Last month we discussed the five stagnations in Traditional Chinese Medicine (TCM) along with two formulas to treat all five. In honor of Spring, which begins this year on Feb 10 (Chinese New Year), we will focus on Qi stagnation now. Spring is represented by the Wood Element and its organs, the Liver and Gall Bladder. Since the Liver rules the smooth flow of Qi, now is a perfect time to discuss Qi Stagnation along with how to prevent and treat it.

Qi Stagnation

When Qi congests, flows improperly or moves in the wrong direction (called rebellious Qi), it stagnates. This is just like rush hour stop-and-go traffic, or cars piling up in a traffic jam. One of the most common disharmonies in the body, it affects not only the Liver, but the other Organs and the Seven Emotions as well.

When administering herbal therapy for Qi Stagnation, it is very important that tonics are not given as this could worsen the condition – like adding more cars to a bad traffic jam. In fact, it is for this reason that an important therapeutic herbal strategy is to first give moving herbs from the Regulate Qi and Move Blood categories along with Heat-clearing herbs before giving tonics, as we discussed in January’s blog on the Five Stagnations.

Signs of Qi Stagnation:

In terms of symptoms, Qi Stagnation has far-reaching effects on the body. Again, because the Liver is in charge of the smooth flow of Qi, this pattern is called “Liver Qi Stagnation.” Since there are so many ways this pattern can appear, it is divided into categories of related symptoms. As with all patterns, it is not necessary for all these symptoms to appear to indicate this disharmony; three or more designate there’s Qi stagnation (those in bold are the main symptoms). See if you can find yourself here (hopefully, you can’t!):

1) Overall

• distension of hypochondrium and chest
• hypochondriac pain
• pains that move from place to place, and change in severity or frequency
• frequent sighing
• hiccupping
• burping
• cysts, fibroids and abdominal masses that appear and disappear quickly

2) Emotions

• depression
• moodiness and mood swings 
• frustration
• inappropriate anger
• unhappiness; a gloomy feeling
• a lump or plum-pit feeling in the throat
• feeling of difficulty in swallowing

3) Gynecological

• PMS tension and irritability
• swollen breasts before periods
• irregular periods
• painful periods

4) Digestion

• nausea
• vomiting
• sour belching
• abdominal pain
• poor appetite
• epigastric pain
• diarrhea or alternating diarrhea and constipation
• churning feeling in the stomach
• feeling of pulsation in epigastrium
• abdominal distension
• borborygmi

5) In the meridians

• lumps in the neck, breast, groin or flank

6) Pulse and Tonue

• Pulse: wiry, difficult or choppy;I often find that with Qi stagnation, the pulse doesn’t move well, if at all, either just in the Liver position (the deep middle position on left hand), in another organ (such as the Stomach, the superficial middle position on the right hand – this is the Liver counteracting on the Stomach) or in the overall pulse. 
• Tongue: body color may be normal or slightly purple; sides may curl up

Qi Stagnation in the Upper Warmer: Emotional and mental signs, depression, hysteria, headaches, dizziness, vertigo, chest pains that change location and/or severity; cysts, fibroids and masses that appear and disappear quickly Qi Stagnation in the Middle Warmer: Burping, gas, bloating, tight abdomen or tightness in stomach, full feeling in the abdomen, pains that move or come and go, change severity and location Qi Stagnation in the Lower Warmer: Stiffness, heaviness, tightness in the lower abdomen and extremities, pains that come and go, change severity and location, cysts, fibroids and masses that appear and disappear quickly Qi Stagnation in Abdominal Diagnosis When the abdomen is gently palpated, if there is any discomfort beneath the ribs and/or on the left side right above, beside or below the navel, these indicate Qi Stagnation. Rebellious Qi When energy flows in the wrong direction, or opposite its normal functional flow, it is called “rebellious Qi.” This is also a type of Qi Stagnation. Examples include:

ORGAN	NORMAL QI DIRECTION	PATHOLOGICAL QI DIRECTION	SYMPTOMS & SIGNS
STOMACH	Downward	Upward	Belching, burping, hiccups, nausea, vomiting
SPLEEN	Upward	Downward	Diarrhea, prolapse
LIVER	Upward	Excessively upward or horizontally – to the Stomach to the Spleen to the Intestines	Nausea, belching, vomiting (Stomach) Diarrhea (Spleen) Dry stools (Intestines)
LUNGS	Downward	Upward	Cough, asthma
KIDNEYS	Downward	Upward	Asthma
HEART	Downward	Upward	Mental restlessness, insomnia

Causes for Qi Stagnation:

There are many factors that can cause Qi to stagnate. Here are several: Pathogenic Influences: The two External Pernicious Influences that affect Liver Qi are Wind and Dampness. Although Wind does not invade the Liver directly, it can aggravate an existing condition of Interior Wind in the Liver. When it does, it causes Liver Qi to stagnate, which can further result in Blood Stasis. It can also cause skin rashes and hives that appear and move quickly. As well, Blood Stasis can lead to Qi Stagnation.

Emotions: Any long-term suppressed or unexpressed emotion stagnates the Qi. This means it’s important to discover the underlying cause for these feelings and find constructive and beneficial outlets. Specific emotions that stagnate Qi are anger, frustration, resentment, irritability, mood swings and depression.

Diet: A diet rich in stimulants, fried, fatty and oily foods, dairy, chips of all kinds, recreational drugs, alcohol, coffee, black tea, chocolate, cocoa, colas, nuts and nut butters, avocados, turkey and red meats, and spicy foods (as in chili and curry) cause the Liver Qi to stagnate.

Lifestyle Habits: Inadequate activity, sex, or exercise, regularly going to sleep late at night (after 11 PM), working at jobs one doesn’t like, any type of stress, or overwork without sufficient rest cause Liver Qi stagnation.

In Part II we will discuss treatments and therapies for Qi stagnation. However, if you feel stagnant just by reading all of this, I suggest you immediately get up and MOVE! Movement is one of the great keys to circulating Qi. It can be exercise, but if you do what you love at the same time, it also smooths emotions and nourishes you, preventing further stagnation.