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The Quartz 2D, or Core Graphics, APIs are the lowest level interface to the windowing system available to the programmer on OS X. They provide a C interface based (loosely) on PDF drawing commands.
You can use the Quartz APIs directly from Objective-C by using the -graphicsPort method on the NSGraphicsContext instance representing the current context. This returns a pointer to some platform-specific system. If you are using GNUstep or some other OpenStep implementation, then this will be defined by the implementation. With Cocoa, it is always a CGContextRef that can be used for Core Graphics drawing.