The first time you fell off your bike as a kid and skinned your knee, you became acquainted with blood.  But most people don’t really understand everything that blood does in our bodies.  And the way blood is viewed in East Asian Medicine is quite different from that of allopathic / Western medicine.  So, let’s take a deeper look at the vital substance known as blood.

In allopathic medicine, blood is composed of red blood cells, white blood cells, platelets, electrolytes, nutrients, proteins and water.  The functions of blood are based on the characteristics of these individual components.  Some of the Western medical functions of blood include distributing hormones, carrying oxygen, carrying energy (glucose and ATP) and supporting the immune system.

In East Asian Medicine, blood is known to do all the same things, but it is not studied at the cellular level and is instead considered how it wholly effects the body.  Blood is viewed simply as the red fluid that is found in the blood vessels and it provides nutrition to the whole body.  The nutrients transported by blood are not just physical in nature.  Blood is seen as a vehicle for qi and it is known to nourish the body, moisten the body and circulate the nutritive qi throughout the body.

Blood is mostly made from food that has been digested and assimilated.  It has special relationships with the spleen, lungs, heart, kidneys and liver and these relationships allow blood to be formed and spread throughout the body.  Blood is also produced with the help of essence or jing, which is stored in the bone marrow.  When everything is in alignment, the blood will provide deep nourishment to the body.

Here is a breakdown of the functions of blood, according to EAM:
1. Nourishes the Body – The main function of blood is to nourish the body. It circulates continuously within the vessels, traveling to the organs in the interior, and to the muscles, tendons, bones and skin in the exterior, providing nutrients.
2. Moistens the Body – Blood also has the function of moistening the body, which qi doesn’t do. The blood of various organs ensures that the skin, hair, eyes, sinews and tongue are properly moistened. For example, liver blood moistens eyes and sinews (since the liver “controls the sinews” and “opens into the eyes”), so that the eyes can see properly and the sinews are flexible and healthy.
3. Harbors the Mind – East Asian Medicine believes that the mind (Shen) lives in the heart and more specifically in the blood vessels (part of the system of the heart).  When blood is deficient, the mind lacks its foundation, resulting in restlessness, anxiety, slight irritability, a feeling of dissatisfaction and insomnia.
4. Blood Determines Menstruation – Pathologies of the blood in women often primarily manifest themselves via their impact on menstruation. For instance, blood deficiency leads to scanty periods or an absence of periods. Similarly blood heat often causes heavy periods.

The relationships of blood within the body are complex.  The circulation of blood results from the mutual action of the heart, lungs, spleen, liver and kidneys. The heart governs the blood by making it circulate.  The spleen makes the blood by creating grain qi.  The liver stores the blood.  The lung qi enters the heart to promote the transformation of blood.  And lastly, the kidneys also have a strong role in the blood creation process.  Of all these, the heart, spleen and liver are the most important relationships with blood.

Blood and the Heart – The heart governs blood. It is the place where heart fire (yang) transforms the mixture of grain qi and clean air into blood (yin). It also is responsible for the circulation of blood throughout the body to all the organs, muscles, tendons, sinews, skin and hair.

Blood and the Spleen – The spleen is the origin of blood, as it produces grain qi which transforms into blood.  Spleen qi is responsible for keeping blood in the vessels. If spleen qi is deficient, qi cannot hold the blood in the vessels and that may result in various forms of bleeding, as well as a tendency to easily bruise.

Blood and the Liver – The liver stores blood. This important function has several meanings. When a person is active, blood flows to the muscles and sinews to moisten them for flexibility and movement. When a person rests, blood moves back to the liver where it is stored and regenerated. Therefore, it is important to rest and lie down when there is blood deficiency (especially liver blood deficiency).

Liver blood also functions to moisten the eyes, promoting good eyesight. Liver blood also moistens the sinews and tendons, supplying flexibility to the joints.

Thirdly the liver also regulates the flow of qi and blood.  It regulates the rate of blood flow within the vessels according to our different physiological needs (activity, rest, etc.).

Lastly, liver blood supplies the uterus with blood and is extremely important for the physiology and pathology of menstruation. Because the liver also regulates the rate of blood flow, periods which are too light or heavy, are often due to a disharmony of the liver blood. Deficient liver blood can lead to amenorrhea or scanty periods, while stagnant liver blood can cause painful periods.

Blood and Essence (Jing) –  Essence stored in the kidneys plays a critical role in the formation of blood. However, it’s a mutually beneficial relationship because blood also nourishes and replenishes the “post-heaven essence”.

Next, we have to explore the relationship between blood and qi.  A traditional saying states that “Qi is the commander of the blood and blood is the mother of qi.” This refers to the inseparable relationship between blood and qi. Blood is actually a form of qi.

Here are the ways that qi and blood are intertwined:
1. Qi Generates Blood – Grain qi from food is the foundation of blood.  It is combined with clean air from lung qi to create blood.  Both are essential for blood production.  So if qi is deficient, blood will also eventually become deficient. This is why qi tonics are frequently given with blood tonics as a remedy for a deficiency of blood.
2. Qi Moves Blood – Qi is the force which moves and circulates blood. If qi is deficient or doesn’t move sufficiently, it can’t push the blood and the blood stagnates. A traditional East Asian Medicine statement goes like this, “When qi moves, blood follows” and “If qi stagnates, blood congeals“.
3. Qi Holds Blood – Qi is in charge of holding blood in the vessels, if it is deficient, blood may move out of its pathways, resulting in various forms of bleeding. This function belongs primarily to the spleen. If spleen qi is deficient, qi cannot hold blood and there may be bleeding.
4. Blood Nourishes Qi – Blood nourishes the organs that produce and regulate qi. It also provides a material foundation for qi, which prevents it from rising up or ‘floating’, causing symptoms of empty heat.

The final section to be addressed with regards to blood is blood pathologies.  There are three basic categories of blood pathologies. These are blood deficiency, blood heat and blood stagnation.
1. Blood Deficiency – In blood deficiency, there is insufficient blood to nourish and moisten the body. This usually affects the organs with which it has special relationships. This is mostly caused by a deficiency of spleen qi and stomach qi, since those are the two organs most involved in the creation of blood. However, other organs may also be implicated, especially the liver and kidneys.  Blood deficiency’s main manifestation in women’s menstrual cycle is scanty periods or an absence of periods (amenorrhea).  Other common manifestations of blood deficiency include paleness, dizziness, fatigue and neuropathy.
2. Blood Heat – In blood heat, too much heat in the body, usually in the liver, since it stores the blood, causes heat to accumulate in the blood and pushes it out of the vessels. In women, blood heat often causes heavy periods. Many skin diseases are also due to blood heat.  Other symptoms associated with blood heat include inflammation, agitation, anger, canker sores, flushed cheeks, excessive thirst, headaches and a bitter taste in the mouth.
3. Blood Stagnation – Stagnation occurs from blood moving improperly due to coldness, heat or stagnation of qi.  Blood stagnation is often very painful and commonly associated with injuries or female issues like endometriosis and fibroids. Other common symptoms of blood stagnation are pain, insomnia, cold extremities, headaches, fibromyalgia and blood in the stool.

As you can see, blood plays a major role in East Asian Medicine, as well as allopathic medicine.  This is why it is so important to pay attention to your body and understand that there may be things you are doing on a daily basis that can be detrimental.  By understanding the connections and the functions, everybody can make informed decisions that can help them live happier, healthier lives.

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