External Pathogenic Factors
External Cold can invade the chest and obstruct the circulation of Yang Qi in the chest. The
obstruction of Yang Qi leads to Chest Painful Obstruction with the ensuing feeling of oppression
and pain in the chest. External Cold is all the more likely to invade the body if there is a
pre-existing deficiency of Yang. In particular, a deficiency of Yang of the Lungs or Heart will
predispose the body to invasion of Cold in the chest.
The "Methods and Rules of Medicine" (1658) says: "In Chest Painful Obstruction pain in the
heart region is caused by Yang deficiency and invasion of Cold."6(356) The "Treatment
Planning according to Syndrome Categories" (1839) says: "In Chest Painful Obstruction Yang
Qi of the chest does not move; after a long time Yin takes the place of Yang."7(357)
Diet
Irregular eating and excessive consumption of fats, sweets, dairy foods or cold-raw foods injure
the Spleen and Stomach. As a result, these cannot transform food and transport food essences,
and Phlegm is formed. Phlegm obstructs the blood vessels leading to stagnation of Qi and Blood.
Stasis of Blood in the chest blocks the circulation of Yang Qi in the chest and this leads to Chest
Painful Obstruction.
Emotional Problems
Worry, brooding and pensiveness injure the Spleen and Lungs. When Spleen- and Lung-Qi are
weak, after some time, Qi may stagnate in the chest. Prolonged stagnation of Qi, on the other
hand, may also lead to the formation of Phlegm in the chest. Both Qi stagnation and Phlegm
contribute to Chest Painful Obstruction developing.
Anger, resentment, frustration and depression injure the Liver and prevent its Qi from flowing
freely. Stagnant Liver-Qi may turn into Fire after a long period of time. Fire, on the other hand,
burns body fluids and condenses them into Phlegm. Both stagnant Liver-Qi and Phlegm lead to
stasis of Blood which obstructs the movement of Yang Qi. This causes Chest Painful
Obstruction.
Old Age
Declining Kidney-Yang fails to warm the internal organs and may lead to Heart-Yang
deficiency.
Declining Kidney-Yin fails to nourish the internal organs and may lead to Heart-Yin deficiency.
If Heart-Yin is deficient, Heart-Yang cannot move and this leads to stagnation of Qi and Blood
in the chest and Chest Painful Obstruction. In both these cases, the Root is the deficiency of Yin