What the Heck is Qi?

I am nearing the end of my first year in traditional Chinese medical school.  To say that I have learned a lot is almost an unforgivable understatement.  Someone asked me yesterday if I feel more confident in my understanding of how the human body works since I’m about to take Anatomy & Physiology III and Surface Anatomy is behind me.  No.  I feel less confident.  Granted, I now know where the parts are, and, sure, I know what a foramen is; but, it is now quite clear to me that I know far too little compared to what there is to know.  I now completely understand why there are medical specialties.  There is too much to know and master.

So, to cope with my feelings of inadequacy, I amuse myself at school by laughing every time I hear the word ‘trochanter’ because it either sounds like part of a horse or a verb.

“I hurt myself trochantering.” OR “The trochanter on that horse is magnificent.” OR “He’s got a far greater trochanter that you’ll ever have!”

My jokes aside, I am also somewhat ashamed to be a Westerner from time to time the more I learn about the Chinese medical paradigm.  There is so much misinformation in the West about what it is.  People believe that it is superstition, folk medicine, or some ancient tradition that the Chinese people refuse to give up and replace with modern medicine.  Then they use words like ‘Qi’ and cite something they heard in the news about villagers killing endangered animals for their penises to prove their point.

I can’t eradicate ethnocentrism and ignorance in one blog post, but I can explain one thing: Qi.  What is Qi (pronounced chee)?

The first thing to clear up is that the use of the word Qi in Taoism is not the Qi of TCM.  These are two very different concepts.  One is a philosophical and almost religious concept while the other is a bodily and/or physical concept.  To help illustrate this, I’ll use a Western concept that many readers will understand.

The second verse of the first book of Genesis says, “Now the earth was formless and empty, darkness was over the surface of the deep, and the Spirit of God (or breath) was hovering over the waters.”.  The Hebrew word for ‘spirit’ is ‘ruach’ which also means ‘breath’.  Qi means ‘breath’, too.  The ‘breath’ or ‘spirit’ of God is referred to many times in the Bible.  When you go to the doctor, however, and you are asked to take deep breaths so that the physician can listen to your ‘breath’, do you believe that the doctor is listening to your spirit? No.  I don’t know one person who confuses their spirit, God’s spirit or breath as it were, with the physical act of breathing or the exhalation of CO2 and inhalation of O2.  We are able to completely separate the two concepts and nary confuse them.

This is precisely the same when one speaks of Qi in Traditional Chinese Medicine (TCM).  We are not confusing the Qi of Taoist thought or philosophy which compares quite closely with the Biblical statement made in Acts 17:28 “We live and move and have our being in Him.”  To the Taoist, we live and move and have our being in Qi–the original breath or source.  This is not, however, the Qi we discuss in medical school or Chinese medical practice.

So, what is this medical Qi then? There are many, many types of Qi.

  1. Pre-Heaven Qi or Congenital Qi: this is what forms the basis of your constitution.
  2. Acquired Qi: this is the Qi that is formed from your lungs and digestive system.  You can improve this Qi throughout your life largely by what you eat.  You can also hurt your Acquired Qi and body by your dietary habits.
  3. Gu Qi (Water and Grain Qi): Food and Water Qi–the Qi or energy that you acquire by your dietary habits.  This Qi is refined and sent to the lungs also from the spleen and stomach.
  4. Da Qi (Air Qi): Air taken in by the lungs to form Zong Qi
  5. Yuan Qi (Source Qi): this Qi serves the material and functional basis for life activities in the body.  It is stored in the kidneys.
  6. Qing Qi (Clear Qi): Refined Qi sent to the lungs from digestive system
  7. Zong Qi (Gathering Qi): Formed by union of Gu Qi and Qing Qi.  Governs breath of lungs and pulsation of heart and circulates movement of Ying Qi and Wei Qi
  8. Wei Qi (Defensive/Protective Qi): Formed by Qing Qi and flows both inside and outside of the channels between the skin and fascia.  It protects body, regulates temperature, governs opening and closing of pores, moistens skin, muscles, and hair, and is distributed superficially during the day and deep during the night.
  9. Ying Qi (Nutritive Qi): Formed by Qing Qi) Formed by Qing Qi and contributes to formation of blood.  It is retained  within walls of the channels and flows throughout the complete channel system nourishing the tissues of the body.
  10. Zhen Qi (True Qi): A combination of Yuan Qi, Zong Qi, Ying Qi, and Wei Qi . This is a a collective name for the functional bases of life activities.
  11. Jing Qi (Essential Qi): Blood, Qi, Fluids or Essence specifically acquired essence, internal organ (zang-fu) essence, and congenital essence.

This is just a list of the Qi that functions in the body.  This is not a list of pathogenic Qi–that which disrupts homeostasis and causes pathogenic changes and disease processes in the body.

There is no superstition involved.  There are no demons as some people have suggested.  No, Qi is not the name of a god, and I’m not worshiping it.  TCM is a different approach.  A different medical model.  And, it is highly effective and healing, but it’s different from what we as Westerners know.

Hopefully, this quick primer on Qi has shed some light on what it is and maybe piqued your curiosity.

By the way, emotions are viewed as internal pathogens in TCM when they disrupt homeostasis, and their activity and effect on the body and well-being are taken quite seriously.

Well, I’m going to study now.  Pathology class in two hours…

 

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4 thoughts on “What the Heck is Qi?

  1. MJ, your blog is wonderful! This was an excellent, elucidating introduction to Qi. Thank you for that. The body, and the various systems in place for understanding it, are fascinating, aren’t they? For years now I’ve been working on learning ballroom dance, and some really surprising things have come out of me. As a result, I’ve started to view the body as a pathway to the unconscious. It has been enormously helpful to work directly on the body itself, to develop more bodily awareness and to physically experience lessons on a cellular level. I wonder…could you elaborate on your final note about how TCM attempts to restore homeostasis when emotions disrupt it?

    Off topic, but I keep circling back to your therapist’s comment about your having “a lot to offer.” In the context of this blog, I couldn’t agree more! But it also makes me uneasy. I keep hearing that statement as a plea for his patient’s insight, rather than the other way around.

    • Good morning!

      Thank you for your comment, and, of course, I will explain. I will first note that TCM has been around for c. 5 millennia. There are approaches that have been built upon earlier ones, and ideas that have been shaped to fit modernity. So, the idea of disease within TCM begins with the notion that there are factors that disrupt homeostasis. And, when that pathogenic factor brings about a pathogenic change that causes the body NOT to be able to maintain its own constitutional or healthy homeostasis, then a disease process has begun. In this context, emotions are viewed as pathogenic factors–endogenous pathogenic factors. Each of the five deep internal organs called ‘zang’ in TCM is understood to have an emotion assigned to it. The liver:anger, the heart:joy (which is really overstimulation), the spleen:worry (in the sense of a ruminating kind of worry), the lung:sorrow or grief, and the kidney:terror and/or fright (the sense that you are being stalked and something terrible is going to happen to you or an anticipatory fear of something bad). When a person experiences any of these emotions consistently, a TCM doctor would want to treat them because 1) all of these emotions disturb the “shen”. In TCM the “shen” is the mind. It has a large meaning. It conveys one’s inner operating system. Our ability to remember, function emotionally, sleep well, think lucidly. And, the “shen” is associated with the heart. All emotions affect the heart and, thusly, because the heart houses the shen. 2) So, in TCM, it is vital to pay attention to shifts in emotions because they affect health. And, when left unchecked, they affect the process of disease. Also, the heart and small intestine are connected in TCM, and this is reflected in Western medicine as well. The gut produces roughly 90% of the bodies serotonin. When the gut biome is out of balance, people experience any manner of mental health issues anxiety being one of the bigger issues, gut disorders notwithstanding. The other side of this is that often when a person experiences a shift in their emotions, this is reflective of an internal organ’s health shifting. It is the principle of the “to know the interior we must observe the exterior”. If someone is suddenly angry constantly and for no reason, we would look at what the liver/gallbladder system is doing since they are paired. In TCM, the emotions are inextricably linked from the organs. Treating the emotions, treats the organ system. Treating the organ system treats the emotions. Lastly, longterm emotional suffering affects the organ system and catalyzes a disease process. So, if a person grieves for years and years, then eventually the lung system would become compromised. If a person is angry and resentful for too long, then the liver system would become compromised. If a person overthinks and worries for too long, eventually the spleen system would become compromised. Not surprisingly, spleen qi deficiency is probably the most common disorder seen in clinic.

      Surprising to so many of us, people’s mood improves. Even people with biologically-based brain disorders who simply can’t sleep or experience peace of mind do. This is one modality of treatment for mental health issues. My daughter has bipolar disorder, and she struggles terribly with insomnia even with the load of meds she takes. After two acupuncture treatments, she is sleeping through the night. It is not a panacea, of course, but should it be incorporated into a line of treatment, patients would get better faster.

      And my therapist’s comments…you are so right. Another reader commented on that as well. I will be ending that therapeutic relationship actually. It’s not a good fit. Your comment is very insightful. He is supposed to offer insight rather than constantly push me to do it. I mean, I have my insights. I’m there to hear his. So, again, thank you. I so appreciate the feedback.

      And, thank you again for sharing about your ballroom dancing. I used to dance when I was younger. There is nothing quite like dance to put you in touch with your body and emotion at the same time. What a great pursuit. What drew you to it?

      All the best to you, MJ

      • What a fascinating blog. I have often thought that there are forces and influences at work in our experience that western science cannot measure and explain. I can see that emotions often have an adverse effect on physical and mental health, but I have never heard the impact described the way you just have. You have already inspired me to do a little bit of research into TCM, and I guess I will try to read some more. I’d like to know more, so I hope you will continue to share your learning experience.
        Best wishes, BR

        • I wonder if I can find any sort of reading material to recommend that is accessible. Some of the stuff we read is not “friendly”. It’s tough stuff, and I’m volunteering for it! But, yes, the Chinese have not separated out the emotions from the body. It is an entirely holistic view. Everything affects the other. It makes sense to me. I’ll see what I can come up with…I’m glad you find it interesting. I do, too, of course. 🙂

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