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Qì stagnation
气滞 〔氣滯〕qì zhì
Also qì depression (气郁 qì yù). This term often connotes affect-mind depression as the cause.
A disease pattern chiefly characterized by distension and fullness, glomus and oppression, distending pain or scurrying pain; signs are intermittent, of unfixed location, triggered or exacerbated by emotional factors and relieved by good moods, belching, or passing of flatus.
Biomedical correspondence: Qì stagnation is seen in gastrointestinal neurosis, chronic gastritis, chronic enteritis, ulcers, diseases of the biliary tract, and chronic hepatitis.
Description: Oppression in the chest; distension and pain in the rib-sides or in the stomach duct and abdomen with pain less pronounced than distension. Distension and pain are of unfixed location (sometimes scurrying
from one place to another), intermittent, sometimes relieved by sighing, belching, or passing of flatus. When attributable to impaired liver free coursing, they can be triggered or worsened by bad moods. The tongue is pale and the pulse stringlike. Signs vary according to location (see below).
Pathogenesis: Inhibited movement of qì in a part of the body or in a specific bowel or viscus. It is a repletion pattern that stems from the following factors:
- Deficient free coursing of the liver attributable to anger, frustration, or affect-mind depression (depressed liver qì).
- Obstruction of the qì dynamic: Static blood, phlegm-rheum, external evils, and food stagnating in the stomach and intestines: all these can obstruct the movement of qì.
- Qì vacuity: When qì is insufficient, it can stagnate.
- Blood vacuity: The blood
bears
qì; when it is insufficient, the movement of qì becomes rough. - Injuries from knocks and falls or to excessive physical straining.
Signs vary according to location
- Head: Oppression and pain in the head; sometimes nasal congestion.
- Upper burner: Oppression in the chest; sighing; in some cases, scurrying pain in the chest and back; inhibited breathing, panting, cough.
- Center burner: Glomus and distension or distending pain in the stomach duct, fullness and distension or distending pain under the rib-side (the affected area sounds like a drum when tapped). Belching, passing of flatus, and good moods may relieve symptoms temporarily.
- Lower burner: Distension and pain in the lesser or smaller abdomen; tenesmus: urinary urgency, painful inhibited urination;
mounting qì
(inguinal hernia); and menstrual pain and menstruation at irregular intervals. - Channels and network vessels: Distension and fullness; or scurrying pain along their pathways.
- Skin and flesh: Swelling that rebounds when pressure is released (qì swelling) or local distension and oppression.
- Pulse: Stringlike.
The pain associated with qì stagnation is of unfixed location or scurrying,
as distinct from pain of fixed location associated with blood stasis. Often, discomfort associated with qì stagnation is temporarily relieved by belching or the passing of flatus.
Affect damage (内伤七情 nèi shāng qī qíng): Mental and emotional problems, traditionally understood as excesses among the seven affects, can affect health in several ways. This is known as affect damage. The most important way in which the seven affects can damage health is when affect-mind depression impairs the liver’s free coursing action causing depressed liver qì.
This mechanism is often referred to as binding depression of affect-mind,
and the condition that results from it, which is one of the main forms of qì stagnation, is called qì depression. Qì depression manifests as sighing, pain and distension in the chest and rib-side (pain of unfixed location), oppression in the stomach duct, torpid intake, and in some cases vomiting. These signs are accompanied by mental or emotional problems that are the root cause, and intensify in periods of depression. Qì depression can also manifest in the form of abdominal pain, stomach pain, and even lumbar pain. Depressed qì sometimes produces abdominal glomus lump that is soft to the touch and that disperses and reforms periodically. In women, qì depression often manifests in swelling of the breasts and menstrual irregularities. It can combine with phlegm to cause plum-pit qì. Whatever form it takes, qì depression easily turns into fire causing rashness, impatience, irascibility, oppression in the chest and rib-side distension, clamoring stomach, dry mouth with bitter taste, constipation, red tongue with yellow fur and stringlike rapid pulse, and in some cases with headache, red eyes, or tinnitus.
External injury (外伤 wài shāng): Qì stagnation can also arise as a result of internal injury when blows to the chest or abdomen cause pain in the rib-side, cough, panting, and pain and distension in the abdomen and stomach duct.
Evil qì (邪气 xié qì): Qì stagnation can result from the obstructive effect of evils, especially cold and dampness. For example, in cold stagnating in the liver vessel, abdominal pain and distension is attributed to qì stagnation caused by cold evil. See also cold; cold-damp. Dampness can cause qì stagnation, as when dampness obstructing the center burner causes abdominal distension. See dampness; damp depression. Damp-heat can also cause qì stagnation as seen in damp-heat dysentery (manifesting in the form of tenesmus) and damp-heat rib-side pain. Qì stagnation can cause, or be caused by, blood stasis. This dual pathology is observed in amenorrhea, liver fixity, dysphagia-occlusion (噎膈 yē gé), and concretions, conglomerations, accumulations, and gatherings (including strings and aggregations, deep-lying beam etc.), welling-abscess (yōng) and flat-abscess (jū) (including intestinal welling-abscess, effusion of the back, sloughing flat-abscess), and internal obstruction.
Qì vacuity (气虚 qì xū): Qì vacuity can cause qì stagnation, e.g., spleen vacuity causing qì stagnation abdominal distension in
Specific forms: Depressed liver qì; liver-spleen disharmony; liver-stomach disharmony; gastrointestinal qì stagnation.
Further developments: When qì fails to move and becomes stagnant, either blood stagnates and blood stasis arises, or else fluids collect, causing phlegm-rheum or qì swelling. Qì stagnation can also give rise to fire formation and to qì block patterns.
Treatment
Medicinal therapy: Qì stagnation is treated by the methods of rectifying and moving qì. Agents such as cyperus (Cyperi Rhizoma,
Acumoxatherapy: To rectify qì and move qì, select as main points
See depression pattern;