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Jing Essence & Cerebrospinal Fluid

In Chinese medicine theory, we speak of the jing essence and its relation to the kidneys and marrow. In TCM, the essence transforms into the marrow and fills the spine and brain. It is worth considering the correlations between jing essence and the cerebrospinal fluid (CSF).

In craniosacral therapy, the pulsation of CSF may be felt by using gentle touch on the skull and other areas. I believe that acupuncturists should consider using CST with acupuncture, as it can complement the effects of acupuncture and increase therapeutic results.

In this article, we will compare TCM theories about essence with what is known about the physiology and production of cerebrospinal fluid. We will also discuss the effects of acupuncture and craniosacral therapy (CST) on the autonomic nervous system (ANS) and how this translates into therapeutic results.

TCM Theory and Physiology - The Transformation of Essence, Blood, and Marrow

Let’s compare some of the traditional views about essence with what is known about CSF.

It is believed in TCM theory that essence can transform into blood and marrow and that blood can also be transformed into essence.

It is known in Western physiology that CSF is produced from blood plasma, and that a special group of cells called the choroid plexus in the ventricles of the brain produce the CSF. (1, 2)

Within the ventricles of the brain, blood plasma is converted into CSF by the choroid plexus. This is the transformation of blood into CSF/Essence.

Cerebrospinal fluid also returns to the blood and circulatory system and there is a continuous transformation of blood plasma into CSF, and CSF back into the blood circulation. This maintains numerous fluid dynamics between the blood and CSF. (2)

Cerebrospinal fluid movement pulsates and corresponds to the heartbeat and pulse qualities. In addition to fluid transformations between essence, blood, “marrow”, and CSF, the production and movement of CSF relates to the beating of the heart. (3) We can think of this as the relationship between qi and essence, and it is also said in TCM that essence and qi may transform into each other. The beating of the heart which is a function of heart qi influences the production of CSF, and this may be understood as the transformation of heart qi and blood into essence and CSF.

Cerebrospinal fluid helps to regulate oxygen levels in the brain, cerebral blood flow, and homeostasis of essential substances including vitamins, minerals, immunoglobulins, and hormones. (3) The substances contained in the CSF correspond with traditional views about essence.

Craniosacral Therapy and the Autonomic Nervous System

It is known that sympathetic stimulation of the ANS decreases the production of CSF. (3)

Inversely, parasympathetic stimulation increases the production of CSF. (3)

Gentle touch, such as done with CST and massage, produces parasympathetic responses and can greatly calm the mind and body.

With CST, the parasympathetic division of the ANS is stimulated, thereby causing relaxation responses, feelings of peacefulness, and sleep. (4, 5)

Parasympathetic responses are correlated with stress reduction and healing in various organ systems.

Acupuncture can also induce parasympathetic responses, and this parasympathetic activity is behind many of the benefits of acupuncture for internal disorders of the organ systems.

This has broad implications for conditions like headaches, migraines, heart disease, diabetes, digestive disorders, kidney disease, and other conditions related to stress and excessive sympathetic stimulation.

Clinical Practice

We can think of craniosacral therapy as being similar to acupressure as it uses gentle touch and pressure at key points. Many of the holds in CST have finger placements on important acupuncture points.

In CST emphasis is placed on feeling various pulsating qualities present with different holds.

Holds and gentle pressure may be applied on the skull, sacrum, spine, feet, and other areas of the body.

When feeling for pulsations in CST it is recognized that there are different pulse qualities and rhythms. These are referred to as the craniorhythmic impulse (CRI), the mid-tide, and the long-tide.

The CRI is the most superficial level of pulsation and the easiest to feel.

This pulsation may be felt as an expansion (flexion) or contraction (extension) when holds are done on the head, sacrum, feet, and other regions.

The mid-tide operates at a lower frequency of pulsation and requires greater concentration and awareness to feel.

The long-tide is a very subtle pulsation that represents the earliest movement of energy from stillness. In some sense, we can think of the long-tide as the prenatal essence transforming into qi. The long tide is synonymous with the earliest movements of bio-energy from stillness.

Clinically, correlations exist between Chinese pulse qualities and the pulsation of CSF. For instance, thin and weak pulses often occur with thin and weak craniorhythmic impulses. Choppy and arrhythmic pulses may also be felt as erratic CRI's. This relates to the role of the heartbeat and circulatory system in the production and movement of CSF. (3)

Applying craniosacral therapy can produce changes in the pulse qualities as felt at the radial pulse.

This offers the therapist a craniosacral mechanism for altering the pulse qualities, ANS, parasympathetic nervous system, and internal organ energy balances.

Learn more about:


1. Wright BL, Lai JT, Sinclair AJ (August 2012). "Cerebrospinal fluid and lumbar puncture: a practical review". Journal of Neurology. 259 (8): 1530–45.

2. Guyton AC, Hall JE (2005). Textbook of medical physiology (11th ed.). Philadelphia: W.B. Saunders. pp. 764–7. ISBN 978-0-7216-0240-0.

3. Sakka L, Coll G, Chazal J (December 2011). "Anatomy and physiology of cerebrospinal fluid". European Annals of Otorhinolaryngology, Head and Neck Diseases. 128 (6): 309–16. doi:10.1016/j.anorl.2011.03.002. PMID 22100360.

4. Wójcik M, Siatkowski I. The effect of cranial techniques on the heart rate variability response to psychological stress test in firefighter cadets. Sci Rep. 2023 May 13;13(1):7780. doi: 10.1038/s41598-023-34093-z. PMID: 37179419; PMCID: PMC10183023.

5. Wanda Girsberger, Ulricke Bänziger a, Gerhard Lingg a, Harald Lothaller a, Peter-Christian Endle. Heart rate variability and the influence of craniosacral therapy on autonomous nervous system regulation in persons with subjective discomforts: a pilot study. Journal of Integrative Medicine Volume 12, Issue 3, May 2014, Pages 156-161

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