This is Part 2 of a series of articles detailing the 21 Things Every Internal Martial Artist Should Know about Chinese Medicine, by Tom Bisio.
More than one senior master in Beijing has told me: “if you want to understand the Nei Jia, you have to know Chinese medicine.” This does not mean you have to be a doctor of traditional Chinese medicine, but it does mean you need to know a few basic Chinese medical facts and principles. Virtually everything in the Chinese internal martial arts is congruent with traditional Chinese medicine. Many of the movements common to the internal martial arts have the dual purposes of teaching martial techniques with correct body mechanics and simultaneously harmonizing organs and meridians.
Read Part One of this article HERE.
6. Qi is the Commander of Blood and Blood is the Mother of Qi.
Qi and Blood are distinct, but are mutually dependent and interconnected. Qi creates and circulates the Blood and keeps it flowing in its pathways, the blood vessels, capillary beds, tissues and organs it perfuses. Blood only moves because it is propelled by the Qi. When Qi moves, Blood also moves. Blood in turn nourishes the organs that produce and regulate the movement of the Qi. Therefore, Blood and Qi, have a Yin-Yang relationship: Yin (the Blood) nourishing and lubricating the functional activities of the Yang (the Qi), and Yang in turn moving and transforming the blood and the substances that make up the blood.
One of the internal harmonies cultivated in the internal arts is for Qi to follow Intention. In practicing martial arts, one is strengthening and harmonizing this relationship of Qi and Blood, so that the blood is smoothly led by to the tissues and organs by the intention and the movements. Smooth, coordinated movement, meshed with intention, leads to smooth, coordinated circulation of Qi and Blood.
7. Qi stagnation leads to Blood stasis and congealed Blood.
Because the Qi moves the Blood, any impairment to the smooth circulation of the Qi can lead to blood stagnating. The term Xue Yu – “Blood Stasis” or “Static Blood” – generally is taken to refer to Blood that is not moving, and has congealed or accumulated, like silt in a river. Just as silt obstructs and slows the normal movement of water in the river, static blood obstructs the free flow of Blood in the vessels, and simultaneously impedes the production of new or fresh Blood. This can happen because of a of a blow, a fall, or even an internal organ imbalance. Martial artists need to be aware of the relationship between stagnant Qi and Blood stasis, because an impact may initially only effect the Qi, causing it to stagnate. If this blockage of Qi is removed immediately, the body will right itself and the Blood will not be significantly effected. However, if untreated, there is always the possibility that this relatively minor injury becomes something bigger over time as Blood begins to stagnate in the injured area and deeper levels of circulation are effected.
A blow or injury may be hard enough to burst blood vessels in the local area, causing Qi, blood and other fluids to stagnate at the same time. A good example of this is a sprained ankle. In this case, dispersing the blockage of Qi and blood may require stronger measures. Understanding that stagnant Qi can lead to stagnant Blood encourages one to treat small things immediately, so that they stay small. A blow to the carotid sinus, or a choke hold that temporarily makes someone unconscious, is effectively a sudden blockage of Qi that should be dealt with immediately. Revival techniques were created for just this purpose. A blow to the shin is a stoppage of Qi and often fluids, that if treated with Die Da Jiu (Trauma Liniment) immediately will resolve very quickly. Left untreated, these kind of injuries often lead to chronic problems.
In enduring chronic diseases, there is usually some form of stasis and “Dead Blood.” In Die Da (literally “Fall/Hit or Trauma) Medicine, blood that is fixed and unmoving is often called ‘dead blood’ or ‘congealed blood’. This conveys not only the idea of a silt-like accumulation, but in Die Da circles it also implies a binding obstruction of the network vessels and the soft tissues. This ‘dead’ blood has not only accumulated, but also hardened, so that it is congealed or dried and cannot return to normal circulation. It stays in the tissues, and the small capillary-like vessels, which include small blood vessels, called the blood network vessels. 
In sports and martial arts injuries ‘Dead Blood’ is often a result of improper treatment, or lack of treatment. For example at the time of the injury, icing the injury or wrapping it tightly, so that extravasated blood is stuck in the tissues. As the blood congeals and dries it can block circulation in the network vessels, or even remain outside the vessels in the tissues, where it prevents normal circulation and restricts movement in these tissues. If allowed to accumulate after an injury, this kind of ‘dead blood’ can create enduring chronic problems that are difficult to treat This is why it is important to treat injuries correctly when they first occur. Repetitive micro-injuries injuries, such as hand or leg toughening through hitting sandbags, or the repeated shin injuries at the level of the periosteum of the bone that occur in arts like Thai boxing, can cause problems later – particularly if they inhibit fluid movement through the local area, or combine with the penetration of cold into the superficial layers of the body. In theory, these types of injuries can even lead to blood clots as they slowly, over time, begin to effect the circulation more profoundly.
8. No free-flow there is pain; Pain there is no free-flow.
Lack of free-flow can be called blockage, meaning an area of the body where the Qi and Breath do not flow smoothly, where the movement and ongoing transformation is interrupted or obstructed. Obstruction is rarely total. Qi and Breath will come up against an obstructed area and attempt to flow around it, just as a river flows around a rock or a log in its path. However, this diversion can mean that the Qi and Breath do not circulate smoothly in the area behind the blockage. Similarly, Qi and Breath may trickle, rather than flow, through a blocked area. In both instances, this retards or drags on the smooth uninterrupted free-flow of Qi and Breath, creating a kind of “dead zone” that always feels “not quite right.”
How do we know something is blocked? Pain is one indicator. The following saying from traditional Chinese medicine sums up this idea succinctly:
There is no pain when Qi flows freely. If the Qi blocks, there is pain. Areas that are tight and painful are blocked. The pain may not be intense. It may be mild or almost unnoticeable. This blockage may be experienced not so much as “pain,” but as tension. Tension may be perceived more externally as tight, jumpy muscles, or it may manifest internally, as an emotional tension or tightness. Often it is both.
Therefore, whether one has an injury, or just tightness due to inner tension, the key is to restore or create free-flow (unobstructed circulation). In order to do this, we must remember that pain and tension are treated and resolved by restoring “free- flow,” not through palliatives that relieve or mask pain. Chinese herbs that are said to “kill pain” in Die Da Jiu (Trauma Liniment), Die Da Wan (Trauma Pills), or other herb formulas for pain and muscle aches, do so by breaking blockages of Qi and Blood and restoring free-flow. They do not mask or cover up the pain. Similarly, exercises and breathing techniques that help us to relax and release muscles and inner tension do so by restoring free flow. Reducing pain and tension allows a return to normal movement, which in turn aids free-flow.
A interesting effect of restoring free-flow is that it sometimes initially leads to an increase in sensitivity and perception of pain. This usually occurs when there is a “dead zone” that has reduced free-flow. Sometimes the reduction in free-flow is great enough to actually reduce sensitivity and perception in the local area. Other parts of the body compensate and may feel tight or painful, but the really blocked area feels numb, as though the mind and body’s ability to communicate with this area has been broken. As this “dead” area “wakes up,” as free-flow is being restored, it actually becomes painful and more sensitive for a period of time. This is a common experience with Nei Gong Exercises and standing Zhan Zhuang exercises, which aim at normalizing and improving free-flow in the body. Once Qi and breath move smoothly and freely again, the pain disappears.
In Die Da Medicine, when an injury first occurs, the main treatment principle is to restore normal movement of Blood, Qi and fluids, so that the body can do its work to heal the injury. There are many ways to do this. Martial arts instructors and students should familiarize themselves with a few tools for treating injuries, like revival techniques, acu-pressure on acu-points that are known to break blockages and restore free-flow, basic massage, and a few Die Da liniments, poultices and pills.
9. The Kidneys are the root of Qi and control the Gate of Life
The Kidneys store Jing (Essence). Jing bestows on the body and the other organs the potential for life. Jing gives life its specific character, rules birth, maturation, development and death. The Kidneys and the Jing are the foundation of Yin and a Yang in the body. The Jing is likened to a fluid and is a material (yin) substance that underlies the formation of other fluids essential to life, such as hormones, cerebro-spinal fluid and blood. Kidney Yang is likened to fire and is called the Mingmen Huo (Life Gate Fire). The Kidneys are the root of Qi and therefore the root of all transformation and change in the body. When Jing is completely expended, or the Mingmen fire extinguished, life is extinguished. The flourishing, maturation and gradual depletion of Kidney Yin and Yang over time is a natural part of the normal life processes. Hence, the kidneys are the root of life and control the “gate of life” (Mingmen).
Chinese medicine recognizes that the life processes gradually expend the Jing and extinguish the life gate fire, because every act of transformation and movement in the body utilizes kidney Yin and Yang. In the internal martial arts, it is recognized that harmonizing the body through correct lifestyle, exercise and internal cultivation can optimize and to some degree replenish the body’s Jing. Therefore, it must be balanced and must also change as we age and the body’s reserves become gradually depleted. Types of training, and the duration and intensity of training, must change in accordance with the life changes that are driven by the Kidneys. Many masters of the internal arts who live to an old and healthy age have said that after age 50, one must carefully regulate one’s training, diet and lifestyle and particularly one’s sexual energy.
10. The Kidneys rule the bones and produce bone marrow.
The Kidneys are said to “rule” the bones. This is a function of the Kidney Jing, the substrate that is the foundation of the body’s development and transformation. Jing produces the marrow, which in turn creates and supports the bones. The teeth are also an extension of the bones, and are considered to be the extremity and surplus of the bones. If Jing is abundant, the bones will be strong. The teeth are considered to be one of the Four Extremities. In practicing the internal arts, the upper and lower teeth should lightly touch, particularly when emitting force. This unifies and connects all the bones of the body.
When healing osseous injuries (bone fractures), it is important to strengthen and nourish the Kidneys. Chinese bonesetters commonly tell their patients not to have sex when they are healing a bone fracture, as sex involves a loss of kidney Jing, and one needs a surplus of Jing in order for the bone to heal properly. Herbs that help bones heal are generally herbs that tonify and strengthen the kidneys, particularly the Kidney Yang. This is why herbs like Gui Sui Bu (“mend shattered bones”) and Xu Duan (“reconnect what is broken“), often appear in formulas to speed bone healing and growth. Herbs that strengthen the kidneys are often herbs that are bones or are derived from bones and hasten the formation of bone callus, after the swelling and bruising have subsided. For example: Xie Ke (Crab Shell), Yu Biao Jiao (Fish Glue) and Long Gu (Fossilized Bone). Additionally foods like kidneys, bone marrow and bone broth also provide the body with the substrate it needs to nourish and promote bone growth.
11. The low back is the house of Kidneys and the Kidneys govern the knees.
The low back is the “house” of the Kidneys partially because of the anatomical location of the Kidneys and Mingmen’s association with the center of the lumbar curve. The low back emanating forward around the sides toward the front of the body is called the Yao.
In the martial arts, power and the ability to change according to the circumstances depends on the Yao and its coordination with the legs. The Kidneys also govern the legs and the integrity and strength of the knees is dependant to some degree on the Kidney energy. If the Kidneys are depleted, it is not uncommon for the knees and low back to ache and feel stiff.
 A Practical Dictionary of Chinese Medicine by Nigel Wiseman and Ye-Feng, Brookline, MA: Paradigm Publications, 1998, p. 408-9.