The following is a response from an acupuncturist to my commentary on qi, yin and yang at the end of a research brief I wrote for MD's. You may want to read that first.

The Acubriefs newsletter directed us to an article by Brian Benjamin Carter which contained the following passage about qi:

"As far as whether qi pervades everything, I do not believe that is an accurate representation of chinese medical theory. Qi can mean many different things in different contexts... but I believe the idea that qi pervades everything is actually a non-traditional new-age idea grafted onto chinese medicine... This is the kind of thing that disturbs me... not only should we not allow the new-agers to claim it as their own, but also we should keep it pure, we should be clear about what really is oriental medicine and what isn't."

This is inaccurate. The notion of "qi pervading everything" is not a "new-age idea grafted onto chinese medicine." Even a passing glance at the history of Chinese thought shows that the concept of "qi" has been important in Chinese philosophy and cosmology long before its more limited application in medical theory. Modern, standardized TCM in particular, takes a decidedly limited and dialectical materialist approach to qi which is not representative of most classical sourcs.

Just as the concept of yin/yang is not limited to human physiology (the works Joseph Needham's demonstrate how it permeated all scientific thought in China, from agriculture to civil engineering), so too does qi have a much wider significance. Angus Graham, a noted British sinologist, described the classical Chinese concept of qi:

"The concept of qi, 'energy', has the place which 'matter' holds in our own cosmology... The universe is not constituted from inert matter, it is a pool of energetic fluid, the qi, out of which through their endless cycles things condense and into which they dissolve... Within the cosmos as a whole it ascends as the air we breathe, while the more massive and inert qi settles down below as the earth (as in man it coheres as the body). Within this cosmology the universe will be activated by the insubstantial free-moving air of Heaven... this Heaven is neither a person living in the sky nor an impersonal and physical Nature named after the sky. It is simply the sky itself."

Zhuangzi writes: "Everything under heaven is a single qi."

Wang Chong writes: "The generation of the ten thousand things, all are endowed by the original qi."

Luo Qinfeng writes "Throughout heaven and earth, from ancient times to the present, everything is a single qi. The qi is originally one, but now moving now still, now coming now going, now opening now closing, now ascending now descending, circulating ceaselessly, accumulation of subtlety becomes manifest, this is the four seasons of warm, cool, cold and hot, this is the generation, growth, gathering and storing of the ten thousand things."

In the Song Era, Neoconfucian philosophers elaborated a cosmology in which all entities are composed of li (principle or pattern) and qi (the driving force of li).

Qi was also conceived as the medium through which heaven, earth and the ten thousand things interact. The idea of "resonance" or "induction" (ying), inspired by magnetic phenomena and resonance of musical instruments, was generally considered to occur through the medium of qi.

The use of the concept of qi in modern TCM theory (with its neat classification into defense qi, source qi, ancestral qi, etc) is only a narrow application of a very large classical Chinese concept (more widely, this concept overlaps with those of other cultures such as Indian "prana," the alchemist's "vital fluid," Hawaiian "mana," Wilhelm Reich's "orgone," etc). This concept was partly based on the practices of Taoist yogis in their experiments with what we now call "qi gong" (qi skill). Since these practices were ncessarily subjective, the language and models they used were drawn from familiar imagery (water, fire, weather, nature, etc). Nevertheless, so far most of the modern scientific explanations that have been offered to explain these experiences, IMHO, merely express the limitations of our current level of scientific understanding. In comparison to the fruits of experience passed down by the ancients, most of the modern explanations are shallow and simplistic.

Matthew

Counterpoint
by Brian Benjamin Carter, M.Sci., L.Ac.

Matthew,

Thanks for your response- I cannot disagree with the historicity of your quotes, and I think we are actually agreeing about some points.

The purpose of the 2003 Acupuncture Research Update was to show M.D.' s that there are more acupuncture studies out there than they generally acknowledge... more than I even knew before I undertook the project.

So, the audience was not those who are deeply interested in Chinese history - not even, necessarily in modern Chinese medicine. I could not have said all you just said in your letter without turning them off. In fact, as a man with a philosophy degree, I know from experience that most people are turned off by philosophy, regardless of its origin or context.

In TCM, qi has a much more narrow meaning than in Chinese or Taoist cosmology. All that concerned me was medicine, and qi's meaning in medicine- particularly, what qi might mean to an MD.

As you know, some of them practice acupuncture with little or no Chinese medical understanding at all; local ah-shi points and/or point protocols from acupuncture research. Most of us know that some efficacy and understanding will be lost when you ignore the original medicine. But, we can't expect the average MD to suddenly give a flip about Chinese philosophy. That might be nice, but it's not a realistic expectation.

Therefore, I took the middle ground. I explained the essential medical ideas, without risking losing my audience.

That's why I emphasized an exclusively medical definition of qi.

As I understand it, Taoism, the soil in which Chinese medicine grew up, can be a philosophy and/or a religion. I don't know what it takes these days to be a religious taoist, or to become a taoist priest, for example... nor do I really care, because the religious aspects of taoism are secondary for those who practice Chinese medicine.

Don't forget that all of the ideas that come to us from CM history are still just theories- many of them are very useful, many needed contributions in areas that biomedicine can't touch, perhaps even with insightful applications for biomedicine - but theories nonetheless. To take them as truth without discussion is to be dogmatic.

That's the problem that all traditions have once they become literal- they become somewhat 'frozen' even though in truth they are organic and alive. There is always a tension between literal history and modern innovation. Throughout CM history, physicians have disagreed with tradition and insisted on innovation. Forgive me if I forget the names and dates- Li Dong-yuan, author of the Pi Wei Lun, said "ancient formulas are not in harmony with modern diseases," and then there was the guy who thought it was ridiculous that we weren't dissecting humans and acknowledging obviously real human anatomy.

My personal belief (shared by European Chinese medicine scholar Philippe Sionneau) is that we must both respect origins and tradition while continuing to grow and innovate. We cannot ignore science as a tool. Nor can we deny that CM and biomed's two perspectives are different viewpoints on the same reality. There is only one reality, regardless of your viewpoint. Already in China, great advances have been made by combining biomedicine and Chinese medicine. This is possible without losing the strengths or essence of either. See Volker Scheid's Plurality and Synthesis for more about this (a great book!) and Philippe Sionneau's forthcoming book on Modern Chinese Herbal Formulas.

A Betrayal of Tradition?

Perhaps for some, practicing CM as a just a mind-body medicine (without peripheral Chinese spiritual practices) is a travesty, a perversion, or a betrayal... who knows, maybe you would pick up on something in diagnosing a patient that I would miss... but it's a very heterogenous medicine (again, see Volker Scheid); it's hard to say this or that concept is absolutely wrong. Get a Japanese style, a Chinese style, a Tong style, and a Korean style acupuncturist together, and try to get them to agree on a treatment protocol. If they didn't beat each other up, they would still probably go home thinking their own style was superior.

But if you look for what is common to all of them, you'll find the basics of Chinese Medicine. You'll find a medicine, not a religion.

The Communists Did Us a Favor?

If you consider that many Christians cannot see the difference between philosophical and religious taoism, and are turned off by both, plus the fact that the communists proved that CM still works as TCM without all the ancillary philosophical ad religious ideas, then we see actually a real advance in making CM accessible to a lot more people.

I accept that I will always be a student, and our medicine is still being translated into English, so it's hard for anyone to claim authority about what Chinese medicine truly is.

Please understand that my job as I see it is to communicate Chinese medicine to people who know nothing about it. That means I have to consider my audience (which usually is not specifically other Chinese medicine practitioners), and prioritize my main points.

As I do that, I want to continue to dialogue with CM historians, translators, and practitioners of every style/bent/viewpoint. It's difficult to transmit simply such a complex and varied medicine to many different groups of people. I hope you'll remain patient and open-minded as I do that.

Thanks,
B