SCIENCES REVIEW # 14, PAGE 04
I wish to being with two quotations which highlight
the challenge to our scientific understanding of energy medicine.
Vine Deloria, writing about the evolution of medical systems prior to
the one currently in use, made the following observation:
For primitive people the presence of energy and
power is the starting point of their analysis and understanding of the
natural world…primitive people felt power but did not measure
it. Today we measure power but are not able to feel it.
René Dubos, commenting on modern scientific principles, has reminded
Sometimes the more measurable drives out the
Researchers of so-called energy medicine are a curious lot. We unearth
ancient practices, dust them off, clean them with modern solvents and
study them under the lens of high technology. All the while, we seek to
distill simple truths about health and illness.
China is a nation of 1.1 billion people where more than 800 million people
reside in rural areas. These individuals lead a lifestyle not altogether
different from the lifestyles of their parent, grandparents and distant
It is said of rural China that the three greatest changes in the past
century are the introduction of the bicycle, of the thermo bottle and,
most recently, the absence of war for more than a quarter century. Chinese
customs have changed relatively little. Children, in the eyes of the Chinese
people, remain the most precious gift of nature and the source of hope
for future generations. But a Chinese child growing up in the latter portion
of the twentieth century will surely face tumultuous change. By law, a
Chinese family can have only one child. As such, an entire generation
of Chinese children will grow up without an understanding of what it means
to have brothers and sisters. Moreover, Chinese children will witness
a rapidly changing economy and a volatile political atmosphere—one which
is struggling to embrace democracy and Western attitudes without destroying
its own cultural heritage.
Furthermore, Chinese children growing up in the 1990s will live in a
country where there are two distinct systems of medical care. One system,
traditional Chinese medicine, is likely favored by the children's grandparents
and rural neighbors. The other system, which we refer to as "modern
Western medicine", is likely preferred by the parents, educated relatives
and urban neighbors.
Traditional Chinese medicine evolved over two thousand years under the
influence of Buddhist and Taoist priests. This medical system emerged
in isolation from Western sciences as we know it. Not until the middle
of the nineteenth century were principles of the scientific method introduced
to China. This occurred as a result of education offered by medical missionaries
from Europe and the United States.
By the turn of the century American and European missionaries had established
medical clinics, hospitals, and several medical schools on the Chinese
mainland. Prominent professors fro universities such as Harvard, Yale,
and Johns Hopkins lectured at the newly created Chinese medical schools.
Western medicine became extremely popular with China's intellectuals
and with it governmental leaders. In an effort to promote Western medicine
the Nationalist Government in the 1920s went so far as to outlaw traditional
Chinese medicine on the grounds that it was "backwards and superstitious".
This effort failed, as the Chinese people perceived Western medicine to
be alien, crude, and highly unnatural.
In 1950, following the establishment of the People's Republic of China,
Chairman Mao Tse-tung was faced with a political dilemma: There were approximately
500 million people in China but only 38,000 Western-style medical doctors.
At the same time, however, there were approximately 500,000 traditionally
trained Chinese doctors. Understandable, Chairman Mao launched a political
campaign to "unite medical workers young and old of the traditional
and Western schools to organize a solid front". For the past four
decades this call for unity and integration has persisted in the People's
Republic of China.
However, if one reviews statistics from the Chinese Ministry of Health
regarding medical manpower throughout the People's Republic of China today,
it is clear that over the past three decades the pendulum has shifted
from traditional medicine to modern Western medicine. Today Western-style
physicians outnumber traditionally trained medical doctors six to one
and Western-style hospital beds outnumber those in traditional Chinese
hospitals by thirteen to one. This trend toward a dominance of modern
Western medicine will continue for the foreseeable future.
And Its Introduction
to the West
What about the introduction of traditional Chinese medicine to the West?
In the United States the turning point, I believe, was a single newspaper
article written by a prominent journalist from The New York Times,
In 1971, while accompanying the Nixon-Kissinger entourage, James Reston
wrote an article entitled "Now Let Me Tell You About My Appendectomy
in Peking". Reston developed acute appendicitis while visiting Bejing
and was operated on using Western anesthesia. The surgery was uneventful;
however, he suffered profound postoperative pain in the area of his incision.
The Chinese medical authorities summoned two prominent acupuncturists
to treat these symptoms. Their treatment consisted of inserting several
needles. So prompt and complete was Reston's pain relief, that he could
barely contain himself from describing this curious technique in detail.
This description introduced the West to a therapy which the Chinese referred
to as "acupuncture anesthesia".
James Reston's article triggered an enormous surge of interest in this
therapy. Medical teams composed of experts traveled to China to witness
surgical procedures involving it. Many of these experts returned to the
United States utterly convinced that acupuncture anesthesia was a real
phenomenon, not merely hypnosis or sham.
I was a college freshman at that time and elected to do an independent
study project regarding acupuncture anesthesia. Little did I know that
none of the 100 libraries at Harvard University contained a single page
Acupuncture had been used to treat common illnesses for more than 2,000
years; however, its application as a surgical anesthetic was new. This
had to do with the fact that there was no major surgery in traditional
Chinese medicine. Major surgery was considered to be a mutilation of the
body and the body was considered to be the ultimate gift of one's parents.
Filial piety dictated that one never deface the ultimate gift of one's
ancestors. Therefore, there was no major surgery in China—only the sewing
up of superficial wounds and stabilization of bone fractures.
Acupuncture was not applied to the surgical amphitheater until the late
1950s, as a direct consequence of Chairman Mao's political directive that
physicians from Chinese and Western backgrounds work together to "form
a united front".
In 1972, when I became interested in acupuncture, there were no English
translations of Chinese experimental texts dealing with acupuncture as
an anesthetic. Instead, I stumbled on English translations of famous reference
texts of traditional Chinese medicine. Chief among them was a book entitled
The Yellow Emperor's Canon of Internal Medicine (see quote, right).
It is still used today as the primary reference for traditional Chinese
This ancient text helped me understand the basic theoretical differences
which distinguished Chinese (that is, Oriental) medical systems from those
used today in the West. Specifically, traditional Chinese medicine emphasized
prevention including diet, exercise, thoughts, and emotions, plays a critical
role in the natural course of illness and one's ability to maintain health.
prospective randomized trials producing convincing data, so-called
energy medicine will not be accepted by mainstream health-care providers.
I was intrigued by the basic principles of Chinese medicine and set out
to learn the Chinese language in the hope that some day I could study
both traditional Chinese and modern Western medicine.
In 1979, when I was a fourth-year medical student at Harvard Medical
School, the United States normalized relations with the People's Republic
of China. The National Academy of Sciences selected me to serve as the
first US medical exchange student to China. In 1979 and 1980, I studied
Chinese medicine at the Beijing College of Traditional Chinese Medicine.
I was not prepared for the education I received in Beijing. Without realizing
it at the time, I was receiving my initial formal education in "energy
I was fascinated by the principal methods of physical diagnosis: tongue
and pulse examination. It was hard to imagine that each radial artery
could be successfully palpated in six separate locations (three superficial
and three deep) and that a masterful clinician could differentiate among
40 different pulse variations at each of the twelve pulse points. More
spectacular still was the claim that these subtle pulse variations enabled
the clinician to know with accuracy the etiology and extent of the patient's
pathology within specific internal organs. Such correlations were unknown
More peculiar still was the Chinese diagnostic approach using the tongue.
Students of traditional Chinese medicine were required to master several
hundred tongue variations. The size, color, coating, tooth indentation,
etc., of each tongue type was said to enable the clinician to make a specific
diagnosis in terms of location and etiology of pathology. Again this claim
seemed utterly fantastic and new to me.
Not only were the diagnostic approaches to the physical examination alien,
so were the specific therapeutic interventions within traditional Chinese
medical hospitals. Each, I came to learn, was based on an "energy"
For example, acupuncture, known in the West primarily in regard to
surgical analgesia, was used daily in the treatment of almost every medical,
surgical and psychiatric illness known. Its application as a means of
"restoring energy balance" was yet another new observation for
me. Clinicians spoke of "putting energy through the needles"
and "taking energy out of the body" in a language which was
alien to me.
Acupressure massage, based on a system of points and meridians identical
to acupuncture, was yet another unexplored modality. Again, claims of
energy transfer were used by my mentors in describing what they were doing
in diagnosing and treating patients on the massage table. I was impressed
clinically by the extent to which patients with acute musculoskeletal
pain and/or pain in association with chronic neurologic or musculoskeletal
problems found relief from massage therapy. More importantly, in many
instances patients' relief was not short-lived but, rather, lasted for
days, weeks or months in a fashion which I could not explain. These were
among my most humbling observations.
The principal mode of Chinese intervention is not acupuncture or acupressure
but herbal medicine. Over the past two millennia the Chinese have developed
a vast pharmacopoeia of plant, animal and mineral substances based on
empirical observation and clinical experience.
Herbal therapy is unquestionably the most respected and difficult of
all Chinese interventions because it requires the study of hundreds of
herbal preparations used in complicated combinations specifically for
the purpose of rebalancing bodily excess, deficiency or stagnation. Without
a mastery of classical Chinese, pulse and tongue diagnosis and insight
into Chinese pathophysiology, herbal therapy is a foreboding if not impossible
…and "Energy": Qi Gong
The other Chinese medical therapy which is most closely related to
the notion of Western "energy healing" is that of "Qi Gong"
(pronounced "che gong").
Qi Gong is a martial art, arguably the oldest and most important martial
art, from which other forms of martial arts have evolved. The physical
movements of Qui Gong, which are circular, symmetrical, and slow, are
similar to those movements used in other martial arts (such as Tai Chi
Chuan and Jung Fu). However, in addition to the physical movements, the
Qi Gong practitioner is instructed in the art of centering, or achieving
a particular state of physical balance, and, simultaneously, to meditate.
The practice of Qi Gong involves some of the key elements found in Western
relaxation training. These include paying attention to one's breathing,
establishing a passive disregard toward one's thoughts, and—unique to
Qi Gong—instructions in techniques to sense the source of one's Qi (vital
energy) at a point below the navel and to learn to move it through one's
body. I will return to this unusual aspect of Qi Gong.
It is said that anyone can learn Qi Gong exercises and that it takes
approximately three to six months before one can "feel one's Qi"
(in the form of heat or fullness) and begin to move it at will.
The practice of Qi Gong, when analyzed from a Western perspective, may
be thought of as a combination of behavioral techniques. These are typically
performed for 30 to 60 minutes every day of the year. The behavioral components
of Qi Gong include the elicitation of the relaxation response and/or other
aspects of relaxation training, aerobic exercise , progressive muscular
relaxation guided imagery, and elements of the placebo effect. In China,
where an estimated 50 million persons practice Qi Gong every day,
there is an unprecedented opportunity to investigate the impact of behavioral
(that is, non-pharmacologic, cognitive) therapies as they relate to a
multitude of illnesses.
The Concept of Qi
There is a single fundamental concept of traditional Chinese medicine
which helps clarify the seemingly disparate diagnostic and therapeutic
techniques I have summarized. This concept is called "Qi" (vital
"Qi" is said to be that which differentiates animate from inanimate.
The body is viewed as a complicated series of conduits through which Qi
flows. These conduits are the acupuncture meridians referred to in Chinese
diagrams depicting human anatomy. Pathogenesis relates to the excess of
deficiency inextricably linked to the force of Yin ("female",
"cold", "hollow", etc.) and its opposing force, Yang
("male", "hot", "solid", etc.)
The Chinese clinician's task is to identify where the Qi exists in excess
or is deficient. This is done chiefly by means of taking a history, observing
and using pulse and tongue diagnosis. The diagnostic label used by the
Chinese clinician refers to the specific imbalance which has been noted
on physical examination. Each therapy, whether it includes needles, herbs,
changes in diet or meditation, is aimed at reestablishing the balance
There is one more piece of traditional Chinese terminology which is worth
mentioning. "Internal Qi Gong" or "Soft Qi Gong" refers
to an individual's ability to sense and move his/her own Qi within his/her
own body. "External Qi Gong" or "Hard Qi Gong" refers
to the (alleged) ability of some Qi Gong practitioners to emit their Qi
externally so as to influence other animate or inanimate structures.
The notion of emitting energy from the human body is yet another example
of how traditional Chinese medical thought diverges radically from that
of conventional Western medicine. Traditional Chinese medicine asserts
that Qi Gong masters can emit Qi at will and use this energy a s treatment
for common illness.
The notion of "Qi" is not unique to China. It is found within
the medical systems of Tibet, India, ancient Greece, branches of the Catholic
Church, and also has similarities to more recent theories such as that
of "animal magnetism" proposed by Mesmer in the eighteenth century.
In the last 1970s and early 1980s the masters of Qi Gong reemerged and
began to perform publicly throughout China. They had all "gone underground"
during the 1960s and '70s as a result of the cultural revolution's ban
on Qi Gong (which was labeled "superstition" by China's political
authorities). These individuals claimed to have practice Qi Gong from
early childhood and proudly displayed their seemingly supernatural skills
to audiences as large as 50,000 persons. Qi Gong masters split stones
with their hands and their foreheads, had trucks drive over them, had
massive stone slabs lowered on their bodies by cranes, claimed to be able
to see within human bodies and to move inanimate objects at will. The
claims seemed carnival-like and appeared to be well-rehearsed circus acts.
Researching Qi Gong
My personal interest in Qi Gong was sparked as a result of a television
broadcast in 1980 which suggested that scientific laboratories in Beijing
and Shanghai were applying rigorous methods of investigation to the physiologic
changes produced by Qi Gong masters. First among these observations were
reports of thermal change in surface skin measurements of Qi Gong masters
who were "emitting Qi". Thermally sensitive films suggested
that when Qi Gong masters emitted energy, the energy tracked down lines
in the forearms and legs which were similar to classical acupuncture meridians.
A second series of publications in the area of microbiology were more
fantastic still. Professor Feng Li Da of Beijing published as article
pertaining to the predictable change of bacterial cell growth in response
to external Qi emission by Qi Gong masters. Her paper reported on the
ability of several Qi Gong masters to increase or decrease bacterial cell
growth in a variety of common bacteria. Dr. Feng claimed to have replicated
these experiments on numerous occasions in multiple laboratory settings
and seemed confident of her results.
A more recent series of assertions has to do with the claim that certain
Qi Gong masters can modulate AC electrical current from any common wall
socket and act as a "human rheostat".
After attending a conference in Beijing in October 1988 I was asked by
a Qi Gong master if he could demonstrate his skill to me on a visit to
my hotel room. He came equipped with an electrical volt meter and a simple
wiring device. The device was no more that a plug attached to two wires
with live ends. He put the plug in the wall and demonstrated its current
by lighting lightbulbs and then tested the current on his hand-carried
volt meter. He then licked his thumb and forefinger of both hands and
grasped the two live wires. I was horrified and worried he would quickly
be electrocuted before me. He was not. Moreover, he convinced me that
he could light a lightbulb by touching it with other fingers from both
hands. More curious still was his ability to regulate voltage across his
two hands, at will, simply by touching the volt meter with the ground
in one hand, the meter device in the other. On several attempts he regulated
the voltage from 0 to 220 volts, or held the voltage constant, at will,
upon my request.
Because I have grown increasingly skeptical of such provocative claims,
I asked him how I could be certain he was in fact conducting electricity
and not simply fooling me by means of some extraordinary high technology
tick. He offered to touch me with his hand while he was connected to the
wall socket. I declined, but a colleague with me at the time volunteered.
When touched on the shoulder by the Qi Gong master, my colleague's trapezius
and biceps muscles went into spasm. Moreover, the Qi Gong master could
control the electrical current so as to induce the spasm or not. I allowed
the Qi Gong master to touch me a for a split second, long enough to feel
the live current emanating from his forefinger. He was "live"
In a final demonstration the Qi Gong master took two metal skewers along
with a one-pound pork steak which he ad brought with him. He put the two
skewers through the steak then grabbed the skewers, one in the left hand
and one in the right so as to complete an electrical circuit. Having grasped
the wires along with the two skewers the circuit was engaged and the pork
chop began to smoke and flame. Within minutes there was a medium-well-done
pork chop which my Qi Gong friend sliced and offered to serve!
I was astounded by this demonstration and have no explanation for why
the Qi Gong master did not injure his skin, or cause a serious heart irregularity,
seizure or other damage to his own person.
Such feats are no more than a tantalizing introduction to the many provocative
clinical applications of so-called External Qi therapy. For example, Lin
Ho Sheng, a Qi Gong master in Shanghai, claims to have emitted Qi directly
to the acupuncture points used for acupuncture anesthesia. As reported,
this type of Qi Gong anesthesia was successfully used in several dozen
operations involving the thyroid gland or abdomen. There is no explanation
for this kind of claim. Hypnosis has been flatly denied by the Chinese.
I am unaware of any replication of this kind of analgesic technique outside
Qi Gong masters throughout traditional Chinese medical colleges in the
People's Republic of China are using External Qi Gong as a treatment for
a wide variety of illnesses. They typically treated patients with chronic
neurologic and musculoskeletal disease, including multiple sclerosis.
More spectacular still is the observation that large numbers of patients
said to have biopsy-proven, non-malignant cancer are being treated with
a combination of Internal and External Qi Gong therapy. Hundreds of purported
cancer patients meet at dawn each morning for the purpose of practicing
Internal Qi Gong and receiving External Qi Gong therapy from a Qi Gong
master. Moreover, the Chinese lay press frequently displays headlines
such as: "Qi Gong Defeats Breast Cancer". These articles tend
to summarize anecdotal case histories and are rarely if ever substantiated
in medical journals.
I wish to point out that recent estimates suggest that 50-60 million
Chinese practice Qi Gong at dawn each day for the purpose of disease prevention
or in an attempt to alter the natural course of serious or lethal illness.
A Proposed Research
I would like to offer a strategy for experimental validation of assertions
regarding Chinese energy medicine (see box on page 8).
- My opinion is that we should emphasize basic
science experiments before attempting to design and implement clinical
trials involving human subjects. My rationale for this is based, in
part, on the fact that clinical subjects committees in hospital and
academic institutions are unlikely to approve human subjects experiments
if they have insufficient basic science data to support their objectives.
- A specific list of basic science experiments
pertaining to energy medicine should include demonstrations of the effects
of Qi on a variety of electromagnetic fields, bacterial growth patterns,
cell and tissue culture models, and plant and animal physiology. Without
measurable, predictable and reproducible evidence in these areas, clinical
research will be difficult if not impossible to promote.
- With regard to clinical investigations, the
first category is that of diagnosis. An effort should be made to assess,
in a critical fashion, the diagnostic acumen of "gifted healers".
They should be tested in comparison to the diagnostic acumen of modern
technology. Moreover, there should be an attempt to describe inter-rater
reliability as well as test-retest reliability among so-called "Energy
- The same general philosophy should ideally be
applied to devices and machines which claim to be based on "subtle
energy" mechanisms. These should all be subject to controlled study
in a rigorous fashion.
- A separate set of experiments should ideally
assess the ability of healers and/or energy devices to induce acute
physiologic change in human subjects. For instance, can healers or "energy
devices" predictably alter organ function (for example, renal flow
or cardiac output) in a fashion which is safe and reliable?
Once demonstrations of acute physiologic change
are completed, experiments should be designed to document sustained
physiologic change. Claims of altering the natural course of illness
will likely only be accepted if and when evidence of sustained physiologic
change can be supplied.
- If clinical therapeutic trails are to be implemented,
they will need to meet rigorous clinical epidemiologic criteria in order
to demonstrate efficacy and effectiveness. Ideally, such studies should
avoid anecdotes and case studies in favor of randomized controlled trials.
Designing such trials will be challenging in that they will need to
include non-biased patient populations, controls for confounding variables
(such as co-intervention, contamination, experimental bias, etc.). The
confounder which is most apt to cause methodological difficulty is that
of expectancy of relief (for example, placebo effect). Without careful
assessment of expectancy factors prior to, during and post intervention,
these studies will likely be subject to savage criticism. Statistical
methods will need to include meticulous sample-size calculations and
attention to both statistical and clinical significance.
- If and when clinical trials involving therapeutic
modalities such as acupuncture, herbal medicine, energy emission devices
and/or Qi Gong are implemented, these trials will likely need to involve
multiple centers, hundreds of patients followed over months or years
and strict outcome parameters which include objective variables such
as health costs, days or work lost and overall medical expense. Such
studies may require the professional involvement of dozens of skilled
researchers and will likely cost hundreds of thousands or millions of
dollars to complete. Without prospective randomized trials producing
convincing clinical data collected under rigorously controlled conditions,
so-called energy medicine will not likely be accepted or promoted by
mainstream health care providers and third-party insurers.
Utilizing Constructive Criticism
I have a number of suggestions whereby energy medicine researchers can
work together to build credibility by inviting constructive criticism
from qualified skeptical colleagues.
The first priority might be to create professional forums wherein debate
pertaining to energy medicine basic science and clinical investigations
can take place. Such debates may take the form of prioritizing research
projects the utilization of financial resources, popularization of ongoing
research and a more meticulous review of work in progress.
We should consider identifying and electing appropriate experts to serve
as mentors and scientific advisers with regard to energy medicine research.
Such individuals might offer constructive criticism to protocols prior
to their implementation. Once successfully implemented, this mentor (or
scientific advisory) group could assist in refining data analyses and
perhaps attempt to implement a replication of successful experiments in
the laboratories of qualified skeptical colleagues.
Ideally, if experiments can be critiqued and replicated in the laboratories
if critical colleagues, they would stand a far greater chance of being
accepted in peer-reviewed journals. Moreover, having engaged qualified
skeptical scientists prior to publication, professional criticism post-publication
is apt to be predictable and more easily handled. This group might also
consider a formal pledge to avoid public disclosure of critical experiments
and/or manuscripts prior to acceptance for publication in peer-reviewed
Last, scientists investigating energy medicine-related phenomena should
be encouraged to share and publish experiments which have resulted in
negative findings as well as those with positive results. Only in this
way will the field gain credibility and will researchers be properly informed
so as to avoid nonproductive methods of inquiry.
I conclude my remarks with a Chinese proverb: "Real gold does not
fear the heat of even the hottest fire." Qi and Qi-related phenomena,
if real, are life precious gold. Undoubtedly, once subjected to the heat
of criticism, they will be reshaped, recast, but not destroyed. This process
of enrichment will enable investigators to demonstrate more clearly the
value of "energy"-related biological phenomena.
"Real gold does not fear the hate of even the
hottest fire." - Chinese proverb
A summary of the
major assertions regarding Chinese Energy medicine (Qi Gong"):
- "Qi" (vital energy) exists as a physical entity.
The Chinese claim the Qi can be measured, controlled and has biological
and clinical significance.
- "Qi meridians" ("energy fields") exist
as physical entities. The Chinese claim that meridians are
measurable, and necessary for pulse, tongue and energy diagnosis.
Furthermore, Chinese theory suggests that meridians can be predictably
influenced by acupuncture stimulation, herbal therapies, massage,
Qi Gong or other cognitive interventions.
- Tongue, pulse and energy diagnoses are reliable and may help
to elucidate important physiologic relationships. The Chinese
claim that subtle variations noted on the radial artery, the tongue
and along acupuncture meridians can elucidate the location and
severity of internal organ pathology.
- Internal and/or external manipulation of "Qi" can
alter the natural course of illness. The Chinese specifically
assert that Qi Gong therapy can alter illness patterns in malignant
cancers, chronic diseases (for example, renal failure, chronic
obstructive pulmonary disease, arthritis, etc.), psychiatric disorders
(such as anxiety, depression and schizophrenia) and immunodeficiency
(for example, AIDS).
- Paranormal (that is, psychic) abilities are "Qi related"
phenomena. There is a long-held Chinese claim that individuals
who practice and become masterful at manipulating internal or
external Qi are capable of unique paranormal skill.
"To administer medicine to diseases which
have already developed and thereby suppress bodily chaos which has already
occurred is comparable to the behavior of those who would begin to dig
a well after they have grown thirsty, or those who would begin to cast
weapons after they have engaged in battle. Would these actions not be
"…I have heard that in early times the
people lived to be over 100 years old. But these days people reach only
half that age and must curtail their activities. Does the world change
from generation to generation or does man become negligent of the laws
"…Today people do not know how to find
contentment within. They are not skilled in the control of their spirits.
For these reasons they reach only half of their 100 years and then they
The Yellow Emperor's Canon of Internal Medicine,
c. 400 BCE
Presented at The John E. Fetzer Foundation Conference: "Energy
Fields, Meridians, Chi and Device Technology" May 11-14, 1989
Eisenberg, MD, is Instructor of Medicine, Harvard Medical School,
Associate in Medicine, Beth Israel Hospital, Boston, and is author
of Encounters With Qi: Exploring Chinese Medicine (see page 45 for
ordering information). Dr. Eisenberg was one of the first American
medical scholars to be invited by the People's Republic of China
to study medicine in that country.