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When qi and excess pathogens contend with each other, blood and qi enter the zang organs, leading to cyanosis of the lips and mouth and coldness of the body, which indicates death. If the body is warm and there is spontaneous sweating, it indicates that the pathogen has entered the fu organs; this is termed Shijue (Corpse-like Fainting).

The classics state: All pain arises from qi disorders. Various diseases are born from qi disturbances. Anger causes qi to ascend upward; joy causes qi to relax; grief consumes qi; fear causes qi to sink downward; cold causes qi to contract; heat causes qi to dissipate outward; shock causes qi to become chaotic; overexertion depletes qi; and excessive thinking causes qi to knot. These constitute the "Nine Qi" differences. According to Zhang Hezi: The qi of heaven and earth is peaceful in its normal state but leads to disease when altered. Moreover, humans inherit the qi of heaven and earth; external influences of the Five Movements invade alternately, while internal conflicts of the Seven Emotions clash within. Therefore, sages cherish qi as a supreme treasure, whereas common people exploit external things and thereby damage their Taihe (Great Harmony) qi. This is why Huangdi and Qibo discussed that all pain arises from qi and all diseases are born from qi, leading to the theory of the Nine Qi differences. Qi is originally one, but becomes nine due to different stimuli: anger, joy, grief, fear, cold, heat, shock, thinking, and overexertion. Generally, severe upward reversal of anger leads to hematemesis or diarrhea, indicating ascending qi. Anger causes yang qi to ascend, allowing Liver Wood to overact on Spleen Earth, resulting in hematemesis and diarrhea in severe cases. Joy brings harmony to qi and openness to the will, facilitating the smooth flow of Ying and Wei (Nutritive and Defensive) qi, thus relaxing qi. Grief tightens the Heart vessels and expands the Lung leaves, obstructing the Upper Jiao, preventing the dispersion of Ying and Wei, and causing heat to accumulate in the middle, thereby consuming qi. Fear causes essence to retreat; retreat leads to closure of the Upper Jiao, obstruction causes qi to reverse, and reversal leads to distension of the Lower Jiao, thus impeding qi movement. Cold closes the interstices (Couli), hindering qi movement, thus contracting qi. Heat opens the interstices, facilitating Ying and Wei flow, causing profuse sweating, thus dissipating qi. Shock leaves the mind without support, the spirit without refuge, and thoughts without focus, thus chaotic qi. Overexertion causes panting and sweating, with internal and external qi escaping outward, thus depleting qi. Thinking retains the mind and spirit, causing righteous qi to stagnate and not move, thus knotting qi. Examining the details of diseases caused by these factors reveals diverse changes. For instance, anger can cause hematemesis, diarrhea, Jianjue (Frying Fainting), Bojue (Thrusting Fainting), Yangjue (Yang Fainting), chest fullness and hypochondriac pain, postprandial qi rebellion, panting, thirst, vexation, Xiao-dan (Consumption Diabetes), Feiqi (Lump Disease), sudden blindness, sudden deafness, flaccid sinews, and sores/carbuncles on the exterior. Joy can cause incessant laughter, dry and brittle hair, internal diseases, unrestrained yang qi, and even mania in severe cases. Grief can cause genital retraction, tendon cramping, muscle bi (obstruction), pulse atrophy, frequent hematuria in men, metrorrhagia in women, nasal sourness/acridity, blurred vision, shortness of breath unable to complete inhalation, and arm numbness when crying. Fear can cause emaciation, bone soreness and flaccidity/coldness, sudden green watery diarrhea, facial heat and skin tension, impotence, and jaw dislocation from terror. Shock can cause tidal salivation, eye twitching, facial deviation, dementia/epilepsy, unconsciousness, stiff collapse, and eventually bi syndrome. Overexertion can cause throat obstruction, rapid panting, hemoptysis, lower back pain and bone flaccidity, lung rales, necrosis of high bones, impotence, spitting blood, dim vision, ear deafness, scanty sperm in men, amenorrhea in women, and in severe decline, a catastrophic collapse like a breached dam. Thinking can cause insomnia, hypersomnia, dizziness, epigastric fullness, closure of the Three Jiao, dysphagia, bitter vomiting from Gallbladder heat, tendon flaccidity, Baiyin (seminal emission/leukorrhea), relief after defecation/qi passage, and loss of appetite. Cold can cause clear and cold fluids excreted from above and below, and clear white diarrhea. Heat can cause panting, vomiting of acid, and acute diarrhea with tenesmus.

I have further examined the treatment methods in the *Neijing*, which utilize the principle of mutual overcoming among the Five Elements. For example, anger injures the Liver, which belongs to Wood. Anger gathers qi in the Liver, injuring Spleen Earth. Excessive Wood also damages the Liver itself. Joy injures the Heart, belonging to Fire. Joy gathers qi in the Heart, injuring Lung Metal. Excessive Fire also damages the Heart. Grief injures the Lung, belonging to Metal. Grief gathers qi in the Lung, injuring Liver Wood. Excessive Metal also damages the Lung. Fear injures the Kidney, belonging to Water. Fear gathers qi in the Kidney, injuring Heart Fire. Excessive Water also damages the Kidney. Thinking injures the Spleen, belonging to Earth. Thinking gathers qi in the Spleen, injuring Kidney Water. Excessive Earth also damages the Spleen. Cold injures the form (body), which belongs to Yin. Cold overcoming heat injures Yang. Excessive Cold also damages Yin. Heat injures qi, which belongs to Yang. Heat overcoming cold injures Yin. Excessive Heat also damages Yang. These factors treat each other mutually. Thus, grief can treat anger by evoking pity through sorrowful words; joy can treat grief by entertaining with playful words; fear can treat joy by terrifying with imminent death; anger can treat thinking by provoking with insults/deception; thinking can treat fear by distracting with complex planning. These five methods must employ deceptive and bizarre tactics to affect the senses and perception. Only those with talent and wisdom dare use such methods. Heat treats cold; cold treats heat; rest treats overexertion; habituation treats shock. The classics say: Shock is treated by making it ordinary. Shock arises from sudden encounters; familiarity breeds no fear. For instance, Zhu Danxi treated a woman whose husband had been away for two years trading. She refused food, lay listless like a dummy, facing inward—this was qi knotting from thinking. Medicine alone could not cure it; joy could resolve it, or inducing anger. (The Spleen governs thinking; excessive thinking knots Spleen qi and stops eating. Anger belongs to Liver Wood; anger raises Wood qi to break Spleen knot.) By provoking her to cry angrily for two hours, then giving one dose of medicine, she requested food. However, she needed joy to fully recover, so they feigned the husband's return, and she recovered. Similarly, Zhang Hezi treated a woman with insomnia from chronic thinking by provoking anger; she slept soundly that night. Cases of qi depletion from overexertion or qi loss from fear are difficult to treat. Joyful people rarely get sick because their pulses are relaxed and harmonious. I heard of Zhuang treating someone ill from excessive joy: Zhuang took the pulse, feigned alarm, said he would fetch medicine and never return. The patient wept in grief and recovered. The *Suwen* states: Fear overcomes Joy, mastering the key mechanism. Such treatments exist in the *Neijing*, but quacks have ignored them for ages. Fortunately, Liu Wansu, Zhang Hezi, and Zhu Danxi clarified these principles, guiding future scholars.

Zhu Danxi stated: Cold qi, stagnant qi, and rebellious qi all result from the Lung suffering fire evil. Qi has an ascending nature; if it rises without descending, it steams the clear pathways, potentially becoming severe. The *Ju Fang* often uses acrid-aromatic drying-hot agents, adding fire to fire—who bears the blame? Saying "qi has no tonification method" is secular ignorance. Qi diseases present as fullness and obstruction, seemingly hard to tonify, but one must consider that deficiency of righteous qi fails to circulate, allowing pathogenic stagnation to persist. The classics say: The strong recover as qi moves; the weak develop disease as qi stagnates. If qi is weak, without tonification, how can it move? Qi belongs to Yang and does not inherently possess cold. Feeling chills from ascending qi is due to hyperactivity causing harm, requiring control. Excess qi is fire. Gao Yangsheng's claim that cold generates qi is erroneous. Sensations of cold rising from below are not true cold; rather, qi ascending from the Liver carries Minister Fire, creating intense heat where extreme fire mimics water (Yang hyperactivity/Yin deficiency). (Liu Wansu argued qi is Yang and subtle; disturbances/injuries are transformations of Yang fire, causing mental frenzy, qi chaos, and heat. Also, extreme emotions become fire. Treatment focuses on calming Heart Fire. Overexertion involves movement (Yang); shock affects the heart (Fire); both require calming Heart Fire. Unskilled doctors misunderstand this, criticizing cold-cooling herbs.)

For Qi Stagnation, use Xiangfu (Cyperus Rhizome), Cangzhu (Atractylodis Rhizoma), and Fuxiong (Ligusticum Chuanxiong). To regulate qi, use Muxiang (Aucklandiae Radix), but since it is acrid and ascending, it is suitable only for stagnation without reach. If Minion Fire rushes upward, using it aids fire; instead, use Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma) with a little Muxiang. Qi rising from the left indicates Liver Fire. Piercing pain belongs to Fire; add Zhiqiao (Aurantii Fructus) to fire-draining formulas. To break stagnant qi, use Zhiqiao, which damages high qi; stop after 2-3 doses to avoid damaging righteous qi; suitable for excess patterns. For internal excess heat and Minister Fire rushing up resembling stagnation, use Zhimu, Huangbai, Huangqin (Scutellariae Radix), and Lianqiao (forbidden here, likely meant Huanglian Scutellariae Radix based on context of clearing heat). For Yin deficiency with qi stagnation, use Siwu Tang (Four Substances Decoction) to nourish blood. For pain from emotional stagnation, use Muxiang to promote flow. For melancholy with phlegm-qi, use Xiangfu (5 qian), Gualou (1 liang), Beimu (3 qian), Shanzha (3 qian), Banxia (1 liang). For robust constitution with piercing pain, use Zhiqiao and Wuyao (Tso-wu-yao Rhizome). For pain from fixed blood, use Taoren (Persicae Semen), Honghua (Carthami Flos), and Guitou (Angelicae Sinensis Radix head). To resolve knotting qi in the Five Zang and benefit Shaoyin blood, use Zhizi (Gardeniae Fructus) charred and powdered, decocted; very effective. Liu Wensu noted: Women are stubborn, prone to qi disorders; start with Zhengqi Tianxiang Tang. Dai Fu'an stated: Seven Qi diseases stem from one qi but vary by symptom; *San Yin Fang* details this. Joy, anger, worry, thinking, grief, fear, shock are the Seven Qi. Phlegm stuck in the throat like cotton wool, neither expectorated nor swallowed, should be treated with Siqi Tang; if ineffective, advance to Dingchen Touge Tang (contraindicated if internal heat exists). If confirmed as excessive thinking, use Siqi Tang minus Fuling, plus Banxia, Renshen (Ginseng Radix et Rhizoma), and Changpu (Acori Tatarinowii Rhizoma). If confirmed as illness from rage with blue-yellow complexion or hypochondriac distension, use Tiaoqi San or Siqi Tang plus Zhiqiao and Muxiang (0.5 qian each). For palpitations from shock/fear, see the Palpitations section. Slippery pulse indicates much blood and little qi; choppy indicates little blood and much qi; large indicates abundant blood and qi; small indicates deficient blood and qi. A deep pulse upon pressing indicates qi disease. Deep-slippery indicates qi with phlegm-fluids. String-taut or soft, or empty-large, empty-slippery, or weak pulses, accompanied by irregular diet, overexertion, mental fatigue, and limb heaviness, require tonification: Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Tiaozhong Yiqi Tang, Shiquan Dabu Tang. In summer, Qingshu Yiqi Tang, Sijunzi Tang (Four Gentlemen Decoction), Siwu Tang, etc., modified. Knotted/choppy or deep-string-taut pulses, rapid contraction,牵引 pain in limbs/abdomen/flanks/waist/hips, inability to turn, caused by Seven Emotion stagnation or trauma, require careful diagnosis and guidance: San Yin Qi Tang, Liuxi Yinzi, Daqi Qi Tang, Suzi Jiangqi Tang, Huqi San, Simo Tang, Da Xuanhu Tang. For deep-slippery pulse with qi-phlegm-fluids, use Erchen Tang (Two Aged Decoction), Jiegeng Banxia Tang, Siqi Tang, plus Zhiqiao, Wuyao, Zisu (Perillae Folium), Dafupi (Arecae Pericarpium), Sangbaipi (Morus Cortex), modified per symptoms.