Transport

Transport: Qi in movement through the body

After Qi has performed its transforming work — transforming food into Gu Qi, Gu Qi into Zong Qi and Zong Qi into Zhen Qi — the resulting substances must be transported to the parts of the body where they are needed. This is the transport function of Qi: moving energy, substances and fluids through the body in the correct direction and at the appropriate time. Transport and transformation are inseparably connected — each depends on the other to perform its function.

The four directions of Qi movement

The transporting movement of Qi takes place in four directions: upward, downward, inward and outward. The appropriate direction for each organ is crucial within TCM physiology. When Qi moves in the wrong direction — descending when it should rise or rising when it should descend — pathological patterns may develop. This concept, known as the direction of Qi movement or Qi mechanism, is one of the fundamental diagnostic frameworks of TCM.

Transport by each organ

The Spleen transports Gu Qi upward toward the Lung. This ascending movement is essential for the formation of Zong Qi and Blood. When Spleen Qi cannot rise, TCM describes a pattern known as "Sinking of Spleen Qi", traditionally associated with fatigue, organ prolapse, diarrhoea and a downward-bearing sensation.

The Lung transports fluids toward the skin and disperses Wei Qi into the space between the skin and muscles — an outward, dispersing movement. At the same time, the Lung sends fluids and Qi downward toward the Kidney and Bladder. When Lung Qi fails to descend and instead rebels upward, traditional manifestations include cough and shortness of breath.

The Kidney participates in movement in two directions: upward toward the Lung to support inhalation and downward toward the Bladder to assist the transformation and excretion of fluids. The Liver promotes the movement of Qi in all directions and is regarded as the regulator of the free flow of Qi throughout the body. When Liver Qi stagnates and no longer flows freely, traditional signs of Liver-Qi stagnation may appear, including tension, irritability, discomfort along the ribs and a sensation of constraint.

Qi stagnation: when transport becomes obstructed

Qi stagnation is one of the frequently described pathological patterns in TCM. It refers to Qi movement becoming obstructed or restricted. Within TCM theory, Qi stagnation may arise from emotional tension, particularly through its effect on the Liver, from Cold causing contraction, from trauma obstructing free movement or from weakness of Qi itself.

Qi stagnation may traditionally manifest as pain or tension that changes location or worsens with emotional stress, sensations of pressure or constraint, fluctuating symptoms and irritability. Treatment in TCM aims to restore the free movement of Qi through acupuncture, herbal strategies intended to move Qi and lifestyle measures addressing relevant emotional tension.