Blood (Xue) - Vital Substances in TCM

Blood (Xue) - Vital Substances in TCM

In Traditional Chinese Medicine, it is said...

  • Blood is denser form of Qi
  • Blood is inseparable from Qi
  • Qi moves Blood; Blood is the mother of Qi
  • Qi gives life and movement to Blood, but Blood nourishes the Organs that produce Qi.

Blood and Ying (Nutritive) Qi are particularly closely connected: flow together in the vessels.

The Origin of Blood

  1. Food Qi produced by the Spleen is sent upward to Lungs, and Lungs push it to the Heart, where it is transformed into Blood. The transformation requires the assistance of the Original Qi stored in the Kidneys.
  2. Kidney Essence produces Marrow: this generates the bone marrow, which contributes to making Blood.

Therefore: Blood is formed from the interaction of the Postnatal Jing (source of Food Qi, refined from Food by Spleen and Stomach) and the Prenatal Jing (stored in Kidneys).

Chinese theory of blood forming function of the bone marrow predated the arrival of Western Medicine.

The Function of Blood

  1. Nourishes the body: complements the nourishing action of Ying Qi. As a denser form of Qi, it flows with the (Ying) Qi in the vessels and channels all over the body.
  2. Moistens body tissues, ensures that they do not dry out. Blood is part of Yin, fluid-like and moistening .
  3. Supports the Shen. The Shen is said to live in the Blood Vessels, which are part of the Heart. The Blood nourishes and supports the Shen, giving it a foundation.

Where Blood is deficient, the Shen can become uneasy, with symptoms of vague anxiety, slight irritability, unease and inability to fall asleep.

Relationship of Blood with the Internal Organs

The Heart

  1. The Heart governs the Blood. The Blood Vessels (tissue associated with the Heart and part of the whole system of the Heart in TCM) are where it circulates.
  2. The Blood is made in the Heart, via the Heart Fire (Yang). Blood on the other hand, cools the Fire and prevents it from flaring up.

The Spleen

  1. Spleen produces Food Qi, which is the basis for the formation of Blood.
  2. Spleen Qi keeps the Blood in the Vessels so that it does not extravasate.

(Deficient Spleen Qi can result in Qi being unable to hold the Blood, resulting in hemorrhages.)

The Liver

Liver stores the Blood.
  • When person is active, Blood flows to the muscles and tendons (governed by the Liver). When person lies down, Blood flows back to Liver.
  • Liver Blood moistens the eyes, ensuring good eyesight and also moistens the sinews, promoting flexibility of joints.
  • Liver Blood supplies the uterus with Blood, together with the Penetrating Vessel (Chong Mai - one of the eight Extraordinary or Ancestral Vessels), with which it is closely related. Therefore Liver Blood is very important for regular and healthy menstruation.

The Liver, Blood, and Gynecology

Kidneys store Jing and Liver stores Blood.
Kidneys are the mother of the Liver in 5 Element theory.
Jing and Blood mutually support each other.
Jing is indirectly transformed into Blood, and Blood nourishes and replenishes Jing.
Kidney Jing controls reproductive function and influences Blood. (Kidney Jing creates Liver Blood).

Women's physiology is more dependent on Blood than that of men.
State of Liver Blood is very important regarding menstruation.
E.g., if Liver Blood deficient, this can cause amenorrhea or scanty menstruation.
E.g., if Liver Blood is stagnant, this can cause dysmenorrhea.


  1. Assist Spleen in sending Food Qi to the Heart to form Blood.
  2. Control the channels and Blood Vessels by filling the Blood Vessels with Qi to assist the Heart's pushing action.


  1. Original Qi (stored in Kidneys) is needed to transform Food Qi into Blood.
  2. Kidney stores Jing, which produces Marrow. Marrow generates bone marrow, which contributes to the formation of Blood.

To nourish Blood in TCM, we must therefore tonify (increase energy of) the Spleen and Kidneys.

However, the Heart, Spleen, & Liver have the most direct relationship with the Blood: Heart governs Blood, Spleen holds Blood in the Vessels and the Liver stores Blood.

References Used

The TCM information presented here has been referenced from numerous sources; including teachers, practitioners, class notes from Five Branches University, the following books, as well as other sources. If you have benefited from this information, please consider supporting the authors and their works by purchasing the books below.

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