The aetiological factors of Qi stagnation are essentially only two, i.e. emotional or dietary.


Emotional stress is the major cause of Qi stagnation: whatever the emotion, they all upset the proper flow of Qi in the Qi mechanism and lead to Qi stagnation. In fact, Qi stagnation is the first result of emotional stress on the body; after some time, other pathogenic factors will gradually form, such as Fire, Phlegm-Fire or Blood stasis. Each emotion has a certain effect on Qi (e.g sadness depletes Qi, worry knots Qi, etc), but, after a short time they all lead to some Qi stagnation, even those that deplete Qi.


The term “anger” should be interpreted very broadly to include several other allied emotional states, such as resentment, repressed anger, feeling aggrieved, frustration, irritation, rage, indignation, animosity, or bitterness.

Any of these emotional states can effect the Liver, if they persist for a long time, causing stagnation of Liver-Qi if the anger is repressed or rising of Liver-Yang or blazing of Liver-fire if the anger is expressed. Anger may affect also the Stomach (if one gets angry at meal times or the Intestines (if one gets angry after meals).

Finally, anger, like all other emotions, also affects the Heart.


Worry knots Qi, which means that it causes stagnation of Qi, and it affects both Lungs and Spleen.

Worry, like all other emotions, affects the Heart too and initially it may cause stagnation of Qi of the Heart manifesting with sadness, an uncomfortable sensation in the chest, palpitations; the Heart pulse would feel very slightly Overflowing (compared to the other positions).


Pensiveness consists in brooding, constantly thinking about certain events or people (even though not worrying), nostalgic hankering after the past and generally thinking intensely about life rather than living it. In extreme cases, pensiveness leads to obsessive thoughts. In a different sense, pensiveness also includes excessive mental work in the process of one’s work or study.

Pensiveness affects the Spleen and, like worry, it knots Qi.

Sadness and Grief

adness includes the emotion of regret, as when someone regrets a certain action or decision in the past and the Mind is constantly turned towards that time. Sadness and grief affect the Lungs and Heart. The Lungs govern Qi and sadness and grief deplete Qi.

Although sadness and grief deplete Qi and therefore lead to deficiency of Qi, they may also, after some time, lead to stagnation of Qi, because the deficient Lung-and Heart-Qi fail to circulate properly in the chest. This may cause symptoms of Qi stagnation in Lungs and Heart such as a n uncomfortable sensation of the chest, a slight breathlessness, palpitations, a feeling of lump in the throat, and a pulse that is very slightly Tight or Wiry on both positions.


Mental shock scatters Qi and affects Heart and Kidneys. It causes a sudden depletion of Heart-Qi, makes the Heart smaller and may lead to palpitations, breathlessness and insomnia.

Shock also “closes” the Heart or makes the Heart smaller. This can be observed in a bluish tinge on the forehead and a Heart pulse which is Tight and Fine.


Guilt is an extremely common emotion and cause of disease in the West. Guilt affects the Heart and Kidneys and it causes Qi to stagnate. It may cause stagnation of Qi in the chest, epigastrium, or abdomen.

Consequences of Qi Stagnation

Qi is like a gas and when it stagnates, it is compressed: this may generate Heat and lead to Fire (of the Liver or Heart, usually), or it may eventually lead to Blood stasis. Since the free-flow of Liver-Qi plays an important role in the fluid metabolism, Qi stagnation may also lead to Dampness and eventually Phlegm. Hence, the consequences of Qi stagnation are:

  • Blood stasis
  • Heat
  • Dampness
  • Phlegm



Clinical manifestations

  • Feeling of distension of hypochondrium for chest, sighing, hiccup.
  • Melancholy, depression, moodiness, fluctuation of moods.
  • Nausea, vomiting, epigastric pain and distension, belching, abdominal distension, loose stools.
  • Unhappy, wound-up, a feeling of lump in the throat, difficulty in swallowing.
  • Irregular periods, painful periods, pre-menstrual tension, breast distention

Liver-qi Stagnation

Treatment principle

Soothe the Liver, move Qi, eliminate stagnation.

Liver-Qi Stagnation With Liver Blood Deficiecy

Liver-Qi stagnation is often the result of Liver-Blood deficiency. This is due to Liver-Blood failing to hold Liver-Qi which stagnates. This is much more common in women: indeed, in women, this situation is more the rule than the exception.

Treatment principle

Soothe the Liver, move Qi, eliminate stagnation, nourish Liver-Blood.


Clinical manifestations

Bad digestion, a feeling of fullness, pain and distension of the epigastrium, belching, nausea.

Treatment principle

Restore the descending of Stomach-Qi, move Qi, eliminate stagnation, calm the Mind.


Clinical manifestations

Abdominal distension, fullness and pain, constipation with bitty stools.


Clinical manifestations

Sighing, slight breathlessness, a feeling of tightness or oppression of the chest, a feeling of lump in the throat, difficulty in swallowing, sour regurgitation, belching, burning in the oesophagus at night, depression, crying, sadness, easily affected by other’s influence.

Treatment principle

Resolve the descending of Lung-Qi, calm the Mind and the Corporeal Soul.


Clinical manifestations

Palpitations, slight breathlessness, a feeling of oppression and tightness under the heart region, sadness, depression, anxiety, a vague mental restlessness, an uncomfortable feeling in the throat from energy rising (“heart in throat”), upper digestive problems (such as oesophagitis).

Treatment principle

Restore the descending of Heart-Qi, calm the Mind, tonify the Heart.