Blood Vessels
Blood Vessels (Xuè Mài) are the pathways through which Blood circulates in the body. Governed by the Heart and supported by the Lungs, Spleen, and Liver, they form a network that nourishes all tissues. The vessel system is assessed through pulse diagnosis, where the quality of the pulse reveals the state of Qi, Blood, and overall health.
Xuè Mài
Blood Vessels
Educational content · Consult qualified TCM practitioners for diagnosis and treatment
Overview
In Traditional Chinese Medicine (TCM), Blood Vessels (Xuè Mài, 血脉) are the physical pathways through which Blood circulates throughout the body. Unlike the Western anatomical understanding of blood vessels as merely conduits for blood, TCM views them as an integral component of the Heart system and a dynamic network that reflects the state of the entire body's Qi and Blood.
The Blood Vessels are considered the "residence of Blood" (血之府), serving as containers that hold and guide Blood on its continuous journey to nourish all tissues and organs. The term "Mai" (脉) originally referred to blood vessels, and this concept later evolved to include the broader meridian system (Jing Mai). The Blood Vessels work in concert with the Heart—which provides the propulsive force—to ensure proper circulation, making them essential for maintaining health and vitality.
The condition of the Blood Vessels is reflected in the pulse quality (also called Mai), which practitioners palpate during diagnosis. A healthy vessel system manifests as a smooth, even pulse and a rosy complexion, while vessel dysfunction leads to various circulatory disorders, pain syndromes, and changes in skin color.
Historical Context
The concept of Mai (脉) is among the oldest in Chinese medicine, appearing in excavated texts from the Mawangdui tombs (circa 168 BCE). The earliest document, the Cauterization Canon of the Eleven Vessels, described vessel pathways before the full meridian system was established. Originally, Mai simply meant 'blood vessels distributed throughout the body.'
By the Han Dynasty and the compilation of the Huangdi Neijing, the concept had expanded significantly. The vessels became integrated with the emerging theory of channels and collaterals (Jing Luo), where Mai evolved from purely physical blood vessels to include the pathways of Qi. The Neijing established that 'the pulse is the residence of Blood,' linking vessel health directly to pulse diagnosis.
During subsequent dynasties, understanding deepened regarding the relationship between vessels, organs, and the pulse. The Jin Dynasty physician Wang Shuhe systematized pulse diagnosis in his classic text Mai Jing (Pulse Classic), cementing the diagnostic importance of vessel palpation. Modern TCM continues to view Blood Vessels as both physical structures and functional concepts integral to circulation, diagnosis, and treatment.
Heart Governs Blood Vessels
心主血脉The Heart is the master of Blood and its vessels. It provides the driving force (Heart Qi) that propels Blood through the vessels, maintaining continuous circulation. The Heart, Blood, and vessels form an interconnected system—when Heart Qi is strong, circulation is smooth and the pulse is regular and forceful.
Vessels as Blood's Residence
血之府Blood Vessels serve as the container and pathway for Blood. They confine Blood to its proper course, preventing leakage while allowing nutrients to reach all tissues. The integrity of the vessel walls depends on sufficient Qi to hold Blood within them.
Lungs Support Circulation
肺朝百脉The Lungs 'meet' all the hundred vessels—meaning all Blood passes through the Lungs to receive Qi from respiration. The Lungs assist the Heart by infusing vessels with Qi, which powers the Heart's pumping action.
Spleen Contains Blood
脾统血The Spleen's Qi has a holding function that keeps Blood within the vessels. When Spleen Qi is deficient, it cannot contain the Blood, leading to various types of bleeding such as bruising, heavy menstruation, or blood in stool.
Liver Regulates Blood Flow
肝藏血The Liver stores Blood and regulates how much circulates based on the body's activity level. During rest, Blood returns to the Liver; during activity, it flows to muscles and tendons. The Liver's smooth flow function also ensures Blood moves freely without stagnation.
Practical Application
Pulse Diagnosis: The Blood Vessels are palpated at the radial artery (Cun Kou) to assess the body's overall condition. Practitioners evaluate vessel quality through the pulse—its depth, rate, rhythm, and force reveal information about Qi, Blood, and organ function. A slippery pulse suggests abundant Blood or phlegm; a choppy pulse indicates Blood stasis; a thready pulse points to Blood deficiency.
Treatment Strategies: When vessels are obstructed by Blood stasis, treatment focuses on 'moving Blood and transforming stasis' using herbs like Dan Shen and Hong Hua, or acupuncture at points like Xuehai SP-10 and Geshu BL-17. For vessel weakness with bleeding, the approach is to 'strengthen Qi to contain Blood' using Spleen-tonifying formulas. Heat in the Blood causing reckless bleeding requires cooling the Blood.
Lifestyle Guidance: Practitioners advise patients to maintain vessel health through moderate exercise (which moves Blood), avoiding excessive cold (which constricts vessels), managing stress (which causes Qi stagnation affecting Blood flow), and eating Blood-nourishing foods like red dates, goji berries, and leafy greens.
Clinical Relevance
Cardiovascular Conditions: Blood Vessel pathology manifests as chest pain, palpitations, and poor circulation. TCM diagnosis differentiates between Heart Blood stasis (fixed stabbing pain, purple tongue), Heart Blood deficiency (pale face, weak pulse), and Heart Fire (red face, rapid pulse). Points like Ximen PC-4 and Neiguan PC-6 directly influence vessel function and cardiac health.
Bleeding Disorders: When vessels fail to contain Blood—due to Spleen Qi deficiency, Blood Heat, or trauma—various bleeding presentations occur. Treatment varies by cause: tonify Spleen for chronic easy bruising, cool Blood for acute hot-type bleeding, or stop bleeding and move stasis for traumatic hemorrhage.
Complexion Diagnosis: Because the face has abundant blood vessels, facial color directly reflects Heart and Blood vessel status. A rosy complexion indicates healthy Heart Qi and Blood; pallor suggests Blood deficiency; a dark or purple hue indicates Blood stasis; excessive redness points to Heat.
Vessel Hardening: TCM recognizes that chronic Blood stasis can cause vessels to become rigid—corresponding to arteriosclerosis in Western medicine. Treatment emphasizes long-term Blood-moving therapy combined with Phlegm resolution if lipid deposits are involved.
Common Misconceptions
'Blood Vessels in TCM are identical to Western anatomy': While TCM Blood Vessels include physical blood vessels, the concept is broader. 'Mai' encompasses both the structural vessels and their functional relationship with Qi, the pulse quality they produce, and their connection to the meridian system. The evolution from 'Blood Vessels' to 'channels and collaterals' shows how TCM integrated anatomical observation with energetic theory.
'The pulse only reflects heart rate': In TCM, pulse diagnosis reads far more than cardiovascular rhythm. The pulse quality—its depth, width, force, rhythm, and texture—provides information about the state of all organs, the balance of Qi and Blood, and the nature of disease (hot/cold, excess/deficiency). This is why TCM practitioners spend considerable time feeling the pulse at multiple positions.
'Blood circulation is solely the Heart's job': While the Heart is the primary governor of Blood Vessels, proper circulation requires cooperation among multiple organs. The Lungs infuse Qi into Blood, the Spleen holds Blood in vessels, the Liver regulates blood volume, and the Kidneys provide foundational essence for Blood formation. Dysfunction in any organ can affect vessel health.
Classical Sources
Huáng Dì Nèi Jīng - Sù Wèn (Yellow Emperor's Classic - Simple Questions)
Chapter 17 - Mai Yao Jing Wei Lun夫脉者，血之府也
The pulse/vessel is the residence of Blood
Huáng Dì Nèi Jīng - Líng Shū (Yellow Emperor's Classic - Spiritual Pivot)
Chapter 71 - Xie Ke经脉者，所以行血气而营阴阳，濡筋骨，利关节者也
The channels and vessels circulate Blood and Qi, nourish Yin and Yang, moisten the sinews and bones, and benefit the joints
Shuō Wén Jiě Zì (Explaining Simple and Analyzing Compound Characters)
Character Analysis脉，血理分袤行体者
Mai (vessels) refers to the blood pathways distributed throughout the body
Yī Xué Rù Mén (Introduction to Medicine)
Zang Fu Section人心动，则血行诸经
When the Heart moves, Blood circulates through all the channels
Modern References
Foundations of Chinese Medicine: A Comprehensive Text
Comprehensive coverage of Blood, vessels, and their relationship to the Heart system in TCM theory
The Web That Has No Weaver: Understanding Chinese Medicine
Accessible explanation of Blood and vessel concepts for Western readers
A Comparative Study on 'Mai' and 'Blood Vessels' in Early Chinese and Western Medicine
Academic comparison of ancient Chinese Mai theory with Hippocratic blood vessel concepts