Posts Tagged ‘Qi’

Science, Scientism, Healing and Medicine

Friday, January 27th, 2012

Today I had a mooch around Waterstone’s. I meandered past the section on religion, where the first book I noticed looked something like an anti-religious polemic; part of the blurb was an endorsement by Richard Dawkins, warning any religious apologist not to risk getting into a debate with the author, who would presumably run rings around their pathetic and irrational arguments. I wandered on to the science section, replete with several titles by the aforesaid Professor Dawkins, but nothing I noticed along the lines of an anti-scientific polemic. Science gets all the good PR these days.

Now I’ve got a physics degree and a healthy respect for the scientific method. But working as I do now in healthcare, I’m not altogether sold on the ability of modern science to make life better and people healthier. In their book ‘Why Do People Get Ill?’ Darian Leader and David Corfield suggest that doctors would be better prepared for their profession if they did an arts degree, rather than a science degree. What leads them to this radical suggestion is their belief, which their book aims to substantiate, that key factors in what make people get ill lie in their emotional life, and thus a good doctor is one who can meet the patient on this emotional level, with understanding, empathy, humanity. (Of course, one might want to question whether people graduating from arts courses have any more humanity than their scientific colleagues!)

 In other words, healing is as much art as science. People cannot be understood if they are just understood as a set of numbers, a set of data. Can illness really be fully understood by science? (It is a sad fact that the word ‘clinical’ connotes a kind of cold rationality.) Of course you want a doctor, a healer, to be able to think clearly: this is no apology for the worst kind of woolly minded alternative therapists. But you also want them to have humanity, even compassion. Not just because it makes the treatment experience more bearable, more civilised, but because it is an essential part of that treatment.

 Good medical treatment isn’t entirely reducible to numbers. In traditional acupuncture, for instance, a lot of emphasis is placed on the Qi of the acupuncturist. The Chinese word Qi is impossible to translate accurately into English – it is something like the vital energy of the individual, which in a healthy person is free-flowing and abundant. (For a more detailed explanation, click here.) The Qi of the acupuncturist includes such things as the quality of the attention of that acupuncturist, their freedom from distraction and sense of presence. Included here is the rapport between the acupuncturist and the patient. Included here is the ability to find the exact right spot to insert the needle, the exact right depth for it, and the ability to sense what lies at the end of the needle, how the needle interacts with the patient’s own Qi. (Of course there are guidelines about where to put the needle and so on, but the fine tuning relies on the Qi of the acupuncturist.) These things are not measured in most scientific trials of acupuncture, probably because they are not so easy to measure, but there is a world of difference between having an acupuncture needle inserted by someone who has been on a few courses and is thinking about what they are going to have for their dinner, and by, say, a serious traditional acupuncturist who practises Chi Kung (a traditional Chinese form of meditative exercise and health preservation) for two hours every morning, and is able to focus his entire attention on what he is doing. Medical treatments of this kind are very complex interactions between two very complex entities: human beings.

 One can distinguish between science and scientism. Scientism is the belief that science is the only valid form of knowledge, the reduction of all forms of knowledge to that which is measurable. My fear is that scientism is invading the world of medicine and healing, so that any form or aspect of treatment which is not measurable (or perhaps not easily or cheaply measurable) is disregarded or downplayed, when in fact it is an essential part of that treatment. 

 I remember reading an article by a surgeon who described how he had postponed an operation by a day for no other reason than he had an intuitive sense that it would be better to wait 24 hours. Personally, if a good surgeon told me he had a gut instinct that we should wait an extra day before my operation, I would be glad to go with that. Some of the most important things that happen in a healing context are not measurable by scientific means. Science, therefore, should know its place! In its place it is fantastic, but it is not the be all and end all of medical treatment.

 

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Illness and Responsibility

Saturday, November 5th, 2011

Why do we get ill? No doubt the answer is often complex, and it is a mistake to think there is just one single cause when very often it is a combination of factors. In Traditional Chinese Medicine these factors include inherited imbalances, poor dietary choices, climatic factors, lifestyle issues and, not least, emotional difficulties. Most of these things we can influence, for better or for worse. This then raises what may be a controversial question. If we are ill, is it our fault? On the one hand, if we tend to answer yes to this question – maybe we eat badly, or avoid exercise, or keep ourselves trapped in a long-standing state of anger or anxiety – this can lead to guilt and even self-loathing, which will only make matters worse. On the other hand, if we bristle with resentment at the very suggestion that our suffering may, in part, be our own doing, we can settle down into the role of the helpless victim.

Thus, especially if we have a serious and chronic illness such as ME or cancer, we need to work out our emotional response to the question, “Why me?” This response needs to avoid the extremes of, on the one hand, beating ourselves up about it all and, on the other, of taking up the role of helpless and resentful victim. In fact this is an issue which every human being has to face, as every one of us reaps the consequences of how we have lived, and few of us have lived like an angel or a sage. Most of us have made mistakes, and have to live with the consequences of those mistakes, whether those consequences manifest as illness or in some other way.

So what should our attitude be to the past? Perhaps we need to acknowledge it, and, in the context of illness, acknowledge the ways in which we may have contributed to our getting ill. However, we may instead say that we have not the faintest idea why we are ill. This is especially so when our health system is so technical and specialised. How can we, a mere layman, understand why we have the illness we have? Something is going wrong, and we do not understand it, and do not understand why it is happening. This may tend to put is in the victim camp.

On the other hand, perhaps we can free ourselves from the shackles of technical medicine, and use our intuition. The more self-awareness we have, the more likely our intuition, or even our common sense, will tell us why we are the way we are. If I go around all the time in a constant state of fear, with my shoulders hunched up, is it not possible that I may end up with a headache or an arthritic neck? If I am always angry and frustrated, is it not possible that my blood pressure gets too high? If I always gobble down my food whilst doing something else, not chewing it properly, is it not possible that I will get some kind of digestive problem, like a stomach ulcer or acid reflux? In some ways the illness we get may be giving us some kind of feedback as to how we have lived our life to date, and if we endeavour to be receptive to that feedback, we may learn something crucial about ourselves.

Traditional Chinese Medicine is often very helpful in helping us to understand why we are ill in the way we are. For instance, it makes useful connections between different emotional states and the way they affect the individual. For example, it says that anger makes Qi rise. (Qi cannot be easily translated, but means something like ‘vital energy’) This means that anger often causes symptoms in the upper body, especially the head and neck – think migraines, headaches, tinnitus etc. Of course everyone gets angry from time to time, but problems arise when we become habitually angry, or when we repress or deny our anger. Prolonged sadness, on the other hand, depletes the Qi, and may especially affect the lungs, leading to shortness of breath, fatigue, a weak voice, even asthma.

Of course these kind of ideas need not to be applied too literally, but they give us a clue, give us a framework to ponder on the connections between our emotional lives and our illnesses. Perhaps they can stimulate us to become more sensitive to the way that emotions manifest in our body – if we are really aware, we can begin to feel how, for instance, excessive worrying is tying our Qi in knots.

If this kind of process leads us to acknowledge that our illness may in part be due to how we have lived, then , knowing that we cannot change the past, we can come back to the present, where we do have a choice. That choice may not include the option of freeing ourselves totally from the consequences of our past actions, but it does include the choice to live in such a way as can at least mitigate the effects of the illness, at least to some extent.

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Inner Rioting

Tuesday, August 16th, 2011

Today the headlines in the English newspapers are all about chaos and anarchy, this because of the rioting over the last few days in London and other cities. Perhaps most of us fear few things more than we fear chaos and anarchy and the loss of order in society.

As with society at large, so with the human individual – most of us value some kind of order in our lives. Interestingly, classical Chinese medicine evolved in part by thinking of the human individual on an analogy with the wider society. The heart, for instance, is spoken of as the emperor, and the other organs compared to government officials, the liver being the general of the army for instance. The meridians which traverse the body are like the waterways of ancient China, which made possible communication and trade between the regions of that vast country. Just as unhindered waterways facilitated such exchange, so do clear meridians make possible the body’s harmonious functioning.

Some kinds of illness, in fact, are like riots, like chaos breaking out within. Internal disharmony affecting the liver, for instance, can lead to an eruption of stagnant energy, or Qi, which courses violently upwards to the head causing, for instance, migraine or even stroke. The natural functioning of the stomach if interrupted can lead to “rebellious stomach Qi”, manifesting as heartburn, acid reflux or vomiting. Notice the political metaphor. Perhaps one of the most common kinds of inner chaos is the panic attack, which in some cases is also seen as rebellious Qi, this time in a meridian called the Chong Mai.

However, whilst mob rule and anarchy may be bad, the other extreme is also to be avoided. As the German philosopher Nietzsche puts it, “one must have chaos within one to give birth to a dancing star.” Too much control and order stifles creativity. Think of totalitarian regimes. Within the individual, if afraid of inner chaos we seek to impose too much order, illness may also follow. Indeed the first example above, the migraine attack or stroke, might be due to a long-term habit of excessive control, particularly of anger. Eventually the pressure becomes too much, and too much order becomes too much chaos.

On a more subtle level, there may be an excessive controlling of what the ancient Chinese referred to as the ‘hun’, sometimes translated as ‘ethereal soul.” This ‘hun’, which is associated with the liver organ, is responsible for a sense of direction and purpose in life, inspiration, dreaming, moving towards our life’s goals. Whilst an uncontrolled ‘hun’ manifests in wild and vivid dreams (so that we wake exhausted rather than refreshed), or more seriously in manic behaviour, an over-controlled ‘hun’ leaves us depressed and apathetic, with no direction or creative spark. The hun’s relation with the liver means that liver pathologies may cause these kind of problems, one way or the other.

So just as in society there needs to be harmony and order, but not excessive control, so too in the life of the individual. Whilst achieving exactly the right balance may be nigh-on impossible, we need to avoid swinging from extremes and tread a middle path so that we have enough freedom to express ourselves and envision our future, but also a well regulated life (regular sleep and meals for instance!), so that anarchic chaos does not overwhelm us.

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What is Qi?

Saturday, May 28th, 2011

What is Qi? This is a question we are often asked by patients, since Qi is such a key concept in Traditional Chinese Medicine. And indeed, even if we are not asked, we need to explain about Qi so that the patient can understand better as to what their problem is and how we are treating it. Explaining what Qi is, however, is no easy thing. Sometimes we may talk of energy circulating through the body, but this is only a very rough and ready way of understanding what Qi is.

It strikes me that there are two ways of going about answering this question. The first one is to try to explain Qi from the outside, in the abstract. The second is to encourage understanding from the inside, as an actual experience. It is a bit like if you were to ask what New York was like. One way to answer this would be to read a few books about that city, watch a film, go on the internet, even talk to some New Yorkers. Another way would be to get on a plane and go there. Or even better, to live there for a while – only then, perhaps, will you really know New York.

So you could read some books about Qi, even do some scientific experiments to try to measure it; or you could experience it. How do you experience it? Through self-awareness, especially as mediated by such practices as Qi Gong or T’ai Chi. If you really want to know, the equivalent of living in New York would be practising Qi Gong under the instruction of a master.

Practising Traditional Chinese Acupuncture in the west raises a lot of interesting problems. In particular, there is a lot of effort expended on testing, explaining and understanding this medicine scientifically – the assumption being that only medicine which has been scientifically verified can be useful, and indeed that all medicine can be scientifically verified. This leads to a lot of (quite expensive) effort in trying to understand things like acupuncture and Qi, but this understanding is almost always of the ‘read books about New York’ type, because this is how science works. This means that someone can be an expert in acupuncture and Qi, by which I mean they know all about it, but have no living experience of Qi at all.

In the Zen Buddhist tradition there are several different kinds of Zen. One type is called ‘Mouth Zen’. This is the Zen of people who know and talk a lot about Zen, probably having read hundreds of books about it, but in fact have not the faintest idea what Zen is, probably because they do not practice Zen. This illustrates, I think, the radically different approaches represented by western science on the one hand, and eastern spiritual, martial and medical traditions on the other. Of course the term ‘Mouth Zen’ is derogatory, but it would be wrong to insist that the kind of approach it represents is always inappropriate, only that there are some things (albeit rather important things) which cannot be grasped by it. Qi, and therefore acupuncture, it seems to me, may be one of these things.

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ACUPUNCTURE: CHINESE OR WESTERN, TRADITIONAL OR MODERN?

Wednesday, March 16th, 2011

Acupuncture is a form of medical treatment which has been practised in China for over two thousand years and which is becoming increasingly popular in the West. Because of its evident effectiveness, it is now utilised by some western medical practitioners such as GPs, physiotherapists and chiropractors; however, most of these practitioners, whilst utilising acupuncture as a technique, discard the traditional Chinese context in which acupuncture has been practised. This article elaborates on the difference between acupuncture as practised within this context and without it. It is important to understand this difference: for example, it would be wrong for someone to conclude that ‘acupuncture doesn’t work’ after a session of acupuncture with a physiotherapist had not produced any improvement in their condition – what the physiotherapist is doing with the needles they use may well be significantly different from what a traditional acupuncturist does with them.

WESTERNISED FORMS OF ACUPUNCTURE

Acupuncture shorn of its traditional context is sometimes known as ‘dry needling’, to distinguish it from the usual way in which needles are used in western medicine – injections! ‘Dry needling’ is usually used as a method of pain relief by chiropractors, physiotherapists, GPs and others; an acupuncture needle is inserted into a tight band of muscle fibre known as a ‘trigger point’, with the aim of releasing the tightness and relaxing the muscle. Usually dry needling is used in conjunction with other techniques such as chiropractic manipulation or massage therapy.

A small number of GPs and other western medical practitioners also practice acupuncture; whilst a very small fraction of these are trained in and utilise classical Chinese medical ideas, the majority of them practise what they call ‘medical acupuncture’. ‘Medical acupuncture’ involves an attempt to understand the mechanisms of how acupuncture works using the framework of western medicine, rather than the classical Chinese framework. ‘Medical acupuncturists’ mainly use acupuncture in the treatment of pain, but also use it for a few other conditions such as nausea and menopausal problems.

TRADITIONAL CHINESE ACUPUNCTURE

There are two kinds of acupuncture practised in the West which continue to utilise the traditional Chinese ideas which gave rise to acupuncture. These are Traditional Chinese Medicine (TCM), and Five Element Constitutional Acupuncture (FECA), which are based on a system of medicine whose roots date back at least 2500 years, and which is still evolving today. Within these forms, acupuncture is used to treat a very wide range of ailments. In this article we shall refer to these two forms as ‘traditional acupuncture.’

WHAT’S THE DIFFERENCE?

The main difference between traditional acupuncturists on the one hand and GPs, physios and chiropractors who use acupuncture on the other, is that the former practice acupuncture broadly within the context in which acupuncture was developed in China, whilst the latter abandon this context and attempt to relocate acupuncture within a western medical context.

Thus when you go for treatment to a traditional acupuncturist, you are going to someone who will understand your health and any health problems you have from a very different point of view from that of a western medical practitioner. A traditional acupuncturist will probably have completed a degree or postgraduate level course in traditional acupuncture, and thus will have spent at least three years studying and training in acupuncture and its application within its classical Chinese medical context. Western medical professionals who use acupuncture may have only done as little as a few days training in acupuncture.

To begin with, the traditional acupuncturist thinks in terms of ‘Qi’ (pronounced ‘chee’.) Qi is a key concept in understanding how acupuncture has been used over the millennia in China and other parts of Asia, but it is quite difficult to translate into English. Broadly speaking we can say that a healthy being has abundant Qi which flows freely – a living being is characterised by constant movement on all levels of their being. Qi is an important concept not only in classical Chinese medicine, but in things like martial arts and philosophy. What a traditional acupuncturist is doing when they insert a needle into the skin, is seeking to influence the Qi; the needle is usually inserted at an ‘acupuncture point’, a specific site on the body at which the Qi can be influenced in various ways. Most traditional acupuncturists will insert the needle until the patient actually feels their Qi responding, when a dull achy feeling, or perhaps a numb or tingling sensation, is felt in the vicinity of the point. Sometimes, especially if the acupuncturist is experienced and skilful, the Qi will be felt to move along a local pathway, called a meridian. The attention of the acupuncturist is focused on the tip of the needle, which provides a point of communication between the Qi of the acupuncturist and the Qi of the patient.

Western medical acupuncturists and dry needlers do not, on the whole, think in terms of Qi. They may be thinking rather in terms of needling into a trigger point to loosen a tight muscle, or possibly in terms of influencing the peripheral and/or central nervous system. Whilst to a casual observer what the western acupuncturist is doing and what the traditional acupuncturist is doing may look similar, there is a considerable difference in what each thinks of themselves as doing. At least from the point of view of traditional acupuncture, this is important; traditional acupuncture stresses the necessity of the acupuncturist having a focused intention on the needle and the effect he or she is trying to have on the patient’s Qi; it also stresses the importance of the acupuncturist’s Qi being free flowing, as the treatment is seen very much as an interaction between the Qi of the clinician and the patient. Many traditional acupuncturists practice disciplines such as T’ai Chi, Chi Kung and meditation which they see as virtually indispensible support for the healing work they do with acupuncture. Of course a good western medical acupuncturist may indeed have this kind of focused intention without thinking of it in these terms; however, the framework of modern western medical science, still not free of the Cartesian separation of mind and body1, might be considered to undervalue the effect of the mental and emotional state of the healer, so that acupuncture can come to be seen as a mere technique not significantly affected by the mental state of the person administering it.

Another one of the hallmarks of the traditional Chinese medical context is that it is holistic. So, for example, suppose you have an ache in your low back. (This is one of the main complaints which acupuncture is used to treat in the UK today – in fact the National Institute for Health and Clinical Excellence recommends that a course of acupuncture is one of the ways in which persistent non-specific back pain is treated within the NHS.) A traditional acupuncturist will, of course, examine your back and ask you about the pain – how long have you had it, what it feels like, what makes it worse, whether there is anything that relieves it, and so on. But they will also be interested in most other aspects of your health – including your digestion, any breathing problems you have, how well you sleep, even what kind of temperament you have and what your emotional life is like. This is because they want to see your back pain in the context of you as a whole person. Let’s say they discover that your digestive system is not working quite as well as it could – maybe you don’t have much of an appetite, but you do have a sweet tooth, you bloat easily and your stools can be a bit loose. Now this has nothing to do with your back ache – or does it? The traditional acupuncturist would consider it likely that there is a knock on effect from this digestive weakness which is affecting your back. After all, the nourishment which the muscles, ligaments and bones of the back need if they are to function properly largely comes from the food we eat – and if we are not digesting that food as well as we could, this will impact negatively on the degree of nourishment. In fact in Chinese medicine there is a well known connection between an impaired digestive system and muscular weakness.

Perhaps also you are under a fair bit of stress – and of course low back pain may add to this. The traditional acupuncturist will probably take your pulse during his or her examination of you, and if they find that the pulse feels ‘wiry’ – a bit like a taut guitar string – and if you report being short-tempered or moody, and get frequent headaches, they will probably conclude that the stress you are under is inhibiting the free flow of your Qi; in plain English, you are uptight and tense. It is again no great surprise that this kind of thing can exacerbate any kind of pain, including back pain. In fact it may even be that the main reason you have got low back pain is because of this up-tightness combined with the digestive weakness.

So what the traditional acupuncturist will probably do is to treat your back with acupuncture, aiming to smooth the flow of Qi through your back, but also will use acupuncture to strengthen the digestive system and promote the smooth flow of Qi throughout your system. That is to say, they will treat the back pain locally, but also address systemic underlying issues which may also be contributing to the back pain and undermining your body’s natural ability to heal itself. They can do this utilising acupuncture points on the lower leg, abdomen and back which in classical Chinese medicine are known to be able to effect the digestive Qi; similarly there are points on the hands and feet which can be used to smooth the flow of Qi throughout the system.

In addition to this they may also suggest dietary changes you may be able to make to help support your digestive system and things you can do, such as Chi Kung exercises or meditation practices, which will help you relax more fully and be able to deal with the stress in your life more effectively. They may also use other classical Chinese medical treatments to help your back, such as moxibustion – the use of mugwort, a warming herb, to improve local circulation and warm and relax the muscles, Chinese massage and cupping therapy.

So when you go to see a traditional acupuncturist for your back problem, you will receive a treatment which addresses the pain directly, but which also seeks to restore balance and harmony to your system as a whole, so that the back pain is less likely to return – and, incidentally, other aspects of your health improve too; in this example, perhaps your bloating disappears, your stools firm up a bit, and you feel more relaxed in general and better able to cope with the strains which life is bringing you.

Of course some chiropractors, physiotherapists and GPs may also be thinking holistically, and they too are unlikely to use acupuncture as a stand-alone treatment. But hopefully the above example makes it clear that there is a considerable difference between western medical acupuncture or dry needling on the one hand, and traditional acupuncture on the other. The point is that it is incorrect to see acupuncture as a technique divorced from the system of medicine in which it is embedded. Traditional acupuncture is acupuncture embedded within the classical Chinese medical context, a holistic form of therapy which seeks to rebalance and strengthen the Qi of the patient through the use of acupuncture and related techniques as well as dietary and other advice; dry needling and ‘medical acupuncture’ use acupuncture as a technique to release trigger points in tight muscles and modify the central and peripheral nervous systems, whilst attempting to understand acupuncture within the framework of western medicine.

1. The Seventeenth century French philosopher Rene Descartes is considered to be at least partly responsible for the way in which western science has tended to view the mind on the one hand, and the body on the other, as separate entities. One consequence of this for medical practice is that people trained in western medicine, which is of course rooted in the western scientific tradition, are not often inclined to consider that their state of mind will have much effect on the treatment they administer. The western doctor, like the western scientist, may tend to think of themselves more as a detached observer who interacts only in a more or less mechanical way with their patient. Although modern scientific advances, such as those in quantum physics, have shown that this tendency to view the scientist/doctor as detached is illusory, the Cartesian legacy remains.

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The End of Antibiotics

Wednesday, January 5th, 2011

THE END OF ANTIBIOTICS

A very sobering recent article by Professor Tim Walsh of Cardiff University
(http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2810%2970143-2/fulltext)
may herald the end of the ability of antibiotics to treat infectious diseases; a new gene conferring high levels of resistance to almost all antibiotics is rapidly spreading through the world, courtesy of international travel and ‘medical tourism’. According to Walsh, in about 10 years time, antibiotics may be powerless to treat many bacterial infections, and so far there is nothing to replace them with.

One can only imagine the world wide consequences of these changes. Add to this the now annual alarms about influenza pandemics, and you could be forgiven for getting a bit worried about our health prospects. But perhaps a better response would be to remember that the stronger and healthier we are, the better able our system is to fight off whatever assails it.

In Traditional Chinese Medicine, we speak of our defence system as the ‘wei qi’, sometimes translated as ‘defensive qi’. A healthy person has good ‘wei qi’, which can throw off an invading pathogen; the stronger our wei qi, the less vulnerable we are to any incoming threat. In the west, with our reliance on antibiotics and immunisation, we are perhaps in danger of neglecting the fact that there is a lot we can do to bolster our system’s defences, to bolster what we call the wei qi. For example, there is a well known acupuncture point on the lower leg, known as zusanli in Chinese, and sometimes referred to as Stomach-36 in the west. Stimulating this point, especially with acupuncture and/or moxibustion, where we burn the herb mugwort to warm the point, is a traditional way to boost the wei qi.

However, the wei qi depends for its formation and circulation around the body, on a number of factors. It depends, for example, on eating well, and being able to digest what we eat effectively. It depends on the freedom of the qi to move around our body, something which in turn depends on our emotional freedom, the health of our lungs, getting enough exercise, amongst other things. So pretty quickly we see again that what we need is holistic health care. If we are a healthy person, we have abundant qi which can flow freely. To stay healthy – or to stay as healthy as we can be – we need to attend to every aspect of our health. This is the strength of Traditional Chinese Medicine, which always looks at the person in total, rather than just focusing in on one particular problem, and aims to strengthen the qi and encourage its free flow, in particular by attending to any underlying imbalances or weaknesses which are the true origin of any problems we have.

Of course, some people are constitutionally weaker than others, and some are weaker because of having suffered from chronic illness, or from having made what are now called ‘unfortunate lifestyle choices’. But weak or strong, there are always a number of things we can do to boost our wei qi and give ourselves the best chance of not needing to rely too much on pharmaceutical drugs some of which are, it seems, losing their effectiveness.

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Cultivating Peace, Creativity and Freeflow in our Lives

Friday, June 18th, 2010

I spotted this quote from Susan Polis Schutz today. I guess its another one of those pieces, like “If” by Rudyard Kipling, that reminds us what life might be like if we set our minds to it.

“We need to feel more to understand others. We need to love more to be loved back. We need to cry more to cleanse ourselves. We need to laugh more to enjoy ourselves. We need to see more other than our own little fantasies. We need to hear more and listen to the needs of others. We need to give more and take less. We need to share more and own less. We need to look more and realize that we are not so different from one another. We need to create a world where all can peacefully live the life they choose.”

Susan Polis Schutz

If we can train ourselves to live our lives in this way, we can be pretty sure that our Qi will flow as smoothly as it can do. And, as the ancient Chinese said, if the Qi flows freely, there is no disease. How we do that is up to each of us…but it starts with the decision!

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Mumbo Jumbo

Wednesday, June 2nd, 2010

Some people say that Chinese Medicine is mumbo jumbo – all this talk of Yin and Yang, Qi and so on. I think these people should be careful; it is not that these ideas were dreamt up by a couple of new age types who didn’t like their GP, they originated in a highly sophisticated culture where they were integral to disciplines as (apparently) diverse as martial arts, medicine, poetry, cooking and philosophy. Dismissing this whole culture, with its perceptive and subtle way of understanding the natural world, because it does not speak the language of Western science, might be a little presumptuous – especially perhaps when the pharmaceuticals Western medicine relies on so heavily start becoming too expensive as the world’s oil reserves run dry.

Two hundred years ago, people in the West believed Christianity was the one true faith, and that it was our responsibility to propagate it to the ignorant world – which was, of course, ridden with ‘mumbo jumbo’. Could it be that our faith in Western science and Western medicine, and the intolerance and even arrogance of those who dismiss any other form of understanding the natural world, is a harping back to this kind of evangelical intolerance?

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QI

Tuesday, August 4th, 2009

If you come for some treatment with a Chinese medical acupuncturist, he or she will probably talk to you, sooner or later, about your Qi. Qi, sometimes spelt ‘Chi’, is one of the key concepts of Traditional Chinese Medicine (TCM), a form of healthcare whose roots date back at least 2,500 years. To understand anything about TCM, you need to understand what Qi is, and also to begin to recognise it in your own experience. Whilst for any Chinese person (except perhaps one who has been so thoroughly westernized as to lose touch with their roots), Qi is an everyday reality, as it will be indeed for any westerner who has trained in disciplines such as T’ai Chi or Chi Kung, for many people in the west Qi is still a strange and foreign concept.

Qi is not only a key idea in Chinese Medicine, it is a key concept in traditional Chinese thought, and no understanding of Chinese philosophy, Chinese religion, or, indeed, what may be termed Chinese science, is possible without grasping something of the meaning of Qi. Chinese civilization is of course very ancient and very sophisticated, and the notion of Qi has been central to how the Chinese have understood the human condition for millennia. However, and this is perhaps illustrative of the traditional Chinese approach to life which is so different from the western approach, Qi is not easily defined or tied down.

Qi is sometimes translated as ‘energy’ or ‘vital energy’. Perhaps the key thing to understand about Qi is that, in a healthy person, it flows. It flows all around the body, on the surface and through the interior, in a network of channels or meridians. In fact all movement in the body, including the circulation of blood and other body fluids, is governed by Qi. Qi also warms and invigorates the body, and aspects of Qi are responsible for defending the body against external pathogens, in a way analogous, to some extent, to the western notion of the immune system. Qi includes both what we would call mind and matter; the subtlest thought is a movement of Qi, just as much as is the movement of food through the digestive system. Patients experience Qi as an unusual dull achy or tingling feeling around the needle, or propagating along the meridian from the needle; this feeling arises when the acupuncturist inserts the needle so as to contact the patient’s Qi.

When people started practicing acupuncture in the west, some people scoffed at the notion of Qi and the meridians, because, they thought, in western medicine there was nothing corresponding to them. The meridians do not correspond to blood vessels for example, or to nerves. However, more recently researchers have been investigating the matter further, partly because acupuncture is so obviously effective – no less a body that the World Health Organization1 lists a number of medical conditions for which it considers that research shows that acupuncture treatment is of proven effectiveness.

Some of the research into how acupuncture works from a western perspective2 shows that the meridians may correspond to lines of slightly decreased electrical resistance, which would suggest that Qi may, at least in part, be made up of micro currents of electricity. (Modern acupuncturists sometimes make use of this fact to locate acupuncture points using a simple device to measure variations in electrical resistance on the skin, although whether this is a more effective technique than the traditional palpatory skill of the acupuncturist is open to question.)

Other research projects suggest that the meridians may be related to connective tissue3, the fibrous support structure for body tissues and organs. The insertion of an acupuncture needle into a traditional acupuncture point may cause changes in local connective tissue which are both long lasting and capable of influencing distant parts of the body, since the connective tissue forms a continuous matrix throughout the body. Since nerve fibres are embedded in connective tissue, the needle may also have modulatory effects on nerve signals. The meridian system may also be explained in part by the notion of migratory tracks in interstitial fluid4, the fluid which surrounds the cells which make up the human body; cells such as mast cells (which have, amongst other functions, a key role in the immune system) and fibroblasts (which play a critical role in wound healing)

One can question, however, the necessity of explaining Qi in western scientific terms. Western science and western medicine are of course highly sophisticated bodies of knowledge, but it is perhaps a touch arrogant of us to consider that they are the be all and end all, the only way of looking at the world – after all, from the point of view of Chinese medicine, western medicine is a relatively new form of medicine. It looks at the person from a particular point of view, which gives it both strengths and weaknesses. Chinese medicine represents a different point of view, with different strengths and weaknesses. It will probably prove impossible to fully explain Chinese medicine in western terms, just as it would be impossible to fully explain western medicine in Chinese terms. The wisest course may well be to use whichever medicine is more helpful in the case in question. In modern China, in fact, this is what does happen: hospitals may be split between departments of TCM and of western medicine.

The scientific findings mentioned suggest that Qi is a relatively subtle and complex phenomenon, which is not to be explained by any one western idea but only by a combination of several (micro currents, connective tissue, interstitial fluid etc). Quite a few patients who come for acupuncture treatment are obviously ill, but western medical tests find nothing wrong with them – from a Chinese medical perspective, the problem lies at the level of Qi. At this level western medicine does not operate – western medicine is effective when the problem is more obvious. From this point of view TCM is effective at treating relatively subtle disharmonies which western medicine does not see, and also at preventing these disharmonies escalating and as it were condensing into more severe conditions.

1. WHO (2002): Acupuncture: Review and Analysis of Reports of Controlled Clinical Trials Available from URL http://apps.who.int/medicinedocs/en/d/Js4926e/5.html

2. Reichmanis M et al (1975) Electrical Correlates of Acupuncture Points IEEE Transactions on Biomedical Engineering

3. Langevin H et al (2002) Evidence of connective tissue involvement in acupuncture The FASEB Journal. 16:872-874

4. Fung P (2009) Probing the mystery of Chinese medicine meridian channels with special emphasis on the connective tissue interstitial fluid system, mechanotransduction, cells durotaxis and mast cell degranulation Chin Med 4:10

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