1. Pectoral Pain & Stuffiness
TCM Diagnoses and Treatments
Obstruction of Qi & blood in the chest.
Main Symptoms: Chest & back pain, short breathing, asthma, even disability to lie down
In mile case: Feels chest pain & breath with difficult
In more serious case: chest pain & palpitation, pericardial pain, back pain, cold limbs
Organs: Heart & Lung
Western medicine disease related: coronary; atherosclerotic cardiopathy; angina pectoris, myocardiac infarction, pericarditis
Etiology & Pathology:

3. A) Def. & Excess Main Points for differentiation
Most case: includes both
Def. : Ht. Qi, Ht. Blood, Ht. Yang, Sp & kid yang, Liv. & Kid Yin,
Excess: Qi Stag. , Blood stasis, phlegm, cold heat
B) Properties of pain
1) Oppressive Pain
2) Stabbing pain
3) Burning pain
4) Colick or twisting pain
5) Dull pain

4. Pectoral pain & stuffiness
Stomach-ache
Chest pain
Location
Left chest pain spreading to back
Stomach area
Not in the left chest
Other sym.
Palpitating, short breathing, difficult to lie down
Belching, acid regurgitation, fullness or distention of abdomen, related to diet
Usually caused by tuberculosis cough, asthma, cold & heat

5. Treating the superficiality first & the origin second
Main Points for therapeutic Principles
Treating the superficiality first & the origin second
But:
if superficiality is not severe & origin has been def. already, should treat by both reinforcement & resolving

6. Treatment 1). Heart blood stag. Signs & Symptoms:
Main Sym. : Stabbing pain in the chest, fixed, worse at night
Concurrent sym.: palpitating, restlessness, oppression in the chest, feel comfortable after massage
Tongue: dark purple
Pulse: deep & uneven
Treatment Protocol:
Prompting blood circulation
Remove blood stasis & stop pain

7. Modifications: Chest Pain -- Jiang Xiang, San Qi, Yu Jing, Yan Hu So
Formula:
Modifications:
Chest Pain
-- Jiang Xiang, San Qi, Yu Jing, Yan Hu So
Oppressed feeling
-- Xuan Fu Hua, Gua Lou Pi, Qing Pi, Sha Ren
Palpitation
-- Long Gu, Mu Li, Dai Zhe Shi
Xue Fu Zhu Yu Tang
Dang Gui
Sheng Di
Tao Ren
Hong Hua
Zhi Ke
Cai Hu
Gan Cao
Niu Xi
Chi Shao
Chuan xiong

8. 2) Phlegm accumulate in the chest
Treatment
2) Phlegm accumulate in the chest
Signs & Symptoms:
Main Sym. : Oppressed & asphyxia feeling & pain in the chest, pain sometime spreading to shoulder & back
Concurrent sym.: obesity, excessive sputum, fullness feeling in St.
Tongue: Mucous & greasy coating
Pulse: slippery
Treatment Protocol:
Activating Yang to eliminate phlegm
Relieving Stag.

9. Gua Lou Xie Bai Ban Xia Tang
Formula:
Modifications:
Smooth Qi to relieve phlegm
-- Su Zi, Su Geng, Zhi ke, Chen Pi, Fu Ling
Fullness in the St. nausea, no appetite, bitter taste
-- Huang Lian Weng Dan Tang
Gua Lou Xie Bai Ban Xia Tang
Gua Lou
Xie Bai
Ban Xia

10. Treatment 3) Cold Accumulation Signs & Symptoms:
Main Sym. : Chest pain spreading to back, worse by cold, onset after infect by cold
Concurrent sym.: oppressed feeling in the chest, short breathing, palpitation, asthma in severe case, disable to lie down, pale complexion, cold limbs.
Tongue: white coating
Pulse: deep thready & tense
Treatment Protocol:
Warm up Yang to release cold
Stop pain

11. Gua Lou Xie Bai Bai JiuTang
Formula:
Modifications:
Warm Upper Jiao & move Qi
-- Tan Xiang
Move Heart Blood
-- Dan Sheng
Move Stag. Qi
-- Zhi Shi
Cough with abundant sputum
-- Sheng Jiang, Ju Pi, Fu Ling, Xin Ren
Severe cold symptom
-- Fu Zi, Wu Tou, Rou Gui, Gan Jiang, Shu Jiao
Gua Lou Xie Bai Bai JiuTang
Gua Lou
Xie Bai
Bai Jiu

12. Treatment 4) Kid. & heart Yin Def. Signs & Symptoms:
Main Sym. : Dull pain in the chest
Concurrent sym.: palpitation, night sweating, restlessness, sleeplessness, sore lower back, weakness of knee joints, dizziness, tinnitus
Tongue: red thin body, less coating
Pulse: thready & rapid
Treatment Protocol:
Nourish Yin & tonify Kid.
Nourish heart to calm down the mind

13. Modifications: Tonify Kid Yin:
Formula:
Modifications:
Tonify Kid Yin:
-- Nu Zheng Zi, Han Lian Cao, Tian Dong, Mai Dong,
Tonify Ht. blood:
-- Dan Shen, Wu wei zi
Restlessness:
-- Dan Pi, Ze Xie, Mai dong, Wu wei zi, Bo zi ren, suan zhao ren
Dizziness due to empty fire goes up
-- Shou Wu, Gou Teng, Shi Jue Ming, Sheng Mu Li
Oppressed feeling in chest & pain
-- dang gui, Dan Shen, Chuan Xiong, Yu Jing
Zuo Gui Yin
Shu Di
Shan Yu rou
San Yao
Gou Qi Zi
Fu Ling
Gan Cao

14. Treatment 5) Qi & Yin Def. Signs & Symptoms:
Main Sym. : Oppressed feeling & dull pain in chest
Concurrent sym.: palpitation, short breathing, lassitude, don’t want to talk, dim complexion, dizziness, constipation or loose stools
Tongue: light red body with or without teeth mark
Pulse: thready & weak or knotted & intermittent
Treatment Protocol:
Nourish Qi & Yin
Prompting blood circulation & open the channels

15. ren shen, mai dong, wu wei zi
Formula:
Modifications:
tonify Yin:
ren shen, mai dong, wu wei zi
Ren shen yang rong Tang
Ren shen
Gan cao
Dang gui
Bai shao
Shu di
Rou gui
Da zhao
Huang qi
Bai zhu
Fu ling
Wu weizi
Yuan zhi

16. Treatment 6) Yang Qi Def. Signs & Symptoms:
Main Sym. : Oppressed feeling & dull pain in chest, getting worse by cold attacking
Concurrent sym.: palpitation, short breathing, cold limbs pain or sore on lower back or knee joints, pale complexion
Tongue: light whitish or dark purple body
Pulse: thready & deep
Treatment Protocol:
Warm yang Qi
Prompting blood circulation

17. Modifications: Yin def. -- Mai dong, wu wei zi
Formula:
Modifications:
Yin def.
-- Mai dong, wu wei zi
Kid yang def. cause water accumulation in the chest
-- Zhen Wu Tang
You Gui Yin
Shu di
Tu Si Zi
Rou Gui
Wu Wei Zi
Lu Rong
Gan cao
Shen Fu Tang
Ren shen
Fu zi