II. Righteous Qi and Immunity

II. Righteous Qi and Immunity

In general, the righteous qi referred to in TCM represents the body's intrinsic resistance to disease, which is analogous to the physiological functions of the human immune system. The body's immune system comprises non-specific immunity and specific immunity. Non-specific immunity is innate, with a defense function that is non-selective and exerts varying degrees of influence on all kinds of pathogens, including normal physiological functions such as the skin-mucosal barrier, blood-brain barrier, blood-fetal barrier, phagocytic action of reticular endothelial cells and neutrophils, as well as the bactericidal enzymes, complement proteins, and interferons present in body fluids. Specific immunity is acquired, and it is targeted, acting only on particular pathogens, including the clearance of corresponding antigens by immune-active T cells and their associated lymphokines, as well as the action of antibodies (immune-active globulins) present in body fluids that correspond to different antigens.

In TCM's righteous qi, wei qi is similar to non-specific immunity. The "Lingshu·Benzang Pian" states: "Wei qi warms the flesh, fills the skin, nourishes the pores, and controls the opening and closing of the orifices." It also says: "When wei qi is harmonious, the flesh is relaxed and the skin is soft, and the pores are tightly closed." This indicates that wei qi is an important factor in eliminating foreign pathogens in peripheral tissues such as muscles, skin, and mucous membranes, functioning as a skin-mucosal barrier. Wei qi can vigorously resist invading pathogens, and the fierce struggle between the two leads to disease. The "Suwen·Zhenglun" says: "Where wei qi is present, it combines with evil qi to cause disease." This phenomenon is similar to the immune response triggered by phagocytes engulfing pathogenic microorganisms. Sometimes wei qi can even surround invading evil qi, causing local abscesses. As the "Suwen·Fenglun" states: "Wind qi enters the meridians along with the sun, spreads between the flesh and muscles, interacts with wei qi, and since the pathway is unfavorable, the muscles become angry and develop sores." The "Suwen·Yongyang Pian" also says: "When cold evil invades the meridians, blood stagnates... Stagnant blood cannot flow, and when it cannot flow, wei qi follows and becomes blocked, unable to move freely, resulting in heat. Persistent high heat leads to tissue decay, and decaying tissue turns into pus." This once again illustrates how similar wei qi is to the phagocytic action of neutrophils and reticular endothelial cells in immunology. Wei qi's role is not limited to skin, flesh, and pores; it also protects internal organs. The "Lingshu·Weiqi Xing Pian" says: "It initially enters yin, often starting from the Shaoyin meridian and going to the kidneys, then to the heart, then to the lungs, then to the spleen, and finally back to the kidneys, completing a cycle." This shows that wei qi can travel through all the zang-fu organs and meridians, much like the reticular endothelial system distributed throughout the body and the systemic humoral immune system circulating throughout the body. The "Suwen·Bilun" says: "Wei qi is the vigorous qi of food and water... It permeates the peritoneum, spreads throughout the chest and abdomen, and if it encounters resistance, it causes disease; if it encounters no resistance, it heals." Thus, wherever wei qi travels, it fights against evil qi—if wei qi loses, disease occurs, which is called resisting qi; if wei qi wins, disease is cured, which is called following qi. This is similar to the outcome of immune responses triggered when pathogens enter the body. The above discussion demonstrates that wei qi in righteous qi has a function similar to non-specific immunity in modern immunology.

In righteous qi, yuan qi is similar to specific immunity. Yuan qi is kidney qi, encompassing both kidney yin and kidney yang, and is the decisive factor in maintaining the body's internal yin-yang balance. The "Suwen·Shengqi Tongtian Lun" states: "When yin is balanced and yang is concealed, spirit is well-regulated... When yin and yang are out of balance, qi is exhausted." This emphasizes that yin-yang balance is a prerequisite for maintaining the body's normal physiological state; once yin-yang balance is disrupted, the body becomes ill, even to the point of death. Modern immunology believes that the functions of T cells dependent on the thymus and B cells independent of the thymus are the main components of specific immunity, or adaptive immunity, and that the precursors of these two types of cells are stem cells located in the bone marrow. The "Suwen·Yinyang Yingxiang Dalun" says: "Kidneys generate bone marrow." From this, it can be inferred that the transformation of bone marrow stem cells into T cells and B cells, as well as the functional states of these two types of cells, are closely related to the kidneys in TCM. Therefore, it is conceivable that by regulating kidney yin and kidney yang, one can improve the body's specific immune response. Modern TCM experimental research has proven that kidney yin and kidney yang are essentially the functions of the hypothalamus-pituitary-adrenal cortex system. Modern immunology believes that the pituitary-adrenal cortex system promotes adrenal cortical secretion through ACTH, thereby reducing and suppressing immune responses, while growth hormone secreted by the pituitary increases and stimulates immune responses. Moreover, this system is maintained by antigens, antibodies, lymphokines, and the nervous system, ensuring its own endocrine characteristics and stabilizing immune function.

In summary, TCM's righteous qi has the meaning of immune function in modern immunology. Wei qi in righteous qi is equivalent to non-specific immunity, while yuan qi is equivalent to specific immunity.

The body's immune process has three functions: physiological defense, self-stabilization, and immune surveillance. These three functions are jointly undertaken by non-specific immunity and specific immunity, which coordinate with each other and work together. For the same organism and the same organ tissue, the immune function produced is the product of the combination of non-specific immunity and specific immunity, just as wei qi and yuan qi exist simultaneously to form the body's righteous qi.

III. Reinforcing Righteous Qi and Consolidating the Root vs. Immunotherapy

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The body's vital energy is equivalent to the immune function of the organism; therefore, reinforcing vital energy and nourishing the root undoubtedly carries the significance of immunotherapy. Wei qi is generated from food and water, originating in the spleen and stomach. From the perspective of its formation, it can be regarded as another aspect of middle qi. Based on this, employing the method of tonifying middle qi and benefiting qi can enhance the pathogen-dispelling effect of wei qi. The traditional Chinese medicine practice of using Buzhong Yiqi Tang to treat and prevent deficiency-induced colds is a clinical application of this concept. In recent years, domestic experimental studies have shown that Buzhong Yiqi Tang can indeed improve protein metabolism in tumor-bearing organisms and enhance their resistance. For example, the Isotope Laboratory of the Beijing Tuberculosis Research Institute administered intravenous injections of 13I-labeled plasma protein colloidal solution to animals, measuring the clearance rate in the blood as an indicator of the phagocytic function of the reticuloendothelial system. It was found that qi-tonifying herbs such as Codonopsis pilosula, Atractylodes macrocephala, and Astragalus membranaceus (the basic ingredients of Buzhong Yiqi Tang) had the effect of enhancing the phagocytic function of the reticuloendothelial system, whereas the control group consisting of yin-nourishing and heat-clearing herbs like Adenophora stricta, Lilium brownii, Fritillaria cirrhosa, and Scutellaria baicalensis showed no such effect. Experiments also demonstrated that Codonopsis pilosula could increase the number of white blood cells in peripheral blood counts. Furthermore, injecting Codonopsis pilosula extract into rabbits resulted in an increased proportion of neutrophils in the peripheral blood. These two experiments suggest that Codonopsis pilosula, which tonifies middle qi, can strengthen the defensive function of white blood cells. The Guang’anmen Hospital of the Chinese Academy of Traditional Chinese Medicine measured the phagocytic function of macrophages in 89 patients with malignant tumors, and all their phagocytic rates were significantly lower than those of healthy individuals. This indicates that the non-specific immune function of diseased organisms is lower than normal. Among them, five cervical cancer patients who received Fu Zheng therapy with spleen-strengthening and qi-benefiting effects saw a significant increase in macrophage phagocytic function, demonstrating that Buzhong Yiqi therapy can enhance the non-specific immune function of the body. The Shanghai Acupuncture Treatment Mechanism Research Group reported that after acupuncture at Zusanli for 2–4 hours in rabbits, the number of white blood cells increased markedly; however, no changes in white blood cell counts were observed after acupuncture at Shangjuxu, Chengshan, or when stimulation was applied to the skin, nerves, or non-acupoint locations. This suggests that only Zusanli (the Foot Yangming Stomach Meridian), which can regulate the functions of the spleen and stomach (middle qi and wei qi), can improve the non-specific immune function of the body, while other meridian points do not have this effect.

From the above data, it can be seen that using traditional Chinese medicine methods to tonify middle qi and regulate wei qi can enhance the phagocytic functions of macrophages, neutrophils, and the reticuloendothelial system, revealing that this therapy has the effect of promoting non-specific immune function.

As for improving specific immune function, numerous experiments have shown that traditional Chinese medicine kidney-tonifying therapies often achieve this goal. The Shanghai Cancer Research Institute used crude fetal alpha-fetoprotein as an antigen to immunize rabbits, inducing an immune response, then divided them into groups to administer kidney-yin-tonifying drugs and kidney-yang-tonifying drugs for antibody measurement. The results showed that yang-tonifying drugs could accelerate antibody formation, while yin-tonifying drugs could prolong antibody survival, indicating that kidney-tonifying therapies can improve specific humoral immune function. Some researchers conducted rose flower ring tests on patients with chronic bronchitis due to kidney deficiency to measure their specific cellular immunity, finding that the ratio of T cells in these patients was generally low. After administering kidney-tonifying herbal medicines, the T cell ratio gradually increased, and clinical symptoms improved accordingly. Others, from the perspective of specific humoral immunity, measured that the IgA content in the sputum of chronic bronchitis patients tended to increase. The First Outpatient Clinic of the Chengdu Military Region conducted serum IgA and IgG measurements on more than 50 patients with chronic bronchitis due to kidney deficiency, and the values were all below normal: IgA averaged 71.62 mg%, while the normal range is 96–440 mg%; IgG averaged 596.30 mg%, while the normal range is 1000–2000 mg%. After applying warming and tonifying kidney-yang drugs via navel patches, the above indicators all increased to varying degrees. This demonstrates the regulatory effect of warming and tonifying kidney-yang on specific humoral immunity.

In clinical trials, some researchers used in vitro lymphocyte transformation tests to study chronic bronchitis and found that yang-tonifying drugs could increase the lymphocyte transformation rate in patients with chronic bronchitis. Others used compound yang-tonifying drugs to treat nasopharyngeal carcinoma patients and also found that they could increase the lymphocyte transformation rate. These two sets of experimental results indicate that yang-tonifying drugs can promote and regulate the transformation of lymphoblasts within T cells and the release of lymphokines, thereby enhancing the body’s cellular immunity.

IV. Fu Zheng Pei Ben Therapy for Immune Diseases

Immune responses are physiological reactions that typically serve three functions: physiological defense, self-stability, and immune surveillance, thereby maintaining the body’s normal disease-resistance capacity. Both excessive and insufficient immune responses are detrimental to the effectiveness of immunity and can lead to immune diseases. Excessive responses refer to hypersensitivity reactions, such as allergic diseases and autoimmune diseases; insufficient responses refer to weakened immune function or damage to immune mechanisms, such as immunodeficiency diseases and states of increased susceptibility to infection. In some abnormal immune responses, although one of the non-specific or specific immune mechanisms may be more dominant, the other often participates synergistically, interacting with each other, complementing or restraining one another. Therefore, when treating such diseases with immunotherapy, it is essential to adopt a comprehensive approach that considers both specific and non-specific immunity. Traditional Chinese medicine’s Fu Zheng Pei Ben therapy for these conditions often includes, in the same prescription, qi-tonifying herbs such as Codonopsis pilosula, Atractylodes macrocephala, and Astragalus membranaceus to reinforce middle qi and support wei qi, as well as six-herb and eight-herb formulas that greatly tonify kidney qi and regulate yin and yang. This traditional medication method aligns with the aforementioned viewpoint.