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What is Qi and do I believe in it?

Eastern medicine is weird.


A decade (or more) of regimented study is necessary to harness its power, but if one becomes too rigid in one’s understanding of it, its power eludes.


It is a medicine of metaphors and mental models, not necessarily facts. Which isn’t to say that it lacks truth! Sometimes I think we have a better relationship with the truth than our biomedical counterparts. More actionable, anyway.


For over five thousand years, Eastern medicine scholars and physicians have observed the human body and its response to environmental pressures and therapeutic interventions, and they have developed mental models to describe what they see. 


Over so long a time, these models have become detailed and complex representations of life. They aren’t literal explanations of how the human body works (at least, I don’t take them to be that - their scientific status is limited). They are more like artists’ renderings - they capture the essence of a thing and help the heart to learn and respond before the mind is quite able to understand.


Metaphor and model form the body of Eastern medicine theory, classifying what is and informing what to do.


For instance, Eastern medicine diagnosis and disease theory often sounds like a discussion about the weather. “A 60 year old male presents with a headache caused by invasion of wind in the head. Resolve with techniques to expel wind.” ”A 28 year old female presents with infertility caused by a cold womb. Resolve using medicinals that warm the interior and stoke the fire at the gate of life.


And the basis of acupuncture is a complex network of Qi (not typically translated) pathways and reservoirs throughout the body - like a system of oceans, rivers, and canals - that must be regularly dredged to prevent blockage and ensure proper distribution of vital resources.


To modern ears, these ideas might sound like fringe mysticism.


And yet…


After more than a decade of practice, I’ve learned that when I study the authentic models over and over again… when I accept and listen to them… Eastern medicine really works. People get better! When I don’t listen to them - when I toss the metaphors overboard and try to chart a more scientifically-palatable approach to using Eastern medicine tools (such as acupuncture needling along pathways of nerves rather than pathways of Qi) - I’m ineffective. Without metaphor, I somehow lose connection with truth. Save the metaphor, save the patient, save the world!


With all of this in mind, I want to tell you about the tiny word I just casually tossed into the conversation above: Qi. A few curious readers have asked about it recently.


It’s arguably the most important word in Eastern medicine. How often do I mention it in my work with people?? Never.


It’s not that I don’t value it (save the metaphor, save the world!), it’s just hard to talk about briefly. Qi is not an accepted concept in Western culture, so if I want to use the word without derailing a conversation, I have to be prepared to offer a lengthy preamble like this. There’s rarely time for that during a typical office visit.


I thought I might use this forum to talk about it.


Qi is the building block of every one of Eastern medicine’s mental models. It represents the foundation (smallest constituent part) of the universe. Everything is made of Qi.


The Chinese character for Qi  氣 conveys something that is, at the same time, both immaterial and material. There is the radical 气, meaning "vapour, steam, gas" outside the radical 米, meaning "uncooked rice". That's Qi - it exists on a spectrum from completely material to completely immaterial.


The material - physical matter - is Qi that has aggregated (come together) to give the impression of physical form. The immaterial is Qi that has dispersed to a degree that it no longer has observable form. It’s still there, but we can’t see or feel it. If we experience it at all, it’s only by observing the effects of its activity, like experiencing the wind by observing how it moves the branches and leaves on the trees.


Everything in the universe is the result of the coming together and moving apart of Qi.


Like the concept of energy in physics, to which it is sometimes haphazardly correlated, Qi cannot be created or destroyed, only changed from one state of materiality to the next.


Human beings, like everything else in the universe, are made up of Qi. Each of us is a vortex of Qi with regions of varying density all interacting with each other. These interactions are, in the Eastern medicine sense, the foundation of physiological function. They are life.

Notice that we are made from the same “stuff” as everything else in nature. In a sense, there is no defined boundary between us and the outside world. You and I experience the effects of everything that happens in the world around us because there is a constant exchange of Qi between our body vortices and the rest of nature - the earth, the air, the water, plants, animals, other human beings. We are all connected, part of the One Qi.


There are subtypes of the One Qi. In the human body, for instance, Qi can be categorized according to its material state, location, and function. You have a kind of Qi which travels with the blood and provides nutrients (called Ying Qi, or nutrient Qi). It is more dense than another kind of Qi which circulates along the borders and boundaries of the body providing protection from things like infection (this is called Wei Qi, or protective Qi). Blood is a dense, material form of Qi, as are Body Fluids. Mental activities, emotions, and aspects of spirit, these are the most immaterial or rarified form of Qi in the body called Shen. Different names, all part of the One Qi.


Climatic factors are types of Qi. For example, wind, cold, dampness, and heat. These are normal phenomena in the environment but they can invade the human body, especially when there is a weakness, and cause dysfunction. Since the Qi of the body and the Qi of nature are both part of the One Qi, this exchange is possible.


All of this is just one meaning of Qi. It has other meanings and has defied attempts to translate it using a single word largely because of this and the fact that its meaning changes depending on context. 


In another context, Qi might mean something more like "life force" or "vital force". Akin to "prana" in Hindu philosophy. There are many traditions that try to cultivate this Qi for health and long life, even power. Some claim to be able to feel or see it.


So do I believe in Qi?


Well… that’s not a very good question. What good is belief when it comes to how the universe works? I doubt my belief makes it work any better. On the other hand, belief that remains rigid when new and contradictory information comes to light has certainly made living in the universe worse.


I believe my wife is a great mother. The preponderance of evidence points to the fact that she is, AND my belief in her helps her find confidence and calm in those peak stressful parenting moments. Belief, in that context, is useful.


But the universe doesn’t need my belief to carry on in a harmonious way. What it needs is my ear. My mind flexible and open to accept its next impulse, not closed around any particular idea.


A better question is, have I found the Qi paradigm of Eastern medicine to be useful so far? Does it seem to engender health, peace, and (collective) prosperity?


Yes.


Such a thing, I expect, must contain at least a kernel of truth.


Do I think that someone will one day prove Qi theory and discover the Qi particle?


I don’t know. Probably not.


My experience of the world tells me that the truth is rarely exactly as we imagine it to be.


I may never understand exactly how everything works, including Eastern medicine. But as long as it does…

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