Nei Wei Qi Represents Immune System in TCM, Part 2
By Yu Chen, LAc
Editor's Note: Part one of this article appeared in the May 2008 issue.
I suggest using nei wei qi as the term for the immune system in traditional Chinese medicine.
Nei wei qi is a part of the body's zheng qi. It comes from yuan qi and is nourished by acquired nutrition. It belongs to qi and yin. It is located both inside and outside blood vessels. It runs through the entire body, including the five zang organs, the six fu organs, and the head and limbs. The normal function of nei wei qi is one of the fundamental factors that ensure the normal function of zang fu organs. Nei wei qi deficiency is one of the reasons for zang fu organ deficiency.
Nei Wei Qi Has Three Functions
Defense. Nei wei qi acts against exogenous pathogens such as microbes, vaccines, toxins, super-antigens and exogenous proteins. It recognizes, attacks and eliminates these pathogens. If nei wei qi is deficient, the body is vulnerable to these pathogens. Deficiency of nei wei qi leads to the deficiency of zang fu organs and makes the body vulnerable to pathogens. Eliminating pathogens not only depends on treatment, but also relies on the body's defense system. In other words, nei wei qi plays an important role in healing and curing.
Surveillance. Nei wei qi recognizes cancer cells and destroys them. The Nei Jing states, "Tumor is caused by the weakness of zheng qi and invasion of xie qi." When nei wei qi is deficient, pathogens attack the body easily and form tumors. Weakened nei wei qi cannot recognize and destroy tumor cells effectively, thus the tumor grows. When nei wei qi is deficient, qi and yin are deficient, qi and blood become stagnant, and phlegm is accumulated. Finally, phlegm, turbulence, qi and blood stick together, developing tumors.
Tolerance. Nei wei qi can recognize and differentiate "foreign" from "self." Foreign bodies, such as pathogenic factors and tumors, are attacked and eliminated, and the "self" is tolerated or not affected by nei wei qi. When tolerance is disturbed, the nei wei qi will act against "self" and cause diseases.
The Relationship Between Nei Wei Qi and Wei Qi
As we know, wei qi is related to the body's defense, but it cannot represent the entire immune system. Since I am using nei wei qi as the term for the immune system in traditional Chinese medicine, wei qi can be viewed as wai wei qi. Nei means "internal," while wai means "external." Wai wei qi is yang, while nei wei qi is yin. Yin and yang (internal and external) work together to protect the body from disease.
Application of Nei Wei Qi
Nei wei qi will be used here to experimentally analyze immune-related diseases such as immunodeficiency disorders (congenital and acquired), autoimmune diseases, allergic reactions and cancers. The deficiency of any component in the immune system can cause immunodeficiency disorders. The type of the disorder depends on which component is deficient. These diseases are characterized by frequent, severe and unusual infections that have a poor response to antibiotics and rare cancers, and a tendency to develop into autoimmune disorders.
Congenital immunodeficiency disorders. These diseases usually are hereditary and present from birth. For example, X-linked agammaglobulinemia, which affects only boys, results in decreased numbers or absence of B-lymphocytes and very antibody low levels. The disease is caused by a defect in the X chromosome. Affected infants develop lung and sinus infections from bacteria such as hemophilus, streptococcus or some unusual viruses. The infections generally do not occur until six months after birth because protective antibodies from the mother remain in the infant at first. Patients can develop polio when receiving the vaccine. They also might develop arthritis.
In traditional Chinese medicine, this disorder is viewed as a congenital deficiency; specifically a nei wei qi deficiency. Due to the weakness of nei wei qi , the defense is deficient; the body suffers from wai xie (such as microbes). The disease is hard to be treated successfully. When nei wei qi is deficient, it doesn't tolerate "self." Nei wei qi belongs to qi and yin, so if qi and yin are deficient, qi and blood are stagnant. In addition, invasion from wind, cold, dampness and heat may cause bi syndrome (arthritis). Since the surveillance function of nei wei qi is insufficient, patients have a tendency to also develop cancers.
Acquired immunodeficiency. The acquired immunodeficiency syndrome is caused by the human immunodeficiency virus (HIV). The virus progressively destroys CD4 + T lymphocytes. These lymphocytes activate and coordinate other immune system cells such as B-lymphocytes that produce antibodies, macrophages, cytokine and CD8 + T lymphocytes, which help to destroy invading organisms and cancerous cells. Patients with AIDS suffer from frequent and severe infections, which may be opportunistic. These infections respond poorly to medications. Cancers such as Kaposi's sarcoma and non-Hodgkin's lymphoma also might develop. Eventually, the patient dies due to extreme exhaustion from the disease.
From the traditional Chinese medical point of view, emotional stress, excessive and abnormal sexual behavior, and contaminated blood weaken nei wei qi and create the opportunity for wai xie (exogenous pathogens) to invade the body. Wai xie invades and destroys nei wei qi directly and causes nei wei qi deficiency. When nei wei qi is deficient, the body's defense is weak and it loses its protection. Any other wai xie , including specific pathogens that usually do not cause any damage, also can invade the body. Every organ can be involved, especially the lungs, spleen, stomach, intestine, brain, eyes and skin. Nei wei qi belongs to qi and yin. When qi and yin are deficient, qi and blood stagnancy occur and phlegm forms, leading to the development of tumors. When nei wei qi is destroyed, the surveillance function is weak and tumors grow easily. Finally, if nei wei qi is exhausted, the deficiency of yin leads to the deficiency of yang. When yin and yang separate, life ends.
Autoimmune diseases. Sometimes the immune system malfunctions. It misinterprets the body's own tissues as foreign and produces abnormal antibodies that attack these tissues. Autoimmune reactions are characterized by inflammation. The inflammation might be chronic and cause damage to normal tissues.
Let's look at an example. Systemic lupus erythematosus (lupus) is more common in women. A number of antibodies can appear in the blood and affect different parts of the body, resulting in episodes of inflammation in joints, tendons and other connective tissues and organs. Symptoms include skin rash; sensitivity to sunlight; mouth sores; fluid buildup around the lungs, heart or other organs; arthritis; kidney dysfunction; low blood-cell count; and nerve and brain dysfunction.
Let's analyze lupus from the traditional Chinese medical point of view. When nei wei qi is congenitally weak, the body has qi and yin deficiency. In addition, overwork, emotional stress or even sunlight can cause excessive heat, further damaging qi, yin and fluids of the body. When yin is deficient, fire is strong. The extreme heat impairs zang fu organs and damages qi and blood, causing more qi and yin deficiency. When qi and yin are deficient, they circulate abnormally, and qi blockage and blood stagnancy occur.
Here, the key points are nei wei qi deficiency, qi and yin deficiency, qi and blood stagnation and wai xie dominance. At the late stage of the disease, the deficiency of yin leads to the deficiency of yang. Clinically, qi and yin deficiency causes lingering low fever, fatigue and redness of the tongue and lips. When heat obstructs the meridian channels, facial rash, muscle aches and joint pain occur. When the spleen is affected, fatigue, fullness in the chest and upper abdomen and edema in the limbs appear. When heat invades the pericardium, the patient may lapse into delirium. When the disease spreads to the kidney, kidney yin and yang deficiency can result. The symptoms are pallor, weakness in the lumbar region and knees, dry hair and hair loss, tinnitus and deafness, excessive urination or anuria, cold limbs, and edema in the lower limbs.
Allergic reactions. This is a hypersensitivity reaction in which normal body tissue is injured due to the reaction of the immune system to antigens. An antigen can be dust particles, plant pollen, a drug or food. The IgE class of antibodies are bound to basophils in the circulation and mast cells in tissues. When these cells encounter antigens, they are triggered to release chemicals that injure the surrounding tissues, causing blood vessel dilation, increased permeability, smooth-muscle contraction and increased gland secretion. For example, in seasonal allergic rhinitis, the antigens are pollens. The symptoms are itchy nose, roof of mouth and back of the throat; watery, red and itching eyes; sneezing; a clear watery discharge from the nose; headaches; coughing; and wheezing.
In traditional Chinese medicine, the seasonal allergic rhinitis is called bi jiou. It is caused by the pathogenic factor-pollen and nei wei qi weakness. Pollen is viewed as abnormal qi and seasonal xie: yi qi shi xie. Nei wei qi reacts with hypersensitivity to this yi qi shi xie. The hypersensitive reaction of nei wei qi is a manifestation of deficiency. The lung and spleen will be affected. The nose is the opening of the lung, while the sclera in the eyes belongs to the Lung meridian channel. When the spleen is deficient, the patient will suffer fatigue and poor appetite.
Cancers. The immune system has a surveillance function. It attacks and eliminates cancer cells. The presence of tumor antigens on cancer cells can activate certain white blood cells such as lymphocytes, natural killer (NK) cells, and monocytes, which are responsible for immunologic surveillance. These cells look for cancer cells and destroy them, with help from antibodies. Due to the unstable specificity and certain genetic factors, the tumor antigens cannot express themselves effectively from normal cells. These antigens therefore cannot activate the specific immune response. The deficiency of the immune system also helps tumor cells evade surveillance.
Tumor growth is due to nei wei qi weakness and the invasion of pathogenic factors. The key points here are nei wei qi deficiency, yin and qi deficiency, qi and blood stagnation, invasion of xie qi and phlegm formation. Then qi, blood, phlegm and turbulence stick together to form a tumor. When the surveillance function of nei wei qi is deficient, a tumor at its early stage cannot be eliminated and the chance of tumor growth is high.
Nei Wei Qi Concept as a Guide for Treatment
The principle of the therapeutics in traditional Chinese medicine is fu zheng qu xie. Zheng means zheng qi - the body's resistance to disease. Here, nei wei qi is representative of the immune system. Xie refers to the pathogens. Fu is help, while qu means to dispel. So, fu zheng qu xie can be explained as "promote immune system, dispel pathogens." The abnormality of nei wei qi runs through the entire course of immune-related diseases. To adjust and tonify nei wei qi is one of the key steps in treatment. For example, in AIDS treatment, the following steps can be considered using the nei wei qi concept.
Educate and screen people who have a high risk of HIV infection in order to find and treat infection early. Even before a person becomes HIV positive, they can have preventive acupuncture, herbal or qigong therapy to adjust and enhance nei wei qi.
Fu zheng qu xie tonifies nei wei qi and eliminates pathogens. During the incubation period after HIV infection, the patient should be involved in active treatment. The treatment includes antiviral therapeutics and nei wei qi tonification. This treatment can inhibit the virus and strengthen nei wei qi to fight HIV. Under this treatment, the appearance of symptoms can be postponed and the course of the disease can be slowed. The infected person might have a much longer period of quality living.
During AIDS-related complex and full-blown AIDS, taking care of both biao (the manifestation) and ben (nei wei qi), should be the principle of the treatment. It means that antivirus and antibacterial therapy, and nei wei qi recuperation should be applied. When acute manifestations appear, they should be treated first and nei wei qi tonified in the interval between two infections. Even at the same time of treating acute symptoms, nei wei qi tonification can be applied in order to get better results.
Yu Chen obtained medical research training in China, Sweden and the United States. Since 1989, she has practiced TCM in Maryland. She may be contacted at