1. On Qi, Blood, Water, and Fire

1. On Qi, Blood, Water, and Fire

Regarding the interrelationships among these four elements, traditional Chinese medicine has long provided a variety of doctrines that guide clinical practice. For example, Zhu Danxi’s assertion that “excess qi becomes fire,” Zhang Zhicong’s claim that “blood is the juice of the middle burner,” as well as concepts such as “qi is the commander of blood,” “blood is the mother of qi,” and “water and fire are in harmony,” all illustrate the shared origins of qi and fire, blood and water, as well as the mutual restraint and interdependence between qi and blood, and between water and fire. However, the mutually generating relationships between water and qi, and between blood and fire, have long been overlooked. Tang Rongchuan conducted thorough research and summarization on these topics, arguing that “water transforms into qi,” “qi and water are essentially one family—treating qi is treating water, and treating water is treating qi,” and “fire transforms into blood,” “blood and fire are originally one family—treating fire is treating blood.” He also cited numerous clinical examples to prove the reliability of these arguments. For instance, when solar qi fails to reach the surface, sweat cannot be released externally, and phlegm accumulates internally; when yin water is insufficient, it can cause dry cough above and constipation below, illustrating the principle that qi and water can mutually cause disease. In terms of treatment, ginseng can tonify qi and also generate fluids; Pig Ling Tang can moisten and drain phlegm and qi—these examples demonstrate the clinical rule that water and qi should be treated together. This perspective, to a certain extent, enriches our understanding of the dialectical relationships among qi, blood, water, and fire.