Dr. Jay Bulloch, DAOM, LAc, C.SMA

The concept of qi (pronounced chee) is pervasive within Chinese culture and central to Chinese philosophy, art, and medicine. A true understanding of Chinese thought and medicine, therefore, depends on one’s understanding of qi. While entire books and dissertations have been written on the subject of qi, this article only aims to serve as an introduction to qi as it pertains to Chinese medicine. It is by no means an exhaustive discussion on all aspects of the topic.

This article will be presented in two parts. Part one will discuss some of the history, evolution, and translations of qi, and part two will discuss its specific meanings and usage within Chinese medical theory.  Hopefully this will begin to provide a better understanding of the worldview and thought process that played such an important roll in the development of this rich and profound medical system from China.

Part 1

Most people in the West, including many authors, think qi means energy, but this “represents a basic misconception that is not supported by Chinese ancient sources” (Unschuld, 1985, p. 72). This common mistranslation has lead to many erroneous ideas and understandings with regards to Chinese medicine. The term qi is complex, multilayered, and at its core, profound. It is one of the most difficult terms in Chinese language to translate. Not only is there no equivalent word in the English language, there is also no all-encompassing, equivalent concept in Western thought or science. The eight-volume compendium of Chinese characters, which would be comparable to the Oxford English Dictionary, lists ten ancient forms of the character for qi. Under the heading for the character qi, there are twenty-three separate definitions given. This fact, however, only hints at the vast complexity and depth of its meaning (Zhang & Rose, 2001, p. 2).

Most of us know what Chinese writing looks like. It does not use an alphabet; instead it is composed of tens of thousands of different symbols, which are called characters. Chinese language developed by using simple pictures/pictograms to communicate. Over time, these pictograms formed into more sophisticated characters, which we can recognize today. The saying that a picture is worth a thousand words could certainly be applied to many Chinese characters, and none more so than the word qi. So much information can be imbedded within each character that it becomes impossible to translate the meaning with a single word or definition in English language.

Qi is an ancient word, which has been found among the oldest writings that have so far been discovered in China. Like all languages, over the centuries Chinese language has undergone various transitions and changes in not only form, but also meaning. The Chinese character for qi is no exception; however, it is a particularly difficult character to translate as its meaning holds so much of the character and flavor of Chinese thought, culture, and spirit. It can been said that to remove qi from its linguistic, literary, and even cultural context is like removing the animating spirit from the human body, leaving only an empty form (Zhang & Rose, 2001). Another reason qi is difficult to translate is because of the very fluid nature of its usage in the literature. It can be different things in different situations and contexts. While part two of this article will discuss the usage of qi in the context of Chinese medicine, a short discussion of the origins of this character is necessary to begin creating a better understanding.

In the pictographic development of Chinese language, the character for qi originally had the shape of rising clouds, which were drawn as three wavy lines. Later, this character was refined to be drawn as three straight lines like this三. Over time it evolved into气 so that it would not be confused with the number three, which was written the same way. The ancient character depicted the mists or vapors that rise and gather to form clouds. Inherent in the early meaning is the essence of qi: “it cannot always be seen, but through its changes, its presence can be sensed, experienced, and understood” (Zhang & Rose, 2001, p. 4). The idea of clouds also carries the meaning that qi is always changing, moving, and lacks concrete form (B. Xin, personal communication, July 16, 2012). As the meaning of qi continued to evolve, it took on the added meaning of breath, or to breathe in and out. Other characters also pronounced, ‘chee’ meant ‘the qi of breathing’, which adds an additional meaning that qi can also refer to function.

An interesting phenomenon in the evolution of Chinese language is the conjunction of ancient characters. When two characters resembled each other in form, sound, and/or meaning, they sometimes came to stand for one another (Zhang & Rose, 2001). Another word pronounced ‘shee’ meant ‘to give nourishment’ or ‘to give rice,’ and yet another pronounced the same as qi meant  ‘to eat.’ Thus the radical for rice, 米, was added to form氣. With this change, the character qi took on the additional idea of “the essential nutritive substance” (Zhang & Rose, 2001, p. 5).

By the 2nd century C.E., the character qi氣 had “taken on an elaborate set of meanings related to vitality and life-sustaining substances and processes, while maintaining its underlying sense of connective and transformative impetus” (Zhang & Rose, 2001, p. 6). In the broadest, and perhaps most profound sense, qi could be said to be related to the “essential substances and functions of the natural world, the human spirit, and the physiological functions of humankind” (Zhang & Rose, 2001, p. 8). In biological terms it can refer to the essential connective, transformative, and nutritive component of all creation, or a “concept of the finest matter believed to exist in all possible aggregate states, from air and steam or vapor to liquid and even solid matter” (Unschuld & Tessenow, 2011, p. 20).

There are many ways in which the word qi can be defined and used in different contexts. These include:

• Vapor, gas, steam, air, ether.
• A process of transformation. (As the original meaning implied invisible forces that transformed water into vapors, vapors into clouds, and then clouds back into liquid in the form of rain, qi can also mean a process of transformation. This is especially important when we get into the discussion of the usage of the word qi in Chinese medicine.)
• Breathing. (As a logical extension of the idea of movement and transformation of vapors or air.)
• Matter-energy, finest matter influences.
• Life force, vital force, vital power, vitality.
• Strength, moving power.
• That which fills the body, that which means life.
• Smell, odor, flavor. (Once again is the connotation of an invisible yet experiential phenomenon.)
• Temperament, feeling, spirit, general mood or atmosphere.
• Anger, upset. (In Chinese medicine, the function, transformation, or lack of transformation of qi is related to the emotions.)
• Spiritual or emotional momentum.
• Style or habit, particularly a bad habit.
• The joining of wills to create action. (The joining of qi)
• Various qualities or nature of people, objects, or phenomenon. (One of the foundational classics of Chinese medical literature, The Yellow Emperor’s Cannon of Internal Medicine, contains 270 different classifications of qi.)
• Destiny, fortune, fate, or life.

Given the translation of matter-energy or finest matter influence for qi, it is reasonable to speculate that that the matter-energy of the universe that Einstein was referring to in his famous E=mc2 equation (energy = mass), and was one of the most important discoveries of modern physics, could be what the Chinese were alluding to with the character qi. It is this qi or matter-energy that comprises all that we would refer to as solid matter. The two, form and function, are also inherently connected.

In terms of how the concept of qi might be applied to understanding the human body and used in medical diagnosis and treatment, some of these definitions may still be too abstract. The next part of this article will discuss how qi may be compared to other scientific phenomena, and how it is classified and used in Chinese medicine to discuss specific substances and functions.

 Part 2

Even if we limit the translation of qi to its usage in Chinese medicine, the difficulty of this task can be contemplated when we consider that one of the foundational classics of Chinese medical literature, The Yellow Emperor’s Cannon of Internal Medicine, which dates back well over 2000 years, records over 270 different classifications of qi (Zhang & Rose, 2001).

To begin to understand how qi is used in Chinese medicine, it is important to remember that the character for qì 氣 is comprised of two radicals. The first one 气 means vapor, steam, gas, or ether, and the second 米 means rice (uncooked). So the character for qì 氣 can indicate something that is at the same time both material and immaterial. This also indicates that qì can be as subtle as steam and vapor and as dense and material as rice. It is said that qi manifests simultaneously on the physical and spiritual level (Maciocia, 1989). When qi condenses, it accumulates into physical form. When we consider that the origin of the word qi comes from the pictograph of clouds, we are reminded that qi is in a constant state of flux and change. It is interesting here to note that, according to Chinese medical theory, illness in humans stems from qi stagnation, which is to say the qi is not properly changing or transforming. When qi becomes pathologically dense, it can also form into lumps and tumors (Maciocia, 1989).

It is probably worth noting at this point that rather than trying to understand qi as some distinct or separate ‘thing’, qi can be viewed as a concept used to describe the numerous types of manifestations, functions, and transformations of the human body and the larger universe.

The Chinese see qì as something that not only creates form but also powers function. Stated another way, we can say that with regards to the human body, qi represents the functional and transformative aspect of human physiology. According to Chinese medical theory, the basic functional aspects of qi are as follows:

• Qi Transforms – It transforms foods and fluids into usable material and waste.
• Qi Transports – It transports usable materials around the body and waste out of the body.
• Qi Holds – It holds blood in the vessels and other fluids in the body. (Spider veins, varicose veins, urinary incontinence, and spontaneous sweats are signs of insufficient qi.)
• Qi Raises – It holds the organs in place. (A prolapsed organ such as hemorrhoids or uterine prolapse is a sign of insufficient qi.)
•  Qi Protects – Think of the function of the immune system. (Poor immunity is a sign of insufficient qi.)
• Qi Warms – It keeps the body warm.

In Western medical terminology, all of these functions come together to create homeostasis, which is the property of a system that regulates its internal environment and maintains a stable, constant condition. The basic functions of qi are nothing more than an expression of all these functions. Therefore, when Chinese medicine talks about regulating the qi in order to achieve a state of balance, it is simply referring to applying different methods such as herbal medicine and acupuncture to help the body self-regulate in order to achieve optimal homeostasis.

While qi propels, or is an expression of function, it also creates form. Therefore, blood has a different meaning in Chinese medicine than it does in Western medicine. Blood is seen as a very dense form of qi.  Qi is said to generate blood, and as qi also pertains to function, it moves the blood and holds the blood in the vessels. Conversely, blood is said to nourish the qi. This brings us to a foundational concept in Chinese medicine that qi is the commander of blood and blood is the mother of qi. Once again, form and function are inseparable. While this idea may still seem like a foreign or strange concept to some, if we think of this in terms of Einstein’s famous equation E=mc2, where mass is a property of all energy, and energy is a property of all mass, energy and mass are interchangeable and interdependent. This Chinese medical concept is no longer a fanciful or antiquated idea. It is a concept substantiated by modern physics. This is why E=mc2 could reasonably be viewed as a modern way to express certain aspects of the ancient concept of qi.

As a side note, the principle of yin and yang that is part of Chinese medical theory can be applied to this idea, with mass/blood being categorized as yin qi and energy/function categorized as yang qi. Yin and yang are not specific things; the yin/yang doctrine is just a way of classifying various qualities, which work together to form a whole. Yin qi and yang qi are simply different qualities of qi. The yin/yang doctrine does not just describe opposites in quality; it is also used to describe the principles of interdependence, mutual engenderment and transformation, and mutual consumption. In Einstein’s E=mc2 equation, energy is yang qi, and mass is yin qi. Therefore, energy and mass can engender each other, transform into each other, and consume each other.

The word qi may also be used when describing a process of transformation or change from one state to another. We can come to this conclusion because the radical for rice (米) that is used in qi is specifically uncooked rice, but there is also steam or vapor rising from the rice (气). This indicates a process of change from an uncooked state to one that generates steam/qi. When steam/qi is applied to rice it transforms from an uncooked to a cooked state, and releases more steam/qi. When the rice is consumed, it provides the body with nutrition/qi. This process of transformation is another indication that both form and function are aspects of the concept of qi, and that qi is in a constant state of transformation – the steam/qi cooks/transforms the rice, which we eat for nutrition/qi. This example represents just two classifications of qi. Remember that the Yellow Emperor’s Cannon of Internal Medicine contains 270 classifications of qi.

When we talk about qi in Chinese medicine, we are referring to the various ways that matter-energy manifests in the body and the various types of interactions and functions of numerous and complex systems. These functions and systems are all a part of the whole that are involved in supporting life and maintaining homeostasis/balance.

As stated before, there are many classifications or types of qi in Chinese medicine. This is just a brief explanation of some of the main ones:

精氣jīng qì [essence qi, refined qi] is the most essential substance from which life begins and depends on for sustenance. The character精jīng can mean essence, semen, or ovum. It is understood that精jīng is the substance and function of the transmission of life through sexual reproduction. Reproduction requires sufficient精jīng, and精jīng is what one inherits from one’s parents. It can be understood as the ancient expression of the modern idea of genetic transmission. Jīng is responsible for growth, development, and reproduction.

原氣 yuán qì [original or primary qi] promotes and stimulates the functional activity of the organs and provides the catalyst or foundation for the production of 真氣 zhēn qì or true qi.

真氣 zhēn qì [true qi] is the last stage of the transformation of qi, which circulates throughout the body and nourishes the organs and provides protection against outside pathogens. It assumes two different forms: yíng qì 營 氣  [nutritive or nourishing qi] and wèi qì 衛 氣 [defensive qi].

營 氣yíng qì [nutritive or nourishing qi] is closely related to blood, and as its name states, it nourishes the whole body. Think of this in terms of the blood carrying all the nutrients to the entire body.

衛 氣wèi qì [defensive qi] is the defensive or protective qi. This is otherwise known as immune function.

宗 氣zōng qì [ancestral or essential qi] would best be described from a Western perspective as genetic qi, but it is also the result of the energy we harness through the food we eat and the air/oxygen that we breathe. It is the culmination of our genetics and lifestyle.

谷 氣gǔ qì [food or grain qi] is the energy and nutrients extracted from food. Remember that one of the early meanings of qi when the rice radical was added is ‘that which nourishes the body.’

空氣kōng qì [air qi] originates from the oxygen filled air that we breath.

Also previously stated, the character for qi can mean to breath in and out, which is yet another example that contains the idea of a process of transformation and change.

The strength or movement of qi could refer to the body’s capacity to transform and change. We can consider this idea when we refer to the Chinese medical condition 氣虚 qì xū (chee shoo), where虚 xū means vacuity, emptiness, void, or weak. Qì xū is characterized by a discontinuity of qì where the substantive and functional aspect of qì in connecting the human organism into an integrated and functional whole is insufficient. Therefore, the whole body is in functional decline. When Chinese medical theory says that acupuncture and herbal medicine regulates and nourishes the body’s qi, this is referring to the use of these methods to strengthen the body and improve its ability to properly regulate physiological function, transform, change, and resolve illness. While modern Western medicine would use terms such as strengthen the immune system and regulate the hormones, Chinese medicine would simply say tonify and regulate the qi as a shorthand way of describing more complex processes.

The following is a more detailed example to illustrate how the term qi is used in Chinese medicine: When a doctor of Chinese medicine says that the stomach qi is deficient, this means that the ability of the stomach to break down and digest food (transform it from one state to another) is weak. If the stomach qi is described as stagnant, the motive ability of the stomach to move the food into the intestines (where nutrients are absorbed) is not functioning properly. A patient with stomach qi deficiency and stagnation may present with gas, bloating, and nausea. They may also complain of excessive belching as gas accumulates in the stomach. Belching would be described as counterflow qi or rebellious qi. Why? Remember that in some contexts qi can simply mean gas, so if the gas/qi in the stomach rises up, as it does when one belches, it is described as qi rebelling upward. Deficient stomach qi (weak digestion) could also result in fatigue, as the body is not able to properly digest food and extract all the necessary nutrients for creating energy. As these nutrients are also a type of qi, weak digestion could lead to what would be described as氣虚 qì xū (chee shoo), or qi deficiency/vacuity. As its name states, this condition manifests as low energy/vitality/qi. In this instance, acupuncture and herbal medicine would be used to strengthen and regulate the stomach qi. This is another way of saying that treatment would aim to improve the function of the stomach, give it the ability to break down and digest food, and then pass the partially digested food along to the intestines where the nutrients could be properly absorbed.

When we talk about an organ in Chinese medicine, we are not only referring to the physical structure but also all of the physiological rolls and functions of that entire organ system. Each organ has its own qi (form and function), which governs a particular aspect of physiology. These functions are not just limited to certain obvious physical functions such as digestion, but also to emotional and psychological functions. While this may sound strange at first to the uninitiated, consider this modern scientific finding: Our gastrointestinal system is now called the second brain, because 95% of all the neurochemicals that regulate emotion are in our gut. They are produced and metabolized as part of our digestive system. An emotion can be viewed in bio-medical terms as a neurochemical event. When released, these chemicals need to be metabolized/digested. Therefore, it is not possible to have optimal mental, psychological, and emotional health without good digestive health, or sufficient digestive qi. All of these physical, psychological, and emotional aspects are all part of the qi dynamic. This will be discussed in later articles. It is being introduced here to further illustrate that the term qi is not simply another word for ‘energy’. It is a very complex, deep, profound, and nuanced concept that cannot be translated with a single word, sentence, or even an entire article.

One can draw many examples and analogies from nature to understand the concept of qi and the eastern view of healing. As qi refers more to an idea or concept than a particular substance or energy, there are other ways of interpreting or viewing this character. The main point of this article is to explain that qi is not a fixed tangible thing or specific type of energy. There are entire books written about the concept of qi. It can be studied for a lifetime with one’s understanding growing not only from intellectual learning, but also with each encounter and experience with qi. It is as philosophical as it is scientific. This short article could not possibly do justice to the discussion of qi, but it is offered here to get those interested to understand that there is much more to qi than a simple, narrow definition can provide.

 

References

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Maciocia, G. (1989). The foundations of Chinese medicine : a comprehensive text for acupuncturists and herbalists. Edinburgh ; New York: Churchill Livingstone.

Unschuld, P. (1985). Medicine in China: A History of Ideas (Vol. Volume 13 of Comparative Studies of Health Systems and Medical Care). Berkeley and Los Angeles: University of California Press.

Unschuld, P., & Tessenow, H. (2011). Huang Di Nei Jing Su Wen: An Annotated Translatin of Huang Di’s Inner Classic – Basic Questions (annotated ed.): University of California Press.

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Yang, J.-M. (2003). Qigong meditation : embryonic breathing (1st ed.). Boston, MA: YMAA Publication Center.

Zhang, Y. H., & Rose, K. (2001). A Brief History of Qi. Taos, NM: Paradigm Publications.