(Schoolof Chinese Medicine, University of Hong Kong)
Objective: Toclarify the inter-relationship between De-Qi and Arrival of Qi.
Methodology: Byre-considering the relevant extracts of the ancient Chinese medicine classic“Nei Jing” , the author compared and contrasted the essence of De-Qi andArrival of Qi, based on his knowledge and perspective on the area .
Results: Theconcepts of “De-Qi” and “Arrival of Qi” are first mentioned in the text of the Chinesemedicine classic “Nei Jing”. “De-Qi” signals the exact puncture hit on anacu-point and is a sign of “Qi arrival at the puncture point”. It is also apre-condition for “Bu Xie” (qi reinforcing or reducing) manipulation. The“De-Qi” sensation can be sensed both by the doctor and the patient. For thedoctor, sensing De-Qi from the needlecan befelt as “tight and swift” “sunken, sticky and tight” or “light, loose and empty”. For the patient, it can be sensed as“warm at the puncture point” or “cold at the puncture point”. De-Qi can alsoexhibit itself as an unperceptive needling sensation when qi moves along themeridians or can take the form of a “even-paced and tranquil” qi sensation (“guqi”) felt by the doctor when qi adjustment is obtained. “Arrival of Qi” has two main concepts : one is“Qi arrival at the puncture point”, second is “Qi arrival at the sourcelocation of illness”. “Qi arrival at the puncture point” has very similarconnotations to “De-Qi”, however, “Qi arrival at the source location ofillness” places more emphasis on “Qi arrival with efficacy”. Efficacy can come in the form of an immediateeffect or a delayed effect. Generally, internal medicine diseases involvingdeficient or surplus imbalances have better treatment efficacy with “Bu Xiereinforcing or reducing qi tranquilization techniques”. Myofascia relateddiseases have better treatment efficacy with “Yi Shen spirit adjustment qitranquilization technique”.
Conclusion:“De-Qi” and “Arrival of Qi” have similar but nuanced connotations. “De-Qi”focuses on the importance of the processes involved during the course ofacupuncture (differentiate the nature of qi, guard the qi, manipulate the qi).It also suggests the clinical significance of “De-Qi” with unperceivable needlingsensation. “Arrival of Qi” emphasises “Qi arrival with efficacy”. For diseasesinvolving myofascia related diseases, “miu ci” (a technique involving thepiercing of the area on the opposite side of the body to the area of thedisease) and shallow piercing can achieve an immediate treatment effect. Although internal medicine diseases involvinginterior, deficient or surplus imbalance scenarios often come with a delayedtreatment response, pulse diagnosis can be used as an indicator of theefficacy. It is important to re-emphasis the application of pulse diagnosis inacupuncture.