脉
下手脉沉，便知是气。沉极则伏，涩弱难治。其或沉实，气兼
痰饮。又曰∶沉弦细动，皆气痛证。心痛在寸，腹痛在关，下部在尺，脉象显然。
证
夫天地之气，常则安，变则病。况人禀天地之气，五运迭侵于外，七情交战于中。是以圣人啬气，如
持至宝；庸人投物，而反伤太和。此轩岐所以论诸病皆因于气，有病皆生于气，遂有九气不同
之说。气本一也，因所触而为九，怒、喜、悲、恐、寒、暑、惊、思、劳也。其言曰∶怒则气上，喜则气缓，
悲则气消，恐则气下，寒则气收，暑则气泄，惊则气乱，思则气结，劳则气耗。夫人身之正气，与血为配。血
行脉中，气行脉外，一呼脉行三寸，一吸脉行三寸，气血并行，周流乎一身之中，灌溉乎百骸之内，循环
无端，营运不悖，此为生生不息之妙用也。经云∶一息不运则机缄穷，一毫不续则穹壤判。若内无七情之所
伤，外无六淫之所感，何气病之有哉。其不善摄生者，五志之火，无时不起；五味之偏，无时不伤。
是以酿成胶痰固积，留滞于六腑；郁火邪气，充塞乎三焦，使气血失其常候，脏腑不能传导。是故外邪得以
乘虚而凑袭矣。以致清阳不升，浊阴不降，而诸般气痛，朝辍暮作而为胶固之疾。非良工妙手，莫易治焉。
若夫为胁痛，为心腹痛，为周身刺痛，甚则为翻胃，为膈噎等证，即此之由也。大抵男子属阳，得气易散；女子属
阴，得气易郁。是以男子之气病常少，女人之气病常多。故治妇人宜以顺气为主，而兼乎散血；治男子宜以养荣为
主，而调气次之，斯得气证治法之大要也。
气之为病，非止一端，有七情气，有郁气，有怒气，有热气，有冷气，有厥气，有逆气，有痰气，
有虚气，有中满气，有腹胀气，务要详究，不可雷同一例治之。
治
治诸气，须用上下分消，不可骤用《局方》金石、乌、附燥热等剂。
一、七情忧结，遂成郁气难治。必须自能知戒，庶几。
一、郁气宜开郁，如苍术、香附、川芎、青皮、竹茹、山栀子、枳壳、连翘、木香、泽泻之类。
一、枳壳破滞气，然多服损胸中至高之气。青皮泻肝气，多服损真气。香附快滞气。陈皮泄逆气。紫
苏散表气。浓朴泻胃气。槟榔泻至高之气，藿香之馨香，上行胃气。沉香升降真气。脑麝散真气。木香行中
下焦气。若此之类，气实所宜。其中有行散者，有损泄者，用之能治气之标，而不能制气之本。
方
四七汤 治喜、怒、悲、思，忧、恐、惊之气，结成痰涎，状如破絮。或如梅核在咽喉之间，
咯之不出，咽之不下，此七情所为也。或中脘痞满，气不舒快。或痰涎壅盛，上气喘急。或因痰饮中
阻，呕逆恶心。并宜服之。
半夏（五两） 茯苓（四两） 浓朴（四两） 紫苏（二两）
上锉，作十剂，生姜七片，枣一枚，水煎热服。梅核气，加桔梗、枳实。一方加槟榔。
分心气饮〔批〕（按此方治诸气平和之剂） 治男子女人一切气不和。多因忧愁思虑，忿怒伤神，或临
食忧感，或事不遂意，使抑郁之气留滞不散，停于胸膈之间，不能流畅，致心胸两胁痞满虚胀，噎塞不通，
噫气吞酸，恶心呕哕，目眩头晕，面色痿黄，口苦舌干，饮食减少，四肢怠倦，日渐 羸。或大病之后，胸
中虚痞，不思饮食。并皆治之。
青皮（五钱） 陈皮（五钱） 半夏（三钱五分） 白茯苓（三钱五分） 紫苏（二两）
腹皮（五钱） 肉桂（三钱五分） 赤茯苓（三钱） 桑皮（五钱） 木通（三钱五分） 羌活
（五钱） 甘草（二钱五分）
上锉，分五剂，生姜三片，枣一枚，灯心十茎，水煎服。一方去芍药、羌活，加木香、槟榔，香附、枳
壳、莪术、藿香、桔梗，善治忧思郁怒，诸气痞满。性急，加柴胡。多怒，加黄芩。食少，加砂仁、炒神曲。
咳嗽，加桔梗、半夏。胸膈痞闷，加枳实、香附。三焦不和，加乌药。气闭，加莱菔子、枳壳。气滞腰
疼，加木瓜、枳壳。上焦热盛，加黄芩。下焦热盛，加黄柏。翻胃，加沉香磨服。水气面目浮肿，加猪苓、
泽泻、车前子、木瓜、葶苈、麦门冬。气块，加三棱、莪术，槟榔、青皮。
利气丸 治一切气滞，心腹满闷疼痛，胁肋膨胀，呕吐酸水，痰涎不利，头目眩晕，并食积、酒毒，
及米谷不化，或下痢脓血，大小便结滞不快，风壅积热，口苦烦躁，涕唾稠粘。此药最能流湿
润燥，推陈致新，滋阴抑阳，散郁破结，活血通经，治气分之圣药也。
大黄（生用，六两） 黑丑（头末，六两） 木香（一两） 槟榔（一两） 枳壳（麸炒，
一两） 香附（炒，四两） 青皮（炒，一两） 广皮（一两） 莪术（煨，一两） 黄连（一两） 黄柏（三两）
上为细末，水丸如梧桐子大。每服一百，临卧以淡姜汤送下，以大便通利为度。如不利，再加丸数服，务使通利为
愈。
一块气〔批〕（按此方治诸气专攻之剂） 治诸气食积，及噎膈痞满，胸胁刺痛， 瘕疝气，并皆治之。
青皮（一两） 陈皮（一两） 三棱（一两） 蓬术（一两） 香附（便制，一两） 神曲
（炒，三钱） 麦芽（三钱，炒） 萝卜子（三钱，炒） 白丑（头末，三钱） 槟榔（三钱
）郁金（三钱） 黄连（酒炒，三钱） 枳实（三钱） 皂荚（二钱五分） 百草霜（二钱五分）
上为末，面糊为丸绿豆大。每三十丸，视疾之上下，为食之先后，热酒姜汤送下。
Pulse Diagnosis
When the pulse feels deep upon palpation, it indicates Qi disorder. If the pulse is extremely deep (Fu), or accompanied by choppy (Se) or weak (Ruo) qualities, it is difficult to treat. If the pulse is deep and forceful (Shi), it indicates Qi stagnation combined with Phlegm-Fluid retention. It is also said that deep (Chen), wiry (Xian), thin (Xi), and moving (Dong) pulses are all signs of Qi pain syndromes. For heart pain, the pulse manifestation appears at the Cun position; for abdominal pain, at the Guan position; for lower body disorders, at the Chi position; these pulse signs are quite evident.
Syndromes
The Qi of Heaven and Earth, when in normal operation, brings peace; when altered, it causes disease. Moreover, humans inherit the Qi of Heaven and Earth. The Five Movements (Wu Yun) alternate to invade from the exterior, while the Seven Emotions (Qi Qing) clash within. Therefore, sages cherish their Zheng Qi (Upright Qi) as if holding a supreme treasure, whereas ordinary people, seduced by external objects, damage their internal Tai He (Great Harmony) Qi. This is why Huangdi (Yellow Emperor) and Qibo discussed that all diseases arise from Qi, and all illnesses are born of Qi, leading to the theory of "Nine Different Qi Transformations." Qi is originally one, but becomes nine due to different triggers: anger, joy, sorrow, fear, cold, heat, shock, thought, and overexertion. The classic states: Anger causes Qi to rise; Joy causes Qi to slacken; Sorrow causes Qi to consume; Fear causes Qi to sink; Cold causes Qi to contract; Heat causes Qi to leak; Shock causes Qi to become chaotic; Thought causes Qi to knot; Overexertion causes Qi to dissipate. The body's upright Qi pairs with Blood. Blood circulates within the vessels, while Qi circulates outside the vessels. In one exhalation, the pulse moves three cun; in one inhalation, it moves three cun. Qi and Blood move together, circulating throughout the body, irrigating the hundred bones, cycling without end, and operating without deviation. This is the miraculous function of continuous life. The Classics state: If Qi movement ceases for a single breath, the mechanism of life is exhausted; if it stops for even a hair's breadth, heaven and earth are separated. If there is no injury from the Seven Emotions internally, and no invasion by the Six Evils (Liu Yin) externally, how could there be Qi disease? Those who fail to preserve their health have the Fire of the Five Wills rising at any time; dietary imbalances injure the body at any time. Thus, sticky Phlegm and solid accumulations are brewed and retained in the Six Fu organs; stagnant Fire and pathogenic Qi fill the San Jiao (Triple Burner), causing Qi and Blood to lose their normal patterns, and preventing the Zang-Fu organs from conducting properly. Consequently, external pathogens take advantage of the deficiency to attack. This leads to Clear Yang failing to ascend and Turbid Yin failing to descend, resulting in various Qi pains that cease in the morning and recur in the evening, becoming stubborn diseases. Only skilled physicians can easily cure them. Conditions such as hypochondriac pain, heart and abdominal pain, stabbing pain throughout the body, and even Fan Wei (Regurgitation) and Ge Ye (Dysphagia) syndromes arise from this cause. Generally speaking, men belong to Yang, and Qi disorders in men tend to dissipate easily; women belong to Yin, and Qi disorders in women tend to stagnate easily. Therefore, Qi disorders are less common in men and more common in women. Thus, treating women should focus on soothing Qi, supplemented by dispersing Blood; treating men should focus on nourishing Ying Blood (Nutritive Blood), with regulating Qi as secondary. This grasps the main principles of treating Qi disorders.
Qi disorders are not limited to one type. There are Qi disorders from Seven Emotions, stagnant Qi, angry Qi, hot Qi, cold Qi, Jue Qi (Rebellious Qi), counterflow Qi, Phlegm Qi, deficient Qi, middle-fullness Qi, and abdominal distension Qi. One must investigate carefully and not treat them all with the same method.
Treatment Methods
To treat various Qi disorders, one must use methods to drain from both upper and lower aspects. One should not abruptly use hot and drying agents like mineral drugs, Aconitum Radix Preparata (Fuzi, 附子), or Aconitum Carmichaelii Radix (Wutou, 乌头) from the *Tai Ping Hui Min He Ji Ju Fang*.
First, Qi disorders caused by Seven Emotions lead to difficult-to-treat stagnant Qi. The patient must self-regulate and avoid triggers for recovery.
Second, Stagnant Qi should be treated with methods to open stagnation, using herbs such as Cyperi Rhizoma (Cangzhu, 苍术), Ligustici Chuanxiong Rhizoma (Chuanxiong, 川芎), Citri Reticulatae Pericarpium Viride (Qingpi, 青皮), Bambusae Lamina (Zhuru, 竹茹), Gardeniae Fructus (Shanzhizi, 山栀子), Aurantii Fructus (Zhike, 枳壳), Forsythiae Fructus (Lianqiao, 连翘), Aucklandiae Radix (Muxiang, 木香), and Alismatis Rhizoma (Zexie, 泽泻).
Third, Aurantii Fructus (Zhike, 枳壳) breaks stagnant Qi, but excessive use damages the highest Qi in the chest. Citri Reticulatae Pericarpium Viride (Qingpi, 青pi) drains Liver Qi, but excessive use damages True Qi. Cyperi Rhizoma (Xiangfu, 香附) relieves stagnant Qi. Citri Reticulatae Pericarpium (Chenpi, 陈皮) drains counterflow Qi. Perillae Folium (Zisu, 紫苏) disperses exterior Qi. Magnoliae Officinalis Cortex (Houpo, 厚朴) drains Stomach Qi. Arecae Semen (Binglang, 槟榔) drains the highest Qi; Pogostemonis Herba (Huoxiang, 藿香)’s fragrance ascends Stomach Qi. Aquilariae Lignum Resinatum (Chenxiang, 沉香) regulates True Qi. Moschus (Shexiang, 麝香) and Borneolum Syntheticum (Nao, 冰片) scatter True Qi. Aucklandiae Radix (Muxiang, 木香) promotes Qi circulation in the Middle and Lower Jiao. Such herbs are suitable for excess Qi conditions. Some promote dispersion, some drain and damage; they can treat the branch manifestations of Qi but cannot control its root.
Formulas
Si Qi Tang (Four-Seven Decoction) treats Qi disorders caused by Joy, Anger, Sorrow, Thought, Worry, Fear, and Shock, which knot into Phlegm-Saliva resembling broken cotton wadding, or feeling like a plum pit stuck in the throat, unable to be coughed up or swallowed down—this is caused by the Seven Emotions. It also treats fullness and stuffiness in the Zhongwan area, uncomfortable Qi sensation, excessive Phlegm-Saliva with wheezing and shortness of breath, or nausea and vomiting due to Phlegm-Fluid obstruction in the Middle Jiao. It is suitable for all these conditions.
Pinelliae Rhizoma Preparatum (Banxia, 半夏) (5 liang)
Poria (Fuling, 茯苓) (4 liang)
Magnoliae Officinalis Cortex (Houpo, 厚朴) (4 liang)
Perillae Folium (Zisu, 紫苏) (2 liang)
Cut into pieces, divided into ten doses. Add seven slices of Zingiberis Rhizoma Recens (Shengjiang, 生姜) and one Jujubae Fructus (Dazao, 大枣). Decoct in water and take warm. For Plum-Pit Qi, add Platycodonis Radix (Jiegeng, 桔梗) and Aurantii Fructus (Zhishi, 枳实). Another formula adds Arecae Semen (Binglang, 槟榔).
Fen Xin Qi Yin (Dividing Heart-Qi Decoction) [Commentary: This is a mild formula for treating various Qi disorders] treats all Qi disharmonies in men and women. It is often caused by worry, thought, anger injuring the Spirit, or distress during meals or unfulfilled desires, causing depressed Qi to stagnate and not disperse, stopping between the chest and diaphragm, failing to flow smoothly. This results in fullness, bloating, and emptiness in the chest and hypochondrium, choking sensations, belching with acid regurgitation, nausea, vomiting, dizziness, yellowish complexion, bitter taste, dry tongue, reduced appetite, limb fatigue, and gradual emaciation. It also treats post-illness chest fullness and lack of appetite.
Citri Reticulatae Pericarpium Viride (Qingpi, 青皮) (5 qian)
Citri Reticulatae Pericarpium (Chenpi, 陈皮) (5 qian)
Pinelliae Rhizoma Preparatum (Banxia, 半夏) (3.5 qian)
Poria (Baifuling, 白茯苓) (3.5 qian)
Perillae Folium (Zisu, 紫苏) (2 liang)
Tangerine Peel / Bigard Fruit (Fupi, 腹皮) (5 qian)
Cinnamomi Cortex (Rougui, 肉桂) (3.5 qian)
Poria (Chifuling, 赤茯苓) (3 qian)
Morus Albae Cortex (Sangpi, 桑皮) (5 qian)
Akebiae Caulis (Mutong, 木通) (3.5 qian)
Notopterygii Rhizoma et Radix (Qianghuo, 羌活) (5 qian)
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (2.5 qian)
Cut into pieces, divided into five doses. Add three slices of Zingiberis Rhizoma Recens (Shengjiang, 生姜), one Jujubae Fructus (Dazao, 大枣), and ten stems of Junci Medulla (Dengxin, 灯心). Decoct in water and take. Another version removes Paeoniae Radix Alba (Shaoyao, 芍药) and Notopterygii Rhizoma et Radix (Qianghuo, 羌活), adding Aucklandiae Radix (Muxiang, 木香), Arecae Semen (Binglang, 槟榔), Cyperi Rhizoma (Xiangfu, 香附), Aurantii Fructus (Zhike, 枳壳), Curcumae Radix (Ezhu, 莪术), Pogostemonis Herba (Huoxiang, 藿香), and Platycodonis Radix (Jiegeng, 桔梗). This effectively treats Qi fullness from worry, thought, depression, and anger. For irritability, add Bupleuri Radix (Chaihu, 柴胡). For frequent anger, add Scutellariae Radix (Huangqin, 黄芩). For poor appetite, add Amomi Fructus (Sharen, 砂仁) and Massae Medicatae Fermentatae (Shenqu, 神曲). For cough, add Platycodonis Radix (Jiegeng, 桔梗) and Pinelliae Rhizoma Preparatum (Banxia, 半夏). For chest/diaphragm fullness, add Aurantii Fructus (Zhishi, 枳实) and Cyperi Rhizoma (Xiangfu, 香附). For San Jiao disharmony, add Linderae Radix (Wuyao, 乌药). For Qi closure, add Raphani Semen (Laifuzi, 莱菔子) and Aurantii Fructus (Zhike, 枳壳). For Qi stagnation with lower back pain, add Chaenomelis Fructus (Mu Gua, 木瓜) and Aurantii Fructus (Zhike, 枳壳). For Upper Jiao Heat Excess, add Scutellariae Radix (Huangqin, 黄芩). For Lower Jiao Heat Excess, add Phellodendri Cortex (Huangbai, 黄柏). For Fan Wei (Regurgitation), add Aquilariae Lignum Resinatum (Chenxiang, 沉香) ground and taken. For Water Qi causing facial/eye edema, add Polyporus (Zhuling, 猪苓), Alismatis Rhizoma (Zexie, 泽泻), Plantaginis Semen (Cheqianzi, 车前子), Chaenomelis Fructus (Mu Gua, 木瓜), Lepidii Semini et Descurainiae Semini (Tinglizi, 葶苈), and Ophiopogonis Radix (Maidong, 麦门冬). For Qi masses, add Bupleuri Radix (Sanleng, 三棱), Curcumae Radix (Ezhu, 莪术), Arecae Semen (Binglang, 槟榔), and Citri Reticulatae Pericarpium Viride (Qingpi, 青皮).
Li Qi Wan (Promoting Qi Pill) treats all Qi stagnation, chest/abdominal fullness and pain, hypochondriac swelling, vomiting of sour fluid, difficult Phlegm-Saliva, dizziness, food accumulation, alcohol toxicity, undigested grains, dysentery with pus/blood, constipation or difficult urination/stool, wind-stuffiness with accumulated heat, bitter taste, irritability, and thick nasal/salivary discharge. This medicine best promotes dampness removal and moistens dryness, eliminates old and generates new, nourishes Yin and suppresses Yang, disperses stagnation and breaks knots, invigorates Blood and unblocks collaterals. It is a sacred medicine for treating Qi aspect disorders.
Rhei Radix et Rhizoma (Dahuang, 大黄) (Raw, 6 liang)
Cassiae Semen (Heiqiu, 黑丑) (Head powder, 6 liang)
Aucklandiae Radix (Muxiang, 木香) (1 liang)
Arecae Semen (Binglang, 槟榔) (1 liang)
Aurantii Fructus (Zhike, 枳壳) (Stir-fried with bran, 1 liang)
Cyperi Rhizoma (Xiangfu, 香附) (Stir-fried, 4 liang)
Citri Reticulatae Pericarpium Viride (Qingpi, 青皮) (Stir-fried, 1 liang)
Citri Reticulatae Pericarpium (Guangpi, 广皮) (1 liang)
Curcumae Radix (Ezhu, 莪术) (Roasted, 1 liang)
Coptidis Rhizoma (Huanglian, 黄连) (1 liang)
Phellodendri Cortex (Huangbai, 黄柏) (3 liang)
Grind into fine powder, make pills with water the size of Sophora japonica seeds. Take 100 pills before bed with light Ginger Decoction. Stop when stools become loose. If not loose, increase dosage until stools are loose and cured.
Yi Kuai Qi (One-Mass Qi) [Commentary: This is a targeted formula for attacking various Qi disorders] treats Qi and Food Accumulation, dysphagia/fullness, stabbing chest/hypochondriac pain, and Jian Hernia (Jian Qi, 瘕疝气).
Citri Reticulatae Pericarpium Viride (Qingpi, 青皮) (1 liang)
Citri Reticulatae Pericarpium (Chenpi, 陈皮) (1 liang)
Bupleuri Radix (Sanleng, 三棱) (1 liang)
Curcumae Radix (Pengzhu, 蓬术) (1 liang)
Cyperi Rhizoma (Xiangfu, 香附) (Processed with urine, 1 liang)
Massae Medicatae Fermentatae (Shenqu, 神曲) (Stir-fried, 3 qian)
Malto (Maiya, 麦芽) (Stir-fried, 3 qian)
Raphani Semen (Luobozi, 萝卜子) (Stir-fried, 3 qian)
Cassiae Semen (Baiqiu, 白丑) (Head powder, 3 qian)
Arecae Semen (Binglang, 槟榔) (3 qian)
Curcumae Longae Radix (Yujin, 郁金) (3 qian)
Coptidis Rhizoma (Huanglian, 黄连) (Wine-fried, 3 qian)
Aurantii Fructus (Zhishi, 枳实) (3 qian)
Gleditsiae Sinensis Spina (Zaojiao, 皂荚) (2.5 qian)
Carbonis Cytisi Ramulus (Baicaoshuang, 百草霜) (2.5 qian)
Grind into powder, make pills with wheat paste the size of mung beans. Take 30 pills each time. Depending on the location of the disease (upper/lower) and timing relative to meals, take with hot Wine-Ginger Decoction.