Qi, acupuncture points and energy meridians (Proceedings)

Qi: Energy or Life Force

Qi pronounced "chee".

Definition

Qi is difficult to translate into Western language. Fundamentally, Qi is what gives life to the universe. The ancient Chinese philosopher, Zhuang Zi (286 BC) stated that, "Qi gives birth to human beings; where Qi exists there is life, but the absence of Qi is death." Qi is complex as it is an energy that is manifested both physically and spiritually-mentally. Additionally, there are many different types of Qi that affect the mind and body, however, each of these forms are simply different manifestations of one true Qi.

Different Types of Qi

Over 32 types of Qi that have been recognized in literature over the past 2500 years. The major forms of Qi are described below.

1. Yuan Qi - Primary Qi, Source Qi, Original Qi Motive force behind normal organ function, maintains development and growth of the body.

2. Qing Qi – Cosmic Qi Energy of the universe. Includes air, light, electromagnetic forces and other energies within the atmosphere.

3. Zong Qi – Pectoral Qi, Gathering Qi, Ancestral Qi, Chest Qi Energy which controls and promotes respiration and the circulation of Qi and Blood. TCM Blood provides moisture and nourishment to the body and the Zang-fu organs (see below for explanation of Zang-fu).

4. Gu Qi – Food Qi or Food Essence Substance produced from food by the body (in TCM, Spleen). Replenishes Yuan Qi and is the source of post-natal essence.

5. Ying Qi – Nutrient Qi, Nutritive Qi Circulates in the blood vessels and produces Blood, nourishing the entire body. In Western biomedical terms, hemoglobin and other serum proteins.

6. Wei Qi – Defensive Qi Can be thought of as immune function, protecting the integument and underlying musculature from external pathogens; also controls the opening and closing of pores and is in charge of thermoregulation.

7. Zang-fu Qi – Organ Qi

The function of each of the Traditional Chinese Medicine (TCM) internal organs. TCM internal organs and their functions vary from the Western biomedical internal organs so will be listed with a capital letter to distinguish between the two. TCM, physiology and pathology are described in terms of these organs. There are 12 organs which are separated into 6 Zang organs (Yin, female) and 6 Fu organs (Yang, male). They are paired as wife and husband with the Zang organs being solid structures while the Fu organs are tubular or hollow. The 6 Zang organs are Lung (LU), Spleen (SP), Heart (HT), Kidney (KI or KID), Pericardium (PC) and Liver (LIV). The Fu organs, listed in order with their paired Zang organ are Large Intestine (LI), Stomach (ST), Small Intestine (SI), Urinary Bladder (BL), Triple Heater (TH) and Gall Bladder (GB). The Triple Heater (aka Triple Burner, Sanjiao) is a topic of controversy as some TCM doctors do not believe it is an actual organ or function, while some believe it to be a passageway for the distribution of Source Qi and Body Fluids. Additionally, some believe it to be the adrenal glands.

8. Jing-Luo Qi – Meridian Qi The function of the actual meridian, which coordinates the activities of the internal organs and communicates between the interior and exterior body. It is the transmission of the acupuncture stimulation by the meridian and is felt as a tingling sensation or energy during acupuncture.

9. Zheng Qi – Antipathogenic Qi, Resistance Qi, Upright Qi Collective term for the various types of Qi that have function in protecting the body from exterior pathogens. In essence, it is the body's comprehensive ability to resist disease.

Functions of Qi

Qi has a variety of functions. On a physical level, it is the basis of all functions and processes of the physiological body and the motive force for all life processes. It is responsible for growth, development, reproduction and mental, emotional and physical activities. On a spiritual level, it is the source of all movement in the universe.

The Importance of Qi

The free flow of Qi is necessary for health. If there is blockage of Qi, there is no nourishment. If we think of the body as a recirculating water fountain, it is obvious that any obstruction or impedence of the flow of water will result in an area of stagnation, where there is excess (pooling or overflow) in one area, but deficiency in another. Hence the blockage of the flow of Qi creates imbalance and a state of disharmony or disease in the body. The early Chinese masters believed that the flow of Qi can be stimulated through the practice of Qi Gong or Tai Chi. Qi Gong is a large collection of Traditional Chinese energy exercises which involve the coordination of different breathing patterns in conjunction with specific physical postures and motions of the body to achieve and maintain the optimal state of good health and mind. Tai Chi is a form of "soft style" martial art which utilizes slow, repetitive routines to promote health and longevity. The Mayo Clinic reports that preliminary research indicates that the regular practice of Tai Chi has specific health benefits especially in older adults.

Dysfunctions/Pathologies of Qi

1. Deficiency (vacuity) – Not enough Qi for proper function of the organs, enabling a disease state to develop. Most commonly this is manifested as weakness or organ insufficiency.

2. Stagnation – Obstruction of Qi. Can manifest as pain, pressure, stiffness or organ dysfunction. Chronic stagnation often affects other organs as well and can lead to heat conditions. Most common patterns seen are stagnation of the Liver (e.g., hepatitis, cholangiohepatitis, elevated hepatic enzymes), Stomach (e.g., abdominal fullness, bloat, flatulence, food stagnation, indigestion) and Large Intestine (e.g., constipation, hypomotility).

3. Rebellion – Pathological counterflow in the flow of Qi. Common clinical signs include regurgitation, vomiting, nausea, hiccups, cough, asthma.

4. Collapsed - Insufficient Qi to maintain the body's internal organs in their proper place resulting in prolapse of organs. Some clinical signs include rectal or uterine prolapse, chronic diarrhea, droopy lips and drooling.

Acupuncture Points (Acupoints)

Shu Xue, pronounced "Shoo shway"

Shu: transporting, distributing, passing, communication

Xue: hole, outlet, depression

Definition

A depression in the skin/underlying tissue that communicates with the Zang Fu organs via meridians and channels (Jing Luo system). Qi gathers at and is distributed from these locations. The relationship between acupoints and the Zang-fu organs is similar to that of viscerosomatic and somatovisceral reflexes in Western biomedicine.

Acupoints have been demonstrated to have decreased electrical resistance, increased electrical conductivity, and a high density of free nerve ending, arterioles, lymphatic vessels and mast cells. Some investigators have noticed a high concentration of hair follicles and a decrease of dermal nuclei at acupuoints.

Acupoints have been grouped into four types according to known neural structures by Gunn et al 1, 2

• Type-I acupoints: Motor points

• Type-II acupoints: Points on dorsal and ventral midline. Bilateral superficial nerves overlap at these points.

• Type-III acupoints: Points which overlie superficial nerves or nerve plexuses.

• Type IV-acupoints: Points at tendinomuscular junctions. There are numerous Golgitendon organs at these points.

Energy Meridians/Channels or Jing Luo system

Definition

Meridians or channels are the pathways where Qi and Blood circulate. They extend over the outside of the body but refer to and connect all of the tissues and organs. They also coordinate the internal organs or Zang-fu organs, and help prevent the invasion of external pathogens.

In TCM, the meridians are known as the Jing Luo system. The two major components in the Jing Luo system are Jing Mai and Luo Mai. Mai means vessels; Jing may be translated as meridian, channel, or major trunk while Luo may be translated as collateral or branch. Thus Jing Mai are the major trunk channels and Luo Mai are the collateral branch vessels. We may think of the Jing Mai as freeways or highways, and the Luo Mai as city streets.

The Jing Mai consist of the 12 Regular Channels and their associates, 8 Extraordinary Channels, 12 muscle regions and 12 cutaneous regions. The Luo Mai consist of the 15 collaterals, small branches and superficial branches.

Meridian Nomenclature

The 12 Regular Meridians refer to the twelve Zang-Fu organs in the body (LU, LI, ST, SP, HT, SI, BL, KID, PC, TH, GB, LIV). They are bilaterally symmetrical so there are 24 regular channels in the body. These 12 Regular Meridians are connected to each other in a fixed order as listed above, and follow 3 repeated cycles on the body. The first meridian, LU [Yin], starts at the chest and ends at the front foot. The LI [Yang] meridian starts at the front foot and ends at the head. The ST [Yang] meridian starts at the head and ends at the hind foot, and the SP [Yin] meridian starts at the hind foot and ends at the chest. This cycle is then repeated 2 additional times. As all Yin meridians start or end at the chest, the chest is known as the "Gathering House of all the Yin". Similarly, as all Yang meridians start or end on the head, the head is known as the "Gathering House of all the Yang."

The 8 Extraordinary Channels do not pertain to the Zang Fu organs and do not have their own acupoints with the exception of the Du (Governing Vessel) and Ren (Conception Vessel) channels which have their own acupoints but share some of them with a few of the 12 Regular Meridians. The Ren and Du channels run on ventral and dorsal midline respectively. Unlike the 12 Regular meridians, the 8 Extraordinary Meridians are not bilaterally symmetrical so there are only one of each of these meridians. The Ren and Du meridians are commonly utilized, hence we often speak of 14 Regular Meridians, not 12.

Circadian Clock and Meridians

There is an endless flow of Qi and Blood throughout the meridians. As the meridians are connected in a specific manner, Qi and Blood must also flow in this same order. It is important to realize that Qi is never depleted in an area, but at specific times of day, Qi will dominate within a specific meridian. The TCM Circadian clock begins at 3:00AM with the Lung meridian; Qi dominates in each of the other 12 Regular Meridians for 2 hours before moving on to the next one. This circadian rhythm may be used both diagnostically and therapeutically. For example, studies in Japan revealed asthma symptoms to be worse between midnight to early morning, with a peak around 4:00AM. Chronotherapy is based on the concept that medical treatments can be improved depending upon the time of administration. Physicians are finding that by utilizing chronotherapy, they can better treat disease such as asthma, arthritis and cancer while also reducing side effects.

References

Gunn CC: Acupuncture loci: a proposal for their classification according to their relationship to known neural structures, Am J Chin Med 4:183-195, 1976.

Gunn CC: Type IV acupuncture points, Am J Acupuncture 5:51-52, 1977.

Kagami M, Tomioka H, Nakazawa T, Yoshida S: Arerugi 2001 Jun: 50(6):528-34.