매핵기 梅核氣

Where they diverge

Traditional concepts do not map one-to-one onto modern diagnoses. Read the divergence note first.

The Donguibogam does not describe Maehaekqi as confined to the throat. Its entry states that phlegm congealed by the seven emotions forms a mass in the chest and abdomen, and that obstruction of the throat happens only "at times"; the Renzhai Zhizhi adds epigastric fullness with difficulty eating and rising qi with panting, and the Qianjin Fang places chest fullness and epigastric hardness before the throat symptom. WHO ICD-11, by contrast, defines Globus (DD90.0) as a sensation confined to the throat. In this direction the traditional concept is the broader one. The difference in the other direction matters more. The ICD-11 definition requires the sensation to be non-painful, unrelated to swallowing, and without structural or motor disorder of the pharynx or oesophagus, and two of the three Rome IV criteria are exclusion clauses. Globus is therefore a name applied only after organic causes have been ruled out by laryngoscopy, endoscopy and related investigations. The traditional accounts of Maehaekqi carry no such exclusion requirement, so cases classified as Maehaekqi may include conditions that would not meet the modern definition of Globus — gastro-oesophageal reflux disease, oesophageal motility disorders, and pharyngeal or laryngeal malignancy among them. The two concepts also converge at one point: the ICD-11 definition notes that the sensation often accompanies acute anxiety or emotional conflict, which corresponds to the traditional attribution to internal damage by the seven emotions and to qi stagnation.

• The divergence note is a draft written from the research document docs/PATTERN_RESEARCH_MAEHAEKQI.md. It is not final until cross-reviewed by one Korean medicine specialist and one physician.
• Mapping confidence is set to the second-highest level. KCD U87.6 registers a traditional concept in the national classification; it does not register a correspondence to a modern diagnosis, so it cannot ground the highest level. The team must settle the reading of this rule.
• Under KCD-8 this entry sat under U72.2, a gallbladder-heat pattern. That placement sits awkwardly with the traditional mechanism described here, so the wording needs care.
• We could not confirm whether ICD-11 Chapter 26 (traditional medicine) carries a corresponding code for this entry.

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