1. Qi Deficiency
Qi deficiency refers to the depletion of vital energy (yuan qi), resulting in insufficient energy throughout the body and weakened functions, leading to the decline of organ functions and reduced resistance to disease. Clinically, it is commonly associated with symptoms such as mental fatigue, lethargy, dizziness, spontaneous sweating, susceptibility to colds, pale complexion, pale tongue, and weak pulse. When it is primarily a deficiency of yuan qi, symptoms may include delayed growth and development, and reduced reproductive function. If it is primarily a deficiency of zong qi (ancestral qi), symptoms may include palpitations upon exertion and shortness of breath.
2. Qi Stagnation
Qi stagnation refers to the pathological state of obstructed qi flow, where the circulation of qi is impeded. Qi stagnation is mainly caused by emotional distress, or by phlegm-dampness, food accumulation, heat stagnation, or blood stasis, which obstructs the flow of qi; or due to dysfunction of the organs, leading to localized 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 insufficient qi leading to stagnation.
Clinically, common symptoms include distension and pain, which can lead to blood stasis and water retention, forming pathological products such as blood stasis and phlegm-dampness. Qi stagnation can also cause lung qi obstruction, resulting in chest tightness and cough; liver qi stagnation, leading to distension in the hypochondrium and lower abdomen; spleen and stomach qi stagnation, presenting as poor appetite and abdominal distension and pain; and gastrointestinal qi stagnation, resulting in abdominal distension and pain that comes and goes, relieved by passing gas or belching. Qi stagnation is most commonly seen in the lungs, liver, and spleen-stomach.
3. Qi Reversal
Qi reversal refers to the abnormal rise and fall of qi, where qi rises excessively or fails to descend, leading to a pathological state of reversed qi in the organs. Qi reversal is often caused by emotional distress, improper diet, invasion by external pathogens, or obstruction by phlegm and turbidity, and can also occur due to deficiency leading to qi reversal. Qi reversal is most commonly seen in the lungs, stomach, and liver.
Clinically, qi reversal is commonly observed in the lungs, stomach, and liver. It can cause the lung to lose its ability to descend, resulting in upward lung qi, leading to cough and wheezing; the stomach loses its harmony and descent, resulting in upward stomach qi, leading to nausea, vomiting, hiccups, and belching; liver qi reversal can cause headaches and distension, facial redness, and irritability; if liver qi is excessively rising, it can lead to blood following the reversed qi, resulting in hemoptysis or hematemesis, and in severe cases, obstructing the clear orifices and causing fainting. Generally speaking, qi reversal is primarily due to excess in the upper body. However, there are also cases of deficiency leading to qi reversal, such as lung deficiency leading to loss of descent, or kidney deficiency leading to inability to receive qi, both of which can cause upward lung qi; stomach deficiency leading to loss of descent can also cause upward stomach qi.