Acupuncture Science 8: Arrival of Qi

Part 8: Arrival of Qi (De Qi)

The phenomenon of “Arrival of Qi” (De Qi) has been described as a vital part of the effectiveness of an acupuncture treatment. It is described as a sensation of soreness, numbness or a feeling of distension around the point after the needle is inserted to a certain depth. At the same time the practitioner may feel tenseness (or ‘grasp’) around the needle. One hypothesis states that the grasp is due to a mechanical coupling between the needle and connective tissue winding during insertion. De Qi is determined by accurate needing of acupoint, depth of needle insertion and needle manipulation to promote the arrival of qi. In ancient Chinese books its importance is described as, “acupuncture therapy does not take effect until arrival of Qi”. This understanding was later revised to explain that the quick arrival of Qi suggested good effects, while slow arrival was a sign of retarded effects.

At the 1st International Symposium of Quantum Medicine the ‘De Qi’ was presented as a broader phenomenon. Acupuncture needle manipulation giving rise to different sensations of moving along the legs, arms or trunk was described as the phenomenon of ‘propagated sensations along the channels’ (PSC). PSC can be manifest or latent, both of which can be detected by changes in the low electrical resistance, cutaneous potential, sound signals, temperature, spontaneous visible light and others.  Research shows that the arrival of PSC results in observed functional changes in certaiorgans and thus ‘De Qi’ was described as a change in Qi conditions at the acupoints, channel or organ, which can be accompanied by sensory responses, including changes in symptoms. The characteristic intensity of Qi arrival relates to the speed of changing Qi conditions and therefore effects of the treatment. The intensity of this phenomenon is subject to the;

  • Functional condition of the patient
  • Structures involved into the reaction
  • Type of Qi stimulated into the reaction

Other studies using extremely high frequency (EHF) puncture through low intensity millimetre (MM) electromagnetic radiation on an acupoint have shown to give rise to sensory reactions in the patient. These include temperature sensations (warm or cool), waves or creeps at certain areas or moving along the limbs or trunk, similar to the ‘De Qi’. Changes in emotional states and changes in functional activity of different organs were recorded via electrocardiograph, electroencephalograph, electro-gastrography, heat monitor, etc.  These sensory reactions have also been associated with temperature changes (0.2o– 0.5oC) at acupoints.  e.g. ‘fullness and heaviness in the abdomen’ was associated with a rise in temperature at Ren-12 and St-25 acupoints, and similarly ‘vertigo’ was associated with temperature changes at Liver channel points, and feeling of ‘changes of the weight’ when needling spleen channel points.  There is a collective conclusion that the key point in treatment efficacy was not the frequency of MM EMR but more importantly its application on the acupoint zone. Instead the frequency determined the range of MM EMR radiation absorbed by the water-containing structures of the skin.

EHF-Puncture research has been investigated in the Traditional Chinese Medicine conditions TCM) of Qi ‘excess’ or ‘deficiency’. Parallelling a ‘place of deficiency’, a deficient condition exhibits the quick ‘De Qi’, while in the case of excess initially there may be a short period of aggravation of the presenting symptoms (similar to the widely accepted acupuncture healing reaction). This temporary worsening of symptoms is explained as reinforcing effects during the start of the EHF treatment which later disappears.

De Qi has shown to initiate changes at acupoints locally, however it does not explain how the effects occur distally. One explanation could be the facial reach into deeper tissues and internal organs, while another theory is based on the phenomenon of mechanical signally resulting from the interaction of the needle and the surrounding connective tissue.

Part 1: How Does Acupuncture Work?
Part 2:  Qi: Vital Energy, Life Force
Part 3: Five Elements Theory
Part 4:  Chinese Diagnosis
Part 5: Integrating Western Physiology with TCM Philosophies
Part 6: TCM Meridians
Part 7: Meridians & Fascia