Tending The Wind

The wǔxíng (five phases) are central to understanding the inner workings of living beings in Chinese medicine. They describe patterns of expression. Each phase is associated with a pair of internal organs (one yīn, one yáng), and their related acupuncture points, functions, and affinities. One of the greatest hurdles for Western students is that these functions and affinities are not only physical in nature; they are also mental, emotional, and spiritual. There is no dualism separating mind and body in Chinese medicine. Flesh and bone are just another expression along the same continuum as thought and feeling. The wǔxíng describe variations along this continuum.

So if an organ isn’t to be understood as a singular anatomical structure housing a finite set of biochemical activities, how are we to understand it? What is the stuff of life in Chinese medicine that is able to simultaneously manifest in the Water phase as the physical kidney, the emotion fear, and the spiritual quality of wisdom? It is called qì (pronounced “chee”), and an attempt must be made to describe it before moving on to the finer points of wǔxíng medical theory. This chapter will explore the meaning of qì, its origins, and its movements.

The character for qì is a combination of two different pictographs, one showing grains of rice (commonly translated as rice or kernel) and one showing curling clouds (commonly translated as air). The pictograph for kernel is enfolded in the pictograph for air. Together, they suggest several possible meanings: the most subtle form of that which sustains existence, the kernel of things and their ever-changing expressions and activities, that which is capable of being both expansive and shifting as well as finite and stable, the most basic mutable form of manifestation. (All of these meanings are lost in the many modern texts that show only the cloud pictograph.) The various English translations of qì include psychophysical stuff, energy-matter, pneuma, and others. It is substance as well as function, involved in and composing all things and events in a continuous process of emergence and transformation.

In quantum physics terms, qì is both matter and energy, particle and wave. As such, it would also exhibit the quantum property of entanglement: two or more objects separated by distance but related to each other on a quantum level respond to changes in each other’s states instantaneously. Entanglement is one possible way to understand how the qì of seemingly disparate structures and processes are resonantly interconnected within a particular phase, so that treatment of one manifest expression along the continuum of that phase affects all the others. For example, treatment of the emotion anger involves treatment of the liver, as both are part of the Wood phase. The world of qì, like the world of quantum physics, should also be thought of as probabilistic rather than deterministic. Just because the qì of a particular organ is likely to behave a certain way doesn’t mean that it will; the practitioner must always have an open and receptive mind.

In Daoist philosophy, qì is the manifest expression of the mystery of the Dào. From primordial oneness it emerges and differentiates into the myriad things (physical and non-physical, dense and rarified, yīn and yáng) and their activities. In the body, it is said to arrive first as the běn qì (běn meaning basic, root, origin, original or personal). This arrival occurs between the kidneys like an igniting spark at the gate of life (mìngmén) in a manner poetically described by the phrase shènjiàn dòngqì – light appearing between the kidneys like the sun through a doorway + moving/acting qì. This then becomes the yuán qì (source qì) for the rest of the body. The transition from basic (pre-form) qì to source (earliest forming) qì is said to happen with the assistance of one’s meditative breath, which creates the space for forming to begin. Hence the great importance of mindful breathing into the abdomen in Chinese therapies.

Many texts refer to mìngmén as or in relation to a greasy membrane between the kidneys (possibly the root of the mesentery) where the igniting spark arrives and from whence the source qì distributes to the rest of the body via a system called the triple heater, also rooted at the source. It is the triple heater along which the acupuncture meridians flow. There is no typical Western organ corollary for the triple heater as there are for the other organs in Chinese medicine, but many texts refer to it as the connective tissue system of “net-like membranes” such as those lining organs and body cavities (e.g. mesentery, pleura, peritoneum) and the fascia lining muscles and lying superficially under the skin. This interpretation is supported by the character for meridian: jīng (threads twisted together + water course), commonly translated as the warp of a fabric, or to pass through or experience.

The significance of mìngmén and its location in the upper lumbar area may be related to events occurring during early embryogenesis. After one cell type has become two, a critical line of further differentiation called the primitive streak appears at the tail end of the embryo, defining its long axis. Processes occurring at this streak mark the beginning of the three germ layers that then become everything else: ectoderm (future skin, nasal/oral linings, nervous system, and sense organs), mesoderm (future muscles, heart, vessels, spleen, lymph tissues, uterus, kidneys, bones and marrow, connective tissue linings, tendons, and ligaments), and endoderm (future digestive tract, respiratory tract, liver, pancreas, and bladder). An interesting Daoist corollary is a phrase in the Dào Dé Jīng, “The Way gives rise to the one, the one to the two, the two to the three, and the three to the ten-thousand things.”

The primitive streak elongates to nearly half the embryo’s length, and then recedes as further growth and differentiation take place. A structure called the primitive node appears at the upper-most end of this streak. From it, mesoderm-forming cells proliferate up the long axis of the embryo creating the notochord, which induces formation of the head, nervous system, and somites (blocks of mesoderm running in pairs along the length of the notochord that become vertebral bones, ribs, basal bones of the skull, dermis, and skeletal muscle). The notochord itself becomes the nucleus pulposus of the intervertebral discs. In addition to causing differentiation of adjacent ectoderm into nervous tissue, the notochord along with the primitive node and related mesoderm determine both the specification and orientation of many other structures. Thus the primitive node and its primordial connective tissue emanations are crucial to the destiny of all the germ layers. It has been postulated that this node may emerge at the future location of the upper lumbar area, the site of mìngmén and the root of the triple heater. The meaning of mìngmén supports this hypothesis: destiny/life/order + double-leafed door, the first appearance of creative differentiation. The acupuncture point of the same name lies on the back between the second and third lumbar vertebrae, and is used to “bank the origin” as ongoing access to one’s basic qì is important for optimum health of the fully developed organism as well as the embryo. The source qì of the triple heater may be considered as a kind of flux-qì, or qì in the process of differentiating. This flux-qì is influenced and nurtured along its journey by qì from outside sources, both physical (e.g. food, water, air, climate) and non-physical (e.g. friendship, enlightenment) which must be assimilated in harmony with one’s inner nature (dé).

The movement of qì along meridians has been described by some authors as a linear progression and by others as a spontaneous appearance at distant sites along the same path. It’s likely a bit of both. Early research into the electrical properties of connective tissues (whose distinguishing feature is the orderly arrangement of various protein fibers) suggests that they are capable of a biologically significant amount of both electrical conduction and charge generation. (Conduction may be via movement of charged atoms closely along the surface of proteinaceous tissue. This requires moisture, and dry connective tissues are poor conductors. Generation may be via the piezoelectric effect wherein distortion of regular lattice-type structures creates a surface charge.) Early research also suggests that the meridians follow lines of condensation of the electromagnetic field of the body. It has been suggested that this system represents a bioelectric communication network more primitive than and basic to the nervous system, capable of responding to stimuli as dense as mechanical distortion and as subtle as electromagnetic fields. The electrical polarites created along connective tissue planes may also guide growth of embryonic structures.

The stimulus used in acupuncture to alter qì flow is the insertion of fine metal needles through the skin into subcutaneous fascia. Acupoints generally exhibit a lower resistance to electrical conduction than surrounding skin, and insertion of metal into body fluids creates a simple battery releasing electrical energy. Bimetallic needles (e.g. copper + stainless steel) create more microcurrent than a single metal alone. Acupuncture is said to be the earliest form of microcurrent therapy, and may treat disease by rebalancing the flow of charged atoms in the body. The character for acupoint is xué (cave/hole) which originally referred to sites in the landscape chosen for their harmonious flow of qì.

Based on the microcurrent concept of qì, some systems of acupuncture therapy have emerged that rely strictly on electrical measurements for point selection and treatment, disregarding traditional Chinese medical theory and philosophy. The danger in this, to borrow Zhuāngzǐ’s line that words exist because of meaning, is that practitioners will focus only on the words and forget the meaning. That is, the earliest measurable expression of qì (electrical current) is not to be confused with qì itself. Just as the physical liver is only one expression of the Wood phase, electrical currents along connective tissues are only one expression of something greater and more profound. The concepts presented by the classical texts give us a way to come closer to the meaning of qì. This is part of what is transferred to the patient by a thoughtful practitioner.

The next chapter will discuss the various forms of qì in the body in relation to five phase and yīn-yáng theory, finally exploring the patterns of expression that are the basis for acupuncture and herbal therapy.