Qì, blood, and fluids pattern identification

The process of diagnosing a morbid condition as a disease pattern of qì, blood, and/or fluids.

Pathologies of qì, blood, and fluids arise when these are damaged, when they fail to be produced, when their normal movement is affected, and when they fail to perform their functions as a result of such factors. This chapter discusses qì, blood, and fluids patterns.

Note that although essence, like qì, blood, and fluids, is a basic substance, it is subject to only one pathology, insufficiency, which is discussed under kidney and bladder pattern identification.

Qì, blood, and fluids are intimately related to the bowels and viscera because they are all produced and used by them. They are also related to the channels and network vessels because these transport them. Any pathology in the bowels and viscera or channels and network vessels can affect the production and movement of the basic substances, causing pathologies of them. Conversely, any pathologies of the substances can affect the functional activity of the bowels and viscera and the channels and network vessels.

Pathologies of qì, blood, fluids, and essence are attributed to numerous causes. There are earlier heaven (congenital) causes, namely constitutional insufficiency, in which kidney essence is depleted and fails to produce qì and blood. There are also later heaven (acquired) causes, such as external contraction of the six excesses, internal damage by the seven affects, dietary irregularities, and imbalance between activity and inactivity.

For more details, see the following:

Qì pattern identification

• Qì vacuity
• Qì fall (see spleen vacuity qì fall)
• Qì desertion
• Qì stagnation
• Qì counterflow
• Qì block

Blood pattern identification

• Blood vacuity
• Blood dryness
• Blood stasis
• Blood heat
• Blood cold
• Bleeding

Fluid pattern identification

• Damage to liquid
• Humor desertion
• Phlegm-rheum patterns
• Water swelling

Interrelationships Between Qì, Blood, and Fluids

Qì, blood, essence, and fluid pathologies can give rise to each other, causing combined patterns. The relationship between qì and blood patterns is the closest. Qì and blood are interdependent physiological substances. Disease of one easily affects the other, in which case the disease pattern is called dual disease of qì and blood.

Below are the main combined pathologies. Note that → means can cause, and ↔ means can cause or be caused by.

• Essence depletion ↔ qì vacuity (essence and qì are reliant on each other)
• Essence depletion ↔ blood vacuity (essence and blood are of the same source)
• Qì vacuity ↔ blood vacuity (when qì’s propelling function is weak, blood production is compromised, and vice versa)
• Qì vacuity → qì stagnation (when qì’s propelling function is compromised, it fails to move and hence becomes stagnant)
• Qì vacuity → blood stasis (when qì’s propelling function is compromised, it fails to move the blood)
• Qì vacuity → bleeding (when qì’s retentive function weakens, it can fail to keep blood in the vessels)
• Qì vacuity → internal dampness phlegm (when qì is insufficient, it fails to move and transform water-damp)
• Qì vacuity → phlegm (when qì is insufficient, it fails to move and transform phlegm)
• Blood stasis ↔ blood vacuity (when blood fails to move, its ability to provide nourishment is compromised; when blood is insufficient, its ability to bear qì is reduced, giving rise to qì stagnation that reduces the movement of blood)
• Blood stasis ↔ qì stagnation (blood stasis obstructs the flow of qì, and stagnant qì fails to propel the blood)
• Blood loss → qì desertion (qì deserting with fluids)
• Bleeding → blood stasis (bleeding causes blood to clot)
• Fluid loss → qì desertion (qì deserting with blood)
• Fluid depletion ↔ blood vacuity or blood dryness (fluids are a major component of the blood)
• Fluid depletion →blood stasis (reduction of the fluid component of blood causes blood to thicken)
• Internal dampness → qì stagnation (dampness obstructs the movement of qì)
• Phlegm → static blood (phlegm obstructs the movement of blood)

Disease Evils’ Effect on Qì, Blood, and Fluids

It is also important to bear in mind the causal relationships between abnormalities of qì, blood, and fluids on the one hand and other conditions, notably cold, heat, and food stagnation on the other.

• Cold → qì stagnation (cold slows down the movement of qì)
• Cold → blood stasis (cold slows down the movement of blood)
• Heat → blood stasis (heat boils the blood)
• Food stagnation → qì stagnation (food stagnation obstructs the movement of qì)