Syndromes of the qi (inner defensive) stage are the syndromes of interior heat due to the inner defense being invaded by pathogenic heat. In this case the anti-pathogenic qi and the pathogenic factor are very strong, resulting in hyperactivity of yang heat. Clinical manifestations are fever and no fear of cold. Since the affected location alters after pathogenic heat is transmitted into the interior, the syndromes of the qi stage can then be classified into different types as follows:

Mild heat in the lung
Fever, perspiration, thirst, cough, asthma, chest pain, red tongue proper with yellow coating, rapid pulse.
Preponderance of interior heat causes fever, rapid pulse, and red tongue proper with yellow coating. Interior heat steams the body fluid bringing on perspiration and thirst. Retention of pathogenic heat in the lung leads to the dysfunction of lung qi's spread and descent, so cough, asthma, and chest pain occur.

Accumulation of pathogenic heat in the chest and diaphragm
Fever, irritability, depression, restlessness, red tongue proper, slight yellowish tongue coating, thirst, constipation, rapid pulse.
Retention of heat inside the body causes fever. Pathogenic heat disturbs the mind, so irritability and restlessness result. Pathogenic heat consumes the body fluid resulting in thirst and constipation. Red tongue proper with a slightly yellowish coating , and rapid pulse are signs of excessive pathogenic heat.

Heat transmitted into the stomach
High fever, thirst with preference for cold drinks, profuse sweating, anxiety, dry and yellowish tongue coating, full and forceful pulse.
The pathogenesis and differentiation of qi stage syndromes is the same as for the Yangming channel syndromes. The only difference is the slower development of the disease condition after the invasion of pathogenic cold is transmitted from the Taiyang into the Yangming, while the transmission of pathogenic mild heat into heat is faster after it enters into the interior.

Retention of pathogenic heat in the liver and gall bladder
Retching, bitter taste in the mouth with thirst, irritability, insomnia, hypochondriac pain, yellowish tongue coating, wiry and rapid pulse.
Disharmony of qi circulation in the liver and gall bladder channels is due to interior heat retention in the liver and gall bladder. This causes hypochondriac pain, bitter taste in the mouth and a wiry pulse. Stagnation of heat in the liver and gall bladder affects the stomach, causing retching. Pathogenic heat disturbing the heart and mind brings on irritability and insomnia. A yellowish tongue coating and thirst are signs of excessive pathogenic heat.

Retention of pathogenic mild heat in the intestine
There are two different groups of clinical manifestations as follows:
Dryness of the intestine causing constipation with manifestations being the same a syndromes of the Yangmin fu organs.
Heat in the intestine leading to diarrhea, a burning sensation around the anus, thirst, yellowish and dry tongue coating, rapid pulse.

Descending heat in the intestine causes a dysfunction of transportation and transformation, thus diarrhea and a burning sensation around the anus result. Pathogenic heat consuming the body fluid produces thirst. Yellowish tongue coating and rapid pulse are signs of excessive pathogenic heat.