bubble_chart Concept

Shortage of qi, also known as "qi deficiency," refers to a symptom of weakness and insufficiency characterized by shortness of breath and lack of strength in speech.

In ancient Chinese medical literature, it is believed that "shortage of qi" is not entirely the same as "shortness of breath." For example, Yizong Jinjian. Zabing Xinfa Yaojue states: "Shortness of breath refers to the inability to sustain breathing; shortage of qi refers to insufficient qi that cannot match the body's form." Zabing Guangyao, when analyzing the similarities and differences in the mechanisms of disease between the two, says: "Shortness of breath due to insufficient breathing is a sign of a strong body, where excess leads to qi counterflow obstruction, hence shortness of breath; also, lung deficiency leads to insufficient qi, which also causes shortness of breath." However, shortage of qi "is due to the insufficiency of visceral qi." That is, "shortness of breath" can be divided into deficiency and excess types, with the deficiency type being no different from "shortage of qi," caused by qi deficiency; the excess type is due to "qi counterflow obstruction," which can be classified as "panting." This section intends to include the former under the discussion of shortage of qi.

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1. Heat Damaging Qi and Yin︰It is commonly seen in the late stage of external-contraction febrile disease [third stage], characterized by fatigue, weakness, emaciation, mild panting, sweating, dry mouth, yellow urine, dry stool, thin and less moist or absence of tongue coating, and thin rapid pulse after fever subsides; or in cases of summerheat injury during the summer season, presenting with shortage of qi, fatigue, fever with profuse sweating, thirst, and restlessness. This syndrome is mostly caused by pathogenic heat invading the lung and stomach, damaging qi and consuming yin. Clinically, it often manifests in two scenarios: one is after the resolution of external contraction, with residual heat lingering in the lung and stomach and fluid injury. As stated in "Treatise on Cold Damage · Differentiation and Treatment of Yin-Yang Transmission and Post-Illness Overfatigue Relapse with Abnormal Pulse," "After the resolution of cold-damage disease, with emaciation and shortage of qi, qi counterflow with a desire to vomit, Bamboo Leaf and Gypsum Decoction is prescribed." The second scenario is injury by summerheat during the summer season, damaging qi and consuming fluids, presenting with shortage of qi, fatigue, hiding fever, excessive thirst with a desire to drink, profuse sweating, and yellow urine. Treatment involves clearing the lung and stomach, tonifying qi and fluids, with modifications of Bamboo Leaf and Gypsum Decoction; if caused by summerheat, the treatment focuses on clearing summerheat and replenishing qi, enriching yin and producing fluid, with the prescription of Summerheat-Clearing Qi-Replenishing Decoction.
2. Spleen Qi Deficiency︰shortage of qi, reluctance to speak, poor appetite, fatigue, large loose stool, complexion shallow yellow turning pale, swollen and tender tongue, weak or soggy pulse. Often due to constitutional weakness or prolonged illness damaging the spleen, leading to spleen qi deficiency, impaired transportation and transformation, inability to transform food into essence, and failure to generate qi, hence manifesting as shortage of qi along with signs of spleen qi deficiency (poor appetite, fatigue, reluctance to speak, loose stool, etc.). As stated in Suwen．Maiyao Jingwei Lun: "When the spleen pulse is firm and long, and the complexion is yellow, it indicates shortage of qi." For spleen qi deficiency and shortage of qi, treatment involves tonifying the spleen and replenishing qi, with formulas such as Liu Shen San or Middle-Tonifying Qi-Replenishing Decoction selected.
3. Heart Qi Deficiency and Weakness︰shortage of qi, palpitation, spontaneous sweating, mental fatigue, insomnia or easily waking after sleep, pale tongue texture, weak pulse. The heart is the monarch fire, its qi nourishes the whole body. If due to weak constitution, prolonged illness, excessive contemplation impairing the spirit, or overexertion of the heart, leading to deficiency of heart qi, symptoms such as shortage of qi, palpitation, sweating, dysphoria, and insomnia may occur. Treatment involves tonifying and replenishing heart qi, tranquilizing the mind and calming the spirit. Prescriptions include Spirit-Tranquillizing Mind-Stabilizing Pill or Prepared Liquorice Decoction.
4. Lung Qi Deficiency︰shortage of qi, spontaneous sweating, faint low voice, weak and feeble breathing, shortness of breath upon exertion, fatigue, pale complexion, prone to common cold and cough, pale tongue texture, weak and soft pulse. The syndrome arises from prolonged lung disease or chronic cough damaging lung qi; or due to congenital deficiency, postnatal malnourishment, and weak constitution, leading to lung qi deficiency. The lung governs qi and controls respiration; lung qi deficiency results in shortage of qi and feeble breathing. As stated in Zabing Guangyao: "The lung governs qi and connects with respiration; if the visceral qi is insufficient, breathing becomes weak and there is shortage of qi." Zabing Yuanliu Xizhu notes: "The lung stores qi; if the lung is deficient, breathing becomes feeble and there is shortage of qi." Key diagnostic points: faint and low voice, short breath and feeble respiration, exacerbated upon exertion. Patients are prone to common cold and cough, intolerant to pathogenic invasion, and their symptoms are more severe than in ordinary individuals. Treatment should focus on tonifying the lung and replenishing qi, with prescriptions such as Lung-Nourishing Decoction, Middle-Tonifying Qi-Replenishing Decoction combined with Jade Screen Powder.

The syndrome of shortage of qi is mainly caused by "insufficiency of visceral qi," which is often acquired after a prolonged illness, leading to severe deficiency in the qi aspect. During clinical differentiation, in addition to the presence of qi deficiency pattern, the manifestations vary depending on the specific visceral qi involved. For example, deficiency of heart qi is often accompanied by palpitations and insomnia; spleen qi deficiency is often accompanied by anorexia, abdominal distension and fullness, and loose stools; lung qi deficiency often occurs after chronic cough disease and is usually accompanied by symptoms such as cough. As for the shortage of qi due to heat damaging qi and yin, it often occurs after Rebing or summerheat stroke, which can be used for differentiation.

bubble_chart Documentation

1. Suwen.Pingren Qixiang Lun: "When a person exhales, the pulse moves once; when inhaling, the pulse moves once, it is called shortage of qi."
2. Zabing Yuanliu Xizhu. "Shortage of qi": "Shortage of qi is a disease of the lung and kidney meridians... Kidney deficiency means qi cannot be generated, thus failing to strengthen the source of qi. Lung deficiency means qi cannot be stored, thus failing to fill the reservoir of qi. The term 'shortage' implies that what remains is not much, weak and timid, unlike shortness of breath where the breath does not connect continuously. Understanding this, shortage of qi can then be treated. Suitable treatments include Four Gentlemen Decoction, Ginseng Astragalus Decoction, and tonifying qi pills."