Traditional Chinese medicine: qi, yin-yang and needles

On the table, a reclining body; on the skin, fine steel needles set into precise points of the wrist, the calf, the crown of the head. The practitioner does not look at an X-ray: he observes the complexion, listens to the breath, palpates three pulses at each wrist and examines the tongue. What he seeks is not a diseased organ, but an imbalance — a hindered circulation, an excess, a lack. Welcome to another way of thinking about the body: traditional Chinese medicine.

Traditional Chinese medicine is a system of care more than two thousand years old, founded on a vision of the body as a whole crossed by energies in motion. Acupuncture, plants, massage, exercises: it is still practised by hundreds of millions of people, while being the subject of a lively scientific debate. To understand TCM is to grasp a cosmology as much as a therapeutics — and to learn to distinguish what science validates from what it contests.

Qi, the vital breath of the body#

At the heart of Chinese medical thought lies qi, often translated as "breath" or "vital energy." According to this conception, qi circulates through the body along channels, and health depends on its free circulation: illness arises when qi stagnates, runs short or surges somewhere. To heal is to restore this flow and its balance.

This circulation is organised around yin and yang, the two complementary and opposing principles — cold and hot, rest and activity, inside and outside — whose harmonious alternation founds life. A healthy body is one in which yin and yang hold each other in dynamic balance. It must be said at the outset: neither qi nor the meridians has any demonstrated anatomical existence. They are concepts of an ancient theoretical framework, not structures one can dissect or measure.

Chinese medicine does not treat a disease, but a terrain: it seeks less to destroy the intruder than to rebalance the territory where it thrives.

The five phases and the meridians#

To the yin-yang duality is added the theory of the five phases: Wood, Fire, Earth, Metal and Water. Far more than a list of elements, it is a system of correspondences linking together the seasons, the organs, the flavours, the emotions and the colours, according to cycles of generation and domination. Each organ is attached to a phase, and illness is read as an imbalance within this network.

The energies are said to circulate along the meridians, a network of invisible channels connecting the body's surface to the deep organs. It is along these lines that the acupuncture points are arranged. Here too caution is needed: the meridians correspond to no nervous, vascular or lymphatic structure known to anatomy. They belong to a theoretical mapping particular to TCM, handed down by the treatises more than verified by the scalpel.

The therapeutic arsenal#

TCM deploys several major practices. The best known in the West is acupuncture: the insertion of fine needles at precise points to, according to the theory, restore the circulation of qi. The term zhēnjiǔ joins the needle (zhēn) and moxibustion (jiǔ), which consists of warming the points by burning dried mugwort.

Next comes the pharmacopoeia, by far the vastest branch: thousands of plant, mineral and animal substances, combined into formulas. Ginseng is its emblem. Added to this are tui na massage (推拿), cupping, and bodily disciplines such as qigong and tai chi, which cultivate qi through movement and breathing. Diagnosis rests on observation: examination of the tongue, taking of the pulses, listening, questioning.

Founding texts millennia old#

TCM rests on a corpus of classical treatises of great antiquity. The most venerable is the Huangdi Neijing (黄帝内经), the "Inner Classic of the Yellow Emperor," compiled around the last centuries BCE in the form of dialogues between the mythical sovereign and his physician. It already sets out yin-yang, the five phases, the meridians and a preventive medicine.

Later, under the Ming, the physician Li Shizhen completed in 1578 the Bencao Gangmu (本草纲目), a monumental treatise of pharmacopoeia listing nearly 1,900 substances and thousands of formulas — a sum that held authority for centuries, in China and beyond. This textual depth explains the prestige of TCM: it presents itself as knowledge accumulated, transmitted and systematised over two millennia.

What science says today#

Should TCM be believed? The honest answer is nuanced. Most of its theoretical foundations — qi, meridians, yin-yang balance — are not validated by modern science: they can be neither measured nor demonstrated. Many traditional remedies have not proved an efficacy superior to placebo, and some pose real problems, of toxicity or of pressure on endangered species (such as the use of pangolin scales or rhinoceros horn, baseless and disastrous for biodiversity).

But nuance matters. Modern research has sometimes drawn major discoveries from the pharmacopoeia: the researcher Tu Youyou, starting from a plant of Chinese medicine, the sweet wormwood Artemisia annua, isolated artemisinin, an antimalarial treatment that earned her the Nobel Prize in Medicine in 2015. Acupuncture, for its part, is the subject of clinical trials with mixed results, studied mostly for certain pains. In 2019, the WHO incorporated a chapter of traditional medicine into its ICD-11 classification — a controversial decision, seen by some as recognition, by others as a risk of endorsement. The reasonable position: to recognise TCM as a major cultural fact and a possible source of molecules, without holding its theories to be scientific truths.

A living and contested heritage#

Traditional Chinese medicine is neither a superstition to sweep away nor a proven science: it is a complex cultural system, deeply rooted in China, integrated into its health system alongside modern medicine, and exported worldwide. Millions of people turn to it, out of habit, preference or as a complement, and its vocabulary — qi, yin, yang — has spread far beyond medicine.

To approach it with lucidity is to hold both ends: to respect a tradition two millennia old and a coherent cosmology, while keeping the demand for proof. To discover TCM is to understand a Chinese way of thinking about the body and the world — and to learn Chinese is to be able to read these words, qì, yīnyáng, zhōngyī, that speak of a vision in which health is never anything but a balance to maintain.

FAQ#

What is traditional Chinese medicine? A system of care more than 2,000 years old founded on qi (vital energy), yin-yang and the five phases. It includes acupuncture, herbal pharmacopoeia, tui na massage and exercises such as qigong, and aims to restore the body's balance.

Do qi and the meridians really exist? Not in the anatomical sense: neither qi nor the meridians corresponds to structures demonstrated by science. They are concepts of an ancient theoretical framework, useful to TCM but unverified by modern anatomy or physiology.

Is acupuncture effective? Clinical trials give mixed results. It is studied mostly for certain pains and nausea, with a debated efficacy hard to distinguish from a placebo effect. It is not a validated treatment for serious illnesses.

Has Chinese medicine contributed anything to science? Yes: the researcher Tu Youyou isolated artemisinin, a major antimalarial, from a plant of the Chinese pharmacopoeia, which earned her the Nobel Prize in Medicine in 2015. The pharmacopoeia remains a possible source of molecules to study.

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