Yin	Yang
Lower part (e.g. Hara)	Upper part (e.g. head)
Front (e.g. chest)	Back (e.g. back)
Interior (e.g. bones)	Exterior (e.g. skin)
Substance (e.g. Blood)	Activity (e.g. Ki)

Table 10.2 Yin and Yang relationships of bodily and metabolic functions

Yin	Yang
Cooling	Warming
Relaxing	Activating
Centering	Protecting
Anchoring	Supporting
Nourishing	Consuming
Moistening	Drying
Storing	Transporting

Human beings are usually born with a full and equal store of both Yin and Yang. Our reserves of the vital Yin and Yang principles are stored in the Kidneys as Kidney Yang and Kidney Yin, which are the foundation for the Yin and Yang of the whole system. In addition, each organ possesses Yin functions, such as the capacity to cool, relax, store or moisten in its appropriate sphere of influence, and Yang functions, such as the ability to transform, warm, move or protect. Excess Yin and Yang can only enter the body in the form of external influences such as Cold, Heat, etc. So by tradition in TCM we speak of Deficiency of Yin and Yang, but not of Excess; we specify Excess Cold, Heat and so on.

The Vital Substances

All of the different functions of Yin and Yang in the human body are embodied in the form of the Vital Substances and their different activities. When we say ‘substance’, however, it does not mean that these substances are entirely physical. Shiatsu and TCM are both forms of ‘energy medicine’ involving vibrational and field phenomena, and all the Vital Substances are non-physical as well as physical in their reality. In other words, they are as much a part of our psychological functioning as of our bodily nature.

When we study Zen Shiatsu we familiarize ourselves with the flow of current within the meridian network, which we learn is Ki. This, we discover, is said to be the basis of everything that exists. While it is true that the interplay of Yin and Yang and the resulting production of what has been called ‘global’ Ki (Kaptchuk 2000) is the origin of all phenomena, human Ki is specific to humans, and has certain ways in which it is produced and maintained. Ki is one of the Three Treasures (see p. 126), with both a universal and a human form, and it therefore links the individual to the cosmos. So, for example, humans do not live in water, like fish, because human Ki needs air for its production; and we cannot live by eating earth, like worms, because we need appropriate food in order to survive. Human Ki is particular to humans, and is extracted and processed from other, sometimes non-human sources of Ki. Not only that, but there are several different types of Ki within us, as we shall see below.

Just as Westerners recognize electricity as a general phenomenon displayed in specific forms (high and low voltage, high and low amperage), the Chinese recognize Qi as a general phenomenon with many variant aspects and functions.

(Ted Kaptchuk 2000, p. 48)

In the human body and psyche, Ki is an aspect of the Yang principle which moves us, warms us and protects us from outside influences. On the physical plane, Ki is the agent for movement and transformation; similarly on the psychological level, free-flowing Ki gives an ability to change our state, to alternate between different emotions, between work and pleasure, activity and rest. Ki is the agent of the Mind, and goes where our attention goes in the body. There is a saying in TCM ‘The Mind leads the Qi’, which is a useful one to remember when giving Shiatsu.

Human Ki also includes the aspect of structuring, of maintaining the integrity and overall unique patterning of each individual, so that as a part of the continually changing and free-flowing Ki that makes up the universe we do not change out of all recognition – a quality which fascinated the English poet Hopkins, who named it ‘inscape’ without knowing anything about Ki.

We have three sources of Ki, our genetic inheritance, our food and the air we breathe. Each of these is stored or processed in a different area of the body, corresponding to the ‘three Burning Spaces’ of the Triple Heater.

1. In the Lower Burning Space is stored our Source or Original Ki, sometimes called Ancestral Ki, which is the dynamic, Yang aspect of Essence (see below). Part of this is present from conception. This Ki which we inherit from our parents, what we might understand as the energy of our genes, remains within us, fueling the activity of all our systems and organs, and we gradually thus deplete it throughout our lifetime. The other part is formed from the purest of the Ki produced by the processes of breathing and digestion, which is sent down to the Lower Burning Space to replenish the source. Source Ki is pure and concentrated, like rocket fuel; a little goes a long way. It acts as a catalyst for all bodily processes and for each meridian, via internal connections governed by the Triple Heater, the ‘messenger of the Source Ki’. Every meridian has a Source Point, from which it takes its feed of Source Ki. Source Ki forms the basis for Kidney Yang, which powers all the Yang energy of the body.

2. The Middle Burning Space is the area in which we process food in order to obtain its Ki (which has different characteristics from those of human Ki) and change it into our own. This is done by the Stomach and Spleen, which, with the help of Source Ki, break the food down into Food Ki (Gu Qi, or ‘Grain Ki’, in Chinese) and send it up to the chest to unite with the third type of Ki.

3. The Ki of air; this is already in a pure state, requiring no processing, and is taken in by the Upper Burning Space to combine in the chest with Food Ki. Source Ki also acts as a catalyst for this process. Thus all three forms of Ki unite to form the individual’s True Ki, which flows in the meridians. A by-product of this transformation is Defensive Ki, which is highly active, ‘strong and bold’, and is sent by the Lungs to defend the surface of the body and field to protect it from unwanted outside influences.

The three transformational areas, or Burning Spaces, of the Triple Heater each contribute their own Ki to support the processes described above, and to combine with the Ki of the organs in that area to provide energy for transformation. Thus the Fire of the Lower Burner contributes to Kidney Yang; the Fire of the Middle Burner is allied with Spleen Yang, and the Fire of the Upper Burner combines with the Ki of the Heart and Lungs to form the transformational power of the Zong Ki, the ‘Big Ki of the Chest’.

I am grateful to my colleague Paul Lundberg, co-founder of the Shiatsu College UK and author of The Book of Shiatsu (Lundberg, 1991) for permission to reproduce his chart, illustrating these processes in a direct and simple form (Fig. 10.1).

Fig. 10.1 The production of Ki (by kind permission of Paul Lundberg).

Essence

The second of the Vital Substances, Jing, is often translated as Essence. Essence is the Yin form of the Source Ki described above. In the same way that Source Ki, being Yang, is the motive force for all our body processes and actions for our lifetime, Essence, being Yin, is the basis for our body substance, the seed of our physical form. One cannot exist without the other. Every time we lift an arm, take a step, digest a meal or make a decision we are drawing on our Source Ki. Every time we draw on our Source Ki, we also consume a little more of our Essence forever. When we have run out of Essence, we die. The quality and quantity of our Essence determines our physical constitution for our lifetime, and the quality of the constitution we hand on to our children. This is discussed further in the chapter on the Kidneys.

There is a philosophical sub-plot to consider here. Essence is the inheritance of living form handed down as generation succeeds generation, whereas Source Ki is dynamic; it is our share of life-force, given to us to use as we will. Essence is one of the Three Treasures (see p. 126) and therefore has a universal form greater than the individual, as well as the unique individual Essence of each of us. There is a fine balance between the need for continuity of our species (Essence) and each individual’s unique potential for shaping a destiny (Source Ki).

Essence, like Source Ki, comes in two forms. The first, Prenatal Essence, is received from our parents, cannot be supplemented or replenished, and gradually decreases with age. Sexual activity in men and childbearing in women deplete our Prenatal Essence the most, since its ultimate function is to generate descendants. Postnatal Essence is obtained from the purest essences of air and food by the Spleen and Lungs, and can be replenished by a healthy diet and breathing exercises, and conserved by a moderate lifestyle.

Prenatal Essence is stored ‘between the Kidneys’, which some authorities maintain is the Hara.^† Other interpretations of its location are Ming-Men, reached through the space between the 2nd and 3rd lumbar vertebrae, and the bao or ‘intimate envelopes’ which contain the uterus in women and the ‘palace of sperm’, perhaps the prostate, in men.

Postnatal Essence is acquired by the Lungs and the Spleen, which transports it to all the organs and body parts, and what is left is stored in the Kidneys. It is considered to belong to the Kidneys more than to the Spleen. Both forms of Essence form the basis for Kidney Yin, the underlying Yin reserve which supports the Yin of the whole body. By the same token the dynamic, Yang form of Essence, the Source Ki, manifests from the Kidneys – where it is stored as Kidney Yang, which supports the Yang of the whole body. They are both equally important for the constitution of the person. Without the Source Ki, the Essence would not have power to manifest and accomplish. Without the Essence, the Source Ki could not be stored and would evaporate. They are indivisible aspects of what Kaptchuk (2000) calls ‘the possibility of development, from conception to death … the basis of reproduction, growth, ripening, withering’.

Disharmonies of Essence

Essence can only be deficient, never in excess. Although nothing can increase the quantity of Prenatal Essence, Shiatsu can help to increase the activity of the organ systems which produce Postnatal Essence.

The symptoms of Deficiency of Essence include:

• retarded growth

• impotence, infertility

• weak constitution

• brittle bones

• poor memory

• prematurely grey or thinning hair

• red tongue with no coating.

In practice, most congenital conditions and some diseases of childhood ^‡ may be linked with a lack of Essence.

CASE HISTORY

A 33-year-old man with grey hair came for Shiatsu for panic attacks after a bad LSD trip. He claimed only to have taken the one dose but with increasing rapport and trust between us, as the session progressed, he revealed that he had in fact been leading a fairly wild life of clubbing and drug-taking. As I worked on his lower back (Kidneys had been one of the diagnostic meridians), he remembered that he had suffered from chronic backache as a child. I told him that he was exhausting his Essence with his lifestyle and gave him Hara breathing to practice whenever the panic struck. His condition improved slowly and steadily and he eventually took on a new job as a phone counselor on a drugs helpline.

Points to tonify Essence BL-23, 43; GB-39; GV-4; CV-4, 5, 6; KI-3

Holding the Hara and back together while the receiver breathes into the area under your hands is a good technique.

Recommendations for Deficiency of Essence

Traditionally, avoid sex! Generally, do not over-tax yourself in work or play. Remember that any mood-altering substances deplete your ‘core store’. Seeds, spirulina (algae), goji berries and soups made with slow-cooked bones with plenty of marrow are foods indicated for the Essence. Hara breathing. Qi Gong exercises and treatment with Chinese herbal medicine from a qualified herbalist can be helpful.

Blood

‘Blood’, with a capital B, the third Vital Substance, is much more than the red liquid familiar to Western science; to the Chinese it is the Yin complement to Ki.

Blood is a fluid, but it also has aspects of Ki and is especially involved in activating the sense organs. ‘Blood and Qi are different in name but are of the same category’.

Ling Shu (Kaptchuk 2000

)

Where Ki goes, Blood goes, and Ki also follows Blood. Whereas Ki performs the Yang functions of moving, warming and transporting, Blood’s role is to moisten, nourish and soothe. Without Blood, all body tissues, substances as diverse as those of the eyes, skin, nails, brain and tendons, lose their moisture, elasticity, nourishment and thus part of their function.

Blood also has an effect on the emotions. It replenishes and satisfies on the psychological, as well as the physical, level. According to Ted Kaptchuk:^§

Qi represents the tension of change from one state into another. Blood represents the completion and acknowledgement of that change, resting in the change, the change made substance … Blood is more than a gynecological issue. It has to do with how kind we can be to ourselves, how much space we can give ourselves to be comfortable.

The Heart and the Blood have a mutual relationship. The Heart contributes to the making of Blood. When the Stomach and Spleen send up the prepared Food Ki to the chest, the Heart gives to a portion of it the ‘imperial seal’ of the red color and infuses it with Shen (see below) making it into Blood. The Blood then carries the Shen throughout the body. The Blood also benefits the Heart in return, by providing a resting place in the Heart for the Shen, sometimes called Spirit or Mind, which otherwise becomes agitated, leading to symptoms such as anxiety and insomnia.

Blood is produced from the Food Ki sent up by the Stomach and Spleen to the chest, as we have seen above. While the Heart is ultimately responsible for the making of Blood in TCM, it cannot do this unless the Spleen is providing enough Food Ki, so that deficiency of Blood is frequently caused by a deficient Spleen. Excessive loss of blood, for example in menstruation or childbirth, can also lead to Blood Deficiency, and this can also be due to a deficient Spleen failing to keep the Blood in the vessels (see p. 269).

Another organ whose function is vital for the quantity and quality of the Blood is the Liver, which stores the Blood when we are at rest and sends it out when we need it for action (see p. 194). Since inefficient storage and distribution can lead to the unavailability of Blood when we need it, the Liver may be a key factor in creating a deficiency of Blood; and as the healthy functioning of the Liver is connected with emotional balance, Blood Deficiency can result from emotional causes.