Shannon L. Sumrall Medical Anthropology Dr. Frate The Concept and Application of the Energy System of the Body Many cultures define health and illness in the framework of the flow of vital energy through the body. Illness is believed to result when the flow of energy is not in balance or is interfered with. Among the more developed and medically effective applications of this concept are India's Ayurvedic medicine and traditional Chinese medicine. Many of the concepts of these two systems are very similar and share much in common as there is a long history of exchange of ideas and concepts between these two cultures. Here we shall focus on the traditional Chinese view and discuss the traditional conception of this energy flow. First, we shall look at the idea of the energy flow involving specific, small points on the body (which can be stimulated both by external pressure known as "acupressure" and/or by acupuncture needles). Secondly, the concept of energy meridians, consisting of groups of these points. Thirdly, the division of these meridians into yin or yang (negative and positive). Finally, the further division of the meridians into a five element classification scheme. After this conceptual groundwork has been applied we shall then turn to what Western science has to offer in way of explanation of the observed effects of this particular medical system and/or view. The final topic to be covered will be the highest "development" of this world-view, in the practice of movement and breathing exercises known as Qigong, which claims to build one's life force and give one the ability to have some control over its flow. The vital force that is seen to course through all of us is known as "Chee," "Chi" or "Qi" in Chinese and "Ki" in Japanese. There is no exact meaning or definition of this concept as it encompasses more than just vital force "everything in the universe, organic and inorganic, is composed of and defined by its Qi" (1983, Kaptchuk 35). The concept of Ki can be further clarified by a metaphor first introduced by Locke (1989), who likens the energy within each of us to a two-headed match that emanates energy from both ends. The bottom part is in our 'center,' the tanden, located approximately two inches below the navel. Our center is eternally lit and emanates energy in the form of vibrations. This concept allows us an avenue of awareness of our bodies and gives us the eventual ability to control our physical selves within the confines of our nature. The other end of the match, our mind, is likewise lit and allows us knowledge and wisdom and to become aware of our mental potential and to cultivate these potentialities. In Locke's metaphor, Ki can refer, on the one hand, to the physical power within, the intense power emanating from our center, a power controlling our movements. The other end portrays another variation of Ki, the power of the mind, the power of consciousness, the piercing power of knowledge which leads to wisdom. (1990, Seitz 462-463). This view of Qi is then divided into the opposites of yin (negative) and yang (positive). "Polarity is the most pervasive principle of the manifest material universe, providing the boundless dynamic force which makes the world go round" (1994, Reid 24). "Without polarity material worlds and physical bodies could not exist, and without polar fields energy could not function, essence could not take form, and the rhythmic cycles of nature could not transpire" (24). However, "there are no absolutes" and "yin and yang must, necessarily, contain within themselves the possibility of opposition and change" (1983, Kaptchuk 8). Thus, the Chinese "hypothesized the principles of Yin and Yang as the major philosophical counterparts revealing the phenomena of nature" (1986, Shen 134). "From these principles, three systems were derived: the five elements (wood, fire, earth, metal, water), the Zang Fu (internal organs), and the meridian system" (134). The five elements are a further division of the conceptual system that classify things into a corresponding element. However, the application of this system medically is "often too rigid to describe physiological functions accurately" and is at times ignored (1983, Kaptchuk 349). The elements are arranged in a healing cycle (fire, earth, metal, water, wood) and a destructive cycle (fire, metal, wood, earth, water) (1994, Dillman 56). Generally, (in concert with the meridian system and yin and yang principle) the healing cycle is used for therapeutic benefit and the destructive cycle is applied for what is known in the martial arts as dim-mak (Chinese) or kyusho (Japanese). The martial aspect is a particularly interesting one and, until recently, has long been kept secret; as one can use it to cause a knock-out or death with no physical marks left on a person (27-28). As with yin and yang this is not absolute and both cycles can be used for healing or self- defense. The flow of Qi through the body is seen to be via the meridian system composed of acupuncture points (also known as pressure points). "The electrical conductance of skin at acupuncture points is normally higher than that of the skin in general" (1995, Cumunetti 328). These points and meridians are seen to be functionally related to corresponding internal organs. Since there are several hundred acupuncture points "the Chinese classified them into twelve main groups and a few subsidiary ones" with each being assigned a relation to a particular organ function (1971, Mann 37). Thus, when one speaks of an organ, in traditional Chinese medicine, it is not in reference to the actual physical organ but the energy meridian it is seen to correspond to. The energy is seen to flow from the ground up the front of the body and down the back with the front being yin and the back yang. The twelve meridians in the order of energy flow, along with their corresponding element and yin or yang state are the following: Lungs, metal, yin; Large Intestine, metal, yang; Stomach, earth, yang; Spleen, earth, yin; Heart, fire, yin; Small Intestine, fire, yang; Bladder, water, yang; Kidney, water, yin; Pericardium, fire, yin; Triple Warmer, fire, yang; Gall Bladder, wood, yang; Liver, wood, yin. All of these are bilateral and occur on both sides of the body. Two additional unilateral meridians exist: on the front midline of the body, beginning at about the lower lip, is the "Conception Vessel" meridian; and, running from about the top lip and down the spine is the "Governor Vessel" meridian. The pericardium is seen as a protective sheath around the heart and the triple warmer "is not a single self-contained organ, but rather a functional energy system involved in regulating the activities of other organs" (1994, Reid 61). You will notice a distinctive pattern of two organs with the same element designation but, opposite yin-yang "charges" and also that the circular flow proceeds via a yin-yin (negative to negative) to yang- yang (positive to positive) cycle. Acupuncture points and their meridians when utilized as a medical treatment have also been described without the concept of the energy flow by Western science as follows: The ways in which treatments involving acupuncture points are believed to work can be described in a scientific framework, e.g., stimulation of nerves, counterirritation treatments, stimulation of the body to produce its naturally occurring chemical compounds, and belief. Sometimes scientists can learn about the modality of effect by the speed at which the effect occurs, or about the influence of belief by experimentation on animals (and some acupuncture treatments do in fact work on animals). It is generally not considered necessary by most Western practitioners to invoke Chi as an explanation. (1995, Huston 41). Regardless of whether Chinese or Western terminology is used to describe the functioning of the points and meridians it seems apparent that they have an effect on both humans and animals. The importance of the mind and its relation to disease, and thus energy flow, in traditional Chinese medicine can be seen in the fact that it believes that strong emotions can be unhealthy. "It is only when an emotion is either excessive or insufficient over a long period of time, or when it arises very suddenly with great force, that it can generate imbalance and illness" and "internal disharmony can generate unbalanced emotional states" (1983, Kaptchuk 129). "Thus, joy hurts the Xin (heart), its Qi being dissipated; anger harms the Gan (liver), its Qi increasing; grief harms the Fei (lung), its Qi Congealing; thinking harms the Pi (spleen), its Qi becoming stagnant; sorrow harms the Xinbao (pericardium), its Qi being weakened; fear harms the Shen (kidney), its Qi decreasing, and shock harms the Dan (gall bladder), its Qi becoming chaotic" (1986, Shen 135). This relation between the mind and illness has only recently received serious consideration by Western science. A growing field that looks at this relation is psychoneuroimmunology, which studies the interactions between behavior, the brain and the immune system. This field believes that the immune system controls neural function, and the central nervous system controls the immune system and "the existence of neural-immune interactions permits behavioral-psychological events to enter the matrix: if neural processes regulate immune processes, then there is a pathway by which psychological factors could impact immunity" and "conversely, if immune processes alter neural function, then they can also potentially impact on behavior, emotion, and thought" (1994, Maier 1005). Thus, "there are a number of important relationships between immune, endocrine, and behavioral factors and most importantly, these relationships are not unidirectional" (1994, Laudenslager 760). Chiropractors are beginning to use the emotional concept of Chinese medicine along with the psychoneuroimmunology theory to treat certain physiological disorders that are cause by emotions. Scott Walker, D.C. is a leading proponent of this method and believes that "emotions are physiological rather than psychological" and "the physiology of emotions is generally an arousal of the autonomic nervous system" and he also reminds us that "Pavlov was a physiologist rather than a psychologist" (1991, Amaro 6). This method is not learned in chiropractor schools but, as part of their continuing education at seminars put on by such people as Walker. A local chiropractor I interviewed uses very similar techniques to treat emotional imbalances and he can, as well, detect and correct Qi imbalances. The method that he generally uses to discover and correct such problems is called muscle testing and based on applied kinesiology principles. The energy flow theory of points and meridians has been explained by Western science under the "Thalmic Neuron Theory" or (TNT). This theory is very similar to the view of psychoneuroimmunology and assumes that the central nervous system (CNS) plays a role in all disease processes. The theory states that "the CNS not only processes incoming physical and chemical information from the periphery, it also sends out physiological commands to the periphery in order to maintain homeostasis for the entire body" (1994, Lee 285). Further, it states that disease is a result of the CNS's learning ability (pathological habituation) resulting in deranged central neural circuitries which leads to chronic disease states and these states "can be reversed by dehabituation through manipulation or modulation of the abnormal neural circuits by physical means (physical neuromodulation) like acupuncture, or chemical means (chemoneuromodulation) such as Chinese medicine, homeopathy or other modern medical techniques in a repetitious manner to mimic the habituation process" (285). This theory results in five general principles: 1. Every dysfunction arising from the periphery,...,will either immediately or eventually lead to an equivalent derangement in the equivalent neural circuitries within the CNS. 2. The CNS then responds by instituting corrective measures, resulting in the normalization of these neural circuits which then correct the deficiencies in the diseased part of the periphery to end the disease process. 3. If the normalization of the physiological programs embodied in the neural circuitries in the CNS is impaired, the initial derangement may remain status quo or can cause other neural circuits to go awry. Hence the disease either stays chronic or progresses. 4. Any event that can adversely affect any central circuitry is therefore capable of inducing pathological changes, resulting in diseases. Overly intense emotions such as anger, grief or fear can cause the central circuitries to malfunction. ...Likewise, devastatingly strong physical stresses such as excessive heat, cold, humidity, etc. are equally capable of setting up neurophysiological derangements within the CNS. These resultant malfunctions in the CNS can not only themselves cause physical illnesses, but can also set up such conditions as to increase the individual's susceptibility to other pathogenic processes. 5. The CNS itself can also malfunction due to aberrant biochemical reactions stemming from say, genetic diseases like manic depression, Huntington's, chorea, etc. (286) The theory also recognizes meridians but, states they only exist in the brain and do not exist in the periphery and are buried deep in the CNS and that "chi is nothing more than neural transmissions" (288). These transmissions can be felt "since spontaneous neural discharges do occur along these meridian pathways centrally" and "are equivalent to the flow of chi and can sometimes be felt subjectively as a sensation traveling along these pathways on the body surface" (288). Mann, lends some support to some aspects of this role of the CNS when he states, "in some places the course of meridians follows the pathways of nerves or the position of dermatomes, in others it does not" and "in most (but by no means all) instances a neurological explanation fits in with more of the observed facts than with the hypothetical meridians" (1971, 228). Breathing and movement exercises to build and control Qi have been developed and claim great therapeutic benefits. These exercises are known as "Qigong" or "Chee Kung" in Chinese and "Kiko" or "Ki Atsu" in Japanese and have much in common with Indian Yoga. Breathing is the most important aspect of this art because "to the Chinese air was non-material and could therefore only be a vehicle for the forces of energy" (1971, Mann 49). Qigong defined as "'manipulation of vital energy,' is a martial art that has been practiced in China for thousands of years" and "it is based on the premise that 'Qi,' or 'vital energy,' is a life force which runs throughout the body and can be developed and directed by Qigong exercises" (1986, Psi Research 40). "The cure of disease is said to be due to the effects of Qi, which under the influence of mind conduction, flows along the meridians and attacks the diseased site" and "Qi also operates systematically to moderate the human body's immunological functions" (1986, Shen 139). "In respect to mind-body effects," medical practitioners "clearly understood the value of Qigong in treating certain diseases" (138). The Thalmic Neuron Theory explains this benefit as resulting from "the peripherally originated stimulations from the breathing apparatus, together with the imagery-induced, neocortex-originated stimulations on the composite homunucleus, stimulate the respiration related neural circuitries and drive the chi or neural transmissions along these channels, normalizing and strengthening the neuronal functions along the way to maintain harmony or homeostasis for the entire body" or, in plain English, "internal chi drives respiration and respiration drives internal chi" (1994, Lee 298). Many of the most skeptical Western researchers explain the benefits of these exercises, without using the foreign concept Qi, as follows: Since such excercises generally include a mixture of low-impact isometrics and stretching exercises, the physical health benefits should be obvious. As for mental and spiritual benefits, these can be explained in two ways. One is the simple fact that regular exercise is good for one's mind and promotes a feeling of physical well- being. More interesting perhaps is the proved effect that meditative-type mental- relaxation excercises can have on one's health. It has been proved that if one forces one's mind to relax, then one's blood pressure, respiratory rate, and so on, are reduced. (1995, Huston 41) Several types of Qigong practice have developed and are recommended for different conditions and among the more widely practiced styles are the following: The Relaxation Exercise (Fang Song Gong). This type of Qigong is the most popular and the easiest to learn. In some ways it is similar to the Western relaxation response advocated by Herbert Benson. It is useful in the treatment of a variety of conditions including hypertension, glaucoma, peptic ulcer, spastic colitis, and asthma. The Internal Cultivation Exercise (Nei Yang Gong). This technique emphasizes the cultivation of Qi and methods of directing the Qi to the Dan Tien point (umbilical region) or the Yang Quan (middle of the sole of the foot), from which Qi is transferred into the Dan Tien, accumulating vital energy. This is effective in treating weak and asthenic persons. New Qigong Therapy (Guo Lin Gong Fa). This is a special type of Qigong in which patients are taught to exercise while walking and breathing simultaneously. Different speeds are recommended for different diseases. Crane Circling Exercise (He Xiang Zhuang). This method comprises five segments of dynamic exercise (Zhan Zhuang). The technique stresses calm and relaxation, and the exercises easily lead the patient into the Qigong state. Some negative side effects have been reported from people using this technique. The Induction Dynamic Exercise. This is a kind of motion exercise generated from the dynamics of Qi. The exercise enables a patient to perform a dance or acrobatic pattern far more expertly than he or she could carry it out without being in the Qigong State. It is indicated for certain motor dysfunctions and arthritic disease, and it helps athletes and dancers to perform more efficiently than usual. (1986, Shen 139). "In spite of these differences, there are common principles to which every type of Qigong has to adhere: mind moderation, body moderation, and breathing moderation" (1986, Shen 139). This leads to the ability to feel Qi and to direct it to specific areas with many systems seeking to complete a circle between the conception and governing meridians. "An individual's sense that the flow of Qi is small or large will vary according to how intensively the patient is practicing Qigong" (139). Not only is the practice of Qigong believed to be beneficial but, if one gains enough experience with the control of Qi and becomes a master then you can possibly use your Qi to heal others. It apparently seems that healing improves your ability to effectively control your Qi, because "it is of the utmost importance for the advanced Qigong practitioner to exercise Qi" (1986, Shen 139). Research is ongoing to determine if emitted Qi from Qigong masters has any actual physical effect. "Researchers at Jiao Tong University in Shanghai have shown that human energy displays electromagnetic properties when flowing within its own meridians, but takes on characteristics of light energy, somewhat similar to lasers, when emitted out from the body through the hands" (1994, Reid 262). This "emission of the external Qi has proved to be closely related to mind conduction" (1986, Shen 140). This Qi "beam of energy projected from the healer's hands travelled over distances of 26-165 yards without a drop in power" and "penetrated 4 inches of leather, 2 inches of wood, 2 inches of brick, and two sheets of iron" (1994, Reid 262). The application of the Western scientific method and Western allopathic medicine to examine the benefits of Qigong has been undertaken only recently. In 1978 a new policy was announced by the Chinese government to scientifically research Qigong and "thousands of people began practicing Qigong and scientists began to conduct research with Qigong masters" (1986, Shen 138). "Advancement of Qigong practice and research achievements eventually stimulated the government's approval of the establishment of the Chinese Society of Qigong Science and Research in April 1986" (138). The medical usefulness of Qigong is still a matter of dispute and much of the research tends to focus on the healing power of masters rather than the benefit of practicing the exercises. However, research has shown "some substantial evidence of the function of Qigong" in many experiments (140). "In China, organic and functional Qigong-treatable diseases, documented in publications include: essential hypertension coronary heart disease, rheumatic heart disease, heart arrhythmia, asthma, obstructive pulmonary disease silicosis, peptic ulcer, chronic hepatitis, spastic colon, hemorrhoids, myopia, headache, dizziness, neurasthenia, mild and moderate cases of myasthenis gravis, and subacute and chronic stages of stroke" (139). Researchers have reported that after Qigong treatment the following effects were observed: "Changes in the way light was diffracted through liquid crystal, after a Qigong master sent his Qi to it for 15 minutes, from a distance of 10-50 cm; ... a 60-80%reduction in the number of bacteria, about a 30% reduction in cervical cancer cells, and about a 50% reduction in influenza viruses after a Qigong master performed exercises around petri dishes and test tubes containing them" (1986, Psi Research 40-41). "Recently, in a preliminary experiment, Chen demonstrated that the external Qi of a Qigong master could depress the growth of cultured BEL 7402 human liver cancer cells" and other researchers have "revealed that external Qi directed at peripheral blood in vitro can induce increase of plasma cAMP and can enhance the phagocytic function of macrophages" (1986, Shen 140). Wang discussed the biological effects of infrared radiation. First, the thermal effect is produced by far infrared radiation. Second, the nonthermal effect is produced by near infrared radiation. Third, absorption and penetration of infrared radiation are influenced by pigmentation of skin, degree of reflection, and distal permeability. (140) Some research suggests that there can be more than a single manifestation of Qi which would be in accord with the yin and yang conception of the theory. "Two kinds of external Qi, functionally speaking, were suggested by Feng: that which depresses the growth of coliform bacillus has a destructive effect, and that which promotes growth has an enhancing effect" (140). Various methods are employed to detect and measure the external manipulation of Qi. "Koo reported that so-called external Qi emitted by highly experienced Qigong masters can be detected using an infrared radiation receiver" and he identified it as " low-frequency infrared radiation" (1986, Shen 140). Another method employed "an AGA 750 Thermal Image Instrument" to measure "thermal image change in the arm and hand of a Qigong master exercising Qigong" it was observed that "temperature rose 2 to 4 degrees centigrade while the image of the flow of Qi linked up in a line much more marked and much clearer than prior to exercising Qi" (140). Both the thermal and image change disappeared and reverted to the original state when Qi flow was stopped and "in healthy persons, this phenomenon did not appear, no matter which procedure a person was taught to perform" (140). "Recently, Lu and his group, using liquid crystal and a He- Ne Laser instrument, have demonstrated that 7 out of 14 Qigong masters emitting external Qi were able to produce double-beam refraction while directing their palm toward the liquid crystal. Different strengths of Qi from the Qigong masters have produced different degrees of double refraction" (140). The concept of the energy system of the body has resulted in some very interesting applications and practices. There are many ways of conceiving of this life-force whether it be as Qi or as nerve transmissions it still involves some type of bioenergy. This concept is certainly worthy of more intensive investigation by Western science and medicine. The concept of this life force can have very tangible results in many areas as stated very well by Tart: If ki is nothing more than an imagined picture, a deliberate but arbitrary visualization, the forms in which we image it should be almost unlimited, since we can imagine almost anything. The fact is, though that visualizing ki as something fluid that is flowing freely, while subjective, has objective effects .... Images, the subjective, can be a very effective way of guiding your body. So in some ways, ki is subjective and imaginary, but it can be an effective use of imagination, especially if the visualization is strong and appropriate. By analogy, the electrical flow comprising the program in a computer is subtle and subjective compared to the solid reality of the hardware. Without a correctly written program to guide it, though, the hardware doesn't do anything useful. (1987 343). The traditional Chinese system has much to offer and teach to Western science and medicine that we are only now beginning to learn and independently confirm. The system is based on very long periods of observation of the human condition and much of the information is difficult to access because it is very intertwined with the rich and complex culture in which it evolved. Slowly, we are beginning to untangle the beneficial practice from its original cultural context and changing it to suit our Western scientific belief model, however, we must be wary of the danger involved in such an undertaking so that, in the translation, nothing of great value is lost simply because we cannot explain it.