On the Differences Between Men and Women

On the Differences Between Men and Women

It is commonly believed that men are primarily governed by Qi, while women are primarily governed by blood; hence, it is said that men's blood is precious, whereas women's blood is cheap. Moreover, it is claimed that men's blood differs from women's, yet in fact, they are fundamentally the same. The only difference lies in the fact that women have menstruation, while men do not—this is the sole distinction. However, since both are blood, why does women have menstruation while men do not? The reason is that women are primarily governed by blood, which is yin and flows downward; its movement is driven by Qi. In other words, women rely on Qi to circulate their blood. Qi itself is transformed from water, as previously discussed in detail. The meeting point of Qi and blood is located in the lower abdomen, within the womb chamber—men call it the dantian, while women call it the "blood chamber" (1). This area is under the control of the liver and kidneys, serving as the main hub for Qi and blood. Qi originates from water and is transformed into water; since men are primarily governed by Qi, when blood enters the dantian, it too is transformed into water, because inside the dantian, blood is transformed into something else, not pure water but extremely concentrated and thick, which is referred to as kidney essence (2). Women's Qi can also be transformed back into water, but since women are primarily governed by blood, their Qi within the blood chamber is entirely transformed into blood, resulting in menstruation. Nevertheless, there is still some water-like substance generated by Qi within the blood, so menstruation is also called "menstrual water," and there is always a pale-colored fluid before and after menstruation. This shows that women's blood always relies on the water component of Qi to initiate and facilitate its flow. Understanding this, we realize that men's essence belongs to Qi and water, yet it never lacks blood or fire; similarly, women's menstruation belongs to blood and fire, yet it never lacks Qi or water. Therefore, if a man's essence is thin, it indicates blood deficiency; if a woman's menstruation is abnormal, it indicates Qi stagnation. Question: It is indeed true that men are primarily governed by Qi and women by blood, as described above (3), but why must women have menstruation while men do not? Answer: Menstrual blood is simply the surplus of blood. As new things are born and old ones are eliminated, this is the natural law of heaven and earth. Hence, the moon waxes and wanes, and the tides rise and fall (4). For women, blood is constantly renewed through the process of eliminating the old and generating the new, so when it reaches fullness, it overflows; when it is full, it must diminish. Women experience menstruation once a month precisely to discharge the excess blood. Since blood is yin and flows downward, it naturally exits from the lower part of the body, becoming menstrual blood. As for men, although they do not have menstruation, they still need to discharge their surplus. Men are primarily governed by Qi, which is yang and flows upward, so the remaining blood does not exit downward but rises along with the Qi, following the Chong and Ren meridians up to the lips and chin, where it grows into facial hair. The growth of facial hair is precisely the way men discharge their surplus blood. Therefore, women have menstruation, while men do not grow facial hair, male

The method of tonifying spleen yang has been thoroughly discussed by previous scholars, but few have specifically explored the method of tonifying spleen yin. I would like to highlight this point, so that people understand that yin and yang should never be neglected.

Tonifying spleen yin to stimulate appetite and promote food intake was discovered through my clinical experience, and I based it on the three characters "preserving fluids" mentioned in the "Shanghan Lun." Beyond that, there is no other evidence. After completing the book, I later came across five Western medical methods, one of which states that the stomach digests food through gastric juice, and that sweet pancreatic juice (7) and bitter bile juice also enter the intestines to digest food. What I refer to as "juice" is precisely what Western medicine calls "fluids." Western medicine often talks about physical substances while neglecting underlying principles (8). However, this particular point actually refers to physical substances, and it does not contradict the principles at all; rather, it serves to confirm my argument, so I am recording it here as well.

[Notes]

(1) Blood chamber: Usually refers to the uterus, liver, and Chong and Ren meridians; here it specifically refers to the uterus.

(2) Kidney essence: Essence is the material basis of life, and it usually has two meanings: ① essence derived from food and water; ② reproductive essence. Kidney essence refers to the latter, because the kidneys are responsible for its production, storage, and excretion, hence the name "kidney essence."

(3) Indeed as stated: Exactly as described.

(4) Tides (xī): Due to the influence of the moon and sun, seawater rises and falls twice a day. When the sea rises in the morning, it is called tide; when it rises in the evening, it is called ebb tide.

(5) Perhaps we can make the most of its wonderful effects! "Shu" means "almost," expressing hope. "Jin shen" comes from the "I Ching": "Beat it and dance it, to exhaust its spirit." That is, to fully utilize its wonders. "Yu" is a particle used to express tone.

(6) The middle burner receives qi and extracts juice, which then turns red and becomes blood: The original text of "Ling Shu·Jue Qi Pian" reads: "The middle burner receives qi and extracts juice, which then turns red and becomes blood." This indicates that blood is formed through the subtle transformation of fluids absorbed by the gastrointestinal tract.

(7) Sweet pancreatic juice: Refers to pancreatic juice.

(8) Talking about substances while ignoring principles: Discussing only concrete things and surface phenomena, while neglecting the underlying principles and internal laws.

[Commentary] This article takes "men are primarily governed by Qi" and "women are primarily governed by blood" as its starting point, and uses logical reasoning to explain the physiological differences between men and women. It refutes the feudal misconception that "men's blood is precious" and "women's blood is cheap" with simple and clear arguments. The author believes that men are primarily governed by Qi, which is yang and flows upward, so blood follows the upward flow of Qi and eventually forms facial hair; women are primarily governed by blood, which is yin and flows downward, so blood forms menstruation. Both women's menstruation and men's facial hair are merely remnants of blood, but because men and women are governed by different elements, there are differences in their rise and fall. Below the navel, men have the dantian, while women have the blood chamber; both serve as the main hub for Qi and blood. A woman's Qi entering the blood chamber can be transformed into blood, resulting in menstruation. A man's blood entering the dantian can be transformed into Qi, and can also be transformed back into water, becoming kidney essence. Although women's menstruation is more blood-heavy and fire-rich, while men's kidney essence is more Qi- and water-heavy, women's menstruation still contains Qi and water, and men's kidney essence still contains blood and fire.

Only in this way can normal physiological functions be maintained. Both men's and women's blood must follow their natural pathways; otherwise, blood will not flow according to the meridians. In women, this can lead to uterine bleeding and infertility; in men, it can cause blood not to nourish the body and result in hematemesis and epistaxis. The author believes that menstruation is a physiological manifestation of eliminating the old and generating the new. "Old" refers to stagnant blood; if stagnant blood does not flow, new blood cannot be produced. Therefore, in treatment, he places particular emphasis on "methods to remove stasis and generate new blood." He also believes that this approach is not only applicable to regulating menstruation in gynecology, but also important for treating hematemesis, epistaxis, and pus-filled lesions in both men and women. Furthermore, he cautions against viewing "removing stasis" and "generating new blood" as two isolated methods. "Removing stasis" can "generate new blood," and "generating new blood" can "remove stasis"; the two are mutually reinforcing and dialectically related. Based on the "Inner Canon's" statement that "the middle burner receives qi and extracts juice, which then turns red and becomes blood," the author believes that the origin of blood production lies in the spleen and stomach, and therefore the root of treating blood disorders should also be in the spleen and stomach. Consequently, he emphasizes the importance of the spleen and stomach in treating blood diseases. In terms of regulating the spleen and stomach, previous scholars mainly focused on tonifying spleen yang to strengthen the spleen, but he believes that nourishing spleen yin is equally important. He also points out that the bile and pancreatic juice mentioned by Western medicine are similar to the "fluids" mentioned in traditional Chinese medicine, both containing the meaning of spleen yin.