Qì counterflow

A disease pattern chiefly characterized by upward surge of (a) lung qì, causing cough and panting; (b) stomach qì, causing nausea, vomiting, hiccup, and belching; or (c) liver qì, causing headache and distension in the head, red eyes, and irascibility. It is seen in lung, stomach, and liver repletion patterns.

Pathogenesis: The term qì counterflow chiefly refers to the counterflow ascent of qì, affecting the lung, the stomach, or the liver. The causes of qì counterflow vary according to the pattern it occurs in, but they can be summed up as follows:

• qì stagnation, often stemming from excesses of the seven affects;
• evil qì obstructing the normal movement of qì (cold, food, phlegm);
• heat or fire encouraging upward movement of qì.

Manifestations

• Lung qì ascending counterflow manifests in cough and/or panting. It arises when externally contracted evils or phlegm-rheum obstruct the lung and thereby disrupt the normal diffusion and downbearing of lung qì. It is often described as qì ascent (上气 shàng qì), referring to the disturbance of the lung’s diffusion and depurative downbearing functions or to the sensation of upward movement of qì that this causes.
• Stomach qì ascending counterflow is marked by belching, hiccup, nausea, and vomiting. It arises when externally contracted evils invade the stomach, or when water-rheum, phlegm-damp, or food accumulation cause stagnation in the stomach, or when liver qì flows cross-counterflow and invades the stomach. In all three cases, the harmony and downbearing of stomach qì are upset. Often seen in stomach patterns.
• Liver qì ascending counterflow is marked by headache and distension in the head, dizziness, red eyes, and irascibility. Because the liver is the unyielding viscus and because it stores the blood, liver qì ascending counterflow in severe cases can involve blood being carried upward, causing expectoration of blood, retching of blood, and vomiting of blood. In severe cases, there is clouding reversal (昏厥 hūn jué, sudden loss of consciousness resulting from disruption of qì), vomiting of blood, or the sensation of qì surging up from the lower abdomen into the chest and throat. It results from affect-mind frustration, depression, and anger damaging the liver, causing excessive upbearing and effusion of liver qì.

Treatment: Depends on the affected organs and causes.