Qì pattern identification

The process of diagnosing a morbid condition as a disease pattern of qì.

Physiology Recap

Qì is the force that powers all the activity and transformation in the human body. It is responsible for moving, retaining, and transforming all substances, as well as keeping organs in place, defending the body against evil, and providing warmth. Many morbid conditions of the body involve one of the pathologies of qì: qì vacuity, qì fall, qì desertion, qì stagnation, qì counterflow, and qì block.

• Movement
• Retention
• Transformation
• Warming
• Defense
• Nourishment

Qì Signs

Qì signs relate to physical strength, breathing, pain (of unfixed location), and discomforts such as distension and fullness.

Fatigue and lack of strength (倦怠乏力 juàn dài fá lì): One of the main signs of qì vacuity.

Scantness of breath (少气 shǎo qì): The mildest form of breathing difficulty marked by a mild feeling of breathlessness and accompanied by a faint low voice. It is attributed to qì vacuity and does not occur in repletion patterns.

Faint breathing (息微 xī wēi), weak faint breathing (呼吸微弱 hū xī wēi ruò): Breathing that is not easily detected visually or audibly. It is mostly a sign of lung qì vacuity.

Pain of unfixed location (痛无定处 tòng wú dìng chù): Pain that appears in different places at different times. When associated with distension as is often the case, it is called distending pain (胀痛 zhàng tòng). When it moves quickly from one place to another, it is called scurrying pain (窜痛 cuàn tòng). Pain of unfixed location is the pain associated with qì stagnation, which is often referred to as qì pain (气痛 qì tòng). Note that wind diseases are often associated with pain in the limbs that moves from place to place; this is usually referred to as wandering pain rather than scurrying pain and is typically associated with wind impediment.

Distension, fullness, and pain (胀满痛 zhàng mǎn tòng): Distension (palpable expansion), fullness (subjective feeling of expansion, bloating) often occurring in the chest and rib-side, breasts, or abdomen. Pain occurring with distension is often called distending pain. These are signs of qì stagnation (often attributable to depressed liver qì).

Qì Patterns

Below is a brief description of the major qì disease patterns, with links to entries that provide more detail.

Simple Patterns

Qì vacuity (气虚 qì xū): Lassitude of spirit and lack of strength; shortness of breath and weak breathing; low voice and laziness to speak; signs are exacerbated by exertion. It is caused by constitutional insufficiency; poor nourishment; insufficient production of qì resulting from functional disorders of the lung, spleen, or kidney; taxation damage; enduring illness; decline in health from advancing age.

Qì fall (气陷 qì xiàn): See spleen vacuity qì fall.

Qì desertion (气脱 qì tuō): Weak faint breathing; incessant sweating; clouded spirit. This is an extreme form of qì vacuity.

Qì stagnation (气滞 qì zhì): Distension and fullness; glomus and oppression; distension and pain; scurrying pain; signs are intermittent, of unfixed location, often triggered or exacerbated by emotional factors and relieved by good moods, belching, or passing of flatus. It is caused by affect-mind depression (mental depression, frustration, etc.); obstruction of qì dynamic by phlegm, dampness, food accumulation, or static blood; or injuries from knocks and falls or to excessive physical straining. Depressed liver qì is a major form of qì stagnation caused by affect-mind depression and other factors.

Qì counterflow (气逆 qì nì): Signs vary depending on whether the lung, stomach, or liver is affected. Lung qì ascending counterflow manifests in panting. Stomach qì ascending counterflow is marked by nausea, vomiting, hiccup, and belching. Liver qì ascending counterflow manifests in headache and distension in the head, red eyes, and irascibility. The causes vary according to the pattern it occurs in.

Qì block (气闭 qì bì): Sudden clouding collapse; asphyxiation; gripping pain; cold limbs; urinary and fecal stoppage. It arises in numerous different ways.

Combined Patterns

Dual vacuity of qì and blood (气血两虚 qì xuè liǎng xū): Qì vacuity preventing blood from being produced or blood vacuity preventing qì from being produced. The signs are dizziness, scantness of breath, laziness to speak, lack of strength, spontaneous sweating, heart palpitation, insomnia, pale-white or withered-yellow facial complexion, pale nails, pale tongue, and a pulse that is fine and weak.

Qì vacuity and blood stasis (气虚血瘀 qì xū xuè yū): Lassitude of spirit and lack of strength; scantness of breath; laziness to speak; spontaneous sweating; with stabbing pain of fixed location in the chest and rib-side and possibly glomus lump under the rib-side; or hemiplegia. It arises when qì is insufficient to propel the blood adequately, causing blood to stagnate.

Qì stagnation and blood stasis (气滞血瘀 qì zhì xuè yū): Qì stagnation causing blood stasis. Distending pain or scurrying pain in the chest and rib-side; impatience, agitation, and irascibility; glomus lump under the rib-side with stabbing pain that refuses pressure and worsens at night. In women, it can take the form of menstrual pain with dark-purple clotted menstrual flow, and a pulse that is stringlike and rough. It arises when qì stagnates and cannot propel the blood adequately, giving rise to blood stasis, which in turn exacerbates the qì stagnation.

Qì deserting with blood (气随血脱 qì suí xuè tuō): Severe blood loss giving rise to qì desertion when the mutually complementary relationship of blood and qì breaks down. The bleeding may be attributable to external injury, digestive tract bleeding, flooding in women, or massive bleeding after childbirth. The signs are bleeding followed by the sudden appearance of somber-white complexion, great dripping sweating, reversal cold of the limbs, hasty panting or faint breathing, clouded spirit, and a fine pulse on the verge of expiration.

Depletion of essence and qì (精气亏损 jīng qì kuī sǔn): Depletion of essence causing depletion of original qì or qì vacuity causing depletion of essence. The signs are developmental or reproductive problems with qì vacuity signs such as poor resistance to evils and susceptibility to illness.

Qì failing to contain the blood (气不摄血 qì bù shè xuè): This is the same as spleen failing to control the blood. It can be regarded as a general qì pattern (rather than a spleen qì pattern) or, since it involves both qì and the blood, as a combined pattern.

Blood running counterflow with qì (血隋气逆 xuè suí qì nì): When qì ascends counterflow, it can carry blood with it. This happens with liver qì. The liver stores the blood and its qì upbears and effuses. When liver yáng is hyperactive, liver qì upbears more strongly than normal, which is called ascending counterflow. Liver qì ascending counterflow carries blood with it and can give rise to vomiting of blood or to clouding reversal.