An Understanding of Qi

Qi is foundational in the theory and practice of Chinese medicine. Qi as a concept is widely accepted in East-Asian cultures, but in the West is often negated or ignored, leading to misunderstandings about the validity of Chinese medicine.

Qi is often described as “energy”, an invisible force that exists in all of nature. Chinese medicine theory tells us that qi travels along channels that connect all parts of the body and disease is the result of the qi being blocked, deficient, or otherwise imbalanced. The use of acupuncture needles or other stimulation at responsive points along the channels rebalances the qi and restores health.

There are a few keys for a deeper understanding of qi and a better appreciation of the sophistication and insight of ancient Chinese medicine.

 

Qi is movement and functionality

This wonderful illustration is from The Expressiveness of the Body and the Divergence of Greek and Chinese Medicine by Shigehisa Kuriyama, showing the difference between the body as purely function or structure.

Life is movement, everything in our bodies from our heart beat and blood flow, to the delicate balancing of hormones and cellular respiration, is a constant dance of movement.

Functionality in the body is always related to physiological movement on some level. The exchange of ions that generate nerve signals, muscle contraction and relaxation, fluid regulation, blood and lymph circulation, the processes of digestion and so on, are all movement.

Qi is invisible because it is the actual activity and function of everything working together in a healthy human person. Qi is the natural movement of our life processes and we cannot see it because it is a description of the healthy functioning of our very lives. When the qi is blocked- that is, when our cells, biochemistry, or organs are not functioning properly- then we have disease and illness.

Modern Western medicine is based on the ancient Greek worldview which emphasized structure and form. We see this in the beauty of Greek art with its perfection of visible structures of the human body.  Greek medicine was based on the body structures found in a dissected cadavers. As the medicine developed into modern allopathic medicine the understanding all of health and life was still based on physical, inert forms. The focus stayed on structure, the keys to health being sought through reductionism instead of holism.

Chinese medicine is based on the ancient Eastern worldview of movement and natural changes. The Chinese model is based on observable function in a living person, within the context of nature, making it a holistic system of medicine. The acupuncture illustration is depicting life and dynamic movement, something time-based in the human body, not static.

 

Qi is a confluence of several body systems working together


Modern Western medicine divides biological systems into discrete functions based on structures.

The basic systems of the body from a Western perspective are musculoskeletal, nervous, integumentary, reproductive, urinary, digestive, endocrine, cardiovascular, respiratory, and lymphatic. Psychological and behavioral functions are considered somewhat separate, unless there is psychological pathology and neurological drugs are brought in.

An integrative discipline called psychoneuroendocrinoimmunology is a Western medical study of how human psychology, neurology, endocrine, and immune systems interact and effect one another. This is a a limited holistic outlook based on a reductionist model, trying to reintegrate systems that are already divided.

Chinese medicine, developed thousands of years ago, started with the philosophy of holism of the body, community, nature, and spirit.

Chinese medicine uses qi to describe the natural confluence among all the systems, including the psychological state, the shen or heart-mind. In Chinese medicine, if the qi is flowing properly then everything is in working physiological and psychological order. If one of the systems is injured or blocked then it naturally effects several other systems simultaneously.

As a simple example is a severe injury to a limb that effects what the Western model would consider 5 different systems: nervous, musculoskeletal, lymphatic, circulatory, and integumentary, the injury causes lack of function in all these areas.

From a qi-based model,  pathology is in the channel of functionality, causing pain and lack of flow of qi (lymph, blood, correct nerve signaling, mobility etc). Stimulating responsive points in the area or in another area to release blockages in the fascia will resolve the issue.

The treatment approach of unblocking the qi with acupuncture, massage, or herbal medicine simply returns the musculoskeletal structure, blood flow, nerves, and lymph flow to proper functioning. Qi in this case is an elegant shorthand for describing the function or lack thereof of several body systems.

Pathology on deeper levels can effect the hormones, immune system, digestion, the psychological state etc, which is still a pathology of qi – a disruption of physiological function in these interdependent systems.

 

Qi travels along the fascial planes, which connect limbs and organs

Fascia is the great ignored organ of the human body. Fascia is a gossamer-thin yet strong and impervious connective tissue that wraps every muscle, bone, and organ.

Fascia layers in between the muscle cells and binds the body together. It also creates important compartments on the body between the organs and different muscles. Fascia connects and creates boundaries and without it the body would not be able to function.

The purpose of fascia is difficult to appreciate from a structural perspective based in cadaver dissection. Early anatomist would have to cut through all this web-like material in the cadaver to get to the muscles, bones, and organs. Most of modern Western medicine anatomy is based on the information from cadavers, not living, breathing, moving, people. The role of fascia was minimized until a more recent interest in the Western medical community rediscovered its importance.

Daniel Keown in The Spark in the Machine: How the Science of Acupuncture Explains the Mysteries of Western Medicine, attributes the mysterious triple burner (san jiao) organ of Chinese medicine to the fascia. In an important Chinese medicine text, the Huang Di Nei Jing, the triple burner is said to have “name but no form”. The fascia is an organ with many specific functions, and has been overlooked in Western medicine, but helps to explain acupuncture channel theory and qi.

Fascia physically connects organs and limbs. The fascial planes often line up exactly with acupuncture channels, at both superficial and deep levels. This is one way of understanding why stimulating a point on the arm can effect lung function.

Fascia is composed of collagen, which is piezoelectric, meaning it generates an electric charge with mechanical stress. Our bodies have mechanical stress all the time from gravity, not to mention movement and exercise, and the electrical charge generated through the collagen keeps bones strong because the charge signals osteoblasts to lay down more fibers on the bones.

According to Daniel Keown we can see the absence of this in astronauts in space, who lacking the mechanical stress of gravity, lose at least 1 percent of their bone mass per month, even with vigorous exercise.

This is all to say that the body has an innate electrical charge which has vital properties, and travels along lines of the fascia, mirrored in the acupuncture channels.

 

Qi is electricity, the life force of our body

The picture above uses Kirlian photography to capture the electrical energy of a living flower. Electricity can also be defined as energy, or a type of energy, which is matter in movement. The famous axiom E=MC2 is a way to express that qi is everything (matter) in movement.

Qi is the movement and function of the piezoelectric charge that runs along the fascia, as well as the motor and sensory nerve signals, the autonomic signals that keep our heart beating, the blood flowing in the vessels, the release of hormones from glands, the balance of fluids in the body, the metabolism of cells etc. etc.

Electricity is invisible but we know it exists by its effects. Qi is invisible and will never be found in a cadaver, but we know it exists because of its effects. Electricity has healing and regenerative properties, and modern hospitals use special machines that induce piezoelectricity to help heal bones.

 

Qi is intelligent and works within a model of universal order

Qi is an intelligent force within the body that creates order, organization, healing, and proper function. The organization and development of a living human from two cells in only nine months is still the great mystery of embryology.

Qi reminds us that our bodies function is a holistic system that cannot be divided up to be healed. We are a part of nature, and we are all connected through a shared life force, and none of this is an accident. It is no surprise then that the best way to achieve health is with good nutrition, moving and exercising every day, appreciating nature, and honoring our community. The qi will do the rest.

Taoist Cosmology

   “Tao is empty- Its use is never exhausted
Bottomless- the origin of all things…
Deeply subsistent-
I don’t know whose child it is.
It is older than the Ancestor.”
-Tao Te Ching, 4

 

Creation and Tao

“Tao engenders One
One engenders Two,
Two engenders Three, 
Three engenders the ten thousand things.
The ten thousand things carry shade
And embrace sunlight.
Shade and sunlight, yin and yang.
Breath blending into harmony.”
-Tao Te Ching, 42

 

Tao translates to “way”. It also implies the void nature of the universe that exited before creation. In Taoist cosmology it is said that from tao (“nothing”) came the the one. The one is called wuji, the infinite space. Wuji is stillness within stillness, inner stillness, inner essence, beneath and interior to any movement.

The one engenders the two, called taiji, the great ultimate.

Taiji is the harmony of opposites of yin and yang.

The two engenders the three, and from the three all of creation, the “ten thousand things”.

 

The Five Phases

The five phases, or wu jing shen, represent the movement of the energies of nature: fire, earth, metal, water, and wood.

The five-pointed symbol here represents the flow of energies in nature. The five phases are not discrete elements like the four elements of classical Greece, but phases of nature which transform into each other in a cyclical way.

These five phases are the basis for Taoist medicine and feng shui, the sciences related to health and harmony in life and nature.

 

The Cosmic Trinity

Tao engenders the three treasures in different scales of existence, each with its own science for mastery.

Heaven is the cosmic scale with the sun, moon, and stars, and its science is astrology.

Earth is the terrestrial scale with wind, earth, and water, and its science is feng shui, or geographic physiognomy.

Human is the microcosmic scale and has the internal jing, qi, shen, the essence, energy, spirit.

 

The Human Trinity

The three treasures of humans are the jing, qi, and shen.

Qi is the term for “energy” in the body, and also in all of nature. Qi is movement and functionality, life force.

Jing is the essence, the root of the qi in our body, and the force that can generate new life, or with special efforts, regenerate us spiritually. Jing is related to our DNA, our instinctive animal nature to survive and reproduce.

Shen is the spirit, or translated literally as “heart-mind”. Shen resides in the heart and is nourished by the blood, or vital fluids in the body. Shen is expansive and connects us to our true nature, beyond the body.

Qi is the mediator between jing and shen, matter and spirit.

The Heart in Chinese Medicine

The Emperor

“The Heart is the emperor, the supreme controller. The Heart is the fire at the center of our being, from which the spirit radiates.” 
-Neijing Suwen (Yellow Emperor’s Classic of Internal Medicine)

From a Chinese medicine perspective, the organs of the body are not just physical but include functional, emotional, and spiritual aspects.

The Heart is called the Emperor because it is the seat of the most important part of our being- the shen, or spirit. According to Chinese medicine and its Taoist roots, humans are of an earthly nature and the divine cosmos. The shen is the divine spark within and governs the individual spiritual aspect of all the other organs.

Shen literally translates to “heart-mind” and mental illness is considered to be a disorder of the shen.

 

Fire Element

In the body, as in nature, the fire element warms, burns fuel, transforms fluid into vapor, and energizes. In its grossest state it provides metabolic function and in its more rarified state it is the fire of the spirit and of love.

There are two pairs of organ systems classified as fire element: Heart and Small Intestine, and Pericardium and Triple Burner.

Small Intestine

Just as the Heart is the throne of the shen, the Small Intestine is the repository of the blood which is the substance that allows the shen to interface with the body’s function.

“The link with the Heart is key to understanding the subtle levels of the Small Intestine function. The Shen, or pure awareness housed in the Heart and whose influence is distributed throughout the body via the Blood, arrives in the physical body at birth like a ‘stranger in a strange land’. In order to be rooted in the physical confines of the human condition and function appropriately within human existence, it must perform the massive task of assimilating the experience of the physical environment and its conditions.” [source]

Pericardium

Also called the Heart Protector. The Pericardium acts as an intermediary between the Heart and the outside world, functioning on the emotional level as interpersonal love and warmth. Because the Heart is considered sacred and the repository of the divine spirit, in some earlier traditions of acupuncture the Heart channel is not needled. The Pericardium is paired with the Triple Burner organ.

Triple Burner 

Also called the Triple Warmer, Triple Heater, Triple Energizer, or the Chinese term San Jiao. This organ has important functions within the body of metabolizing fluid and regulating temperature.

There is discussion that the Triple Burner corresponds to the lymphatic or fascial systems, but it really has no physical biomedical counterpart.

 

Chinese Medicine and the Heart

Disorders of the Heart in Chinese medicine are related to anxiety, sleep disorders, and mental illness. Basically an over or under-functioning fire element in relation to general enthusiasm about life. The Heart can be treated directly, or through supporting the Pericardium or Small Intestine systems.

 

Love and the Heart

“I am certain of nothing but the holiness of the heart’s affections, and the truth of imagination.”
-John Keats

A broken heart is not just an expression but a real understanding that the heart is affected physically by emotional turmoil and trauma. Loving involves an opening of the heart, a connection of the fire element to another person, and even an electromagnetic connection. Loss and heartbreak affects us on an electro-magnetic level and takes time and therapies to heal.

A connection to something greater than ourselves is crucial for a healthy heart whether it is a spiritual, humanistic, community, family, or creative connection.

About Cupping

Cupping is an ancient practice used almost universally in traditional healing arts. It is still practiced today in many forms of holistic medicine.

Cupping uses specialized glass or rubber cups to draw out congested fluids, blood, and localized toxins, making it very useful to resolve colds, flus, and other acute respiratory disorders. Acupuncturists apply cupping to treat acute colds based on the principle that a pathogenic factor such as Cold or Wind has penetrated the tissues causing stagnation, and therefore the achiness, fatigue and other symptoms.

Massage therapists and manual therapists can use cupping as a bodywork modality to provide relief from pain and tension by separating stuck muscle and connective-tissue layers. Cupping acts as a myofascial release technique and is an effective treatment for large areas of sore muscles. It is excellent in combination with massage to treat soreness and tension in the back, hips and legs.

As the cups draw congested fluids and toxins to the skin surface there is often a discoloration called “sha” that can look like a rash or a bruise. This is a normal part of the process of resolving stagnation in the muscles, and the sha typically fades in a few days.

Although cupping is an ancient technique there is some current research for its effectiveness including this article from the Mayo Clinic on cupping therapy for fibromyalgia.

The most traditional style of cupping is fire cupping which uses a simple glass cup that looks like a small fishbowl where a vacuum is created using a flame that is inserted briefly into the cup, the flame never contacts the client’s skin. Also commonly used are rubber or silicon cups with built-in suction. More info about styles of cupping here.

Cupping disinfection guide

The Organs in Chinese Medicine

In traditional Chinese medicine the organs are considered to be not only the solid structures we recognize in modern Western medicine, but also a sphere of influence that can include cellular, hormonal, muscle-skeletal, emotional, energetic, and inter-organ functions.

In traditional Chinese medicine theory there are twelve organs (zangfu), each with a yin or yang assignment which describes something important about its nature. In this article, to distinguish the Chinese medicine conception of the organs as opposed to the Western medicine conception the names of the organs will be capitalized.

Yin (zang) organs are solid organs that store qi, blood, fluids, or other substances. They generally benefit from nourishment and suffer from depletion. Yang (fu) organs are hollow and are meant to be active in transformation and movement of substances, not storage. They generally benefit from harmonizing and moving and suffer from stagnation.

The Lung, Heart, Spleen/Pancreas, Liver, Kidney, and Pericardium organs are yin. They store substances. The most Yin organ of all is the Kidneys, being the Water element, a very yin element, and located low in the body. The Kidneys store our most important substance the jing, our ancestral life-force

The Large Intestine, Small Intestine, Stomach, Gallbladder, and Triple-Burner organs are yang. They are hollow and use the qi to digest, transform, extract nutrients, and eliminate waste.

Zangfu is an important component of diagnosis and treatment for internal medicine and of particular use with herbal medicine.

On Breathing

Relaxed abdominal breathing is fundamental for health and wellness

diaphragm

Along with bringing the body into a parasympathetic “rest and digest” mode, it is the body’s most efficient way to expand the lungs while also preventing unnecessary neck tension.

The diaphragm is a parachute shaped muscle that occupies our entire midsection and can be thought of as shaped like two merged umbrellas which attach from our lumbar spine around the entire bottom and front of the rib cage.

The lungs are shaped like two jelly fish that start at the tip of the shoulder where it meets the neck, just under the scalenes muscles, and then each lung drapes down over the double umbrella shape of the diaphragm. When the lungs are expanded the diaphragm is contracted down so belly breathing contracts the diaphragm, which pushes down on the soft abdominal organs, expanding the abdomen. This draws the lungs downward, because they’re draped over the diaphragm, and thanks to negative pressure in the pleural cavity.

The close relationship between neck tension and breathing is due to the location of the lungs, which sit rather high in the chest cavity and only extend as low as about the 8th rib, leaving two rib spaces worth of empty pleural cavity.

When we are not breathing with the abdomen we are chest breathing and using our accessory muscles of breathing, the scalenes and sternocleidomastoid

These overworked muscles attach onto our upper two ribs from a large portion of the sides of the cervical spine and from the bottom portion of the back of the skull to the collar bone, respectively.

These muscles can easily get chronically tight when chest breathing is predominate. Not to mention that all that prime abdominal real estate space of pleural cavity that is underused down there at the 9th through 11th ribs when chest breathing is in action. So, relax, take a breath, and notice the difference.

Resources
Kendall, F., McCreary, E., Provance, P., Rodgers, M., Romai, W. (2005). Muscles testing and function with posture and pain (5th ed.). PA, USA: Lippincott Williams & Wilkins.