Healthy and pathogenic qi

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Healthy qi and pathogenic qi are two central ideas in traditional Chinese medicine. Healthy qi is a pithy concept that reflects all of TCM's core understandings of what health is and how health is maintained. Pathogenic qi, on the other hand, is a term that refers to the various environmental, mental-emotional, and pathophysiological factors that can undermine good health and lead to illness.

"Healthy qi"

The Chinese character qi
  • Healthy qi (aka “righteous qi” or “correct qi”) is a traditional Chinese medicine term that describes the qi of a human being in physical, emotional, mental, and even moral health. One who "has" healthy qi enjoys a state of being marked by subjective feelings of vitality and wellbeing as well as objective vigor and harmonious physiological functioning.
  • Healthy qi is not a synonym for what modern medicine calls “the immune system,” nor is it a mysterious "energy," nor is it any other isolable bodily system or function. Rather, it is a state of harmoniously integrated functioning which yields holistic health in the present moment as well as the capability to continue being healthy throughout the life course; it is adaptive, dynamic homeostasis in mind and body.

"Pathogenic qi"

  • Pathogenic qi (aka "pernicious qi," “pathogenic factors,” “pernicious influences”) is a TCM term that refers to factors in life that cause imbalances in or weakening of human beings’ qi, and therefore can lead to illness.
  • Pathogenic qi can have external origins, meaning they are found in the environment and/or diet. It can also have internal origins, arising from imbalances in thoughts, emotions, or the qi of the zang-fu organs and/or meridians.
  • Pathogenic qi is usually referred to in terms of wind, cold, dryness, dampness, heat, and fire/inflammation. Sometimes pathogenic qi is literally caused by climatic factors; at other times, Chinese medicine uses these words metaphorically.

A deeper dive into our gonzo terminology

If there were ever two terms that sounded like they belonged to snake oil salesmen in the Old West, they’re “righteous qi” and “pernicious influences.” How could the two relatively sane-sounding terms above—pathogenic and healthy qi—have such bizarre-sounding synonyms? If the answers in the discussion below seem very philosophical, that’s because TCM theory is basically what happens when Chinese philosophy gets applied in a medical context.


To get a handle on these unusual terms, looking at their Chinese origins is very helpful. The word pathogenic qi comes a compound of two Chinese characters, 邪 and 氣, xie and qi. Yep, that’s the same qi you see me talking about all over the place. That xie there isn't always translated as "pathogenic," though. Some people translate it as “pernicious” and in the past some translators even used the term “evil,” although in traditional Chinese medicine that is a usage that has gone (rightly) out of fashion.

How can one Chinese character—xie—have so many translations? Well, the flexible nature of the Chinese language, the incredible length of China’s history, and the fact that the language has been shared by countless millions of people means that most common characters have accumulated a lot of definitions. It is quite true that one of the meanings for xie is “evil,” but it's important not to get confused and think that TCM believes wandering clouds of mischievous energy are what makes you sick. Traditional Chinese medicine also does not teach that people get sick because of any intent, malicious or otherwise, on the part of mother nature or any other "being."

Rather than focus on the word “evil” to understand pathogenic qi, we should look at another meaning of the character xie: "askew," or to be a bit more colloquial about it, "outta whack."

When we talk about the types of qi that cause illness, we're basically talking about pathologies caused by or metaphorically represented by six types of climactic phenomena (wind, cold, heat, dampness, dryness, and fire), or else common emotional states humans experience, especially fear, anger, joy, sadness, and worry. The effects these "qi" have on us aren’t really that important to us most of the time, because usually they don't make us ill. However, when one of these factors becomes strong enough to interrupt our body's healthy homeostasis—knock us askew, as it were—then we begin to take notice. Thus, it's when an otherwise innocuous factor in the external environment, our body's internal environment, or our mental-emotional environment becomes strong enough to negatively influence the human body that we give it the name pathogenic qi.


"Healthy qi from head to foot"—zheng is the big character second from the left
The Chinese character zheng (正) is always the opposite of the character xie. The word zheng is very important to TCM doctors, because it comprises one half of the word "healthy qi." If one considers the word zheng in light of how I describe xie just above, then it connotes "upright," in the sense of a situation where nothing is askew or off-kilter. You could say that "healthy qi," is a state where nothing's outta whack.

To look deeper, the character zheng is comprised of two ideograms, 一 (one) and 止 (foot). This combination's most ancient meaning denoted moving in the direction of a central target or goal, with no twisting or deviation along the way. Among its many other definitions, it also refers to correctness and straightness; "just right-ness;" purity; positivity; and normalcy. Finally, zheng is also used to denote the number one, as in the case of the first month of the Chinese calendar. It's not hard to see why the Chinese chose this meaning-rich character to represent health. You can also see why healthy qi is sometimes called "righteous qi" or "correct qi."

Understanding "oneness" and holistic health

Above I wrote that the top part of the character zheng is the Chinese character for the number one. In Chinese medicine, oneness creates good health. When all aspects of a person’s qi—including body, mind, and emotion—are balanced and healthy, then they naturally fall into a type of harmonious homeostasis that we can, philosophically, call oneness. To make it less abstract, think of it this way: when all of the instruments in an orchestra or the voices of a choir are in harmony, then they unite as one sound, which is both beautiful and powerful in its ability to stir listeners’ hearts. When your body and mind harmonize, they too create “one” qi, the power of which is “righteous” in the same way that a world-class orchestra’s sound is. This powerful harmony, where all your parts and functions are cooperating marvelously, keeps you healthy and, indeed, protects you from the factors that cause illness. This state is zheng—healthy qi.

Losing harmony and losing health

If healthy qi is analogous to a grand orchestra full of master musicians playing in exquisite harmony, then how might we imagine that which we call pathological qi? Here're two examples that'll hopefully bring the term to life:

Firstly, imagine you were in the audience listening to that orchestra, and somebody in the back of the concert hall picked up a drum and started bashing away. Would this disrupt the music? Not necessarily. If the size, volume, and integrity of the orchestra were great enough, and the sound of the drum weak enough, then the orchestra's music would drown out even this uncivilized little drummer boy, and the concert would go on, with the drummer giving up or going away when his arms tired, or else getting kicked out by the security guards, who are a bit like your wei qi. This analogy is like the case of a tiny cold draft blowing on your neck for a few minutes—a bit uncomfortable, sure, but not enough to knock your system out of whack and make you sick.

One rogue drummer might not be a big deal, but what if a multitude of vandals in the audience all whipped out their own instruments and began drumming, strumming, and piping away? This unfortunate disturbance would slowly but surely result in a cacophony capable not only of competing with the sound of the orchestra, but also interfering with the musicians’ ability to concentrate and play properly. Such a scenario is comparable to the effect of pathological qi from the external environment (for example cold or dampness) attacking the healthy qi of the body.

The second scenario that would disrupt the harmony or “oneness” of the orchestra works a little differently. Imagine that within the orchestra itself certain sections were underpaid, underfed, and generally felt disrespected. They would certainly begin to play with less attention and energy—or maybe even start following their own rhythms or going on strike outright—and soon enough the beautiful harmony of the orchestra would be undermined by these musicians unable or unwilling to play their parts properly. This state of affairs could be compared to the effect of pathological qi arising due to weakness and imbalance in the qi of the zang-fu organs and meridians.

Your mind's role

Ah, the misty mountains! This young Daoist happ'ly surfing the internet is practically the picture of healthy qi—wonder if he reads Return to Spring?
If we continue with the above analogy we might ask, who in the orchestra , more than anybody else, would really cause trouble if he or she were to start acting up? The conductor! A conductor who has lost his or her connection to the music will send everybody in the orchestra into a state of havoc, and very quickly the music is going to be completely disharmonious, which means that the internal righteous qi of the organs and meridians is now also compromised. What happens next? The audience will start booing loudly and throwing things at the stage—just like external pathological qi joining the party to make things worse once internal harmony and oneness have been lost. The conductor is analogous with the mind, and just as a conductor neglecting his or her duties will cause chaos in the concert hall, the more one strays from mental and emotional harmony, the more likely one is to develop illnesses—a reality that modern, Western medical research is beginning to “discover.”

That there are so many factors involved in maintaining the integrity of one’s healthyqi is what makes traditional Chinese medicine truly a holistic discipline. It's also part of the reason that making psychological and lifestyle changes is necessary for anybody hoping to "return to spring" and recover their health. Making the changes you’ll need to make to improve your health can seem like very hard work at first, but it's not impossible, and the payoff is worth it. Precisely because body and mind are so intimately intertwined, the more you develop healthy qi the happier, sunnier, more energetic, and downright younger you'll feel. Not bad, eh?

For more information on how TCM teaches us to look after ourselves, check here for all kinds of ideas about what we can do to stay healthy.