Herbs that regulate the Qi are able to regulate, harmonize or spread the Qi so they can treat the syndrome of Qi stagnation. Stagnation of Qi is often caused by emotional disturbance, and accumulation of internal Cold, Heat, Phlegm, water and food. It also occurs in trauma and stagnation of Blood.

The characteristic of the syndrome of Qi stagnation is distension in the affected region. The quality of distension is determined by the degree of the stagnation; generally speaking, fullness exists in a mild case, distension is seen in an advanced stage, and pain occurs in a severe condition.

The syndrome of Qi stagnation varies according to the affected organs and regions. If the Lung-Qi stagnates, the symptoms are breathlessness, stifling in the chest, cough and wheezing. If the Stomach-Qi and Spleen-Qi stagnate, the manifestations are fullness and distension of the entire abdomen, reduced appetite, belching, acid regurgitation, nausea, vomiting, abdominal pain and irregular bowel movement. If the Liver-Qi stagnates, the symptoms are hypochondriac distension and pain, irritability, depression, distension and pain in the breasts, irregular menstruation, and pain in the lower and lateral abdomen. If the Qi stagnates in the meridians, the main symptoms are stiffness, heaviness, numbness or tingling of the limbs and in the affected regions, or migrating pain in the limbs. Most patients with a syndrome of Qi stagnation have a white tongue coating and a wiry pulse when there are no other pathogenic factors.

As well as treating the syndromes mentioned above, in clinical practice these herbs are often used to treat accumulation of water, Phlegm or food and stagnation of Blood, since these pathological factors always cause Qi stagnation and make the original disorder worse. Herbs that regulate the Qi can stimulate the movement of Qi as well as enhancing the effect of other herbs that treat different accumulations. Furthermore, herbs that regulate the movement of the Qi are often used in formulas for tonification because the tonifying herbs are heavy and sticky, so easily disturb the function of transportation and transformation of the Spleen and cause stagnation of Qi.

Herbs that regulate the Qi have the following characteristics.

All of these herbs come from the tangerine tree and have the function of regulating the Qi. However, each has its own characteristics.

Ju Hong is the reddish layer of fresh tangerine peel. It is pungent, bitter and warm. Pungency has a dispersing property, bitterness causes a descending action, and warmth can dry Dampness and expel Cold. Ju Hong enters the Lung meridian, and is effective for eliminating Damp-Phlegm and stopping cough. It is used for treating a cough with a large amount of sputum that is easy to expectorate caused by Wind and Cold attacking the Lung.

In Chinese, ‘ Chen’ means ‘old’, and ‘ Pi’ means ‘peel’. Chen Pi is the dry tangerine peel, and normally it should be kept for a year before it is used. Compared with the fresh peel, it is more pungent and bitter but less warm. It enters the Stomach and Spleen meridians and is effective for regulating the Qi of these organs. Its aromatic smell can stimulate the Spleen, transform the Dampness and soothe the Stomach-Qi and is often used for distension and pain in the abdomen, reduced appetite, fullness of the stomach, nausea and vomiting.

Ju Luo is sweet, bitter and neutral, and enters the Liver and Lung meridians. According to the concept that the pith of fruit enters the collaterals of the human body, Ju Luo is able to regulate the Qi, open up the collaterals and remove Phlegm there. It is used for treating a chronic cough with Phlegm that is difficult to expectorate, a stifling sensation in the chest and hypochondriac region, such as is seen in chronic bronchitis and emphysema. It can be used together with other herbs such as Si Gua Luo ( Luffae fructus) and Ju Ye to regulate the Liver-Qi in order to treat pain and distension in the breasts and hypochondrium, such as occurs in premenstrual syndrome and mastopathia.

Ju Ye is pungent, bitter and neutral. Like Ju Luo, it enters the Liver meridian, and it specially regulates the Liver-Qi and breaks down nodules. Its action is stronger than that of Ju Luo. It also enters the Stomach meridian and regulates the Stomach-Qi there. Because the Liver and Stomach meridians pass through the breasts, this herb is able to treat distension and pain of breasts in mastopathia.

Ju He is pungent, bitter and neutral, and enters the Liver and Kidney meridians. It is effective for regulating the Qi, breaking down nodules and stopping pain. According to the concept that seeds move downwards, it is especially used for treating Cold accumulation in the Liver meridian that manifests as cramping pain in the sides of the lower abdomen with a cold sensation, such as occurs in dysmenorrhea, amenorrhea, inguinal hernia and hydrocele of the testis.

Zhi Shi and Zhi Ke come from the same tree. Zhi Shi is the unripe fruit of the bitter orange; Zhi Ke is the big, nearly ripe bitter orange. Both are bitter, slightly cold, and enter the Spleen and Stomach meridians. They can regulate the Spleen-Qi and Stomach-Qi, and treat distension and pain in the abdomen, nausea and vomiting.

Zhi Shi has the stronger bitter taste and it moves downwards strongly. These properties lead to an intensive action of breaking up the obstruction of Qi and the accumulation of Qi, Blood, food or Phlegm, and it can also promote bowel movement. In clinical practice, it can treat severe distension and pain in the chest and abdomen, shortness of breath and constipation, such as is seen in gastroenteritis, intussusception, intestinal obstruction, dysentery, irritable colon, pleurisy and pneumonia.

Zhi Ke also has the function of regulating the Qi, but its action is gentler and slower. It moves horizontally in the Upper Jiao and Middle Jiao. It opens the chest and reduces distension, and is used to treat Qi stagnation in chest, stomach and hypochondrium, which brings about distension in the upper abdomen, stifling in the chest, a reduced appetite, irritability and depression. It also has the function of dissolving Phlegm and treating cough due to Heat in the Lung.

These three herbs all come from tangerine or orange. They can promote Qi movement and reduce distension and pain. Their individual characteristics are as follows.