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Visitors to China from the West (and also from Japan) are impressed in the early morning when they first wake up in their hotels to see many Chinese people quietly and beautifully performing Tai Chi Chuan (TCC: Tai-kyoku-ken, in Japanese, and, incidentally, Tai Chi Chih® is a registered trademark of a school of TCC) in the park just next to their hotels. Also it is now not unusual to see TCC practised by Westerners in New York or London these days. We remember that we were quite amused to see in the film Star Wars a somewhat caricatured version of martial arts probably related to TCC shown off in a ‘Western’ way. Although it seems difficult to ‘define’ what TCC is, given its broad range from health exercise to martial art, it would be pertinent to say that its essential components are meditation, breathing and slow body movement. We usually understand it as a mode of Qigong (Ki-kou, in Japanese), which may be roughly translated into ‘effectuation of Qi (Ki, in Japanese)’ in English. Qigong as applied to health practice can be divided into ‘external’ and ‘internal’ facets. In the former mode, Ki external to a subject is transferred into the subject mediated by an outside ‘master’ Ki practitioner. In the latter mode, a subject carries out sequences of practices by him/herself to enhance (or effectuate) his/her own Ki. It has now become clichéd among people interested in complementary and alternative medicine (CAM) that the modern analytical medicine should be transformed or evolved into more ‘holistic’ medicine. Many people will agree that one of the keys to this ‘holistic’ approach is mind/body integrity. The concept of Ki would be of great value towards this direction, as it is understood as a kind of ‘energy’ of mind/body as a whole. If, therefore, there was some concrete method to enhance (strengthen) Ki, it would become one of the cornerstones of holistic medicine of the future. Scientific study of Qigong is warranted from this perspective, and thus Irwin’s review ‘Shingles Immunity and Health Functioning in the Elderly: Tai Chi Chih as a Behavioral Treatment’ in eCAM (1) is a timely one. The basic principle of Qigong as a ‘health’ practice, we believe, is the assumption that if Ki is ‘depressed (or vacant)’, illness (evil) will develop (‘illness out of hollowed Ki’). This kind of understanding will be better illustrated by using the concepts of Yin/Yo (Yin–Yang, in Chinese: or maybe ‘overt/covert’ in this case) and Kyo/Jitsu (Xu-Shi, in Chinese: or maybe ‘hollow/full’ in this case) (2) as seen in Fig. 1. According to this scheme, a subject’s Ki is either Kyo (hollow) or Jitsu (full), while external evil’s potency is also Kyo (hollow) or Jitsu (full). When a subject’s Ki is Kyo, even an external evil with Kyo potency will cause disease. A typical example of such a situation would be opportunistic infection in immunocompromised patients. On the other hand, when a subject’s Ki is Jitsu but the potency of an external evil is Kyo, the subject will overcome the evil. When a subject’s Ki is Kyo but the potency of an external evil is Jitsu, in contrast, the evil will overcome the resistance of the subject and the subject will become ill. This kind of situation is the Yin condition of the disease, such as advanced cancer in old people. When both a subject’s Ki and the potency of an external evil are both Jitsu, there will emerge a Yo condition of disease, such as febrile chicken pox in young children. Thus, from the medical point of view, Ki can be seen as the totality of the body’s healing systems or defense mechanisms which include the immune system as their essential part.

evidence-based complementary and alternative medicine

Mind–Body, Ki (Qi) and the Skin: Commentary on Irwin's ‘Shingles Immunity and Health Functioning in the Elderly: Tai Chi Chih as a Behavioral Treatment’