Qi: A Modern Philosophical Perspective
John Walters, L.Ac.

As the use of acupuncture continues to become more widespread, people naturally want to know its theoretical basis and how it achieves its clinical effects.

The fundamental basis of acupuncture is qi (气), which is popularly and, somewhat incorrectly, defined as “energy.” Moreover, the Western scientific community has been skeptical of the concept of qi, skepticism not unreasonable when we try to understand qi from a strictly scientific basis. Applying philosophical methodology and broadening our perspective helps us to understand how qi fits quite logically in the overall structure of traditional Chinese medicine (TCM).

The Ancient Chinese View of Qi

Ancient Chinese philosophy holds that everything in the universe evolves from qi. It is the initiating or causative force of all creation. Qi is said to be initially without shape and it simultaneously manifests on both the physical and spiritual levels. Qi is in a constant state of change and at varying levels of aggregation. When qi condenses, energy transforms and accumulates into physical form and processes. In Chinese medicine, qi represents the functional activity of the internal organs as well as the energy they produce. Qi represents the motive force said to have five primary functions, namely; to transform, lift, contain (or hold), warm, and to defend (or protect). In illness or disease, qi sinks, stagnates, counterflows or rebels, or becomes vacuous or empty. In clinical practice, an acupuncturist attempts to observe and, at least in a relative sense, measure the flow/movement of qi in the body in order to ascertain whether that movement is harmonious or dysfunctional. When the free flow of qi is impeded or otherwise disturbed – through invasion of pathogens, emotional disturbance, inappropriate diet or lifestyle, or from local trauma – illness and disease result.

The Chinese believe that the outside of the body is surrounded by a field of qi and that qi moves through the body via a system of conduits called Jing Luo - 经络 (pronounced “jing loo-uh). Click here to read our article describing the Jing Luo.

As is true of all terms, “qi,” is simply a convention; a term used by ancient Chinese to describe observed phenomena even though, as we recognize, qi itself cannot be observed. As it turns out, this is not so far removed from modern Western medicine methodologies as we might first think.

Reconciling Western Clinical Medicine and Qi

The concept of qi has always seemed inconsistent with the Western scientific model, specifically the requirement that phenomena be observable and measurable. It is a contemporary irony that acupuncturists diagnose on the basis of directly observable clinical signs and symptoms, whereas Western medicine relies increasingly (and almost exclusively) on indirect laboratory analysis and/or imaging studies. For example, while the acupuncturist attempts to discern the internal state of the body via palpation of the radial pulses, assessment of the tongue body and coating, the characteristics of the patient's skin and voice, etc., modern Western medicine might utilize a non-direct method such as MRI which alters the magnetic field in the tissue variation in tissue protons can be detected used to create an image. The radiologist really doesn’t directly observe the tissue, but rather observes a representative image of the tissue generated by an algorithm.

The Philosophical Basis for Qi

We recognize that the environment includes phenomena that were once unavailable to the five human senses or to our instruments of measurement. For example, prior to the discovery and refinement of optics, the microscopic world of cells, protozoa, viruses, and bacteria were unknown to humans. We were subject to and could observe some of their effects (cholera, dysentery, pneumonia, etc.), but we really had no knowledge about the organisms themselves.

Another example of accepted but non-directly observable or measurable phenomena is Self. Many, if not most, of us accept that each human being is associated with a Self (the “I”). This Self is neither directly observable nor directly measurable, but there are observable and measurable phenomena which suggest (perhaps even prove) the existence of Self and which we readily accept.

The Self, body and mind each exist and each performs its respective functions. When I touch a hot stove with my finger I scream, “I am in pain!” But what is this “I” to which I refer? The reference is to that force which controls my hand and which I associate with “my Self.” Similarly, a mother whose child is killed in an automobile accident by the senseless act of a drunk driver experiences not simply grief, but sometimes even very real, even measurable, signs and symptoms (headaches, tremors, insomnia), the same as someone who suffers from a physical disorder. Yet her symptoms are said to be psychological – of the mind.

Still another example is provided by the stories of certain heart transplant patients who report experiencing feelings and memories unknown to them previously but which were strongly associated with the life of their organ donor.

Even though both body and mind are things belonging to the Self, no one has yet identified a separate, independent entity of Self. All indications are that Self exists. But it has yet to be located or discovered by search, analysis, or measurement. The Self must be located within the confines of one's body as it could be nowhere else. It is impossible to find or describe the substance or unique characteristics of Self by investigating the area circumscribed by and contained within one's body in order to determine what the Self actually is. But each of us and those with whom we interact have no doubt about our existence by virtue of our thoughts, functions, activities, and interactions; by our experience of life. So although not able to be directly discern or observe Self, we have general agreement that indirect evidence of Self is sufficient to prove that it exists and is a part of each of us.

The fact that we are unable to fine, measure or accurately describe Self does not negate it existence.
But when it is in no way found within, around or among the area or place where it must exist, it is obviously established not under its own power but through the force and/or interaction of or with other phenomena or conditions. We see evidence of Self but we cannot observe it directly.

Some might argue that traditional Chinese medicine simply works by acting upon blood, the neurological system and cells as does Western medicine, and that there is no qi involved. But as Western science continues to identify and describe ever smaller forms of matter and energy, it becomes impossible to fully describe (or perhaps to even identify) the ultimate force that forms, activates and moves other things or phenomena. After all; what forms and moves it?

Qi is as much a concept to describe what we can observe about the human body - its temperature regulation, circulation, constant growth and transformation, and all its functions. After years of treating patients my own thinking about qi has evolved. My sense is that, absent the sophisticated technologies available in the practice of modern biomedicine, long-ago practitioners of traditional medicine styles in China developed methodologies for observing markers (i.e., effects associated with) certain bodily processes that, when taken together, gave a holistic sense of a patient's state of health. The ancient Chinese (and no doubt other ancient peoples) seemed to understand that there was some underlying spark that animated all life. They could directly observe the effects of this animating force even if they could not directly observe the force itself. This remains true today. Cardiologists describe a heartbeat as spontaneously initiating with an electrical impulse in the sinoatrial node, after which the current is stepped-down at the atrioventricular node (loosely akin to an electrical utility distribution station), and then distributed via the His-Purkinje network, the pathway of nerve fibers leading to the heart muscle. And while various heart cells exhibit electrical impulses, what, exactly, initiates the start of this cellular activity?  No one really knows. But we know it occurs. Where it all ultimately begins is the chicken-and-egg question. That's qi. 

Meanwhile qi represents a theoretical underpinning of traditional Chinese medicine, a system of medicine that has benefited very many people over thousands of years and which continues to benefit patients today.

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