What is the theory of qiqi?

  Chinese medicine believes that the human body is an organic whole and the internal organs not only communicate with each other structurally through the meridian system, but also have a mutually synergistic and interdependent relationship in terms of function, the expression of which is the movement of qi in and out. The movement of the internal organs has its own characteristics due to the specificity of the function of the internal organs. For example, among the five organs, the heart and lungs are on the top, and those on the top should descend; the liver and kidneys are on the bottom, and those on the bottom should ascend; the spleen and stomach are in the middle, communicating up and down, and are the hub of ascending and descending. The six internal organs transmit and transform things but not hide, to pass for use, so the qi of the internal organs to descend as smooth, descend then the qi of the internal organs to get through, the dregs to get diarrhea. On the other hand, because of the complex connection and collaboration between the internal organs, the qi activity is expressed as ascending in descending, descending in ascending, ascending and descending, descending and ascending in many forms. For example, the heart, kidney, water and fire are in harmony, the spleen and stomach rise and fall, and the liver and lungs are in order.  The movement of qi must be adjusted to be smooth, through the qi is unobstructed, adjusting the lift in and out of order. So that the body’s qi can be fully spread in the five organs, six internal organs, limbs and bones, to play its warmth, promote, consolidate, gasification and defense functions, to ensure the continuous production and distribution of gas, blood, fluid, essence, liquid and other fine substances, as well as the continuous excretion of dregs, waste liquids, to maintain the normal operation of human metabolism. Therefore, qi regulation is the fundamental and healthy guarantee of human life activities. As the saying goes, the lifting and lowering of the in and out, the body of heaven and earth, the capsule of all things, the program of all diseases, the pivot of life and death.  Second, the pathological changes of the qi “Su Man lifting pain theory” said: “a hundred diseases born in the qi.” General refers to the wide range of qi disease. Zhang Jiebin said: “Qi in people, and is the right Qi, not and is the evil Qi. Where the surface of the real and the real, the reverse smooth and slow, all because of the gas, so all diseases are born in the gas.” The six external injuries, internal five evils, the seven emotions of internal depression, diet, labor and fatigue can lead to Qi imbalance. The six diseases, such as wind attacking the surface, depression and obstruction of the lung; cold and stagnant blood stasis; fire and heat, depletion of qi and injury to yin; dryness and robbing the lung, loss of coordination of publicity and descent; dampness and stagnation of the spleen and stomach. The five internal evils are not only the product of dysfunction of the internal organs, but once formed, they inevitably affect the operation of the qi of the whole body. Such as liver and kidney yin deficiency, liver Yang hyperactivity wind; spleen and kidney Yang deficiency, cold and damp condensation blocking qi; spleen and stomach wet trapped, no power to ascend and descend the turbid; internal dryness injury to the lungs, the propagation and purification of the dysregulation; water and fire, heart fire on the inflammation as a problem. Under normal circumstances, the seven emotions of happiness, anger, sadness, pity, fear and fright are the external manifestations of human mental activity, but if the various mental stimuli are too strong or last too long, the body cannot adjust itself to adapt, which can lead to the imbalance of yin and yang, Qi and blood, meridian blockage and disorder of the internal organs. Overeating and overworking can also make the qi rebellious, leading to qi, fire, phlegm, dampness, food and stasis because of the disease, forming a variety of illnesses.  The principle of “treating all diseases” starts from the regulation of Qi Qi Qi disorder is the source of all diseases, therefore, taking the regulation of Qi Qi Qi as the basic treatment idea, we can grasp the main disease mechanism for diagnosis and treatment among various complex clinical manifestations, and achieve the purpose of managing the complexity and treating the root of the disease. In the Su Wen Zhi Zhen Yao Da Lun, it is said, “Be careful to observe where the yin and yang are and regulate them, in order to calm the period.” In the case of Qi imbalance, we should pay attention to regulating the movement of Qi up and down and in and out, and adopt the methods of supplementing its deficiency and losing its surplus, and diarrhea for actuality and supplementation for deficiency, so as to bring Yin and Yang back to a relatively balanced and harmonious state, which is the basic principle of “treating all diseases”.  In the process of regulating the qi flow, one should pay attention to the overall connection of the body, pay attention to the characteristics of the internal organs, take care of the essence of the five organs and six bowels, and achieve the purpose of eliminating disease and evil and restoring the normal function of the body through regulating the qi flow. Secondly, we should pay attention to the pivot of the spleen and stomach, so that it can communicate with the upper and lower, and coordinate the transportation. Third, we should pay attention to the relationship between the internal organs, meridians, qi and blood, and fluids, and pay attention to the correction of the phase because of the problem. Fourth, we should choose the drugs carefully to prevent blocking the qi, and give the evil qi a way out by taking advantage of the situation in treatment.  Fourth, the clinical practical value of regulating the qi qiqi originated from the “Nei Jing”, through the play of Zhang Zhong Jing, Liu Heshan, Zhang Jie Gu, Li Dongheng, Zhang Jinyue, Ye Tianshi, Zhou Xuehai and other medical experts, gradually formed a systematic and complete doctrine. Modern clinical departments use the theory of qi lifting and lowering to analyze and explain the causes and mechanisms of disease, symptom manifestations and prognosis, and treat various diseases with increasingly broad applications, showing the clinical practical value of the theory of qi regulation.  1, personal illnesses have a lot of depression, the clinical evidence must be examined in detail “Xue’s medical case, the flat treatment of a collection of” said: “qi and blood rushing and harmony, all diseases do not arise, a whisk depression, all diseases are born. In the author’s opinion, the “yu” in this case, there is a functional and emotional division. There is a difference between the so-called functional yu, in the broad sense, and the narrow sense. The broad sense of yu refers to the macroscopic and overall scope of the obstacles to the flow of qi. Narrow sense of yu, refers to the local, microscopic yu. For example, the external depression, depression in the muscle surface, Ying and Wei blocked; internal injuries caused by depression, depression in the internal organs, loss of harmony between Qi and blood; long-standing illnesses and strange disease of depression, the Qi and blood, phlegm and paralysis, the function of the internal organs is impaired. The so-called emotional depression, in general, minor illnesses are light depression, while major illnesses are heavy depression. And the function of the depression and the depression of the emotion are closely related, both interlinked and mutually influential, mutual cause and effect. Therefore, at the time of clinical evidence, the patient’s functional depression and emotional depression must not be ignored. According to Jin, the characteristics of psychosomatic diseases in TCM are that the disease affects the five organs and is centered in the brain; disorders of qi are easily transformed; different personalities have different illnesses; abnormal fluctuations of emotions and moods often lead to sudden aggravation or rapid deterioration of the disease. According to Liu, Qi disorders are the central link in the development and transformation of diabetes: some people who are easily agitated have stable symptom control after suffering from diabetes, but after getting angry and depressed, Qi disorders occur and blood glucose suddenly rises within a short period of time and symptoms worsen. Some patients entering menopause, because of emotional instability, the condition is easy to fluctuate, progressing quickly and difficult to control.  2, pay attention to the overall connection of the body, in line with the characteristics of the five organs and six bowels people get sick because of qi stagnation, so the key to cure the disease is to regulate the qi. The five viscera and six bowels are a whole, but have their own different physiological characteristics, therefore, the manifestation of qi stagnation is also different, and the regulation of qi must be in accordance with the characteristics of its ascending and descending, “adjust its yin and yang, to calm the period.” Li believes that cholecystitis is mostly caused by liver qi stagnation, spleen loss of health, and dampness and heat, and that liver and gallbladder are in phase with each other, and liver depression and qi stagnation affects bile drainage. Therefore, the treatment of cholecystitis “should be sparse and easy”. The main focus of dredging is Chai Hu, with the use of Qian Cao, Jiang Huang, Bai Shao and Yu Jin to dredge the liver and bile. Tong refers to the circulation of Qi from the internal organs, using Rhubarb, Citrus aurantium, Yin Chen, Yuan Hu Suo, and Chuan Dong Zi to unblock Qi and Blood and clear dampness and heat. Han et al. studied coronary heart disease, wind heart disease, liver and gallbladder disease and bronchitis from the perspective of “liver ascending and lung descending” and concluded that the key to treatment is to harmonize liver and lung ascending and descending in order to be effective. Although there are various types of clinical evidence, such as liver qi stagnation, liver stagnation and spleen deficiency, liver and gallbladder stagnation and heat, liver stagnation and blood stasis, liver stagnation and fire, and liver yin deficiency, etc., Xia’s treatment of plum kernel qi takes liver qi stagnation as the main point of identification and treatment, but dredging the liver and moving qi to relieve stagnation throughout. Yang explores the relationship between Qi elevation and diabetic nephropathy, and believes that deficiency of the spleen and kidney is the root of Qi elevation malfunction, and blood stasis is an important factor in Qi elevation malfunction. Therefore, the main treatment method is to regulate the qi of the spleen and kidneys, to raise the clear and lower the turbidity, and to activate blood stasis.  The spleen and stomach are located in the middle jiao and communicate with the upper and lower levels. It plays an important role in maintaining the overall balance of qi flow up and down. The Spleen and Stomach are the foundation of the posterior heaven. If the Qi flow does not rise and fall properly, the food and water cannot be digested, the water and grain can hardly be produced, the qi of Yang cannot be spread, and the position of the internal organs cannot be maintained. Therefore, among the many abnormalities in the elevation, especially in the spleen and stomach, abnormal elevation has the greatest impact. Therefore, it is important to pay attention to the lifting and lowering state of the spleen and stomach qi, so that it rises and lowers the turbidity, and the coordination of the nasal transportation is the first treatment. For example, Zhong’s theory of gangrenous disease seizes the general pathogenesis of the derangement of the elevation of the spleen and stomach, whether phlegm and dampness are blocking or phlegm and stasis are intertwined, on the basis of identification, he applies the method of resolving phlegm and invigorating blood, elevating the qi mechanism, and appropriately uses almonds, spleen stalks, ascending mushrooms, whirlpool flowers, yujin and foxglove to significantly improve the therapeutic effect. Li et al. used the theory of elevation and declination of the spleen and stomach to treat gynecological diseases such as rebellious menstruation, yin tingling, and malignant obstruction of pregnancy with good results. Zhang and others believe that the etiology of gastric prolapse is mainly due to the malfunction of the stomach’s circulation and descent, and based on the principle that the six internal organs should be smooth, the stomach should be lowered, and the descent should be harmonious, the method of “circulation and descent of the internal organs and regulation of qi” is proposed for treatment, which opens up new ideas for clinical practice.  The human body is an organic whole, the organs of the internal organs communicate with each other through the meridian system, and the function of the organs is maintained through the coordinated movement of Qi, Qi and blood can cause disease; the seven emotions of internal depression, six perversions of trauma, diet and fatigue can also cause Qi disorder. Once the Qi is out of balance, the Qi, fire, phlegm, dampness, food and stasis will be affected by each other. Therefore, the interrelationship of the internal organs, meridians, qi and blood, and fluids must be emphasized to regulate the qi flow. Zhao believes that the cause of hyperlipidemia is related to the dysfunction of the viscera and the disorder of the qiqi causing abnormal metabolism of water and moisture and fluids in the body, stopping them into drinks, coalescing them into phlegm, and gathering phlegm and phlegm, making lipid paste and injecting it into the blood vessels. In terms of pathogenesis, it widely involves the five viscera, therefore, the method of regulating qi is used in all treatment stages of hyperlipidemia. Pan’s treatment of dry syndrome is based on the theory of qi, and he believes that qi and fluid are closely related, and if qi is vigorous, fluid will be filled, and if qi is regulated, fluid transmission and distribution will be normal, and if not, fluid generation, transmission and distribution and excretion will be affected. In dry syndrome, Yin deficiency and fluid deficiency are the root cause and dryness and heat are the symptoms, and the pulse is mostly sunken, thin, small and astringent. The treatment is based on the principle of “moistening the dry”, focusing on replenishing qi and regulating qi flow. On the one hand, the deficiency of essence, qi, blood and fluid; on the other hand, phlegm and dampness, water-drink, qi-blood blockage form various diseases. Therefore, we pay attention to tonifying the five organs, so that they can lift and lower in an orderly manner; to promote paralysis and blockage, so that their qi can be restored; to use drugs in a calm manner, so as to maintain the body’s vitality; and to use food therapy, so that the elderly are happy to accept it, reflecting the characteristics of holistic treatment, regulating qi, and nourishing and prolonging life.  5, careful selection of drugs, to prevent blocking the qi, to give the evil to the way out According to the doctrine of Chinese medicine qi rise and fall, drugs on the human body have the tendency to rise and fall, respectively, can correct the body’s qi malfunction, or take advantage of the situation, help to drive out the evil, to achieve the purpose of “dredging its blood and qi, so that it is adjusted to reach and peace”. Generally speaking, drugs with the effect of raising Yang, dispersing wind and cold, and opening up the orifice can all go upward and outward, and their medicinal properties are ascending and floating; while drugs with the effect of diaphoresis, clearing heat, diuresis, permeating dampness, calming and tranquilizing the mind, quenching wind and submerging Yang, eliminating stagnation, lowering rebellion and astringency, and relieving cough and asthma can all go downward and inward, and their medicinal properties are sinking and descending. Clinically, according to the different parts of the disease and the tendency of the disease, choose drugs with different medicinal properties of lifting and sinking, in order to correct the imbalance of the body’s qi mechanism. For example, Dong’s use of tonifying Zhong Yi Qi Tang with Hovenia husk, Citron peel, Buddha’s hand, and Big belly peel, the name of the additional flavor tonifying Zhong Yi Qi Tang, lifting and regulating spleen deficiency without the right to transport and transform, the stomach stagnation of water and grain does not transform the evidence; and the treatment of angina pectoris in coronary heart disease with the method of tonifying the internal organs, the symptoms of heart Qi deficiency, heart vein stagnation, the use of Huang Qi, Radix Codonopsis to tonify the heart Qi, and the whirlpool flower, Yu Jin, Dan Shen, Panax notoginseng to regulate Qi and activate the blood vessels. Wu applies Zhu Danxi’s saying that “most of the evidence of depression is in the middle jiao”, and treats the evidence of depression by treating the deficiency of the spleen and stomach, while at the same time, smooth the qi and open the depression. The treatment of depression with phlegm is based on Hou Pu and Panaxia to strengthen the spleen and resolve phlegm; for depression with dampness, Fu Ling and rice kernel are used to strengthen the spleen and promote dampness; to nourish the spleen, Dang Ginseng, Huai Shan Yao and Bai Zhu are often chosen; to transport the middle, lentils and raw rice kernel are mostly used. The predecessors in the long-term clinical practice, summarized the system lift medicine pairs, such as ephedra to promote the lung and calm asthma, sedum to lower the qi and gas, and used to stop coughing and asthma; orris rose to disperse lung qi, amber to lower the diuretic, take the method of lifting the pot to uncover the lid to treat retention of urine; wood butterfly rose to disperse the pharynx, persimmon tissues to smooth the qi and lower the rebellious, up and down to treat plum kernel gas; Ge Gen rose to send clear yang, rhubarb to lower the qi of the internal organs, rise clear and lower the turbidity to treat dysentery. All of them reflect the principle of exorcising evil out of the body according to the situation. In addition, Chinese medicine has many Qi, blood, nourishing, nourishing Yin drugs, easy to cause congestion, so in the tonic medicine with appropriate qi moving drugs, can be complementary but not stagnant, such as the spleen soup, tonic in the qi soup, four things soup, six Junzi soup are not lack of qi moving products, to prevent blocking the qi.  To sum up, the theory of qi elevation is an important part of the theory of Chinese medicine, and the physiological characteristics, pathological changes and therapeutic regression of the internal organs are closely related to qi elevation, which has high clinical application value and needs to be studied, discussed, organized and brought into play by clinical practitioners in a broader field to further enrich the theoretical system of Chinese medicine.