China, Chi, and Chicanery: Examining Traditional Chinese Medicine and Chi Theory
Traditional Chinese medicine is thousands of years old and has literally more than a billion satisfied customers. Many of its treatments and teachings are based on the effects of Chi, a mystical form of bio-energy.
Today in America, traditional Chinese medicine is undergoing something of a rebirth. Although at first this seems curious, from a historical perspective and seen in hindsight it is really not much of a surprise. The history of Sino-American relations is in part a story of Americans looking to the East and interpreting a huge, complex, and, to an outsider, confusing culture in such a way that they see what they desire or fear the most. Like a cosmic Rorschach test, China has been many things, including the Yellow peril, the Red peril, and paradoxically a land full of loving workers united in harmony and living in communes. During the Depression to many “the China market” was going to save us and our economy. Ronald Reagan once referred to China as a “so-called Communist country; when in fact it actually was (and still is) a Communist country.
Today, many people, often with good reason, are apprehensive about modern scientific medicine. Although it is undoubtedly one of the most effective forms of health care ever seen on earth, there is little doubt that modern science has produced a system of care that can be frighteningly impersonal. Too often the patient is reduced almost to the level of a defective machine while being cared for by an overworked staff of specialists with little chance to provide the patient with personal attention or emotional support. Treatments tend to be invasive, frighteningly complex in theory and practice, and seem to function without any input from the patient. The sterile hospital walls, mysterious shots and capsules, and complex machinery seem far removed from how nature intended us to live. Occasionally we read of treatments that cause serious harm, and of cases where impersonal healthcare results in accidental, or sometimes even intentional, tragedies.
It was almost inevitable that many people would look for alternative forms of treatment, and that traditional Chinese medicine (TCM) would be one of them. At first TCM seems to be Just what the doctor ordered.” With its long history, many assume its techniques have been proved to work. Others are attracted by its emphasis on gentle remedies made from organic compounds. TCM emphasizes improving bodily harmony and focuses on the growth of Chi energy. Since TCM was a subject of Bill Moyers’s recent television series, “The Mind and Healing,” which surveyed much of the system’s appeal in an interesting manner, I will occasionally cite examples from that show.
The basis of much of TCM’s teachings lies in the manipulation of Chi, supposedly one’s life energies. It is nearly impossible to give a definition of Chi without somehow mentioning “energy.” With few, if any, peculiar exceptions, to be alive means to create, use, and exchange energy. This energy is of many different sorts. For instance, we are dealing with one sort of chemical process when we digest our morning bowl of breakfast cereal. We use a different sort of energy when our muscles are activated to throw a basketball. And when the brain creates small amounts of electricity to pass down to the nerves and stimulate the muscles and the heart to contract, this electricity is created by a large number of small cellular microbatteries inside the skull.
But this is a new and relatively unnatural way for humans to see themselves. To the ancients it seemed natural to hypothesize that the energy of life was a single and quite special sort. This idea continues to flavor some of our popular notions when we speak of a “life force” or when we refer to a person who appears vibrant and energetic as being “full of life.” The Chinese of ancient times felt, and many if not most Chinese today feel, that there is a special sort of life energy that flows through us and keeps us alive.1 This energy is called “Chi” or “Qi.”2 According to traditional Chinese thinking, the Chi flows through our body in a rhythmic manner, and most acupuncture and acupressure methods employ stimulation of points that lie along the acupuncture “meridians” through which Chi is said to flow. When one manipulates an acupuncture point, the traditional explanation for any effect that occurs is that it is caused by an alteration of the flow of Chi under that point.
In TCM, the notion of Chi and Chi-flow is probably the single most important concept. If a patient is feeling weak and lethargic, then a healer will embark on a course of action that he or she feels will increase the patient’s flow of Chi. He will do this according to carefully taught ancient techniques. Treatment options might include changes in diet, a prescribed course of exercises, massage, herbal or other organic medicines, and perhaps techniques like acupuncture, although Westerners should keep in mind that these are only one small part of the overall system. There is also the more esoteric belief that through the manipulation of Chi one can ultimately learn to perform superhuman feats and display miraculous powers. Claims for these powers vary greatly, some of which make one immediately suspicious, such as telepathic effects, telekinetic effects, invulnerability to injury, and so forth.
There has been considerable interest in the West in the effects and applications of acupuncture anesthesia. A typical, yet highly dramatic exhibition of this technique was shown on the Moyers series. The patient had a brain tumor and needed surgery to remove it. The procedure was performed in what appeared to be an operating room by a Chinese surgical staff The surgical techniques appeared to be quite up to date, the only addition being the inclusion of acupuncture as a supplement to a greatly decreased dosage of conventional sedatives and anesthetics. The patient remained fully conscious throughout the operation, and Moyers and his travel companion, David Eisenberg, M.D., an American expert on TCM, were allowed to observe the proceedings. Moyers and this home viewer were noticeably impressed.
Yet before wholeheartedly accepting this as a miracle, we have to stop and look back at the procedure to see what it says about the capabilities of the body and the possible role that Chi played in the process. Can science explain this anesthetic effect?
As in so many such cases, we must first define the effect for which we wish to find an explanation. The claims of acupuncture anesthesia cannot be accepted without careful analysis. Acupuncture anesthesia came to the attention of the Western world dramatically when James Reston, the New York Times journalist, developed an inflamed appendix while in China in the summer of 1971. Acupuncture anesthesia was used, and this organ was removed in Beijing’s Anti-imperialist Hospital (Porkert 1982). The name is significant and typical of the time, for it was during China’s notorious period of chaos known as the Cultural Revolution. At this time, ultra- Communist ideology gripped the country. Those who were suspected of “counter-revolutionary tendencies” often found their homes ransacked, their careers ruined, and themselves shipped off to the countryside to “learn from the peasants through labor.” The only way to keep oneself alive and remain afloat was to keep one’s mouth shut, and when asked a question, to repeat the official party line.3
This is relevant to acupuncture anesthesia and the belief that it showed great untapped potential, because it was part of the official party line. To question its effectiveness, even in a scholarly manner, was to risk seeming disloyal and suffering personal injury or disruption of one’s career. Whether they liked it or not, many medical practitioners were virtually forced to use and parrot the effectiveness of acupuncture anesthesia regardless of their opinions about its usefulness (Keng and Tao 1980). Needless to say, this is counterproductive to good scholarship. Since it was during this period that interest in TCM began to develop in the West, it is not surprising that many books from this period were translated into English. Some are still in print, and few question the efficacy of the techniques described in the texts.
Although it was impressive that, during the operation on the Bill Moyers program, the patient was fully conscious and alert, this is relatively standard practice in many types of brain surgery in both the West and China. By keeping the patient conscious, the surgeons are able to carefully monitor the effects of their work and the stimulation of various portions of the brain. Furthermore, the amount of pain considered to be tolerable by a human being varies greatly from culture to culture (Baker 1990). It is probably safe to say that modern Americans expect little pain and modern Chinese routinely tolerate more discomfort than does the average world citizen. Speaking from personal experience, I’ve seen (and felt) Taiwanese general practitioners perform foot surgery, treating both an infected puncture wound and an ingrown toenail with amazingly little anesthesia and a surprisingly loud patient. (I was one of these patients, and the doctor found it quite funny that I screamed when having a little thing like a scalpel cut into my foot.)
But to some extent these are peripheral issues. Although the effects of acupuncture anesthesia are undoubtedly exaggerated, few doubt that it does in fact have an effect. Can science explain this without resorting to Chi theory? The scientific explanation lies in the “gate theory.” According to this theory, the nerve is gently stimulated by insertion of a needle. This gentle stimulation prohibits the passage of stronger pain signals down the same nerve and produces an analgesic effect (Lu and Needham 1980).
But it is important to understand that acupuncture anesthesia is only a small, but dramatic, part of the overall uses of acupuncture. And acupuncture in turn is only a small part of TCM, a unified system of healthcare. It is a holistic system of healthcare that is based on ancient ideas about how the human body works. Often these concepts are in conflict with modern science, but it seems fair to say that despite this, at least some of its treatments do provide relief or cures for some afflictions. Among its treatment modalities are changes in diet and lifestyle, herbal and other medicinal treatments, exercises, and stimulation of various points on the human body through various means.
There are a variety of points on the human body that are traditionally stimulated in acupuncture, and practitioners believe that these points are generally indicative of the underlying flow of Chi throughout the body. The exact number of points is controversial and varies from school to school and historical period to historical period, but most practitioners today probably employ more than 600, spaced relatively evenly over the surface of the human body. Stimulation of these points can be accomplished through various means. The three most common of these are manipulation of the points by hand (called either “massotherapy” or “acupressure”), stimulation by insertion of needles into the points themselves (acupuncture), and stimulation by heat (referred to as “moxibustion” after the herb moxus, which is normally burned to provide the heat).
Some of these acupoint treatments may work, but it is surprisingly difficult to know with any accuracy which ones do. Ironically, this is due to the mind’s ability to affect the health of the body, which is one of the main appeals of such systems anyway. If one places a needle in a person and the treatment works in the way in which the patient believed it would, was the cure due to the needle or the belief in the effect of the needle? Naturally, no one can say with any accuracy, and most Chinese consider the point to be pretty much irrelevant just so long as the cure does in fact work through one means or another. With new drugs, tests can be designed that involve substituting inert placebos for a drug, but it is quite difficult to develop a test that resembles acupuncture that does not, in fact, involve sticking needles into people.
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.
A variety of exercises are designed to improve one’s Chi, and therefore one’s health. One common example is Tai Chi Chuan, best described as a sort of slow-motion kung fu. It does seem to have many positive health effects. A variety of exercises known collectively as “Chi gong” are somewhat similar. Still these effects can be described without invoking Chi theory. Since such exercises 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 ones mind and promotes a feeling of physical well-being. More interesting perhaps is the proved effect that meditative-type mental-relaxation exercises 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. Herbert Benson, a medical researcher, has termed this effect the “relaxation response,” and meditation is said to be one of the most effective means of producing it.4 Since Tai Chi Chuan and other Chinese exercises do involve systematic mental programs of mood and mind training, it is only natural that they should produce this relaxation response among practitioners.
It is a widespread belief that one who has trained extensively in Chi gong can produce effects that take place outside the body and often seem to defy the laws of science. Unfortunately for believers, these feats are rarely, if ever, performed under properly controlled conditions. To the best of my knowledge, these effects have not been proved to occur in such a way that they cannot be explained by our current understanding of science. In some cases, for instance, when martial artists break concrete or wood, they may believe that they are using Chi when in fact the feat is quite explainable within physics as we understand it.5 Invoking Occam’s razor, that the simplest solution consistent with the facts is more likely to be true, We are once again left without evidence of Chi.
Other feats are much more difficult to explain and require the services of a qualified magician to help design control conditions. When such conditions have been provided, the effect of the Chi power again disappears, leaving little or nothing to support the existence of these powers. A 1988 CSICOP delegation to China provided such tests, and without exception remarkable powers failed to manifest themselves (Kurtz et al. 1988). Sociologist Marcello Truzzi (1985) had a similar experience. I viewed a report on a supposed test of Chi gong-inspired psychokinesis in Taiwan, and I was appalled at just how poorly designed the test was. This response was doubly felt since I had just finished reading James Randi’s The Truth About Uri Geller. The parallels were simply overwhelming.6
These powers, as alleged proof of Chi, were shown in the Moyers series in a segment in which Moyers viewed a Chi gong teacher known as Master Shi. In a dramatic episode, Master Shi allegedly demonstrated his control over Chi by such acts as pushing over large numbers of students with one hand, and in turn not allowing himself to be pushed over when a large number of these same students shoved him in unison. In a particularly dramatic incident, one of the students, an American studying in Beijing, attempted to pick up and throw Master Shi, but met with no success.
I have watched this Moyers sequence carefully about a half dozen times to see if there was any evidence of fakery on the part of the students or the teacher. I have noted the following: Different students when pushed by the same wave of Master Shi’s hand fall and roll different distances. Similarly, the students have different expressions on their faces. As they are thrown back, some grimace as if the experience was unpleasant, while others laugh and seem to enjoy it. Meanwhile, Eisenberg seems somewhat unimpressed by these performances. The American student then announces that he is going to try to pick up his Chi gong teacher and throw him down on the ground. He explains to Moyers that he really does want to do this, while Master Shi, who presumably speaks no English, looks on with apprehension from the background. The student then slides into throwing position and grasps the teacher’s arm. His body trembles with the apparent effort of this attempt at a throw. Meanwhile Eisenberg yells, “Try harder. You look like you’re faking.” The student’s foot begins to flop around like a dying fish, supposedly to show just how much effort he is evincing in this attempt to throw this man to the ground. Ultimately, he gives up and announces that Master Shi is reversing his energy through his use of Chi gong and that it is in fact.humanly impossible to pick up and throw his teacher.
I offer the following comments, which should supplement Eisenberg’s (“You look like you’re faking”). Most Asians, particularly a Chi gong instructor, are quite concerned with face and image. If one is interested in his teacher’s saving face, then it is quite important not to bounce him on his head on international television. If you do so, then the teacher might, at the very least, not teach you anymore. Second, I have found myself in many situations where I have been required for one reason or another to lift people up off their feet and into the air (ambulance attendant, hospital orderly, rock- concert security guard, older brother, happy uncle, etc.). Step one in picking up another person is pretty much always to make sure that you have your feet firmly planted on the floor, or else you both might land on your faces as you fall over. It would seem that before we accept this segment of the Moyers program as cause to revamp Newton’s laws of motion, we should at the very least conduct a few controlled tests to see if the student just might have been trying to make his instructor look good in front of Bill Moyers. I’ll leave to someone else the mechanics and ethics of designing a double-blind test to see if a martial-arts student can throw a non-Chi gong master more easily than a Chi gong master.
Having surveyed the evidence so far, there seems to be little evidence of substance that supports the existence of Chi. Although some, including myself at times, find this quite disappointing, it is really not too surprising when we look at the extent of the claims and the way science works. Science and scientific theories and knowledge don’t just happen arbitrarily. They are developed based on careful observation and testing over the course of many years, if not generations. Chi theory states that the function of the human body is based on a system of energy that circulates throughout all other existing systems and integrates with them all. There is no evidence that such a system exists. Similarly, if such a system does exist, but for whatever reason has managed to avoid detection by science, then it would seem logical that there would be large and sweeping gaps in our knowledge of human physiology every time we examined a system that the Chi interacted with. In other words, if Chi controls and influences the behavior of the human body, and we have not detected Chi, then the existence of Chi would be conspicuous by its absence. Personally, I believe that further study of traditional Chinese medicine should uncover many valuable things, such as some useful herbal treatments. I also believe that modern medicine and healthcare have many problems that should be looked at seriously and possibly fixed. Despite these, it is important to examine any body of knowledge critically before employing it for anything as important as healthcare, and this includes the traditional arts and sciences of other cultures. If one wishes to truly understand something, one must be willing to look beyond the explanation traditionally presented. To be truly open-minded, one must be willing to step beyond the boundaries and limitations that have been inherited. To pursue the truth, you must be willing to consider the teachings that cultures have to offer, but you must also hold those teachings up to careful examination.
- Actually this life force, Chi, is believed to flaw through everything that exists in varying amounts, not just living matter. The study of how Chi flows through landscaping and living environs and how it can he manipulated to benefit humanity is known as “feng shui,” or Chinese geomancy. Feng shuj is still taken quite seriously by many people throughout China.
- Chinese is, of course, written in Chinese characters and not the Roman alphabet. There exist two commonly accepted forms of Romanization in widespread use and at times the differences in the two systems can result in widely divergent spellings of the same Chinese word. For instance, in previous articles (e.g., Kurtz, et al. 1988) the official Chinese Pinyin system of Romanization was used, resulting in the spelling “Qi.” This is the system of Romanization in use in all official documents and is favored for reporting current events in China in the West. Bill Moyers’s spelling of “Chi” is from the much older Wade-Giles system of Romanization which is favored in Taiwan and by Western historians. The latter tends to appear more frequently in Western documents regarding the traditional and anomalous Chinese claims. “Ki.” the Korean and Japanese equivalent for “Chi,” is also frequently seen in the West and appears in words such as at-ki-do” and “hapkido,” two interesting martial arts that incorporate Chi theory into their teachings.
- For a readable account of what it was like to grow up in this period, see Heng and Shapiro, 1983.
- It should be mentioned that many do not like the work of Herbert Benson. I do. He has a tendency to express an interest in some of the spiritual and theological aspects of the systems that developed the meditative procedures that he studies to an extent that some find distasteful.
- There has been discussion in these pages in the past as to how and why martial artists insist on breaking things by striking them with their hands, feet, or other body parts. This is done normally to test one’s ability or to increase one’s self-confidence, although there is a great deal of debate within the many-faceted world of martial arts about what pragmatic use such acts actually have. Although some have suggested that martial artists treat wood and other targets to make them more easily breakable, it is important to understand that in some cases they actually treat materials to make them more difficult to break and thus increase the challenge. Having broken many pieces of wood and other material with my body over the years, I will simply say that, although it is sometimes a silly thing to do, it is also a lot of fun.
- For those, like me, who have a strong interest in studying alleged Chi powers but lack a thorough background in conjuring and magical effects, I cannot recommend the Leung Tang (1983,1991) books highly enough. Written by a Chinese magician in Hong Kong (in English) they explain numerous means of recreating the very same effects that many Chinese attribute to Chi gong and other mysterious powers. Unfortunately, these books can be quite difficult to find in the United States, but large martial arts suppliers sometimes have copies for sale. These dealers advertise in martial-arts magazines and elsewhere.
- American Institute of Physics Science Report. 1990. The fiercest punch — the physics of a Karate strike. SKEPTICAL INQUIRER, 15: 25-26, Fall.
- Baker, R. A. 1990. They Call it Hypnosis. Buffalo, N.Y.: Prometheus.
- Benson, H., and Z. Kipper. 1975. The Relaxation Response. New York: Avon.
- Benson, H., and W Proctor. 1984. Beyond the Relaxation Response. New York: Berkeley.
- Dennert, D. 1991. Consciousness Explained. Boston: Little Brown.
- Heng, L., and I. Shapiro. 1983. Son of the Revolution. New York: Vintage Books.
- Ho, S. I, and L. K. Lu. 1981 . The Principles and Practical Use of Acupuncture Anesthesia. Reprinted by Southern Materials Center, Taipei, Taiwan. This appears to be a reprint of a Mainland text or Hong Kong translation of a Mainland text. I have thus far been unable to learn the original publisher.
- Huston, Peter. 1994. Trying to understand traditional Chinese medicine. SKEPTICAL INQUIRER, 18: 207-208, Winter.
- Keng, H. C, and N. H. Tao. 1985. Translated by P. U. Unschuld, “The Evaluation of Acupuncture Anesthesia Must Seek Truth from Facts.” in Medicine in China: A History of Ideas, by P U. Unschuld, University of California Press, Berkeley.
- Kurtz, Paul. 1988. The China Syndrome. SKEPTICAL INQUIRER. 13: 46-49, Fall.
- Kurn, P, J. Alcock, K. Frazier, B. Karr, P J. Klass, and J. Randi. 1988. Testing psi claims in China: Visit of CSICOP delegation. SKEPTICAL INQUIRER, 12: 365-375, Summer.
- Leung Ting. 1983. Skills of the Vagabond. Hong Kong: Leung’s Publications.
- —-. 1991. Skills of the Vagabonds II: Behind the Incredibles. Hong Kong: Leung’s Publications.
- Lu, Gwei-djen, and Joseph Needbam. 1980. Celestial Lancets: A History and Rationale of Acupuncture and Moxa. London: Cambridge University Press.
- Marcus, P 1984. Acupuncture: A Patients’ Guide. Wellingborough, Northamptonshire, England: Thorson’s Publishing Group.
- Porkert, M., with C. UlIman. 1982. Chinese Medicine. New York: William Morrow.
- Randi, J. 1982 [1975). The Truth About Uri Geller. Buffalo, N.Y.: Prometheus Books.
- Unschuld, P U. 1985. Medicine in China: A History of Ideas. Berkeley: University of California Press.
- Watkins, Arleen J., and William S. Bickel. 1989. The Kirlian technique: Controlling the wild cards. SKEPTICAL INQUIRER, 13: 172-184, Winter.
- —-. 1986. A study of the Kirlian effect. SKEPTICAL INQUIRER, 10: 244-257, Spring.