Placebo and Qi

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An article in the September 3-9, 2018 issue of Time magazine, “Placebo’s New Power,” describes instances of people knowingly taking placebos and getting relief.  These “honest placebos” were administered in a study of irritable bowel syndrome (IBS) patients.  One patient, whose IBS symptoms improved dramatically during the study, later found her symptoms recurred.  She decided to continue the placebo treatments at the researcher’s private clinic and achieved remission again.


Overall, results were so encouraging in this Beth Israel Deaconess Medical Center study that the National Institute of Health has awarded the research team a $2.5 million grant to replicate the study.


Placebos have been around since time immemorial, used to advantage in numerous conditions.  Their use is predicated on the belief that a patient’s faith in the treatment has a healing effect.  Formal pharmaceutical studies in Western medicine measure a presumed new drug’s effects against placebo to determine whether it will work on a large scale.  In Western medicine, generally, the “placebo effect” is disparaged, as though there is something “un-scientific” about it.


The Time article speculates about why people who know they are taking fake pills get better.  It notes patients appreciate doctors who validate their suffering.  They fare better with doctors they perceive as warm and competent.  We are told that confidence in “medical industry leaders” in the US has plunged to 34%, from 73% in 1966.


To me, this is another example of Western medicine taking credit for applying common sense.  Not once does the article mention such old-fashioned terms as “bedside manner,” which cannot be measured or billed for in the codified, prioritized list of “evidence-based” protocols that wants to squeeze patients into convenient, binary-based boxes. 


In Western medicine, the patient is seen as a relatively passive recipient of medical care.  The doctor, treatments, and pills act upon the patient, with the external agent believed to effect the healing. 


In contrast, Oriental medicine perceives the body is its own healing agent, presumed to have its own homeostatic wisdom, and to want healing, with the practitioner a partner and participant in the process.  Belief in the treatment, and in the practitioner’s competence, are valuable and acknowledged aids in the healing process.  Far from being “placebo,” the partnership between patient and clinician becomes an integral component of the treatment goal.


A fundamental difference between Oriental and Western medicine involves “qi,” (also spelled “chi”) or “life force.” In Oriental philosophy and medicine, “qi” pervades all things, and is crucial to life. When the body’s “qi” is depleted, restricted, or out of balance, it leads to trouble.  Disharmonies begin on a spiritual level, then become increasingly “dense,” manifesting as intellectual, emotional, and finally physical levels.  Practices like acupuncture rely on stimulating or balancing qi along specific energy channels called “meridians.”


There’s a mistaken belief in the West that we know more than we do about the body.  While we point to specific brain chemicals, such as neurotransmitters serotonin or acetylcholine, these are only two of perhaps thousands of brain messengers that interact in a constant dynamic.  The brain is only one organ in an equally complex body, with signals going back and forth at lightning-fast speed.  Western science presumes the body is like a machine, but the mechanical construct of Western medicine gives no credit to life. 


For me to say Western medicine is backwards, that the practice of dehumanizing patients under mechanical models works against health, may sound extreme.  But I suspect that the commercialization and institutionalization of the “health care industry” has devitalized the system in the name of high-tech, low-yield placebos that only help if you believe they work, and often not even then.




Mustafa Kemal Added Sep 3, 2018 - 2:01am
Katharine,  intriguing. 
Thanks for lettiing us know about the placebo effect. 
Let me tell you how I understand Qi.  For those of us who practiceQi Qong, Tai Chi Chuan, Baguazhang or Xing Yi, the internal arts, when we read articles about Qi and the fact that western medicine does not recognize its existence, a little smile comes on our face. Among the serious practitoners  that I know, it is not a philosophy or a physiology about something that is supposed to be happening inside us,  it is a reality. Now apparently this reality is different for all of us, but we dont debate its existence or its power. And we dont believe in it. We experience it, and  we practice the cultivation of it, Qi Gong.  And those that do have no problem motivating ourselves to get our daily workout in, it is a joy.
Qi Gong (Energy work) has a another translation, breath work. If you think of the human breath, the flow of Qi in the body, when well cultivated, has a breath to it. Taoist meditation is essentially the harmonization of the virtual breath (Qi breath) with the physical breath. Here great healing occurs for the same reason that the advanced practiioner can stand before you smiling on one leg and you cannot push them over with all your strength. With simply the mind and the results of much practice  this harmonization heals much.
We have a fundamental principle here that is diametrically opposed to western thought. Whereas western athletics emphasizes giving %110,
here one should exert %70, but practice more. A simple hip swing example is a perfect example. In this excercise you are to let your arms hang perfectly freely, which is almost impossible to do without training.
With two feet at hip spacing  feet parallel, you shift your weight from left to right weighted. Here one must end up completely single weighted, meaning that you can lift your unweighted foot slightly off the ground with no teeter. When you shilf left you also rotate left and when you shift right you rotate right.  When you rotate, your arms should swing aroung naturally. The objective here is to “open the hips”. Incidently, learning to be able to relax the arms opens up the shoulders. But one does not do extreme yogas or stretching, it is very gentle. Most who first try this attempt to get 30 degree rotation, but 10 is about as much as one should really shoot for. If you try to hard to get more rotation, the tensions in the body DO NOT allow the hips to open up and the excercise does not work. It takes most people many years before they finally truly understand this simple principle. It took me 6 years before they started to really open up. 
Another part of this principle is the breath. The breath is fundamental. The Qi comes from the exhale of physical breath. If the breath is not sound the Qi flow is weak.   So if you even just slightly hold your breath to obtain an additional rotation, you are defeating yourself. 

The ability to stand and not have you be able to move me is called “root”
and anyone who gets good gets a very serious root to the ground. In fact, one can judge individuals on how good of a root they have to assess how much you need to concern yourself with them if things should get rough. But the main point is, understanding “single weightedness” also called separation of powers and developing root allows an older person to substantially reduce their risks of falling and breaking a hip thus leading to their terminal decline. It also makes you a good dancer and a much safer fly fisherman.
There is much more to this story, I cannot say enough good things about it. But i would like to connect with the bedside manner subject you brought up.  Possibly one of the benefits of the placebo is that the patients breath becomes true, and this openness allows the type of Qi circulation to occur that provides healing. Just a thought.
Finally, we have a saying: “Dont just do something, stand there” which exemplifies the differences between these methods and traditional  western methods. Wu Chi, simple correct standing, is the foundational excerise. Most Tai Chi groups do not empasize its practice because westerners have such little patience for such little action. But evidently Sun Lu Tang made one of his  students stand in Wu Chi  for 2 years worth of class while the rest of the class worked out. This student became his finest. The standing practices can be very grueling but their health benefits, both physical and mental, are immense.
The Burghal Hidage Added Sep 3, 2018 - 8:15am
This is why a medical office is referred to as a "practice". Its a verb, not a noun :)
Stephen Hunter Added Sep 3, 2018 - 8:23am
Great article Katherine, this is a great topic and you have nailed it! Western medicine is good at the mechanical stuff like heart issues, but is definitely missing something. 
I often wonder why in drug tests that they do not have 3 groups- 1) the drug being tested 2) placebo given but subjects told it is a placebo 3) Placebo given to subjects but they do not know it is a placebo
Dino Manalis Added Sep 3, 2018 - 8:30am
 Placebos sometimes work, because people are hopeful, but real medicine is needed to treat patients effectively.
Doug Plumb Added Sep 3, 2018 - 8:40am
It is truly amazing how complex the human brain really is, the body also has a complexity that is beyond comprehension. I have a certain respect for doctors who constantly move about this not fully  unchartered territory. I can't do something that I do not fully understand, and I strive to understand math daily because its an integral part of my field, engineering.
Did the ancient Chinese know more ? I doubt it, but they tried a lot of things that worked, and I guess no one completely understands why. They know things we don't.
Western medicine is great for what is termed heroic medicine, fixing a broken body that was broken from a physical force such as a car accident or shooting. It doesn't appear to do much for the mind. Lorraine Day explains all of this in multiple youtube videos. They are not for those who are not yet prepared to lose their innocence.
My own experience tells me that excercise cures all, I used to swim for an hour and a half 18 years ago and two weeks ago began doing this again. I can swim a 50 meter without a dive at 32 seconds, not bad for a 54 year old. If I can quit smoking I could compete in Masters in 400 meter, the toughest race. If medicine could help me quit I'd be very happy, so far I have been unable to give it up. It would change my life if I could. Palcebos won't work. I cannot be hypnotized either.
Neil Lock Added Sep 3, 2018 - 11:02am
Katharine: I think the basis of your argument is right, in that health (absent physical trauma) is all in the mind.
But where physical trauma is present (as I know, being a sufferer from gout) then Western "chemical" solutions can help.
And I have difficulty understanding what you're trying to say in your last paragraph. In fact, the middle sentence of the three seems to contradict both the other two, and your overall theme.
Katharine Otto Added Sep 3, 2018 - 9:35pm
Thanks for the valuable addition to this post.  Although I have only taken a couple of workshops on qi gong, I saw an amazing demonstration by a master when I was in China.  I've studied acupuncture but not enough to feel proficient.  However, I do think in terms of qi and understand what you mean by saying it is a reality.  However, it's hard to explain to westerners who have no equivalent.  
Also in China, the elderly have a habit of doing tai chi every morning in the public parks.  That is also good for balance and coordination, and as you say, it's not supposed to be strenuous.  I wish something like that would catch on in the US.  It's possibly one of the best ways to maintain health well into old age.
You have posted something about qi gong before, and I hope you will do more of it.  I would like to learn more and believe others would, too.  
Katharine Otto Added Sep 3, 2018 - 9:37pm
We are always practicing, unless we quit learning.  There's always more to learn (and the older I get, the more I have to un-learn).
Katharine Otto Added Sep 3, 2018 - 9:40pm
It's only the beginning.  The contrasts between Eastern and Western medicine run deep.  As far as medications go, I'm beginning to wonder how effective they really are.  Recent studies are showing anti-depressants in children, for instance, don't work that well.
Katharine Otto Added Sep 3, 2018 - 9:42pm
Studies on acupuncture for pain, for instance, might contradict you on that.  No medications are involved.
Katharine Otto Added Sep 3, 2018 - 9:55pm
The concept of qi is in some ways akin to the idea of an aura, I think.  The premise is there's an energetic body that perfuses the physical body and may extend beyond the body we can see.  There's no question that the body is largely an electrical network.  Many cellular messengers, both inside and between cells, are anions and cations, like sodium and calcium.  The Western explanation for how acupuncture works is that the acupuncture needle through the skin creates an electrical potential difference between outside and inside, and this stimulates electrical flow.
I agree about "heroic" medicine and believe exercise does cure a lot.  However, motivating to do the exercise can be a challenge.
You mention Lorraine Day frequently.  I will have to check her out.
Katharine Otto Added Sep 3, 2018 - 10:00pm
You caught me.  The middle sentence of the last paragraph was reversion to my old, largely outgrown (I hope) sarcastic self.  I have learned that sarcasm doesn't work well in written communications.  I will revise it and omit that sentence.  Thanks for the editorial suggestion.
George N Romey Added Sep 4, 2018 - 1:38pm
I turn 59 today and haven’t been to a doctor since 1998. Listening to drug ads a should be dead for not continuously seeing the doctor and taking all kinds of bills. But somehow I live on.
Katharine Otto Added Sep 4, 2018 - 3:15pm
Happy birthday.  You are living proof that the health scare/snare racket is not necessary to health.  Many happy returns.
Doug Plumb Added Sep 4, 2018 - 6:34pm
I mention Lorrain Day whenever the chance arises, in conversation and online.
Doug Plumb Added Sep 4, 2018 - 6:36pm
Sorry for the discombobulated post earlier in the week. I'm a little discombobulated.
Jeff Jackson Added Sep 6, 2018 - 7:50am
I was once told that in ancient China, if the patient didn't get well, the doctor was paid nothing. Pay for performance, like in sales jobs and many other professions, could be an incentive. Why pay and stay sick? The doctor's job is to heal you. I understand things like cancer and terminal diseases notwithstanding. Take ALS. I watched a family member die of it, and it was horrible. Perhaps pay for performance could be the incentive.
Katharine Otto Added Sep 6, 2018 - 3:04pm
I've heard that families in China paid doctors to stay away.  Why would anyone choose to be a doctor if income was so undependable?  There's also the question of what constitutes healing.  A person could pretend to stay sick in order to save money.  Malingering for financial gain, as in malpractice suits, is not new.
John Minehan Added Sep 7, 2018 - 7:22pm
It may have a lot to do with the part that illness, like good health, is a spectrum and a process. 
You get sick and (usually) you recover.  However, some things do not ALWAYS heal by themselves, hence a need for interventions.
I'll give you an analogy.  I knew a Brigade Signal Officer ("SIGO") in the Gulf War who, when you couldn't talk on the radio, would tell you it was probably atmospherics and it would probably pass in 15 minutes. 
He was relieved.
The next SIGO we got would get in there and check wires and take a pencil eraser to the connectors if you could not talk.
He was awarded a Bronze Star and received a glowing OER.
After the war, I said I noticed he usually spent about 10 to 15 minutes doing that.  He said, of course, it was really only a matter of atmospherics how changing temperature and how dry or wet the ground was govern radio wave prorogation, but you can't let the supported headquarters know that.        
Katharine Otto Added Sep 7, 2018 - 9:43pm
Good one, John.  Placebo in action.

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