When the “Qi” in our body does not function properly, we become ill and uncomfortable.
Qi stagnation refers to a pathological state where the flow of Qi is obstructed and stagnant.
Qi stagnation is primarily caused by emotional distress, or by the obstruction of phlegm, dampness, food accumulation, heat, and blood stasis, which affects the circulation of Qi; or due to dysfunction of the organs, such as the liver failing to disperse Qi or the large intestine failing to conduct, leading to local or systemic Qi stagnation, which can result in dysfunction of certain organs and meridians. Qi stagnation generally belongs to the category of excess pathogenic factors, but it can also occur due to Qi deficiency leading to insufficient propulsion.
The pathological manifestations of Qi stagnation are diverse: Qi stagnation in a specific meridian or local area can lead to corresponding symptoms of fullness and pain. When Qi stagnates, blood circulation is impaired, and the distribution of body fluids is obstructed; thus, severe Qi stagnation can lead to blood stasis and fluid retention, resulting in pathological products such as blood stasis and phlegm-dampness.
Due to the liver’s role in ascending and the lung’s role in descending, the spleen and stomach play a crucial role in regulating the overall Qi mechanism, making Qi stagnation in the lungs, liver, and spleen-stomach quite common. Lung Qi obstruction can manifest as chest tightness and cough; liver Qi stagnation can lead to emotional distress and pain in the hypochondrium or lower abdomen; spleen-stomach Qi stagnation can present as abdominal fullness and pain, intermittent discomfort, and constipation.
The manifestations of Qi stagnation may vary, but the common characteristics are fullness, distension, and pain. In cases where Qi deficiency leads to stagnation, the symptoms of fullness, distension, and pain are generally less pronounced than in excess conditions, and corresponding signs of Qi deficiency may also be present.
Let us examine how to differentiate Qi stagnation in different organs.
Qi stagnation in the spleen leads to reduced appetite, fullness, and pain.
When the spleen and stomach are weak, or after an illness leading to insufficient central Qi, the spleen loses its ability to transport, and the stomach fails to receive, resulting in symptoms such as epigastric fullness, poor appetite, nausea, and vomiting; Qi stagnation leads to difficulty in bowel movements; spleen deficiency results in insufficient Qi and blood production, leading to general fatigue, shortness of breath, pale complexion, and fatigue; the tongue is pale with a white coating, and the pulse is deep and thin, indicating Qi deficiency.
For spleen deficiency with Qi stagnation and abdominal distension, the treatment principle is to strengthen the spleen, open the stomach, move Qi, and resolve fullness, using the formula: Xiang Sha Zhi Zhu Wan (Atractylodes and Amomum Pill) with modifications.
For abdominal distension due to spleen deficiency and Qi stagnation, the distension is worse in the afternoon, worsens with food intake, and improves after digestion; the tongue is pale with a white greasy coating. A constitutionally weak spleen or excessive sweating harming spleen Yang can lead to spleen Yang deficiency and impaired transformation, resulting in internal phlegm-dampness, which obstructs the Qi mechanism, causing abdominal Qi stagnation and fullness. This is a mixed pattern of deficiency and excess.
This condition is characterized by deficiency mixed with excess, where abdominal fullness is generally heavier in the morning, lighter in the afternoon, and particularly heavy in the evening, but the fullness does not like warmth or pressure. The treatment principle is to strengthen the spleen, eliminate dampness, and relieve fullness, using the formula: Hou Po Sheng Jiang Ban Xia Gan Cao Ren Shen Tang (Magnolia Bark, Fresh Ginger, Pinellia, Licorice, and Ginseng Decoction).
Qi stagnation in the liver leads to rebellious liver Qi, hypochondriac pain, and irritability.
Rebellious liver Qi is primarily due to liver Qi stagnation, where Qi is not smoothly dispersed, leading to the accumulation of turbid Qi in the body, resulting in liver dysfunction, emotional repression, and unhappiness. In addition to emotional issues, rebellious liver Qi can cause various symptoms that disrupt the body and harm health.
Any ascending Qi emerges from the liver. The liver wood nature ascends and disperses; if obstructed, Qi will rebel, leading to belching, distension, vomiting, irritability, hypochondriac pain, chest fullness, loss of appetite, diarrhea, and hernia, all of which are manifestations of rebellious liver Qi.
The treatment principle is to soothe the liver, regulate Qi, invigorate blood, and relieve pain, using the formula: Chai Hu Shu Gan San (Bupleurum Powder to Sooth the Liver) with modifications.
Qi stagnation in the lungs leads to rebellious lung Qi, excessive phlegm, cough, and wheezing.
This is often due to the invasion of external pathogens or the obstruction of phlegm-dampness, preventing lung Qi from dispersing and descending, leading to cough and wheezing. Rebellious stomach Qi can occur due to cold drinks, phlegm-dampness, or food accumulation obstructing the stomach, or external pathogens invading the stomach, causing it to lose its harmony and leading to hiccups.
The treatment principle is to tonify Qi, consolidate the lungs, descend Qi, and relieve wheezing, using the formula: Shen Zhe Zhen Qi Tang (Ginseng and Red Earth Decoction).