Can Qi and Western Medicine Coexist?

Qi: A Modern Philosophical Perspective

John Walters, L.Ac.
All rights reserved.

As the use of acupuncture continues to become more prevalent, 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, a 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 move, transform, defend (or protect), warm, and contain (or hold). In illness or disease, qi sinks, stagnates, 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 (Jing Luo). 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 increasingly (almost exclusively) relies 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, etc., modern Western medicine might utilize a non-direct method such as MRI which alters the local magnetic field in the tissue being examined so that the detectable differences in tissue protons returning to equilibrium can be used to construct an image. The doctor really doesn’t directly observe the tissue; she instead observes a representative image of the tissue generated mathematically.

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 (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 hit my thumb while using a hammer, I exclaim, “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.

Yet 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 there is, as far as we can discern, no separate, independent entity of Self. There is every indication that Self exists, but it cannot be found upon searching or analysis. This writer’s Self must be located within the confines of his body; it could be nowhere else. Yet, if I were to ask that you investigate the area bounded by and contained within my body what the true John Walters is (besides my various cells, tissues and organs), it would be clear that the Self does not have its own substance.

Still, “John” really exists, as a man, acupuncturist, husband, etc., who eats, works, recreates, sleeps, and otherwise experience life. So we might say that existence of Self is inferred or that each of us is imbued of Self. It is generally agreed and accepted that this is sufficient to prove that something exists, even though it cannot be directly observed or found.

Thus, among the bases of Self, we can find nothing that actually is the Self. Does this mean that Self does not exist? No, it surely does exist. But when it still cannot be 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 of other conditions. We see the evidence of Self, but we cannot observe it directly.

Some might argue that Oriental medicine simply works by acting upon blood, the neurological system, and cells much as Western medicine does, 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 ultimately forms and moves other things or phenomena. After all; what forms and moves it?

The real relevance of qi is that it 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.