Syndromes of the qi stage

The syndromes of the qi stage are interior heat syndromes in which the febrile pathogen is transmitted inwards to affect zang - fu organs. In this stage there is fierce contension between the excessive pathogenic factor and the strong antipathogenic qi, which manifests in hyperactivity of yang and heat.

As invasion of the qi system by the pathogenic factor involves different zang - fu organs, various related pathological manifestations will occur. Frequently seen syndromes of the qi stage are retention of heat in the lung, retention of heat in the chest and diaphragm, retention of heat in the stomach, and retention of heat in the intestinal tract.

The main pathological manifestations of syndromes of the qi stage are fever, aversion to heat as opposed to aversion to cold, a red tongue with a yellow coating and a rapid pulse. These are often accompanied with mental restlessness, thirst and deep - yellow urine.

In retention of heat in the lung, cough, asthmatic breathing, chest pain, and expectoration of thick yellow sputum may be seen. Retention of heat in the chest and diaphragm may present mental restlessness and uneasiness. In retention of heat in the stomach, there may appear high fever, dysphoria, thirst with preference for cold drinks, profuse sweating, a dry and yellow tongue coating, a rapid and rolling pulse or superficial, large and forceful pulse. Retention of heat in the intestinal tract may exhibit tidal fever, constipation or fecal impaction with watery discharge, fullness, hardness and pain in the abdomen, a dry, yellow or even burnt - black tongue coating with thorns on the tongue, and a deep and forceful pulse of the excess type.

The common feature in syndromes of the qi stage is excessive heat. As febrile pathogen invades the qi system and causes a vigorous struggle between the antipathogenic qi and the pathogenic factor, excessive yang and heat appear in the form of fever with aversion to heat, deep - yellow urine, a red tongue with a yellow coating and a rapid pulse. Since the pathogenic factor has left the body surface, there is no aversion to cold. Consumption of body fluid by excessive heat leads to thirst. Disturbance of the mind by heat gives rise to mental restlessness.

Retention of heat in the lung impairs the lung ' s function in descending, resulting in disorders of qi which manifest as coughing and chest pain. The heat in the lung condenses body fluid to phlegm, presenting profuse, thick and yellow sputum. Retention of heat in the chest and diaphragm binders the passage of qi, and restlessness and uneasiness become apparent. When the exterior is affected by excessive heat, a persistent high fever occurs. Heat in the interior forces out the body fluid and profuse sweating results. Consumption of body fluid by excessive heat gives rise to dysphoria, thirst with preference for cold drinks, and dry, yellow tongue coating. Excessive movement of qi and blood due to hyperactive interior heat causes rolling and rapid pulse or superficial, large and forceful pulse, retention of heat in the intestinal tract combines with wastes and blocks the qi of fu organs, resulting in fullness, hardness and pain in the abdomen, constipation or fecal impaction with watery discharge. Excess of the Yangming fu organ with interior hyperactivity of heat and dryness manifests as afternoon fever, dry, yellow or even burnt black tongue coating with thorns, and deep and forceful pulse of the excess type.

The principle of treatment is to clear heat from the qi system. Points are selected from the Du Meridian, Yangming Meridians of Hand and Foot, and meridians related to the diseased organs or areas. The method to treat excessive heat in the stomach and retention of heat in the intestinal tract is identical to that used from syndromes of the Yangming Meridian and Yangming fu organ in the differentiation of syndromes according to the theory of the six meridians.

In principle, points of the Lung Meridian and Large Intestine Meridian are used for retention of heat in the lung. Points of the Pericardum Meridian, Heart Meridian and Stomach Meridian are usually selected for retention of heat in the chest and diaphragm.