1. A Scene: A Question Mark on the Medical Report
March 2024. Spring came late to Florence that year. The afternoon sun filtered through Giaogiao's windows, landing on a corner table. Maria, 52, Italian, had been an internist at the University Hospital of Florence for 25 years. She pushed open the restaurant door—not to eat, but to find me.
"Liu," she said, her tone more clinical than casual, "I was in Beijing last week for a medical conference. A Chinese colleague gave me a 'check-up'—not a CT, not bloodwork, but a traditional Chinese doctor feeling my pulse. He said I have 'Qi deficiency.'"
"And then?" I asked.
"Then I asked: What is Qi? He answered: Qi is the breath of life. I said: How do you quantify it? He said: You don't quantify it. You feel it."
Maria looked at me like I was a case she had studied for 25 years without finding an answer.
"I'm an internist. In my world, everything must be quantified. Blood pressure, blood sugar, white blood cell count. But Qi—something invisible, intangible, immeasurable—how can it be the foundation of medicine?"
I poured her a cup of tea.
"Maria, when you wake up in the morning, have you ever had that feeling of 'today I just don't have it'? Not sick, not feverish, but like your body is missing a bar of battery?"
"Of course."
"That feeling of 'missing a bar of battery'—what do you call it in English?"
"Low energy?"
"Right. But 'low energy' is a result. You don't need to know the physics definition of 'energy' to know your body is telling you: today is not enough."
"Qi is the name Chinese people gave to that feeling of 'missing a bar of battery.'"
Maria fell silent.
---
2. A Funny Misunderstanding: Is Qi Mysticism?
"Let me ask you another question," Maria said. "If Qi is just a feeling, why did the Chinese turn it into a complete medical system? Acupuncture, herbs, massage—all based on Qi. That's not science. That's faith."
"Wrong," I said. "Qi is not faith. Qi is a model."
"A model?"
"Yes. Like Newton's gravity. Newton never 'saw' gravity. He saw an apple fall. So he created a concept—gravity—to explain why the apple fell."
"Qi is the same. Ancient Chinese doctors saw: some people are bouncing with energy, others listless. Some speak with booming voices, others barely whisper. Some have rosy complexions, others are pale."
"They needed a concept to explain these differences. So they created 'Qi'—Qi is the sum total of life activity."
"So Qi is not mysticism," I said. "Qi is the Chinese observation model for bodily life activity. Just as Western medicine uses 'metabolism' to describe the body's chemical reactions, Chinese medicine uses 'Qi' to describe the body's life state."
Maria thought about it: "So Qi is not some mysterious energy, but a descriptive concept?"
"Yes. It describes whether your heartbeat is strong, your breathing smooth, your digestion good, your sleep deep—the combined state of all these life activities."
---
3. The Chinese Explanation: The Three Identities of Qi
"But Qi is more than a concept," I said. "In Chinese culture, Qi has three identities."
"First: Qi is breath."
"Have you noticed the traditional Chinese character for Qi? 氣—top part is '气' (air), bottom part is '米' (rice). Ancient Chinese believed Qi comes from two sources: air (breath) and food (rice). That's why Chinese medicine says 'Qi is born from the essence of water and grains'—your Qi comes from what you eat and drink."
"Second: Qi is function."
"Chinese medicine doesn't say 'insufficient blood supply to the heart.' It says 'insufficient heart Qi.' It's not saying there's a physical problem with the heart, but that the heart's functional state is not good enough. When Qi is abundant, the heartbeat is strong; when Qi is deficient, the heartbeat is weak."
"Third: Qi is relationship."
"This is the deepest layer. Chinese people believe Qi does not exist in isolation. Your Qi is connected to the Qi around you. Your Qi with nature's Qi, society's Qi, family's Qi—all influence each other."
"So Qi is not just your personal state. It is your relational state with the entire world."
Maria's eyes slowly lit up.
"This reminds me of systems medicine," she said. "We don't look at just one organ, but the whole system. Qi—this concept—isn't it a bit like a Chinese version of systems biology?"
"Very much so," I said. "And it predates systems biology by 2,000 years."
---
4. The Deeper Logic: Why Do Westerners Find Qi Elusive?
"Let me tell you a story of my own," I said.
"In 2008, I got sick in Italy. Nothing serious, just a cold, but it dragged on for two weeks. I went to an Italian doctor. He said: 'Viral infection. No specific treatment. Drink more water. Rest.'"
"Then I went to Paris. A French Chinese medicine doctor felt my pulse. He said: 'Your Qi is trapped by dampness. Dampness is like fog. Fog blocks Qi. Qi cannot reach where it should go.'"
"He prescribed herbal medicine. A week later, I was fine."
"But the issue wasn't whether I got better. The issue was: the language that French doctor used was completely different from what the Italian doctor had said."
"The Italian doctor said: 'Virus'—the language of microbiology."
"The French doctor said: 'Qi' and 'dampness'—the language of relationship."
"Western medicine's language is: what happened (pathology). Chinese medicine's language is: why it happened (relationship)."
"Western medicine says: bacteria invaded. Chinese medicine says: your Qi was not strong enough to block the external evil."
"Western medicine says: kill the bacteria. Chinese medicine says: strengthen your Qi."
"This is not opposition. This is two different perspectives."
Maria nodded: "As a doctor, I completely understand. Western medicine focuses on the enemy. Chinese medicine focuses on yourself."
"Yes," I said. "But the key is here: Qi is not the language of 'confrontation,' but the language of 'relationship.'"
"When you say 'Qi deficiency,' you are not saying 'your body lacks a certain substance'—you are saying 'the energy exchange between your body and its environment is not smooth enough.'"
"This is why Westerners find Qi elusive: Western medicine trains us to look for enemies, while Chinese medicine trains us to observe relationships."
---
5. Learn a Chinese Word: Why Is It Called "Qi"?
"Speaking of observation," I said, "let's learn a Chinese word today."
I wrote a character on the paper: 气.
"Look at this character. What does it look like?"
Maria looked carefully: "Like a cloud?"
"Yes. The oracle bone script for Qi was three upward-flowing streams of air, floating like clouds."
"Ancient Chinese people observed nature: clouds floating in the sky, smoke rising from fire, breath exhaled from the mouth. They saw a common thing: invisible, intangible, but perceptible."
"So they called this thing 'Qi.'"
"Later, the character gradually expanded. Qi is not just air, not just breath. It became synonymous with life itself."
"Chinese people say '生气' (shēngqì)—not 'angry,' but 'the vitality of life.'"
"Chinese people say '气色' (qìsè)—not 'color,' but 'the outward manifestation of life.'"
"Chinese people say '气氛' (qìfēn)—not 'atmosphere,' but 'the life force pervading a space.'"
"Maria, have you noticed: when you walk into a room, you sometimes feel 'this room is oppressive' or 'this room is warm'—that's not temperature, that's Qi."
"Chinese people use Qi to describe everything invisible but perceptible."
"So Qi is not mysticism. Qi is the Chinese way of naming the 'invisible vitality of life.'"
---
6. One-Sentence Summary: What I Took 25 Years to Understand
Maria put down her teacup and looked out the window. The afternoon sun of Florence was shining on her face. She looked thoughtful.
"Liu," she said, "I'm going to change the way I ask questions when I see patients."
"How?"
"Before, I asked patients: 'Where does it hurt?' From now on, I'll add one more question: 'How do you feel the Qi in your body?'"
"Not treating with Chinese medicine, but listening with Chinese medicine."
"Because 'Qi' is not a medical concept," she said. "It's the patient's way of describing their own life state."
I smiled.
"You understand. Qi is not something for doctors to define. Qi is something for patients to feel."
"The ultimate goal of Western medicine is to eliminate disease. The ultimate goal of Chinese medicine is to restore balance."
"And Qi is the measure of balance."
> Qi is not mysticism. It is the Chinese observation model for life activity.
>
> It took me 25 years to understand: when I feel "Qi," I am not feeling some mysterious energy. My body is telling me—whether my relationship with the world is harmonious.
---
Have you ever had that feeling of "Qi rushing chaotically through your body"? Or when "Qi just won't come up"? Tell me your story—the next xiaokz article might just be written for you.