Chest impediment

From The Magic Pivot (灵枢 líng shū, běn zàng)

1. In Emergency Standby Remedies (肘后备急方 zhǒu hòu bèi jí fāng) (281–341, Jìn) and Essential Prescriptions of the Golden Cabinet (金匮要略 jīn guì yào lüè), chest impediment is described as a disease pattern characterized by fullness and oppression in the anterior chest, in severe cases with pain stretching to the back, and panting that prevents the patient from lying down. It is caused by yīn evils like phlegm turbidity and static blood that congeal and bind, preventing diffusion of chest yáng. Depending on the severity, chest impediment may take the form of fullness in the chest or chest pain.

Biomedical correspondence: Observed in what Western medicine classes as heart disease, pulmonary emphysema, and pleurisy.

Medicinal therapy: Warm yáng and boost qì; course qì and sweep phlegm. In enduring cases, blockage of the network vessels by static blood can be addressed by freeing the network vessels. Formulas such as Trichosanthes, Long-Stamen Onion, and White Wine Decoction (栝楼薤白白酒汤 guā lóu xiè bái bái jiǔ tāng), Trichosanthes, Long-Stamen Onion, and Pinellia Decoction (栝楼薤白半夏汤 guā lóu xiè bái bàn xià tāng) or Aconite Main Tuber and Halloysite Pill (乌头赤石脂丸 wū tóu chì shí zhī wán).

Acumoxatherapy: Base treatment mainly on HT, PC, and CV. Main points: BL-15 (Heart Transport, 心俞 xīn shù), BL-14 (Reverting yīn (jué yīn) Transport, 厥阴俞 jué yīn shù), CV-14 (Great Tower Gate, 巨阙 jù què), CV-17 (Chest Center, 膻中 shān zhōng), PC-6 (Inner Pass, 内关 nèi guān), and HT-5 (Connecting Lǐ, 通里 tōng lǐ).

• For phlegm turbidity congestion, add ST-40 (Bountiful Bulge, 丰隆 fēng lóng), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), needling with drainage.
• For qì stagnation and blood stasis, add BL-18 (Liver Transport, 肝俞 gān shù) BL-17 (Diaphragm Transport, 膈俞 gé shù), LR-3 (Supreme Surge, 太冲 tài chōng), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), needling with even supplementation and drainage and adding moxa.
• For yīn evil obstruction with pronounced cold signs, add CV-6 (Sea of Qì, 气海 qì hǎi), and CV-4 (Pass Head, 关元 guān yuán), needling with supplementation and large amounts of moxa.

2. In Pathoconditions, Causes, Pulses, and Treatments (症因脉治 zhèng yīn mài zhì), stomach impediment wèi bì; characterized by fullness and oppression in the anterior chest, pain on swallowing, and in some cases occasional vomiting. Compare heart impediment.