This issue covers:
1.Qi Deficiency
2.Qi Stagnation
3.Qi Rebellion
4.Qi Sinking
5.Qi Obstruction or Qi Collapse
Abnormalities of Qi include pathological changes such as Qi deficiency, Qi stagnation, Qi rebellion, Qi sinking, and Qi obstruction or collapse.
1.Qi Deficiency
Qi deficiency refers to insufficient Qi that cannot normally propel the organs to function properly, resulting in a pathological state of organ dysfunction.
Common symptoms of Qi deficiency include mental fatigue, lethargy, dizziness, spontaneous sweating, susceptibility to colds, pale complexion, pale tongue, and weak pulse. Individuals with severe Qi deficiency may experience delayed growth and development or premature aging; those with deficiency of Zong Qi (Ancestral Qi) may have palpitations and shortness of breath upon exertion. The pathological manifestations of Qi deficiency vary among different organs and will be discussed in the section on organ pathophysiology.
The causes of Qi deficiency may be due to congenital insufficiency, lack of nourishment postnatally, insufficient generation of Qi, or excessive fatigue and prolonged illness leading to excessive Qi depletion.
2.Qi Stagnation
Qi stagnation refers to a pathological state where Qi does not flow smoothly and becomes obstructed.
The common characteristic of Qi stagnation is the presence of distension, fullness, and pain at the site of stagnation. Qi stagnation in the lungs can lead to chest tightness and cough; liver Qi stagnation may result in emotional distress and pain in the hypochondrium or lower abdomen; spleen and stomach Qi stagnation can cause abdominal distension and constipation.
Qi stagnation can impede blood circulation and fluid distribution, leading to pathological products such as blood stasis and phlegm-dampness. These pathological products can further obstruct the flow of Qi, exacerbating the stagnation.
The causes of Qi stagnation may include emotional factors affecting Qi movement; obstruction by tangible pathogens such as food accumulation, dampness, phlegm, or blood stasis; structural changes in the body that obstruct Qi pathways; or Qi deficiency leading to insufficient propulsion.
3.Qi Rebellion
Qi rebellion refers to a pathological state where Qi rises abnormally.
Qi rebellion is commonly seen in the lungs, stomach, and liver. Lung Qi rebellion manifests as cough and asthma; stomach Qi rebellion can present with nausea, vomiting, belching, and hiccups; liver Qi rebellion may cause headaches, facial flushing, irritability, and in severe cases, can lead to blood being expelled with cough or vomiting, or even loss of consciousness due to Qi obstructing the clear orifices. Qi rebellion can also occur in meridians such as the Chong Mai (Penetrating Vessel) and Tai Yang (Sun Meridian).
The causes of Qi rebellion may include emotional factors such as anger causing Qi to rise; excessive internal heat leading to upward inflammation; external cold constraining the upper body; food accumulation obstructing the middle; or phlegm turbidity blocking the pathways, causing righteous Qi to push against pathogenic Qi; or Qi deficiency leading to insufficient upward movement, resulting in rebellion, such as lung Qi deficiency causing weak asthma or stomach Qi deficiency leading to vomiting after eating. In cases of excess, Qi rebellion is strong and forceful, while in deficiency, it is weak and feeble.
4.Qi Sinking
Qi sinking refers to a pathological state where Qi cannot rise normally and remains in the lower part of the body.
Qi sinking can be divided into two conditions: “insufficient upper Qi” and “middle Qi sinking.”
“Insufficient upper Qi” refers to Qi not adequately supplying the upper body, leading to symptoms such as dizziness, vertigo, tinnitus, and forgetfulness.
“Middle Qi sinking” refers to the inability of Qi to lift certain internal organs, resulting in conditions such as gastric prolapse, renal prolapse, uterine prolapse, and rectal prolapse.
The causes of Qi sinking are often due to Qi deficiency, where the body cannot overcome the effects of gravity; or prolonged downward pressure on the body, such as excessive weight-bearing, long-term fear or depression, or deep cold invading the organs.
5.Qi Obstruction and Qi Collapse
Qi obstruction refers to a pathological state where Qi is blocked internally, leading to sudden fainting. Qi collapse refers to a pathological state where there is a significant loss of Qi, resulting in sudden bodily failure.
Both Qi obstruction and Qi collapse share the common feature of sudden fainting and loss of consciousness, but Qi obstruction is an excess condition, while Qi collapse is a deficiency condition. Qi obstruction often presents with a flushed or dark face, clenched teeth, rigid body, clenched fists, and a strong or deep pulse that is forceful upon pressure; Qi collapse may present with a pale complexion, closed eyes, open mouth, flaccid body, incontinence, and a weak, slow pulse or one that is barely palpable.
Qi obstruction may occur due to exposure to foul air, where turbid pathogens block the upper and middle Jiao (regions); sudden emotional shock leading to Qi stagnation; severe pain drawing Qi to the painful area, causing obstruction; or phlegm blocking the airways leading to phlegm obstruction, etc. Qi obstruction occurs when the upward and outward pathways of Qi are suddenly severely blocked, preventing smooth circulation of Qi and blood to the brain, leading to loss of consciousness. Qi obstruction can resolve spontaneously, but if it does not recover on its own, it can lead to death.
Qi collapse may occur due to long-term Qi deficiency, suddenly encountering external pathogens, leading to depletion of Qi; or due to chronic illness where righteous Qi gradually diminishes; or due to significant blood loss, excessive sweating, or severe diarrhea, leading to loss of Qi. Qi collapse occurs when Qi is extremely deficient and unable to supply the brain, resulting in loss of consciousness.
Qi collapse, along with Yang collapse and Yin collapse, represents severe functional decline due to extreme deficiency, but Yang collapse is characterized by sudden large loss of Yang Qi, presenting with cold sweat and cold extremities; Yin collapse is characterized by sudden large loss of Yin fluids, presenting with profuse sweating while the skin remains warm, agitation, and rapid pulse; Qi collapse does not exhibit obvious cold or heat signs but shows manifestations of Qi deficiency and functional decline.