Chinese Patients Exercise Their Way Back To Health

by Chiu-Nan Lai

My introduction to Chi gong, an ancient Chinese system of therapeutic exercises which is largely unknown to the West, took place about one week after my arrival in Beijing in September of 1981. Under the auspices of the National Academy of Sciences (Committee for Scholarly Communication with the People’s Republic of China) I was to spend three months at the Cancer Institute in Beijing collaborating with their scientists on a project studying the modifying effect of a regional Chinese diet on the incidence of esophageal cancer.

It was the first morning after settling into the National Labor Union Guest House, which was to be my home for the next three months. Suffering from jet lag, I woke up hours before having to report to work at the Cancer Institute, located just around the corner. I decided to go for a walk in the park across the street. Once outside, I was confronted with a continuous stream of bicyclists. The traffic, even at this hour, was unlike anything that I had ever seen. There were at least three lanes of bicycles going in each direction. I looked across the street to the entrance of the Ritan Park and was bewildered. Suddenly I remembered my cousin’s advice on crossing the street in China: “Just walk at a normal pace. Don’t stop or slow down and the bicycles will go around you.” I stepped off the curb and walked with my eyes focused directly ahead of me. To my amazement, I found myself on the other side of the street, at the gateway to a totally new experience.

Ritan Park, located only a few blocks away from the American Embassy, was once an imperial ceremonial ground known as the Sun Temple. A burst of flowers in bright red, orange, and yellow greets visitors at each of the four entrances. The spacious grounds of the park, dotted with evergreens, surround a small hill with a pagoda on the top and several buildings. A pond with fountains and a sculpture of flying swans completes the imperial scene. In the center is the temple itself, an enclosure surrounded by a circle of walls. In the imperial days, all of this was off-limits to ordinary people, but now it is open to the public.

In the early morning hours the park bustles with activity. Men with weathered faces sit on a bench deeply engrossed in a lively conversation. They stop now and then to admire the cages of birds resting at their feet. A short distance away more birdcages hang from the trees while their owners stroll nearby keeping a watchful eye on them. A young couple giggles while playing badminton, and joggers pass by. Hidden voices sing an aria from a famous western opera.

In the shadows of pine trees several groups of people perform various slow movements. A banner next to one group reads “Beijing Athletic Association, Tai Chi Chuan.” Another reads “Beijing Chi Gong Research Association.” I moved closer to the Chi Gong group, because I had heard of the recent popularity of this ancient healing art. A robust woman in a blue jacket and baggy blue pants leads the group: “Xi-xi, hu; xi-xi, hu (xi means inhale, and hu means exhale)”. The breathing drill is synchronized with a step of a slow walk. “Relax, swing your arms to the left, to the right.” The students appear to be totally absorbed with their walk, eyes half-closed, oblivious to others around them.

The Chi Gong classes, which start at six a.m. and last an hour, attract people with various chronic illnesses. The Chinese believe that Chi Gong can combat a host of ailments including diabetes, heart disease, arthritis, liver and kidney problems, and cancer. Hospital patients have found that by doing Chi Gong exercises every morning the side-effect of cancer treatments are reduced. They notice improved appetite and sleep, as well as an increase in overall immune resistance. And best of all, they become optimistic and cheerful. This is no small feat because cancer is such a psychologically devastating disease. Chi Gong deals directly with the psychological needs of cancer patients, a virtually unexplored area in modern Western medicine.

As a cancer researcher, I was particularly interested in the Chi Gong class for cancer patients. When I inquired about signing up for the classes, a bystander directed me to Mr. Fu, the person in charge of registration. “What is your illness?” Do you have a doctor’s diagnosis?” he asked. I explained that I was just interested in learning the exercises for cancer patients because I work in cancer research. He shook his head and said: ”The exercises can be practiced only by cancer patients. Besides, foreign guests cannot register without special permission from the secretariat of the Chi Gong Research Association.” I was surprised that he knew I was not local. Because I was born in Taiwan but had ancestral roots in Hunan, I spoke fluent Chinese. I even had on a blue jacket and baggy blue pants and was trying my best to blend in.

I pressed for an explanation. “Oh, it is easy. The way you move and your facial expressions give you away,” he said. When I asked further about the success of the Chi Gong class for cancer patients, Mr. Fu said: “Let me put it this way, in the one-and-half years since the beginning of the classes, we have never heard of one single case where the patient came one day and did not make it the next.” Our conversation was interrupted when a man came up to register his wife, who had cancer. I was not really satisfied with Mr. Fu’s remarks but they were intriguing. All he said was that patients who can come to the class do not die the very next day. It told nothing of their condition after they stopped coming to class or how the exercises had helped them.

My early morning walk became a daily ritual. I learned more about Chi Gong. “Before you start the exercise, imagine a happy event. Let that image totally engulf you. Pick a stationary object in your mind. Focus on it. If you have high blood pressure, choose a low-lying object like a small flower. If your blood pressure is low, choose an object at eye level like a small pine tree. Return to the image when distracting thoughts interfere with your concentration. Don’t concentrate too hard either.”

I also learned that many of the students in the cancer class were patients at Ritan Hospital across the street. They claimed the daily one to two hours of Chi Gong exercises contributed significantly to their fight against cancer. At the very least it seemed to reduce the side-effects of cancer treatments, such as loss of appetite, weight loss, and lowering of white blood cell counts. Improved appetite and sleep are usually the first noticeable changes. “I was very depressed at first,” a women athlete in her thirties told me in speaking about her cancer. “But after I came here, and saw how cheerful everyone else was, I stopped worrying.” Indeed the most striking feature of the Chi Gong classes is the optimism and the cheerfulness of the students.

It is well known that two of the side-effects of cancer are depression and fear. Chi Gong deals directly with the psychological aspect of the disease. Even before the cancer patients begin the program, their confidence is bolstered by the positive experience of more advanced students of Chi Gong. In addition, as part of the Chi Gong exercises, the patient’s mind is focused on pleasant images or memories. All of this creates a positive mental attitude in the patient. To what extent this may contribute to the benefit of Chi Gong is largely unknown since the psychological aspect of cancer is still not fully understood. Scientific studies have shown that stress can stimulate the neuroendocrine system, leading to depression of the immune system. Furthermore, the genesis and growth of cancer can be influenced by stress through such mechanisms. Removal of psychological stress alone can alter the neuroimmunal functioning of the body to the extent that it can change the course of cancer development.

Ritan Hospital is the best known cancer hospital in the country. It has all the facilities of a modern hospital including surgery, radiation, and chemotherapy. The only Chinese touch is the presence of an herbal pharmacy from which doctors can order traditional herbals to counteract the side-effects of the Western treatments on their patients. In the hospital courtyard, gowned patients walk or sit on the benches in order to enjoy the autumn sun. On a typical afternoon most of the hospital rooms remain empty because patients go to the courtyard or to the park across the street.

Patients are expected to look after themselves. As long as they are physically capable, patients make their own beds and pick up their own meals from the meal carts that come to their wards. The meals are ordered ahead of time and an array of typical Chinese dishes is offered. Those who are taking Chi Gong classes rise early and after changing into street clothes arrive in the park for their daily Chi Gong exercises. Classes always finish in time for them to return to the hospital for breakfast.

Many of the hospital personnel are ambivalent toward the classes. “It just does not look good when our patients run around in the park,” a head nurse was told by her superior. “But the patients complain that the hospital gate opens at six a.m. instead of five-thirty a.m.” Apparently the gate opens later as winter approaches. The physicians and nurses agree that patients taking Chi Gong classes appear not to suffer from the side-effects of the radiation and chemotherapy treatments. They continue eating well and maintain their weight. One study performed at the Beijing Lung Cancer Research Institute showed that Chi Gong exercises increased immune resistance among lung cancer patients. This was indicated by studies of white blood cell counts and skin tests. Some physicians recommend Chi Gong to their patients as a last resort when other therapies fail.

In order to fully appreciate the value of Chi Gong it is necessary to consider it in the context of the philosophical foundation of Chinese medicine. Chinese medicine views a human as an integral composite of mind, emotions, and body which are intimately connected with the heavenly and earthly environments. Health and longevity result from harmonizing these components within oneself and in the environment. This requires following the seasonal changes in the choice of foods, seasonal fluctuations in sleeping and walking patterns, and temperance in all indulgences. Most importantly, a tranquil mind, which is achieved through reducing desires and quieting random thoughts, is essential in maintaining health.

Illnesses are perceived as the results of imbalances in any of these aspects of living. Emotional stresses can induce physical problems while physical problems can induce emotional responses. For example, worry and anxiety are related to the heart, and continual worry or excessive anxieties can result in heart problems. Anger and the liver are related. While anger emotions can injure the liver, liver problem can also bring on frequent outbursts of anger or an attack of bile as they say in the west. The psychosomatic aspect of health and disease has an important place in the tradition of Chinese medicine. The inter-relationship between the physical and emotional states has guided medicine in China for thousands of years.

The term Chi Gong is difficult to translate. Firstly, chi has the meanings of air, breath, or gas. It is the substance traditionally believed to permeate the human body, flowing along paths called meridians. These meridians are not linked to the vascular system but influence metabolism and the functioning of different parts of the body. This Chinese view of the human body with the chi flowing through the meridians is still somewhat of a mystery. When the flow of chi is unobstructed, health prevails. Obstruction of chi in any part of the body brings on sickness. Obstruction can be brought on through neglect and abuse of the body or from emotional disturbances. All the traditional Chinese medical practices work on removing obstruction. The flow of chi can be manipulated by inserting needles at specific points on the meridians and this is of course the new popular practice of acupuncture. To illustrate how pervasive this concept of chi is in Chinese culture, the Chinese word for anger is shen-chi or “(to) generate chi” and the word for temperament is pe-chi or “spleen chi.” Even the word for weather, tian-chi, means “heavenly chi”.

Secondly, gong means work, effort, or accomplishment. Together the two words Chi Gong mean “working on the chi” or “mastery of the chi.” This mastery of chi is accomplished through specific movements, rhythmic breathing, sounds, and mental imagery. The most famous Chi Gong movements imitate the movements of five animals: bear, tiger, monkey, deer and bird. The breathing accompanying the movements are generally slow and unhurried and perhaps softly audible. Depending on the nature of the disease, the rhythm may be two short inhalations, one exhalation, or one in and one out. The emphasis for cancer patients is in breathing in a lot of oxygen and the two short inhalations and one exhalation method of breathing is preferred.

However, the essential aspect of Chi Gong has to do with the mind. The success of Chi Gong depends to a large degree on whether the mind is relaxed during the exercises. To arrive at the mental state of tranquility and peacefulness, students of Chi Gong are first advised to avoid indulging in the seven emotions: elation, fear, fright, sadness, yearning, anger, and worry. Excesses in any of the emotions prevent reaching the state of tranquility and aggravate any existing health problems. Furthermore, interference by random thoughts during exercising is prevented by focusing on certain themes – imagery of objects or words. Chi Gong exercises often employ only imagery to guide the flow of Chi to different parts of the body. Whether the unobstructed flow of Chi is accomplished through movements, breathing, sound, or imagery, the end result is an improvement in health and longevity.

The earliest mention of Chi Gong was recorded in the classic of internal medicine, the Nei Ching, over four thousand years ago. Nei Ching, or more fully Huang Ti Nei Ching, is the oldest known writing on Chinese medicine. It provides the foundation for the practice of Chinese medicine. Also during recent archaeological excavations of Han Tombs in Changsha, Hunan, which are approximately two thousand years old, archaeologist found among medical writings extensive drawings of Chi Gong movements, indicating that even in the Han dynasty it was still popular as a form of therapy.

The practice of Chi Gong, however, is not restricted to the context of medicine. Until very recently it was particularly popular among Taoists, who strive to follow the Tao or the order of the Universe. They felt that by being in harmony with nature one enjoys not only peacefulness of mind but longevity and a youthful body. The practice of Chi Gong is consistent with the attainment of inner harmony. Since the Taoists preferred secluded areas far away from civilization to practice their beliefs, it was necessary for them to learn self-defense to protect themselves form wild animals and bandits. One school of Chi Gong developed into the martial arts. In time Chi Gong became associated with the exhibition of unusual powers: crushing bricks with bare fists, jumping over high walls, immobilizing an enemy with the touch of a finger. This approach was practiced only by small groups of people and considered too esoteric for the general public.

Today large numbers of Chinese are turning to Chi Gong for health reasons. According to the Chi Gong Research Association, which sponsors many classes, over ten thousand people are enrolled through out the greater Beijing area. In addition, organizations such as the Beijing Athletic Association sponsor their own Chi Gong classes. There are also classes personally supervised by the famous Chi Gong master, Madame Guo Lin in Ditan (Earth temple) Park and the Purple Bamboo Garden.

Madame Guo first taught Chi Gong in the parks more than ten years ago, long before the current popularity. She is the one individual most responsible for the current interest in Chi Gong. Even now, at the age of 73, she still personally supervises classes. On Sunday mornings she can be seen working with her thirty or so volunteer teachers and aides at Ditan Park, and on Monday and Wednesday mornings she teaches at the Purple Bamboo Garden Park.

Guo Lin does Chinese brush-painting of landscapes and flowers for a living and is a founding member of the Beijing Art Institute. She has been painting since she was eight, but she has an even longer experience with Chi Gong. Brought up mostly by her grandfather, a Taoist, she was first instructed in the ancient exercise of Chi Gong when she was six. Later, in her career as a landscape painter, she found herself visiting many famous mountains of China, where she encountered several Chi Gong masters, with whom she studied.

She modified Chi Gong specifically to cure diseases after her own bout with cancer thirty years ago. It was during the stressful years of the “liberation” of Shanghai that she developed cancer of the uterus. After six operations to stop the spread of the cancer she started working on modifying Chi Gong to restore her health. It worked and now she has been practicing the “new” Chi Gong for over twenty years and teaching it for over ten years. She now turns over teaching responsibilities to many of her former students. She serves as a consultant to the Chinese Chi Gong Research Association and personally supervises only the more difficult cases. In Beijing alone there are three to four hundred students who participate in her classes annually.

The popularity of her classes was helped by numerous newspaper reports as well as several television documentaries about Chi Gong. She and her assistants have been invited to start classes all over China. A story in an important Chinese scientific magazine drew many inquiries from readers. In response to the intense interest generated by the article, the magazine asked Guo Lin to write books about Chi Gong, which resulted in two titles (available only in China). The first, New Chi Gong Therapy for Beginners, describe the basic exercises for treating chronic illnesses. The second book, New Chi Gong Therapy for Cancer, is more specific. In addition to basic exercises it describes special ones geared for cancer patients. In both books there are many illustration depicting the exercises in great detail.

The case histories at the end of the books contain hospital records as well as the patients’ own accounts of the disease. In the first book, the cases include chronic heart problems, hepatitis, digestive problems, kidney inflammation, arthritis, glaucoma, and respiratory problems. All were cleared up after several months of practice. Hospital checkups showed healthy patients free of the original problems.     Guo Lin’s second book covers many types of cancers including lung, breast, liver, and lymph node. In almost all cases the disease had progressed to the late stage with extensive metastasis. Here are two interesting cases:

Mr. Gau, age 55. Profession: Assistant Secretary in the Department of the Navy. In 1976, Gau was diagnosed from x-rays and a biopsy as having cancer of the lung. Exploratory surgery revealed extensive metastasis. The doctors closed his chest without any further surgical operation. He received radiation and chemotherapy treatments as well as herbal medicine. Despite all these efforts his health continued to deteriorate. He suffered from swelling of the lower limbs after the chemotherapy treatment as well as headaches, dizziness, poor appetite and poor sleep. His white blood cell count fell below 4600 compared to an average of 9000. His doctors guessed he had six months to live.

In May of 1977 he was introduced to Chi Gong. In the beginning he could do only very limited exercise, walking no more than two hundred steps per day. Gradually he did more – three hundred, four hundred, and eventually ten thousand steps each day. This is the level he has maintained for the last four years. Like most new students of Chi Gong he was skeptical at first but after two weeks he noticed improvements: better sleep at night, bigger appetite. The swelling in the lower limbs also slowly went away as well as his radiation-induced pneumonia. After the first year he went back for a checkup. His doctor was amazed that Gau was still alive. Two years later he went for another checkup – the doctor was even more surprised. Three years later his annual checkup indicated that he was in good health. Gau returned to work in March of 1980 and except for his daily “walks” leads a normal life. When I met him in Madame Guo’s art studio in November of 1981, he was in good health.

Ms. Chiang, age 42. Profession: Research Assistant, Institute of Dynamics, Chinese Academy of Sciences. Chiang was first diagnosed in 1975 as having cancer of the right chest with involvement of the lymph gland in the left breast. In May of the same year the right breast was removed. In March of 1977 the cancer spread to the ovary. A second operation removed the ovary. She was also given radiation and chemotherapy treatments. She began the Chi Gong exercises in July of 1977. The cancer that had earlier spread to the left breast ceased growing. The side-effects experienced during radiation and chemotherapy treatments such as loss of appetite, poor sleep, and lassitude all disappeared. Her blood count also returned to normal. Her physician noticed that macrophages obtained from her had the capacity to attack cancer cells. She has since returned to work and shows no signs of cancer. Originally she was expected to live only six months. It has now been more than three years since she started Chi Gong. Her case has inspired other patients with cancer and chronic illnesses in her institute to take up Chi Gong. In response to the interest, special classes have been organized at her place of work.

There are many more cases like these two. Madame Guo has records of over 7000 cancer cases from the Chi Gong classes throughout China. There are even more cases of people with chronic illnesses who have regained their health through practicing this ancient exercise.

How has the Chinese government responded to the popular interest in this ancient healing art? Basically not at all. After all, China has more pressing problems, with “modernization” having the highest priority. This in part explains the lack of interest on the part of the medical establishment in Chi Gong. The cancer researchers at the Cancer Institute are preoccupied with modernizing laboratory research such as bringing in new equipment and techniques but are unaware of the remarkable movements taking place across the street in Ritan Park. When asked specifically about what they thought of Chi Gong, the response ranged from complete ignorance to mild interest. At a time when the top leadership is urging modernizations, paying attention to an ancient healing art is probably viewed as a retrograde step. Regardless of what the government or scientists think, the present popular interest in Chi Gong is likely to continue. To those who are suffering from pains of human illnesses it is what works that matters, be it a twentieth-century invention or a four-thousand-year-old exercise.

Since my visit to China last year, Madame Guo’s work has received more recognition in China. At least two more articles have appeared in print about her work, one in an English language magazine, Women of China. The other article, “Cancer Does Not Mean Death,” written by the famous Chinese writer Ke Yan, appeared in a Beijing literary magazine. It was based on the author’s own encounter with cancer and Chi Gong.

(Originally published in East West Journal, March 1983)

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