Qi collapse pattern refers to a general term for various critical symptoms caused by the deficiency and timidity of the body's healthy qi, the exhaustion of original qi, qi collapse following blood loss, and the impending separation of yin and yang. This syndrome is often caused by external contraction or internal damage, prolonged illness without recovery, the inability of the body's healthy qi to overcome pathogenic factors, or external injuries, menorrhagia, postpartum hemorrhage, and other disease causes. It often manifests as sudden and severe symptoms and signs, requiring urgent rescue.

The main clinical manifestations of this major syndrome include: sudden profuse sweating, listlessness, closed eyes and open mouth, pale complexion, shortness of breath, involuntary urination and defecation, a pale and swollen tongue, and a fine and weak or hollow and large pulse.

This syndrome is scattered among conditions such as "unconsciousness," "shiver sweating," "apoplexy," "menorrhagia and metrostaxis," and "postpartum dizziness due to hemorrhage."

Qi collapse pattern should be differentiated from "yin collapse pattern," "yang collapse pattern," and "qi syncope syndrome."

bubble_chart Differentiation and Treatment

Due to the different disease causes and mechanisms of disease progression leading to this syndrome, the clinical manifestations also vary.

1. For example, this syndrome can be seen before "unconsciousness," often caused by the lingering of pathogenic heat from an unresolved external-contraction febrile disease, which depletes body fluids. At this stage, if sweating or purging is mistakenly induced, symptoms such as sweating or diarrhea, mental fatigue, closed eyes, shortness of breath, convulsions in the hands and feet, weak qi, a crimson tongue with scant coating, and a tendency to collapse may appear. Treatment should focus on nourishing fluids to extinguish wind and tonifying qi to stabilize collapse, using the modified Major Wind-Stabilizing Pearl (Wenbing Tiaobian).
2. It can also be caused by constitutional kidney deficiency, insufficient original qi, or prolonged illness. In such cases, mistaken sweating or purging may lead to profuse sweating, mental exhaustion, pale complexion, faint and thin pulse, and a pale, swollen tongue. Treatment should aim to tonify qi, stabilize collapse, and rescue from collapse, using modified Ginseng Decoction (Shiyao Shenshu) or Ginseng, Aconite, Dragon Bone, and Oyster Shell Decoction ("Empirical Formula").
3. Another example is when this syndrome results from excessive "shiver sweating," often due to warm pathogens lingering in the qi aspect without entering the nutrient aspect. Here, healthy qi is still strong, but pathogenic qi persists, attempting to expel the pathogen through shiver sweating. Shiver sweating occurs as a struggle between healthy qi and pathogenic qi, causing full-body tremors and sweating to expel the pathogen. After shiver sweating, symptoms like cold limbs, clear consciousness, fatigue, and a weak, slow pulse may appear. With proper care, recovery can occur as healthy qi is restored. However, if cold limbs, restlessness, and a rapid pulse occur after shiver sweating, it indicates a critical state of healthy qi collapse, requiring urgent treatment with Ginseng Decoction or Pulse-Reinforcing Powder (Neiwaishang Bianhuo Lun).
4. This syndrome can also appear in the collapse pattern of "apoplexy." Yijing Suhui Ji states: "Apoplexy is not caused by external wind pathogens but by internal qi disorders. People over forty, during periods of qi decline, or those emotionally distressed, often suffer from this disease." This is due to improper rest, depletion of original qi, and liver-kidney deficiency, leading to internal wind movement. Symptoms include sudden fainting, pale complexion, closed eyes, open mouth, cold limbs, incontinence, facial distortion, hemiplegia, a flaccid tongue, and a faint pulse. Treatment should focus on tonifying qi to rescue from collapse, using modified Ginseng Decoction or Ginseng and Aconite Decoction (Furen Liangfang).

Qi collapse syndrome commonly occurs in individuals with constitutional yang qi deficiency, prolonged illness, or elderly weakness. However, women with "menorrhagia" or "postpartum hemorrhage" often experience qi collapse following blood loss, leading to this syndrome.

1. For example, qi collapse due to "menorrhagia" is often caused by dietary overexertion or excessive worry, leading to spleen-stomach qi deficiency, depletion of original qi, failure of qi to control blood, and instability of the Chong and Ren meridians. Symptoms include hypermenorrhea with pale, watery blood, blurred vision, dizziness, pale face, mental fatigue, anorexia, shortness of breath, sore lower back, weak limbs, a pale, swollen tongue, and a faint pulse.
2. In cases of qi collapse due to "excessive postpartum blood loss," it is often caused by multiple pregnancies, uterine damage, emptiness of the Chong and Ren meridians, exhaustion of original qi, and massive bleeding. Symptoms include persistent postpartum metrorrhagia, continuous lochia, profuse cold sweating, mental exhaustion, pale face, sunken eyes, shortness of breath, cold limbs, a pale tongue, and a large, hollow pulse.
3. In ophthalmology, qi collapse can lead to blindness. Lingshu. Jueqi states: "Qi collapse leads to unclear vision," referring to the collapse of the essential qi of the five zang-organs. Due to the exhaustion of the five zang-organs' essential qi, which fails to nourish the eyes, symptoms like dry eyes, blindness, or dilated pupils may occur.
4. In pediatrics, children with insufficient innate endowment and depleted original qi, being in a state of immature yang, are prone to sudden high fever, sweating, flaring nostrils, rapid breathing, persistent diarrhea, mental fatigue, and shortness of breath, all manifestations of qi collapse syndrome.

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It must be pointed out that this syndrome is closely related to the lungs, spleen, and kidneys. Clinically, it is often caused by lung-spleen qi deficiency, leading to sudden great dripping sweating, or it can be caused by spleen-kidney qi deficiency, resulting in sudden and persistent diarrhea. Therefore, this syndrome can develop from insufficient qi deficiency. Sweating can occur due to the inability of qi deficiency to consolidate, leading to the loosening of striae and interstice. Qi belongs to yang, and the inability of yang qi to protect the exterior and its leakage can also cause sweating. Hence, great dripping sweating must damage yang qi, and qi collapse can also lead to yang exhaustion, which is the first point. Sweat is transformed from body fluids. If qi is not consolidated, continuous sweating leads to the external leakage of body fluids, which can damage fluids and deplete yin, indicating that qi collapse can also lead to yin exhaustion, which is the second point. Of course, excessive diarrhea can similarly consume qi and collapse fluids, resulting in the aforementioned two outcomes. Clinically, it is crucial to prioritize the emergency treatment of qi collapse pattern. After the original qi is restored, it is essential to address the disease causes and clinical symptoms or sequelae that lead to various syndromes, and to provide targeted treatment. Otherwise, the qi collapse pattern may recur, and the condition may become more severe.

bubble_chart Differentiation of Similar Patterns

1. Yin collapse pattern and qi collapse pattern: Both are critical symptoms and signs, and both manifest as great dripping sweating. Yin collapse pattern is often caused by the inward invasion of pathogenic heat, the depletion of true yin, or excessive sweating, persistent diarrhea, etc., leading to the exhaustion of yin fluids, yin failing to control yang, and the separation of yin and yang. Symptoms include unconsciousness, listlessness, oily sweating, flushed cheeks, dry throat, red and deep tongue, peeled tongue coating, and a weak, thin, and rapid pulse. On the other hand, qi collapse pattern results from great dripping sweating leading to the depletion of body fluids and qi deficiency, but it only manifests as mental fatigue without unconsciousness. Therefore, qi collapse pattern can be a precursor to yin collapse pattern, and the two should be differentiated based on this.
2. Yang collapse pattern and qi collapse pattern: Both are critical symptoms and signs, and both manifest as great dripping sweating. Yang collapse pattern is often caused by the decline of true yang, or excessive sweating, persistent diarrhea, etc., leading to the exhaustion of yang qi, yang failing to retain yin, and the separation of yin and yang. Symptoms include unconsciousness, cold sweating, closed eyes, open mouth, limp limbs, involuntary urination and defecation, weak breath, pale tongue texture, and a faint, thin pulse on the verge of disappearing. On the other hand, qi collapse pattern results from great dripping sweating leading to qi deficiency on the verge of collapse, but it does not manifest as unconsciousness, only mental fatigue. Therefore, qi collapse pattern can be a precursor to yang collapse pattern, and the two should be differentiated based on this.
3. Qi syncope syndrome and qi collapse pattern: Both are critical symptoms and signs, and both are related to pathological changes in "qi." Qi syncope syndrome is often caused by damage from the seven emotions, anger, fright, liver depression failing to disperse, rage causing qi to rise, leading to the disruption of qi movement, filling the chest, and disturbing mental activity. Symptoms include sudden fainting, unconsciousness, cold limbs, convulsions, etc. On the other hand, qi collapse pattern is caused by insufficient original qi, qi failing to consolidate, leading to great dripping sweating and listlessness. Therefore, the former belongs to an excess pattern, while the latter belongs to a deficiency pattern. The disease cause, mechanism of disease, and symptoms are different, and the two should be differentiated based on this.

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bubble_chart Documentation

1. Lingshu．Tongtian Chapter: "When both yin and yang are depleted, sudden death occurs without consciousness."
2. Nan Jing．Chapter 20: "When yang collapses, one sees ghosts in the dark."
3. Jingui Yaolue．"Treatment of Blood Impediment, Deficiency Fatigue, and Abnormal Pulse": "A pulse that is deep, small, and slow is called qi collapse. The person will pant and gasp when walking quickly, experience reversal cold in the hands and feet, abdominal distension and fullness, and in severe cases, sloppy diarrhea, with food not being digested."
4. Jingyue Quanshu．"Guidelines for Women": "When the placenta is delivered during childbirth, both qi and blood are lost. Suddenly, the eyes go black, the head feels dizzy, unconsciousness and lockjaw occur, and the person becomes unaware. The ancients often said that lochia attacks the deficiency, leading to postpartum dizziness due to hemorrhage. However, it is not known that there are two conditions: postpartum dizziness due to hemorrhage and qi collapse. If qi collapse is mistaken for blood deficiency and treated with pungent and aromatic blood-resolving and phlegm-resolving agents, death will occur immediately. Caution is necessary."
5. Linzheng Zhinan Yi'an．"Commentary by Xu Ling-tai on Collapse": "The term 'collapse' refers only to the sudden escape of yang qi, the separation of yin and yang, oily sweating, feeble pulses on the six positions of the wrist pulse, and acute and urgent symptoms. Only then is it called collapse."