Thoughts on the Relevance of Qigong to the Understanding and Practice of Chinese Medicine

Despite its fundamental role in the genesis of Chinese medicine, qigong is surprisingly little understood by Chinese medicine practitioners and students. The practice of qigong, which ultimately connects us to the Dao - the natural and all-pervading way of things - can form a vital middle way between the excessively intellectual and analytical, and the superficial ‘new age’, approaches to Chinese medicine education and practice. It is through experiential qigong practice that practitioners can learn to become true healers, and patients can learn to heal themselves.

When your body is not aligned,
The inner power will not come.
When you are not tranquil within,
Your mind will not be well ordered.
Align your body, assist the inner power,
Then it will gradually come on its own.
Nei-Yeh (Inward Training, 4th century BCE), chapter 111

Although becoming more well known, the concepts and practices of qigong are still obscure to a surprisingly large proportion of contemporary practitioners and students of Chinese medicine. This is surprising, given the fundamental role that qigong has played in the very genesis, and in the subsequent development, of that which they practise.
So, what, essentially, is qigong, and what is its relevance to Chinese medicine, in particular to its clinical practice?
Such questions are really only to be answered by the one who asks, for qigong is an experiential thing, something that needs to be (correctly) practised and experienced, and then the body knows what it is. It is in the doing that knowingness - and relevance - arises.
We can, however, gain some understanding of what it is, and what it may be, by undertaking a brief journey back to its roots.
Qigong (literally 'skill in cultivating the dynamic life-force') is a contemporary term used to describe an ancient Chinese method of health-care based upon correct breathing and specific movements designed to open, release and connect the body. This integration of breath and movement is formulated to influence the free and harmonious movement of qi and blood, and promote a state of well-being in body, mind and spirit.
Although other ancient cultures had similar indigenous forms, few seem to have been as refined and continuously practised as the Chinese methods.
Scholars, and the secret teachings of the more classic traditions, generally place the genesis of what we know as qigong today to the first millennium BCE, possibly a little earlier. At this time the practices were known as daoyin exercises and were an essential aspect of yang sheng shu, the art of nourishing life. They were based on the shamanic concept of establishing a connection to, and communication with, the world surrounding human existence.
One of the axioms of original and classical qigong practice is its ability to communicate with the Dao, the natural and all-pervading way of things. Scientific opinion (e.g. quantum mechanics) increasingly entertains the idea that we live in a pervasive field of bio-connectivity. This represents a paradigmic shift away from the earlier, alienating Descartian mind-body separateness, and the later constructs (and constraints) of Newtonian law. It would seem that both ancient and modern thinking is inexorably reaching a similar conclusion, that, as spatially insignificant as we may seem, the greater reality is that we are intimately and inter-dependently enmeshed in the vast scheme of things.
It was close, systematic and inspired observation of the rhythms and cycles of nature, and the movements and innate characteristics of animals in the wild, which became the basis for this method of universal intercourse and evolved into what is known as qigong today.
One of the first, possibly the very first, formal methods to emerge and develop from this early shamanic period in human history was the 'Five-Animal Primal Qigong set' (Wu Qin Yuan Xi), and the essential aspects of its conception and practice remain with us today. Although it was modified to some extent by later Daoist worldview concepts, and still later by practitioners with a more considered approach to the principles and practice of Chinese medicine, the original intent of this form - to access, awaken and free the primal spirit - remains undiminished.
Other classical systems which developed directly from, or were inspired by, this deeply influential approach were the Bone Marrow Washing set (Xi Sui Jing), the Muscle/Tendon Changing set (Yi Jin Jing) and the Eight Pieces of Silk (Ba Duan Jin), as well as several sets of Daoist longevity exercises, including special qigong walking forms.
All these classical methods were embraced by different schools, and modified or selectively practised according to the specific interest and needs of that school, whether the health and longevity focus of the Medical school, the strength and neigong ('inner skill') intentions of the Martial school, or the spiritual aspirations of the Meditative school. In fact, as any developed practitioner of qigong will know, there is development in every aspect of these three traditions that occurs with correct and consistent practice of any one of them, and such categories seem both unnecessary and irrelevant if one practises the classical methods correctly and mindfully.
The modern history of qigong includes a period in which its practice (and that of the martial arts) was officially banned during the so-called Cultural Revolution, a particularly ignominious period of Chinese history from which China and her people have yet to recover. Nevertheless, notwithstanding refinements along the way, the classical qigong systems remain today, essentially unchanged.
Understanding this background, students, practitioners and scholars will begin to have a deeper sense of the fundamental association of qigong with the development of Chinese medicine. They will better understand how these early Shamanic practices gave rise to the conceptual theories that form the very basis of Chinese medicine, from the deceptively simple but all-pervading concept of yin and yang, its natural extension into four (and later five) phase observation of the transformation of all things, and into the eight-directional (ba gua) concept. Given this understanding, practitioners may well begin to ask themselves whether the practice of qigong could be beneficial to them, both on a personal and a professional level, and whether to engage in its (correct) practice may influence and develop in themselves that which they seek to access and develop in others - the harmonious, full and timely movement of qi, blood and spirit.
It is with this understanding that the practice of qigong can take on a deeper significance. As we become increasingly aware of opening, releasing and connecting our inner world, both structurally and energetically, we begin to feel, to sense, to 'extend beyond the self' and enter a world previously unknown to us, a world where we become aware of a conscious interplay with all that is, and (by natural extension) all that has been and all that will be.

To some, this is the 'spiritual' side of qigong, yet the general Western connotation of the word 'spiritual' is not what is alluded to in classical qigong work; nor in higher level martial art skill. Rather, what is meant is that, through cultivating a 'spirited' practice, there is a natural extension and bio-connectivity of our innate life vitality into the Dao, the all-pervading and fundamentally elusive Unknown.

This extension beyond (or rather, extension into) however, depends not upon exclusively mind-orientated concepts and practices, but rather upon sound structural (physical) and functional (energetic) roots. It is from this base that the human spirit can most fully and radiantly shine. This is 'shen ming', the radiance and projection of the inherent life-vitality, essentially dependent upon the anchoring and sustaining nature of our essence. Traditional qigong and martial arts practices pay particular attention to the cultivation of these structural and functional factors.

It is an often repeated admonition that you first need to strengthen and deepen the roots, and in such classical training, spiritual practices are much better defined as spirited practices. In fact, most Daoist schools of thought (for example, the Lung Men, Dragon Gate school) and all traditional internal martial arts systems, stress the importance of non-spiritually orientated endeavour, understanding that such unfoldings are a natural consequence of what, to the Western mind, may seem more basic practises.

In this context, to 'treat the spirit' in Chinese medicine might be more realistically interpretated as ensuring that the roots, the foundations of the spirit (the life-seeking, life-sustaining drive) are in sound order, relative to the individual. It is this order, this sustainable source, which allows the free and unfolding movement of a spirited and maturing approach to life and all its trials and tribulations, as well as its joys and its pleasures.

To develop this sense of order and well-being within oneself would seem to be an almost fundamental requirement - even a responsibility - for anyone entering any healing profession, particularly one with the depth that Chinese medicine, in its full and wholistic manifestation, encompasses.
It is a natural extension of this practitioner commitment that a therapeutic presence arises from within, one which has a subtle yet often profound effect upon any clinical encounter, and may indeed lead the patient, both consciously and subconsciously, to a different state of being, and potentiate a different outcome than may have otherwise been possible.
The other natural outcome of this deeper realm of practitioner awareness is the development and refinement of one's diagnostic skills through the heightened sense of energetic sensitivity that so often accompanies any developing qigong skill. This refinement of diagnosis by pulse, by observation, and by a knowing born from stillness, opens us to a new level of therapeutic engagement, helping us more deeply assess the appropriate needs and treatment protocol for each individual patient, each unique manifestation of matter and energy, who seeks our assistance.
The qigong trained practitioner is also in the position of being able to offer prescriptive qigong to those patients he/she feels would benefit. Indeed, there are a number of clinical scenarios where qigong is the treatment of choice, given its inherent ability to powerfully move stagnant qi and blood, which, of course, lie at the very core of many states of disordered being, and are often implicated - directly or indirectly - in most clinical presentations.
In doing this, in so educating our patients, we are able to give them not only an individually tailored and relevant prescription (much like classical Chinese herbal medicine), but also a tool of substance to actively assist in their own recovery and to foster their own awareness. This is intrinsically empowering and develops both self-worth and self-responsibility, two of the greatest gifts we can give to those who come to our door. It is then that the practitioner begins to enter the realms of healer, an often misunderstood (and misused) word today, bearing little relevance to the common and superficial new age use of the term.
In some ways, practitioners of Chinese medicine have both a historical and a personal responsibility to 'be all that they can be' in this context, and to not only uphold and continue this unique approach to fostering and maintaining wellness of being, but to embrace and support the innate push of the human spirit to develop and refine the concept of well-being, of being well, even further.
However, we have been witness to some degree of naivety and ignorance - and not a little invention - in the development and presentation of Chinese medicine in the West and, to a lesser but significant extent, in China itself. On the one hand this has led to, and encouraged, a more intellectual, overly analytical, even scientific approach to the understanding, presentation and practice of Chinese medicine. And on the other hand it has fostered a 'new age' type interpretation of classical Chinese methods which are of little substance and dubious clinical value. These two trends have shifted us away from some of the clinically useful and enlightening old ways, the lao-gong (old skills). One aspect of this is the dismissal or misinterpretation of the fundamental relevance of classical qigong understanding and skill to the practice of Chinese medicine or, alternatively, its representation as veiled in mystery and 'spiritual' whitewash.
It would seem, however, that we are now seeing a new, and more aware, generation of students entering into Chinese medical education. In consequence, it may well be that these two approaches will die a natural death. We may then witness the emergence of a more wholistic classical approach that - given a sound understanding of the principles and practices of classical Chinese medicine - asks that we embrace that innate body wisdom that we each possess, a 'cellular knowing' that so often remains dormant within, awaiting a Spring that never comes, or if it does, then only fleetingly.
It is the middle path that we must seek. This will be informed by scholastic endeavour and challenged by contemporary enquiry and research, yet equally empowered by an experiential awareness of, and an openness to, the unseen (but not unknown), the all-pervading dynamism that puts the human into the being and potentiates so much more than many of us realise.
As has been said before by the ancient Daoists, "It is not so much what we think or say that most determines our life, but what we do."
References
1. Original Tao, Harold D. Roth, Columbia University Press, 1999, page 66.
Roy Jenzen is a doctor of Chinese medicine with some 28 years of clinical experience. Roy is based in Perth, Western Australia, and is a long-time practitioner of qigong and the Chinese internal martial methods of xingyi chuan and bagua zhang.