now.

The six states and their signs

Qi Deficiency (Kikyo) — Insufficient Qi

Getting tired after moving just a little. Having no energy in the afternoon. Voice becoming quiet. Poor appetite and feeling very sleepy after meals. Easily catching colds and having them linger. Feeling like the stomach has dropped in the evening.

A clue for identification is that you feel better when you rest.

Qi Stagnation: When Qi is blocked

A feeling of a lump in the throat or pit of the stomach. Abdominal bloating. Frequent burping or sighing. Alternating between irritability and feeling down. Symptoms that change location from day to day. Symptoms that worsen after tension.

A clue for identification is that you feel better when you move.

Blood Deficiency: When there is not enough blood

Dizziness upon standing. Pale complexion or pale lips. Brittle nails. Thinning hair. Dry or blurry eyes. Leg cramps. Shallow sleep with many dreams.

A clue for identification is that the color becomes pale.

Blood Stasis: When blood is stagnant

Stiff shoulders or headaches that always occur in the same spot. Dark circles under the eyes, dull skin. Easy bruising and slow healing of bruises. Cold hands and feet but a flushed face. Dark-colored lips.

A clue for identification is that the color becomes dark, and the location does not change.

Yin Deficiency: When there are not enough fluids

Frequent thirst or dry throat. Dry skin and hair. Hot palms and soles of the feet. Night sweats. Feeling a flush of heat in the face in the evening.

Clues for identification are dryness and heat. In humid Japan, fluid stagnation is a more common complaint, but there are times when internal moisture decreases due to summer air conditioning or aging.

Fluid Stagnation: When fluids are stagnant

Swelling in the legs in the evening. A heavy, sluggish body. A heavy head. Feeling unwell before rain or due to low atmospheric pressure. Dizziness or a floating sensation. Nausea. Teeth marks on the edges of the tongue.

A clue for identification is that it changes with the weather.

Determining the direction with three questions

When you are unsure, try asking yourself these three questions in order.

First: Do you feel better when you rest, or when you move? If you feel better resting, it is a deficiency; if you feel better moving, it is a stagnation.

Second: Look in the mirror—is your color pale or dark? If it is pale, it points toward Blood Deficiency; if it is dark, it points toward Blood Stasis.

Third, does it change with the weather? If you feel unwell before it rains, consider water stagnation.

Representative Prescriptions

For each condition, there is a core prescription that serves as a basis for thinking. You do not need to memorize the names. It is enough to keep the direction of 'replenish if deficient, move if stagnant' in the back of your mind.

On the side of Qi deficiency, Hochuekkito is often mentioned. The central crude drugs are Astragalus and Ginseng.

On the side of Qi stagnation, there is Hangekobokuto. It appears when a sensation of a lump in the throat is the focus of the consultation.

The foundation for the side of Blood deficiency is Shimotsuto. It is composed of four ingredients: Angelica Root, Cnidium Rhizome, Peony Root, and Rehmannia Root, and it is incorporated into many prescriptions.

In situations where Blood deficiency and water stagnation overlap, Tokishakuyakusan is mentioned, and on the side where Blood is stagnant, Keishibukuryogan is mentioned.

On the side where water is stagnant, there is Goreisan. In situations where the body is cold and the power to move water itself has dropped, Shinbuto appears.

*Kampo medicines vary from person to person depending on their constitution (sho) and symptoms. To choose a Kampo medicine that suits you, please do not rely on self-judgment and be sure to consult a pharmacist or doctor knowledgeable about Kampo. Also, if symptoms are severe, persist for a long time, or change suddenly, please consult a medical institution first.

Lifestyle Habits by Direction

For those on the deficiency side, the goal is not to reduce before replenishing. Stop staying up late for one day. Reduce your schedule by one task. Cut back on one cold drink. Since both Qi and Blood are made from what you eat, drastically reducing your food intake will thin out the materials. For those with Blood deficiency, try adding one dark-colored food such as black sesame, black beans, hijiki, or jujube. Avoiding excessive eye strain also helps protect Blood. For those with Yin deficiency, be mindful of foods that moisturize the body (white wood ear mushrooms, yams, pears, white sesame, etc.) and try to cut back on spicy foods or alcohol, which can dry out the body's moisture.

For those on the stagnation side, the goal is to move and warm. Exhale slowly and deeply. Walk. Rotate your shoulders. Soak in a bathtub. Do not stay in the same posture. Since coldness exacerbates all types of stagnation, do not let your ankles or abdomen get cold, even in summer. For those with water stagnation, try creating opportunities to sweat and rotating your ankles.

Key Points of This Article

I have summarized just the key points for you to save.

• Kampo views the body through three elements: Qi, Blood, and Water

• Disorders occur in two ways: 'deficiency' or 'stagnation.' Three times two equals six

• Qi is the invisible force that moves the body. It warms, protects, pushes, and supports

• Blood carries nutrients and moisture, and calms the mind. When deficient, changes appear from the extremities

• Water is moisture other than blood. When deficient, it causes dryness and hot flashes (Yin deficiency); when excessive, it causes heaviness and swelling (water stagnation)

• Qi deficiency feels better when resting; Qi stagnation feels better when moving

• Blood deficiency causes a pale color, while blood stasis causes a dark color and fixed location.

• Fluid stagnation changes with the weather. Tooth marks on the edges of the tongue are a clue.

• It is normal for two or three to overlap. You do not need to settle on just one.

• Do not reduce the deficient side; move and warm the stagnant side.

Tomorrow, I will send you practice questions to review the content from this past week. If you try working through them yourself rather than just reading, you will be surprised at how much better the information sticks.

I hope your daily life becomes even a little more energetic and comfortable.

Yuyu Kampo

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