What the Heck is Qi?

Stack of stonesThe concept of qi lies at the heart of Traditional Chinese Medicine and is central to Taoist philosophy. Qi is defined as the energetic or animating force associated with all living things. The concept of an animating force is not unique to Chinese culture. In Japan it is called ki. In India,  prana. The ancient Egyptians referred to it as ka and the ancient Greeks called it pneuma. Native Americans know it as Great Spirit. In Africa it’s known as ashe and in Hawaii as ha, or mana.

If you’ve had acupuncture before, you’re probably familiar with the sensation of qi, especially when “stuck” qi becomes “unstuck” and begins to flow again (picture moving a beaver dam from a river and the flood of water downstream that would result). Qi is the feeling of warmth you feel at an acupuncture point, or the deep pressure that seems to travel in an outward direction. It can also present as bursts of energy that zip through a limb or arrive as a heavy, sinking feeling at the end of an acupuncture treatment. Since there are so many different manifestations of qi, it follows that there are different words to describe the range of sensations a person may experience during an acupuncture treatment. Suan means aching or soreness, ma is numbness or tingling, zhang is fullness or pressure, and zhong is heaviness.

I once had a patient describe an acupuncture treatment as a “resettling of the spirit.” When she initially came to the clinic, she had two major complaints — the first being a sudden bout of constipation. The second was more of an emotional complaint; she reported that her soul seemed “stuck in negativity” after a particularly ugly divorce that had taken a full year to complete. In the past, acupuncture had been the only thing that could move her at a level deep enough to facilitate the kind of change she craved which, according to her, was wrapped up in being able to forgive her ex-husband (and herself) after many years of failed attempts to make their marriage work. She had seen a therapist for the year surrounding her divorce but felt as if the emotional pain was stuck in her physical body, specifically in her lower abdomen and heart. She came for acupuncture once a week until she felt good enough to wean from regular treatments. On her third treatment, she walked in gave me a high-five. “Hallelujah!” she said, “The train is back on track.”

In other words, she was pooping again!

By her 7th treatment, she was sleeping through the night, more at peace with the past and, as an added bonus, had shed some extra pounds that accompanied the high levels of stress she had experienced in the past year. The last time I saw her, she snuck out before saying goodbye but left a square of gourmet chocolate and a card on my desk. The card read: My qi was stuck. Now it’s not. I appreciate you, and I appreciate your medicine.

I loved the card. One of the best parts about being an acupuncturist is observing how quickly the body and the spirit will return to homeostasis when given some extra help and a little time to relax. Sometimes giving qi that’s no longer flowing smoothly a little nudge in the right direction is enough. The cascade of self-healing begins and though the results may be subtle at first, over time the transformations I am privileged to observe means that I am witness to the wonders and the complexity of, well … being human. In other words, though I see extremes of emotional and physical pain on a daily basis, I also get to see what happens when things get quiet and qi begins to move smoothly again, allowing the body to balance and the spirit to resettle.

But What About Science?

Okay, enough with the anecdotes. What about science?

Many people with a strong biomedical bent absolutely DESPISE the animating force description of qi — they resist the concept of “meridians” and “qi” and require a biomedical explanation.

For those of you who embrace quantum mechanics and find that branch of physics a feasible way of making sense of our world —well you probably don’t need much of an explanation regarding the intersection of science and qi. However, some people find quantum mechanics to be nothing more than flapdoodle. If you are loyal to the cold hard sciences, check out the following theories based in biomedicine.

Fascial Planes/Connective Tissue

In many circles, the “connective tissue theory” of acupuncture reigns supreme.

Fascia is a connective tissue that surrounds structures in the body — it envelops muscles, nerves, blood vessels and organs.  If you’ve ever cooked with raw meat you’ve seen fascia — it’s those really thin (almost transparent) layers with the silvery sheen. Fascia serves to “hold” everything together; it literally connects us from our heads to our toes.

Helene Langevin, Professor of Neurology at the University of Vermont, has found that many acupuncture points occur where fascial planes converge. When an acupuncture needle is inserted through the skin and rotated, the loose connective tissue under the skin becomes mechanically attached to the needle (picture spaghetti winding around a fork) and the surrounding connective tissue becomes stretched as it is pulled by the motion of the needle. Using this theory, blocked qi is seen as a pathological alteration in the fascia due to trauma/overuse/underuse/ etc. Since the connective tissue surrounds nerves, blood vessels and lymphatics, reducing tissue tension through needling could affect how these structures function.

Other Possible Explanations

Chris Kresser, licensed acupuncturist and practitioner of functional medicine, argues that the “energy meridian” theory used to explain acupuncture is actually the result of a single moment of poorly translated text that resulted in a perpetuated misconception. His website is full of fascinating information about Traditional Chinese Medicine, but written in the language of modern medicine. Below are some highlights from a series of posts on how acupuncture works from a biomedical perspective. If you’d like to see the supporting research underlying these theories or read about them in more detail, visit his website at chriskresser.com.

Kresser argues that there is a good amount of evidence indicating that acupuncture points are areas with an abundant supply of nerves. According to Chen Shaozong, “For 95% of all points in the range of 1.0 cm around a point, there exist nerve trunks or rather large nerve branches.”  In other words, the qi sensation can be explained as a stimulation of the peripheral nervous system.

Acupuncture promotes blood flow.  Acupuncture has been shown to increase blood flow and vasodilation in several regions of the body.

Acupuncture releases natural painkillers. Inserting a needle sends a signal through the nervous system to the brain, where chemicals such as endorphins, norepinephrine and enkephalin are released (some of these substances are 10-200 times more potent than morphine).

Acupuncture reduces both the intensity and perception of chronic pain. It does this through a process called “descending control normalization,” which involves the serotonergic nervous system.

 Acupuncture reduces stress.  Recent research suggests that acupuncture stimulates the release of oxytocin, a hormone and signaling substance that regulates the parasympathetic nervous system (the parasympathetic nervous system is the system that promotes “rest and digest” as opposed to the sympathetic nervous system, which is in charge of “fight or flight.”)

Glad to know that we’re all on the same page here, right?! Ha! However you decide to describe qi (or not describe it) we must acknowledge one unarguable point: Even Obi-Wan Kenobi has been schooling us on qi — ever since he was written into our collective consciousness and taught us about the importance of The Force.

“It surrounds us and penetrates us. It binds the galaxy together.” – Obi-Wan K.

Conclusion

So, what do I think?

Personally, I love learning through experience. I think the amount of conflicting information on the Internet is overwhelming (especially when you get into the world of Complementary and Alternative Medicine), and beyond that, the information is often sadly partisan.

So, when it comes to something as controversial as “qi” and acupuncture, my suggestion is to explore qi by moving it and through moving it … well, feeling it!

In other words, before blowing off the existence of qi as hocus pocus, give it a whirl! Walk on over to your local community acupuncture clinic, relax in a recliner and have a treatment. Ask questions. Welcome the healthy skeptic that lives in your cerebral cortex —  it’s totally normal and healthy. But don’t let it stop you from trying something that might benefit you in subtle (or major) ways.

If you need cold hard evidence before trying anything, then keep an eye on Chris Kesser’s website and check out the Society for Acupuncture Research whose mission is to “promote, advance, and disseminate scientific inquiry into Oriental medicine systems.”

In order to bring this article to a close, I’ll quote one of the masters in the field, Arthur Rosenfeld, who is a Tai Chi master and an author of many critically acclaimed books on Eastern thinking.

“Knowing qi, feeling it, sensing it,” says Rosenfeld, “you can learn what techniques and choices enhance it and allow it to flow freely (stagnant qi is seen as a source of disease) and you may find this sensitivity helps you stay healthy and enjoy life more. At very least, entertaining the idea of qi introduces the notion of as-yet-undefined forces into the nuts-and-bolts way we look at the world–a view limited both by our senses and by the accepted truths of the day–and thereby deepens our experience of what it is to be alive.”

This post was written by Lauren Breau, L.Ac, acupuncturist at Wildwood Medicine in Portland.

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Diane Atwood

About Diane Atwood

For more than 20 years, Diane Atwood was the health reporter on News Center 6. She's now a regular guest on the Morning Report. Before she became a health reporter, Diane was a radiation therapist/dosimetrist at Maine Medical Center. In 2000, she left the world of reporting to manage marketing and public relations for Mercy Hospital. In 2011, she decided to pursue a longtime dream of being a freelance writer and launched her award-winning blog Catching Health with Diane Atwood.