or Yang of Kidneys and Heart, and the Manifestation is the stagnation of Qi and Blood in the
chest.
As for pathology, although from a Chinese viewpoint the Heart is central to the condition of
Chest Painful Obstruction, other organs, notably the Lungs and Stomach, also play a prominent
role. The Lungs govern Gathering Qi (Zong Qi) of the chest. This assists the Heart in pushing
Blood through the blood vessels and if Gathering Qi is weak, the Heart lacks force in pumping
and Blood may stagnate in the chest. The "Spiritual Axis" in chapter 75 says: "If Gathering Qi
does not descend, Blood will stagnate in the vessels."8(358) Hence the importance of moving Qi
in order to move Blood: the point Ren-17 Renzhong, where the Gathering Qi collects, is an
important point to move Qi in the chest to relieve Blood stasis.
The Stomach also affects the Heart and Blood circulation: the Great Connecting channel of the
Stomach gives the pulse the force to contract and dilate. This channel emerges from the Stomach
and goes to the area below the left breast: the pulsation which can be felt here, called Xu Li, is
the pulsation of the Great Connecting channel of the Stomach. Hence the importance of treating
the Stomach to support the Heart and help to move Blood: the point ST-40 Fenglong, for
example, is extremely important to open the chest and improve the circulation of Blood there.
The point ST-36 Zusanli is very important to regulate the pulse and should always be needled
when the pulse is irregular. Retention of food in the Stomach also affects the development of
Chest Painful Obstruction: when food stagnates in the Middle Burner it may obstruct the
circulation of Qi and Blood in the chest and prevents Heart-Qi and Lung-Qi from descending.
This situation is actually very common in Western patients when it is often difficult to
distinguish the chest from the epigastric symptoms. In treatment, it is therefore important to pay
attention to the condition of the Middle Burner and, if there is retention of food (manifesting
with sour regurgitation, belching, a feeling of fullness, lack of appetite, a thick-sticky tongue
coating and a Slippery-Full pulse on the right Middle position), this should be treated with the
addition of herbs such as Lai Fu Zi Semen Raphani sativi, Ji Nei Jin Endothelium Corneum
Gigeraiae Galli or Mai Ya Fructus Hordei vulgaris germinatus.
Chest Painful Obstruction is always characterized by a combination of Deficiency and Excess.
The Root of the disease is usually a deficiency of Spleen, Heart or Kidneys or a combination of
these. The Manifestation is characterized mostly by stasis of Blood, Cold or Phlegm (Figure
13.1(359)).
The symptomatology of Chest Painful Obstruction is characterized by obstruction of blood
vessels which leads to pain. Stasis of Blood is therefore nearly always present in this condition,
either by itself or in combination with other factors. In long-standing conditions Phlegm is often
present.
In chronic conditions there is an interaction between stasis of Blood and Phlegm, with one
aggravating the other. The "Spiritual Axis" says in chapter 81: "When body fluids are
harmonized, they are transformed into Blood."9(360) Since body fluids provide the substance