4 QI IMBALANCES and 5 ELEMENTS
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1 4QIIMBALANCESand5ELEMENTS ANewSystemforDiagnosisandTreatment byjeremyross PartI:Introductionto4QI+5E COMPLEXPATIENTS Modernchronicpatientsarerarely simple.manyhaveabouttendifferent Chinesesyndromesatthesametime, andsometimesasmanyastwenty. Thismakestwoproblemsforthe beginner,orevenfortheexperienced practitioner. FirstproblemAftertheconsultation, thepractitionerisburiedindata,and maylosesightofaclearoverallpicture ofthepatient sneeds. SecondproblemThepractitioner doesnotknowwheretofocustheir attention,sothatdifferentialdiagnosis lacksprecisionofthedetails. Itwastosolvethesetworelated problemsthatidevelopedthesystemof 4QiImbalancesand5Elements. Thissystemprovidesasystemthatcan befocusedup,toviewthebigpicture, andfocuseddown,toviewpartsofthe pictureinprecisedetail. 4 QI IMBALANCES simple overview CONCEPTOF4QIIMBALANCES Togetaclear,simpleoverviewofa patient,anacupoint,oraherb,wecan saythattherearefourmainqi pathologies: Deficiency Stagnation 4 Q I Disturbance Excess DEFICIENCY Thismeansthatthepatientis exhausted,duetonotenoughqi,yang, Yin,Fluid,Blood,orJing. Forexample: DeficientYangwithexhaustion andsensationsofcold DeficientYinwithexhaustion, restlessness,insomnia,andsignsof Heat DeficientBloodwithexhaustion, anemia,faintnessonstanding,and blurredvision DeficientJingwithexhaustion, retardationofphysicalgrowth,or retardationofmentaland behaviouraldevelopment Principleoftreatment:tonify 4 QI IMBALANCES + 5 ELEMENTS for detail & precision 2009JeremyRossandVerlagfu rganzheitlichemedizindr.erichwuḧrgmbh 1
2 EXCESS Thisreferstoapathologicalexcessthat mayonlylastforarelativelyshorttime. Forexample: ExteriorWindinvasionofExcess typeasininfluenzawithno sweating ExcessInteriorHeatasinhigh fever ExcessLiverHeatasinviolent angerwithshouting,wholeface red,andsensationsofheat FoodStagnationofExcesstype withepigastricdistension, discomfort,andnauseadueto massiveovereatingofrichfood Principleoftreatment: STAGNATION Thismeansthatthereisablockagein theflowofqi,sothatqiisthere,butitis notmoving. Thismayresultindistension, discomfort,pain,ordepression,until theqisagain. Forexample: StagnationofLungQiascan happeningrieffollowing bereavement,withsensationof blockageandfullnessinthechest StagnationofHeartBloodwith sensationofdiscomfortorpainin theheartarea StagnationofFluidsascan happeninedemafollowingtrauma StagnationofQiinthechannels withdiscomfort,pain,stiffness,or immobilityofjointsorextremities Principleoftreatment: DISTURBANCE Thismeansadisturbanceorirregularity intheflowofqi,includingqimovingin thewrongdirectionorwiththewrong rhythm. Thismayresultinphysicaldisturbance suchascoughing,vomiting,or borborygmus,orinemotionaland mentaldisturbance. Forexample: HeartSpiritDisturbancewith disturbanceofsleep,mind, emotions,orbehaviour LiverHyperactiveYangwith irritability,restlessness, impatience,anger,dizzinessor headache RebelliousStomachQiwith hiccups,belching,nausea,or vomiting RebelliousLungQiwithcough, expectoration,wheezing,or dyspnea Principleoftreatment:calm 2009JeremyRossandVerlagfu rganzheitlichemedizindr.erichwuḧrgmbh 2
3 PRINCIPLESOFTREATMENT Theprinciplesoftreatmentforeachof the4qiimbalancescanbesummarized asfollows: tonify calm Deficiency Disturbance 4 Q I Stagnation Excess Tonify Thismeanstoaddenergytothe system,ortohelpthebodyto strengthenitself,bynutrition, herbs,moxa,oracupuncture. Drain Thismeanstoenergyfrom thesystembybleeding,purging, sweating,orothertreatment,orby reducingtheleveloffunctionofone ormoreorgansystems. Move Thismeanstoobstructionto theflowofqi,blood,orfluids,for examplebyexercise,massage, cupping,acupuncture,orherbs. Calm Thismeanstocalmdisturbance,for examplewithherbs,acupuncture, orrelaxationexercises. Thenthepersonfeelsmorecalm andstable,lesstenseandrestless, andlessangry,orfearful. Thismayreducenausea,vomiting, borborygmus,orcolic,andreduce coughingortightnessofbreathing. 4QIIMBALANCES+DISEASE FACTORS Diseasefactors,suchasHeat,Cold, Damp,Phlegm,andExteriorWind,can beassociatedwithoneormoreofthe4 Imbalances. Forexample,Phlegmcanbeassociated withdeficiency,excess,stagnationor Disturbance. Deficiency+Phlegm SpleenDeficientQicanleadto formationofphlegmdueto reducedtransformationoffluids, andlungdeficientqicanresultin reducedclearanceofphlegm Excess+Phlegm LungPhlegmofExcesstypecanbe associatedwithfeelingoffullness inthechest,withprofusesputum, andfullslipperypulse Stagnation+Phlegm PhlegmcanobstructtheflowofQi inthechannels,withsensationsof heavinessanddullness,discomfort orrestrictedmobilityinjointsand limbs Disturbance+Phlegm HeartPhlegmorLiverWindwith Phlegm,canbeassociatedwith mentalorbehaviouraldisturbance duetophlegmcausing irregularitiesintheflowofqi 2009JeremyRossandVerlagfu rganzheitlichemedizindr.erichwuḧrgmbh 3
4 COMBINATIONSOF2IMBALANCES Obviously,apatientmayhavemore thanoneofthe4qiimbalancesatthe sametime. Forexample,Disturbancecanbe associatedwithdeficiency,excessor Stagnation. Disturbance+Deficiency Inthiscase,theDisturbanceofQiis associatedwithdeficiencyand exhaustion. IfthereisnotenoughQi,Blood,or Yintoholddownandtoholdstable lightandmovingenergiessuchas HeartSpiritorLiverYang,these energiesmayriseupthebodyinan irregularmanner. Thismaycausephysicalsymptoms suchaspalpitations,headache,or dizziness,ordisturbanceof emotions,mind,andbehaviour. POT:calm+tonify Disturbance+Excess ExcessHeat,forexample,maygive risetodisturbancesuchasliver HyperactiveYang,LiverWind,or HeartSpiritDisturbanceby increasingagitatedandirregular upwardment. POT:calm+ Disturbance+Stagnation Obstructionintheflowofariver, suchasaboulder,cancause turbulenceintheflow.similarly StagnationofQiinthebodymaybe accompaniedbydisturbance. Forexample,inpre menstruation, StagnationofLiverQiisoften accompaniedbyliverhyperactive Qi,withheadacheandirritability. POT:calm+ COMBINATIONSOF3or4 IMBALANCES Patientswithcomplexconditionsoften havethreeorfourqiimbalances simultaneously. Herearetwoexamples. Deficiency+Stagnation+ Disturbance Thepatienthasthreemain complaints: - exhaustionduetospleen DeficientQi - abdominaldistensiondueto LiverStagnantQi - headacheduetoliver HyperactiveYang POT:tonify++calm Excess+Stagnation+ Disturbance+Deficiency Thepatienthasfourmain complaints: - severesensationsofheatfrom LiverExcessHeat - depressionfromliverstagnant Qi - angerfromliverhyperactive Yang - tirednesswithrestlessnessfrom LiverDeficientYin POT:++calm+tonify 2009JeremyRossandVerlagfu rganzheitlichemedizindr.erichwuḧrgmbh 4
5 PRIORITIZATION Relativeimportanceofeach Imbalance Thepractitionermustdecidethe relativeimportanceofeachimbalance foraparticularpatient,sothatthey knowhowmanyacupointsorhow manyherbstouseforeachimbalance. THESTARRATINGSYSTEM Thestarsystemawards0 3starsfor eachofthe4imbalances,accordingto therelativeimportanceofeach Imbalanceforthepatientataparticular time. Thestarratingthereforeindicatesthe relativenumberofacupointsorherbs neededforeachofthe4imbalancesina pointorherbcombinationfora particularpatient. ExampleLetuscomparetwodifferent patients,fredandjohn,using4qi Imbalancediagramsandthestarrating system. tonify tonify Fred John calm calm Ifthepractitionerwantedtousea6 herbcombinationforeitherofthese patients,thetableshowsthenumberof herbsrequiredintheprescriptionfor eachimbalance. Herbs Fred John to tonify 1 0 to calm 2 3 to 1 0 to 2 3 4QIIMBALANCES+5ELEMENTS 4QiImbalances:simplicity Theconceptofthe4QiImbalancesis onlyhalfthenewsystem. Itistogiveabroadoverview,anditis notmeantfordetail. 4QiImbalances+5Elements: precisionanddetail Thesecondhalfofthesystemprovides theprecisedetailrequiredforclinical efficiencyandsafety. thisincludesthefiveelementsand thesyndromesoftheorgan systemsofchinesemedicine eachofthefiveelementsandthe fivemainorgansystems,heart, Spleen,Lung,Kidney,andLiver,are organizedintermsofthe4qi Imbalances starratingsforeachorgansystem canindicatetherelativenumberof herbsrequiredintheprescription totonify,,,orcalmthat organ 2009JeremyRossandVerlagfu rganzheitlichemedizindr.erichwuḧrgmbh 5
6 ExampleThediagrambelow representsapatientwithstagnation anddisturbanceinbothheartand Liver. Probablesignsandsymptomswouldbe depression,anxiety,andmaybe headacheandirritability. Inaneight herbprescription,this patientwouldrequire,approximately: 2herbstocalmLiverYang 2herbstocalmHeartSpirit 2herbstoLiverQi 2herbstoHeartQi tonify calm FURTHERREADING Thisisthefistofaseriesof3articles, whichcanbedownloadedfrom Jeremy swebsitewww.jeremyross.com PartII:Patientexamplewithherbs PartIII:Howtocomparedifferentherbs LR KI HT 4 Q I + 5 E LU SP 2009JeremyRossandVerlagfu rganzheitlichemedizindr.erichwuḧrgmbh 6
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