If you come for some treatment with a Chinese medical acupuncturist, he or she will probably talk to you, sooner or later, about your Qi. Qi, sometimes spelt ‘Chi’, is one of the key concepts of Traditional Chinese Medicine (TCM), a form of healthcare whose roots date back at least 2,500 years. To understand anything about TCM, you need to understand what Qi is, and also to begin to recognise it in your own experience. Whilst for any Chinese person (except perhaps one who has been so thoroughly westernised as to lose touch with their roots), Qi is an everyday reality, as it will be indeed for any westerner who has trained in disciplines such as T’ai Chi or Chi Kung, for many people in the west Qi is still a strange and foreign concept.
Qi is not only a key idea in Chinese Medicine, it is a key concept in traditional Chinese thought, and no understanding of Chinese philosophy, Chinese religion, or, indeed, what may be termed Chinese science, is possible without grasping something of the meaning of Qi. Chinese civilization is of course very ancient and very sophisticated, and the notion of Qi has been central to how the Chinese have understood the human condition for millennia. However, and this is perhaps illustrative of the traditional Chinese approach to life which is so different from the western approach, Qi is not easily defined or tied down.
Qi is sometimes translated as ‘energy’ or ‘vital energy’. Perhaps the key thing to understand about Qi is that, in a healthy person, it flows. It flows all around the body, on the surface and through the interior, in a network of channels or meridians. In fact all movement in the body, including the circulation of blood and other body fluids, is governed by Qi. Qi also warms and invigorates the body, and aspects of Qi are responsible for defending the body against external pathogens, in a way analogous, to some extent, to the western notion of the immune system. Qi includes both what we would call mind and matter; the subtlest thought is a movement of Qi, just as much as is the movement of food through the digestive system. Patients experience Qi as an unusual dull achy or tingling feeling around the needle, or propagating along the meridian from the needle; this feeling arises when the acupuncturist inserts the needle so as to contact the patient’s Qi.
When people started practicing acupuncture in the west, some people scoffed at the notion of Qi and the meridians, because, they thought, in western medicine there was nothing corresponding to them. The meridians do not correspond to blood vessels for example, or to nerves. However, more recently researchers have been investigating the matter further, partly because acupuncture is so obviously effective – no less a body than the World Health Organization1 lists a number of medical conditions for which it considers that research shows that acupuncture treatment is of proven effectiveness.
Some of the research into how acupuncture works from a western perspective2 shows that the meridians may correspond to lines of slightly decreased electrical resistance, which would suggest that Qi may, at least in part, be made up of micro currents of electricity. (Modern acupuncturists sometimes make use of this fact to locate acupuncture points using a simple device to measure variations in electrical resistance on the skin, although whether this is a more effective technique than the traditional palpatory skill of the acupuncturist is open to question.)
Other research projects suggest that the meridians may be related to connective tissue3, the fibrous support structure for body tissues and organs. The insertion of an acupuncture needle into a traditional acupuncture point may cause changes in local connective tissue which are both long lasting and capable of influencing distant parts of the body, since the connective tissue forms a continuous matrix throughout the body. Since nerve fibres are embedded in connective tissue, the needle may also have modulatory effects on nerve signals. The meridian system may also be explained in part by the notion of migratory tracks in interstitial fluid4, the fluid which surrounds the cells which make up the human body; cells such as mast cells (which have, amongst other functions, a key role in the immune system) and fibroblasts (which play a critical role in wound healing)
One can question, however, the necessity of explaining Qi in western scientific terms. Western science and western medicine are of course highly sophisticated bodies of knowledge, but it is perhaps a touch arrogant of us to consider that they are the be all and end all, the only way of looking at the world – after all, from the point of view of Chinese medicine, western medicine is a relatively new form of medicine. It looks at the person from a particular point of view, which gives it both strengths and weaknesses. Chinese medicine represents a different point of view, with different strengths and weaknesses. It will probably prove impossible to fully explain Chinese medicine in western terms, just as it would be impossible to fully explain western medicine in Chinese terms. The wisest course may well be to use whichever medicine is more helpful in the case in question. In modern China, in fact, this is what does happen: hospitals may be split between departments of TCM and of western medicine.
The scientific findings mentioned suggest that Qi is a relatively subtle and complex phenomenon, which is not to be explained by any one western idea but only by a combination of several (micro currents, connective tissue, interstitial fluid etc). Quite a few patients who come for acupuncture treatment are obviously ill, but western medical tests find nothing wrong with them – from a Chinese medical perspective, the problem lies at the level of Qi. At this level western medicine does not operate – western medicine is effective when the problem is more obvious. From this point of view TCM is effective at treating relatively subtle disharmonies which western medicine does not see, and also at preventing these disharmonies escalating and as it were condensing into more severe conditions.
1. WHO (2002): Acupuncture: Review and Analysis of Reports of Controlled Clinical Trials Available from URL http://apps.who.int/medicinedocs/en/d/Js4926e/5.html
2. Reichmanis M et al (1975) Electrical Correlates of Acupuncture Points IEEE Transactions on Biomedical Engineering
3. Langevin H et al (2002) Evidence of connective tissue involvement in acupuncture The FASEB Journal. 16:872-874
4. Fung P (2009) Probing the mystery of Chinese medicine meridian channels with special emphasis on the connective tissue interstitial fluid system, mechanotransduction, cells durotaxis and mast cell degranulation Chin Med 4:10