Fundamental to TCM is the concept of qi, characterized as life force energy that flows through the body, maintaining balance and overall well-being, much like the force in Star Wars. Classical definitions of qi in TCM describe it as both a tangible and intangible force. It includes physical aspects derived from air, water, and food, as well as vital fluids and energy flowing through the body's meridians. Qi maintains the body's functions and health by ensuring smooth and harmonious energy flow. Imbalances in qi lead to illness and discomfort.
However, by maintaining a purely qualitative perspective on qi, we risk trivializing this profound aspect of TCM, reducing it tO mystical or new-age rhetoric rather than recognizing it as an essential component of an effective method for treating seriious illness. To bridge the gap between traditional and modern perspectives, we can look at historical precedents that provide a neurological understanding of qi. In his work on the biliary system, in L'Acupuncture Chinoise, George Soulié de Morant explains that from the perspective of TCM, the gallbladder meridian encompasses not only the meridian itself, but also the organ, the bile duct, the sphincter of Oddi, and the associated nerve plexuses responsible for the biliary reflex. Soulié de Morant highlighted the importance of maintaining open and unobstructed fascia pathways for qi utilization within the body. This concept can be applied more broadly to understand how the utilization of qi includes the local cellular environment.
Developing the Concept of Qi
PVT illustrates the cascade of events in the fight-flight-freeze response on both systemic and local levels. Effective care must consider both the quantity of qi and the cellular environment's patency. A parasympathetically neutral or dominant environment is required for all processes in the ANS that include rest, digest, and repair. "Qi," as a qualitative description of the body's vital energy, encompasses both its quantity and its availability in terms of cellular biology. Without a parasympathetically neutral environment, essential functions such as rest, repair, and digestion are inhibited at the cellular level. Additionally, the extracellular matrix (ECM) is skewed towards myofibroblast differentiation, resulting in the deposition of more fibrotic tissue with less elastin and more bone-like qualities.
With a broader understanding, qi is not merely the amount of energy, like filling a gas tank; we must consider the cellular environment where cellular respiration occurs, and what affects communication between areas. The sympathetic charge (yang/+) in the ECM significantly inhibits local biochemistry, resulting in diminished rates of ATP synthesis and reduced repair processes in cells chronically in a high arousal state. Therefore, our understanding of qi in TCM should include considerations of patency, glucose transport, insulin, the ECM, enzymatic activity, and the state of sympathetic charge systemically. More simply, when the ECM is in a yang dominant state, the aspects of rest, digest, and repair (Ying Qi) are prevented from occurring at their optimal levels. These factors are at the root of the indurations and areas of tension observed in Fukushin or Hara diagnosis.
Recent studies illustrate some of the effects that elevated stress levels have on the body's response to insulin and glucose. Studies conducted by the American Diabetes Association have investigated the effects of sleep restriction on insulin sensitivity in healthy young men. These studies found that short-term sleep deprivation, restricting sleep to 5 hours per night over a week, led to reduced insulin sensitivity and diminished glucose uptake. Sleep restriction increased cortisol levels and reduced cellular uptake and responsiveness to insulin. Even short-term sleep deprivation can significantly affect insulin sensitivity and glucose metabolism, tilting the body into sympathetic dominance, creating temporary insulin resistance in healthy individuals. Therefore, restoring the yin-yang balance (sympathetic/(+) charge/yang and parasympathetic/(-) charge/yin) of the ANS must be addressed as part of the root treatment.
Of we extrapolate to our society as a whole, we see that much of the planet is in a metabolically diminished state due to chronic sympathetic dominance. Individuals working long hours, double shifts, overtime, and parenting sick kids are often functionally metabolically resistant. Optimal absorption and learning are severely hindered in this state. Residents in graduate school traditionally do 80-hour weeks, and first responders often work 70-hour. Working parents? 100-hour weeks. If chronic sleep deprivation impacts one hormone this significantly after 7 days, what is the impact when this state is expanded to 6 billion people and years of deprivation?
Sympathetic dominance hinders the absorption and effective utilization of qi (in the form of glucose-insulin and cellular respiration), with cells less able to perform essential functions like ATP production. Therefore, a qualitatively description of qi in TCM must include consideration of cell receptivity, reflected by glucose transport, insulin, the ECM, enzymatic activity, and the local cellular environment. Ying Qi, representing nutritive aspects, must include oxygen-rich blood and adequate insulin to support proper cellular respiration and energy production. Without a parasympathetically neutral environment, the body's ability to maintain optimal cellular function is compromised. Thus, addressing chronic sympathetic dominance restores parasympathetic balance to the ANS. It illustrates how expanding our understanding of qi from a mere concept to a comprehensive view of metabolic function contributes to systemic treatment.
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