九气者，谓怒、喜、悲、恐、寒、热、忧、劳、思。因此九事而伤动于气，一曰怒则气
逆，甚则呕血及食而气逆也；二曰喜则其气缓，荣卫通利，故气缓；三曰悲则气消，悲则使
心系急，肺布叶举，使上焦不通，热气在内，故气消也；四曰恐则气下，恐则精却，精却则
上焦闭，闭则气还，气还则下焦胀，故气不行；五曰寒则气收聚，寒使经络凝涩，使气不宣
散故也；六曰热则腠理开，腠理开则荣卫通，汗大泄；七曰忧则气乱，气乱则心无所寄，神
无所归，虑无所定，故气乱；八曰劳则气耗，气耗则喘且汗，外内皆越，故气耗也；九曰思
则气结，气结则心有所止，故气留而不行。
众方说此九气，互有不同，但气上之由有九，故名为九气类也。
平人无寒热，短气不足以息者，体实，实则气盛，盛则气逆不通，故短气。又，肺虚则
气少不足，亦令短气，则其人气微，常如少气，不足以呼吸。
诊其脉，尺寸俱微，血气不足，其人短气。寸口脉沉，胸中短气。脉前小后大，则为胸
满短气。脉洪大者，亦短气也。
五膈气者，谓忧膈、恚膈、气膈、寒膈、热膈也。忧膈之病，胸中气结，烦闷，津液不
通，饮食不下，羸瘦不为气力。恚膈之为病，心下苦实满，噫辄酢心，食不消，心下积结，
牢在胃中，大小便不利。气膈之为病，胸胁逆满，咽塞，胸膈不通，噫闻食臭。寒膈之为病
，心腹胀满，咳逆，腹上苦冷，雷鸣，绕脐痛，食不消，不能食肥。热膈之为病，脏有热气
，五心中热，口中烂，生疮，骨烦，四肢重，唇口干燥，身体头面手足或热，腰背皆疼痛，
胸痹引背，食不消，不能多食，羸瘦少气及癖也。此是方家所说五膈形证也。
经云∶阳脉结，谓之膈。言忧恚寒热，动气伤神；而气之与神，并为阳也。伤动阳气，
致阴阳不和，而腑脏生病，结于胸膈之间，故称为膈气。众方说五膈，互有不同，但伤动之
由有五，故云五膈气。
The "Nine Qi" refers to anger, joy, sorrow, fear, cold, heat, worry, labor (exertion), and thought. Injury and disturbance of Qi caused by these nine factors are described as follows: First, anger causes Qi to rebel; in severe cases, it leads to vomiting blood and rebellious Qi after eating. Second, joy causes Qi to relax; when Ying and Wei (Nutritive and Defensive Qi) are smooth and unobstructed, Qi becomes relaxed. Third, sorrow causes Qi to dissipate; sorrow makes the heart vessels tense and the lung lobes rise, obstructing the Upper Jiao (Upper Burner) and causing heat to remain inside, thus dissipating Qi. Fourth, fear causes Qi to sink; fear causes essence to retreat, which closes the Upper Jiao; closure causes Qi to return, leading to distension in the Lower Jiao (Lower Burner), so Qi fails to circulate. Fifth, cold causes Qi to gather and contract; cold coagulates and obstructs the meridians, preventing Qi from dispersing. Sixth, heat causes the Cou Li (pores and interstices) to open; when Cou Li open, Ying and Wei flow freely, resulting in profuse sweating. Seventh, worry causes Qi to become chaotic; chaos in Qi leaves the mind without a focus, the spirit without a refuge, and thoughts unsettled, thus disrupting Qi. Eighth, exertion causes Qi to be consumed; consumption of Qi leads to panting and sweating, with both internal Qi and external fluids escaping, thus depleting Qi. Ninth, thought causes Qi to knot; knotting of Qi means the mind lingers on one object, causing Qi to stagnate and fail to move.
Various medical texts offer differing explanations for these Nine Qi, but since there are nine causes for rebellious Qi, they are categorized as the "Class of Nine Qi."
A person who is otherwise free from aversion to cold or fever but suffers from shortness of breath and insufficient respiration may have this condition due to excess constitution. Excess constitution implies abundant Qi; abundant Qi leads to rebellion and obstruction, causing shortness of breath. Conversely, deficiency of Lung Qi results in insufficiency, also causing shortness of breath; such individuals have weak vital energy, often feeling like they have "insufficient Qi" and cannot breathe adequately.
Upon pulse diagnosis, if both the Cun (Inch) and Chi (Cubit) positions are faint, it indicates deficiency of Blood and Qi, leading to shortness of breath. A deep pulse at the Cun Kou (Radial Artery) suggests shortness of breath in the chest. A pulse that is small at the front and large at the rear indicates chest fullness and shortness of breath. A surging and large pulse may also present with shortness of breath.
The "Five Ge" (Obstructions) refer to You Ge (Sorrow Obstruction), Hui Ge (Resentment Obstruction), Qi Ge (Qi Obstruction), Han Ge (Cold Obstruction), and Re Ge (Heat Obstruction).
You Ge is characterized by knotted Qi in the chest, irritability, obstruction of body fluids, difficulty swallowing food, emaciation, and lack of strength.
Hui Ge presents with painful fullness and solidity in the epigastrium, frequent belching with acid regurgitation, indigestion, accumulation and binding in the epigastrium firmly lodged in the Stomach, and difficulty in urination and defecation.
Qi Ge manifests as rebellious fullness in the chest and hypochondrium, throat obstruction, blockage in the chest and diaphragm, and belching accompanied by the smell of food.
Han Ge involves abdominal fullness, coughing and wheezing, cold sensation in the abdomen, borborygmus (rumbling intestines), periumbilical pain, indigestion, and intolerance to rich/fatty foods.
Re Ge is marked by internal heat in the Zang organs, heat in the five centers (palms, soles, and chest), oral ulcers and soreness, bone烦 (bone-steaming/irritability), heaviness in the limbs, dry lips and mouth, occasional heat in the body, head, face, hands, and feet, pain throughout the lower back and waist, chest bi (painful obstruction) radiating to the back, indigestion, inability to eat much, emaciation, scanty Qi, and formation of masses (Pi). These are the morphological signs and symptoms of the Five Ge as described by physicians.
The Classics state: "When Yang pulses are knotted, it is called Ge." This implies that sorrow, resentment, cold, and heat disturb Qi and injure the Spirit; since both Qi and Spirit belong to Yang, damaging Yang Qi leads to Yin-Yang disharmony and disease in the Fu and Zang organs, with pathology knotting between the chest and diaphragm, hence termed "Ge Qi." While various texts differ on the Five Ge, they share five etiological factors, thus referred to as "Five Ge Qi."