The Qi of Body, Mind, and Spirit: A Contextual Perspective on the Elusive Nature of Qi

Abstract

Background:

A definitive meaning for the notion of Qi is elusive. Theoretical explanations range from the rational physiologic to the subtle energetic, from the tautological to the Tao. In this article, the author suggests a practical approach that frames the concept contextually, illustrating differences with three case-histories.

Cases:

The cases were as follows. A 74-year-old man had low back, left-hip and lateral left-leg pain. Acupuncture addressed his anatomical/structural issues. A 58-year-old woman had left upper-chest discomfort, restricted left-shoulder movement and periodic left frontal headaches and dry eyes. Acupuncture addressed her Etheric body. A 40-year-old woman had headaches and depression associated with grief over family losses. She visited a clinic and met a former patient there with whom she bonded. Acupuncture addressed her emotional state and she experienced subsequent phenomena that enabled her to release her grief.

Results:

All 3 patients experienced resolution of their symptoms, with the exception of the woman's dry eyes in Case 2.

Conclusions:

Qi-nature can vary among gross, subtle, and causal levels. These levels can coexist and overlap during treatments of patients. This tripartite explanation may represent the Oriental pictograms better and be consistent with the philosophical root of Chinese Medicine—the Tao.

INTRODUCTION

There is an ongoing debate about the nature of Qi and meridians, particularly in the context of evidence-based medicine. On the one hand, some practitioners think of Qi in terms of “energy,” while, on the other hand, others tend to dismiss such notions as fanciful nonsense.

To add to the confusion, some classical scholars have pointed out that the “Qi as energy” idea is based on mistranslations of ancient texts.¹ Essentially, the idea is that Chinese writing uses suggestive pictograms rather than linear text and, therefore, all translations must, at best, be approximations. Pictograms have a fluidity that reflect process and change (becoming), and the specific gist can vary with context.

Maciocia addresses this difficulty by giving Qi the broadest possible range of meaning when he says, “Qi is an energy which manifests simultaneously on the physical and spiritual level.”² He adds that the Three Treasures and Five Vital Substances (Qi/Blood/Essence, Jing, and Shen) are all fundamentally forms of Qi. In other words, almost everything is Qi.²

Yet, according to evidence-based medicine, the chief difficulty with the energy view lies in its lack of rational scientific rigor. There are no double-blinded studies showing the effectiveness of energy medicine. And, still, even this perspective is becoming increasingly questionable among its supporters because it artificially fractures the whole.^3.4

With broad definitions, mistranslations, and an apparent lack of repeatable evidence, clarifying what Qi is can be problematic. One way to address the conundrum is through the use of illustrative case histories that expose 3 different forms of Qi: (1) the rational/physiologic; (2) the energetic; and (3) the indefinable (Tao).

A Body–Mind–Spirit (Gross–Subtle–Causal) Perspective

Western Esoteric, Ayurveda, and Taoistic philosophies all assert that the body is more than a physical structure and includes more-subtle dimensions such as mind and Spirit. Of course, each tradition has its own terminology and ways of understanding, but, at their root, they are all inclusive of structure, energy, and wholeness.

There is a broad agreement across the 3 traditions that the physical body is immersed in an energetic biofield—known variously as Qi, Prana, or simply energy—that ranges from the least-subtle (Etheric body),⁵ to the more-subtle (Astral body), to the most-subtle Spirit (Causal body). See Table 1 and Figure 1. This 3-aspects view, while somewhat simplistic, is eminently practical, and, furthermore, corresponds to practitioner experience while still embracing rational physiology.⁶

Table 1.

The Body–Mind–Spirit

Aspect	Field aspect	Acupuncture options
Body	Gross (Physical)	Conventional medicine, musculoskeletal conditions, TCM
Mind	Subtle (Biofield)	Channels understood energetically, 5-Phase approaches.
Spirit	Causal (Tao)	The Tao: Primordial or Yuan Qi

TCM, Traditional Chinese Medicine.

FIG. 1.

The QI of Body, Mind, and Spirit.

Gross (Physical or Structural) Body

Qi manifests in and through the Physical Body via the bodywide matrix of collagen and fascia, interstitial spaces, blood, and blood vessels.⁷ At this level, Qi might be seen as an aspect of Blood (Xue); meridians seen as blood vessels (Mai); and acupuncture points seen as neurovascular nodes. Additionally, needling could be understood to promote phenomena such as mast-cell degranulation,⁸ release of bradykinins and enkephalins, activation of ascending/descending spinal-cord pathways,⁹ and vasoconstriction/dilation.¹⁰ Such explanations work well for musculoskeletal symptoms, but can also be adapted for Chinese Medicine (CM) concepts such as Liver Qi/Blood Stagnation, fluid retention from Deficient Spleen Qi, or general frailty from Deficient Kidneys.

Subtle Body (Biofield, Mind, Emotions)

Qi manifests in the Subtle Body as an Etheric field (a subtle replica of the physical body), and an Astral field (encompassing mental, emotional, and constitutional tendencies). Such phenomena represent “energy” in a broad sense; yet, their existence and pertinence to acupuncture are part and parcel of CM. Furthermore, their presence can be detected and assessed by practitioners using touch (pulse), sensation (heat/cold/tingling), sight (images), and intuition in ways that go beyond physiologic explanations.¹¹

Spirit (Shen–Causal–Tao)

Qi manifests through Spirit as the primal source, the Tao, which transcends the division of Yin and Yang. At this level, the Qi is neither material nor emotional, nor constitutional type-dependent; yet, somehow, it still is. CM recognizes it as Pre-Heaven Qi, or original (Yuan) energy. Given that ego and individuality reflect Yin/Yang separation, Pre-Heaven Qi being prior to the division, cannot be described objectively. Moreover, its effects are nonspecific and unpredictable. When acupuncture is grounded at this level, the trickle-down effects on constitutional and symptomatic levels can be profound.

Note

The author generally uses a style of acupuncture, developed personally, which combines distal Master/activation points (Table 2) with breathing techniques to encourage myofascial and emotional release, described as Dynamic Interactive Acupuncture (DIA). The techniques promote more-rapid access to the most-appropriate CM treatment level and are elucidated elsewhere.¹²

Table 2.

Points mentioned in the Text: Case History Points

Point	CM name	Translation	Function
LV-3	Taichong	Great Surge	Resolves Stagnation, tonifies Yin
LI-4	Hegu	Union Valley	Promotes Qi/Blood circulation
GB-30	Huantiao	Jumping Round	Opens the gluteals and I-T band
GB-31	Fengshi	Wind's Market	For lateral leg I-T band pain
GB-41	Zulinqi	Foot Overlooking Tears	Brings Shao Yang energy to feet
BL-25	Dachangshu	Large Intestine Shu	Relaxes lower back L-4–L-5 area
KI-6′a	Zhaohai	Shining Sea	Coupled point of CV
BL-62′a	Shenmai	Extending Vessel	For Wind/Cold in the Taiyang
SP-4	Gongsun	Grandfather's Grandson	Opening point of Chong Mai
KI-22	Bulang	Corridor Walk	Exit point, opens the chest
PC-1′b	Tianchi	Celestial Pool	Entry point, opens the chest
GB-21	Jianjing	Shoulder Well	Moves Qi down, relaxes shoulders
M-UE-48	Jianneiling	Inner Shoulder Mound	Treats shoulder pain
LI-10	Shousanli	Arm's Three Measures	Treats shoulder pain

^a K-6′ and BL-62′ are both located slightly below the traditional points (see reference 18, Helms pp. 335 & 535).

^b PC-1′ is located as the most tender point found just medial to the axillary crease (see reference 18, Helms p. 343).

CM, Chinese Medicine.

Case 1: Body (Structure and Physiology)

Practitioners who focus primarily on anatomy/physiology often have their own protocols. For example, Travell, Simons, and Simons developed myofascial techniques, now widely used by physiotherapists and acupuncturists alike¹³; Wong described neuroanatomical acupuncture¹⁴; Doane developed Distal Needling Acupuncture^15,16; and Tan utilizes distal points on the opposite side of the body, while still retaining Traditional Chinese Medicine anatomical and somatotopic rationales.¹⁷

History and results

A 74-year-old man with a Taiyin–Yangming CT, had pain in his low back, left hip, and lateral left leg, possibly originating from a remote lumbosacral strain. X-rays showed age-related lumbar and hip osteoarthritis. He was mildly overweight and prone to constipation, and he experienced periodic sinus congestion. A physical examination revealed paralumbar tension, and several trigger points located on the left iliotibial band, suggesting bursitis or lumbar (L-4–L-5) root irritation.

Acupuncture was aimed at the anatomical/structural issues rather than the CT. Points chosen were bilateral LV-3 (Taichong), GB-41 (Zulingqi), left GB-30 (Huantiao), 31 (Fengshi), and BL-25 (Dachangshu) bilaterally to target the approximate nerve roots. He was encouraged to allow himself to experience shaking, shivering, and emotional release per DIA protocols. After 2 treatments, 3 days apart, he was pain-free.

Case 2: Mind (Etheric Body, Prana, Energy Channels)

Practitioners who think energetically tend to focus on using needles to restore Qi flow in meridians and balancing the energy field. Some of these practitioners have suggested that subtle channel blockages can be sensed through awareness training and refined practice. Hadlock has taken this idea further by suggesting that needles are not always necessary and claims to get good results with a combination of mutual intention and light touch.¹⁸

The following case in no way covers the broad range of energetic acupuncture, but, it is hoped, illustrates how channel blockages can sometimes be sensed.

History and results

A 58-year-old woman with a Taiyang–Shaoyin constitution had left upper-chest discomfort, with pain and restricted movement in the left shoulder. She also experienced periodic left frontal headaches, and dry eyes. Her medical history included a left mastectomy with axillary lymph-node dissection some 15 years previously, shortly after which, she went through a stressful divorce.

While scanning the area with his hand, the current author sensed an emptiness over the left upper chest, suggesting an exit–entry block between Water and Fire.¹⁹ No doubt, the blockage was related to her surgical scars, but there was clearly a subtle energetic component too, perhaps related to the relationship breakdown. An attempt was made to try opening the block across her chest energetically using DIA principles in the context of Shaoyin constitutional balance rather than needling the scar directly during the first session.

Needling initially involved KI-6′and BL-62′ (both located slightly below the traditional points) to engage the Taiyang–Shaoyin axis, while suggesting slightly deeper breathing to encourage some dynamism (per DIA). Her legs started trembling almost immediately. In–out needling was performed on tender points at left KI-22 and PC-1′ on either side of the blocked upper chest. With these points stimulated, her pelvis and left shoulder joined in the general shaking so that her whole body started shivering, while she simultaneously voiced feeling cold. She was covered with a blanket while she continued to shiver. At this stage, palpation of the neck and shoulder revealed tender triggers at left ME-UE-48 (Jianneiling), GB-21 (Jianjing), and LI-10 (Shousanli), which were needled in and out. She shivered for another half-hour and cried as memories of her relationship difficulties came up, before relaxing into a deep calmness. After the session her neck/shoulder tension was significantly reduced.

She returned for several more treatments over the next few months, focusing on balancing the CT. Over that time, the neck/chest symptoms and headaches abated, while the dry eyes unfortunately persisted.

Case 3: Spirit (Shen, Causal Body, Tao)

The third level of Qi (Primordial, Yuan Qi) relates to the primal source, the Tao, which transcends the division of Yin and Yang. At this level, the Qi is neither material nor emotional, nor even CT-dependent. However, CM suggests it is possible to access the Yuan Qi using the Chong Mai and other Extraordinary Meridians. In that regard, the following case was quite remarkable.

History and results

A 40-year-old woman (M-1) attended the Victoria Pain Clinic's (VPC) 10-day residential facility with headaches and depression. She was grief-stricken over several family losses, the most significant being the loss of her son (S-1) when he was 20. During the initial consultation, her husband recalled a dream in which he had seen their son in a setting that resembled the VPC clinic location.

During her stay a former client (M-2) visited the clinic for lunch. The 2 women met and chatted. Interestingly, they looked quite similar, and M-2 had also lost a son (S-2), albeit at the age of 7 months.

M-1's first acupuncture (DIA) session included LV-3 to promote the general flow of Qi, and SP-4 (Gongsun), the Master Point of the Chong Mai, to engage original energy. She engaged in mild deeper breathing, and she was encouraged to allow feeling–sound–movement per DIA protocols. Within a few minutes, myofascial shaking started in her legs, moving fairly rapidly up to her knees, pelvis, and spine. As this shaking progressed up to her head she began crying, and, within moments, she was shouting her long-held, bottled-up feelings. When she returned to normal consciousness, her headache had gone temporarily, and she looked considerably lighter.

At this point M-1 recalled visiting a psychic, who had seen her together with another woman and child, whose names, incredibly, were M-2 and S-2. This revelation, combined with M-1's husband's dream, made the whole clinic situation seem more than a simple coincidence. A few days later, M-1 saw a moving swing hanging on an oak tree near the clinic, and felt a strong impulse to go and sit on it. She returned later to say she had sensed quite clearly that her son (S-1) was there, along with the baby S-2. Furthermore, her son had told her not to worry, that he was “okay,” and that it was all right to let him go.

From that moment on, M-1 was totally different, with her depression lifting completely. In the months that followed, she and M-2 became firm friends. It turned out they lived only a few blocks from each other, and their sons had both died on the same month and day, 12 years apart.

DISCUSSION

From a practical standpoint, Qi might be understood as a wide-ranging notion that covers concepts spanning from gross and subtle to causal, from the physiologic to the transcendent.

Certainly, when dealing with musculoskeletal and pain syndromes, scientific explanations involving blood and biochemistry are adequate. However, sensing energetic blockages with hand-scanning over invisible meridians requires an openness to field theories, and perhaps, more to the point, inexplicable synchronicities leave no coherent explanation at all. Yet in all 3 histories, Qi is clearly involved.

The beauty of acupuncture philosophy is that it is poly-paradigmatic, capable of embracing a variety of viewpoints.²⁰ In that light, maybe the best answer to the conundrum of Qi is perhaps not to try and constrain it either physiologically or energetically, but rather to allow these various aspects to coexist within the larger context of the Tao. After all, in the grand scheme of things, everything has its place.

CONCLUSIONS

The true nature of Qi may always defy a simple discrete rational definition. However, a relatively simple tripartite contextual understanding is certainly possible, and only requires that Qi-nature be allowed to vary among the gross, subtle, and causal levels. With that accepted, the 3 faces of Qi can often be seen to coexist and overlap in the treatment room, sometimes 1 or another coming to the fore in any particular experience, as the foregoing case histories illustrated.

Far from being incoherent and fanciful, this explanation is comprehensive without being overreaching, perhaps representing the Oriental pictograms better, and is consistent with the philosophical root of CM in the unknown and indefinable Tao.

AUTHOR DISCLOSURE STATEMENT

No competing financial interests exist.

FUNDING INFORMATION

No funding was received for this article.