Symptomatic Diagnosis: Chest & Back

The diagnostic “Ten Asking Song” pays particular attention to the chest and back. This article describes common complaints that arise from these areas, along with their differential diagnosis and herbal treatments.
Back Pain
Weakness of the lower back and knees
Chest Pain
Mass Formation in the abdomen

Back Pain

• Accumulation of cold and damp (bi syndrome)

  Clinical manifestations
  
  • Pain which can radiate to neck
  • back feels heavy, stiff.
  • symptoms aggravated by cold damp weather.
  Formula
  
  • Qiang Huo Sheng Shi Tang (Notopterygium Decoction to Overcome dampness)

• Qi and blood stagnation due to recent trauma (acute)

  • Sudden onset of pain
  • Limited range of motion, acute symptoms
  • P: Tense
  • Could develop into chronic pain…
  • Yunnan Bai Yao (A pre-made formula)
  • Huo Lou Xiao Ling Dan (Fantastically Effective Formula to Invigorate the Collaterals)
Clinical manifestationsFormula

• Qi and blood stagnation due to past trauma (chronic)

  • Dull aching on & off, numbness aggravated by rest (deficiency beneath)
  • T: Purple
  • P: Thready and/or choppy
  Treatment Principle
  
  • Tonify and activate qi and blood
  Formula
  
  • Du Huo Ji Sheng Tang (Angelica Pubescens and Sang-Ji-Sheng Decoction) + Tao Ren (Sm. Persicae) and Hong Hua (Flos. Carthami)

Weakness of the lower back and knees

• Kidney/Liver deficiency

  Formulas
  
  • Zuo Gui Yin (Restore the Left (Kidney) Decoction)
  • You Gui Yin (Restore the Right (Kidney) Decoction)
  • Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet)
  • Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia)

• Jing deficiency

  Clinical manifestations
  
  • Infertility, tinnitus, vertigo, sore back, premature ejaculation, amenorrhea, grey hair, premature aging
  Formulas
  
  • Kidney/Liver formulas plus Zi He Che (Placenta Hominis), Lu Rong (Cornu Cervi)

• Yin deficiency

  Clinical manifestations
  
  • Emaciation, tidal fever, heat signs, five center heat.
  Formulas
  
  • Kidney/Liver formulas plus Huang Bai (Cx. Phellodendri), Zhi Mu (Rz. Anemarrhenae)

• Yang deficiency

  Clinical manifestations
  
  • Cold signs such as cold hands and feet.
  Formula
  
  • Kidney/Liver tonic formulas plus Fu Zi (Rx. Aconiti Lateralis Praeparata), Ba Ji Tian (Rx. Morindae Officinalis), Bu Gu Zhi (Fr. Psoraleae)

• qi deficiency

  Clinical manifestations
  
  • Weakness of the lower gates (urethra, colon, etc.) incontinence, premature ejaculation, urination problems
  Formula
  
  • Kidney/Liver tonic formulas plus astringent herbs such as Sang Piao Xiao (Ootheca Mantidis), Yi Zhi Ren (Fr. Alpiniae), Wu Wei Zi (Fr. Schisandrae), Fu Pen Zi (Fr. Rubi)

Chest Pain (often connected to the heart)

• Heart qi deficiency

  Clinical manifestations
  
  • Mild pain
  • Neurosis, heart condition,
  • dull achy chest pain on one or both sides.
  • Chest congestion, palpitations
  • Spontaneous sweating, fatigue
  • T: Pale
  • P: Weak and thready
  Treatment Principle
  
  • Tonify Heart qi
  Formula
  
  • Bao Yuan Tang (Preserve the Basal Decoction)

• Cold accumulation (yang deficiency) Painful

  Clinical manifestations
  
  • Coronary Heart Disease,
  • chest pain, usually on the left side which could radiate tot he right, back shoulder,
    and arm.
  • Pale complexion, spontaneous sweating, cold extremities.
  • T: Pale, swollen, teeth marks
  • P: Deep, slow, knotty and intermittent
  Treatment Principle
  
  • Tonify heart yang, promote circulation of blood
  Formula
  
  • Gua Luo Xie Bai Bai Jiu Tang (Trichosanthis, Allii, and White Wine Decoction)

• Heart blood stagnation (still a form of yang deficiency)

  Clinical manifestations
  
  • Typical angina pectoris. Intense pain that can make the patient lose consciousness due to its intensity
  • Spontaneous cold sweating, fear, fatigue
  • T: Pale purple
  • P: Deep, thready, choppy, knotty, intermittent
  Herb:
  
  • Dan Shen (Salviae Miltiorrhizae) for chest pain
  Formula
  
  • Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction)
  • Ge Xia Zhu Yu Tang (Drive Out Blood Stasis Below the Diaphragm Decoction)

• Phlegm accumulation (Involving the Lungs)

  Clinical manifestations
  
  • Cough
  • excess phlegm, pain with cough

Mass Formation in the abdomen

• Qi and blood stagnation

  Clinical manifestations
  
  • Enlargement of the Liver and Spleen
  • Abdominal mass begins soft, but becomes harder as time goes by.
  • Distention, emaciation, fatigue,
  • Dark dull facial complexion
  • low appetite, dry skin
  • T: Purple spots
  • P: Wiry, tense
  • Cancerous tumors tend to be more blood stagnation than qi stagnation
  Treatment Principle
  
  • Activate blood, yin deficiency unimportant now
  Formula
  
  • Ge Xia Zhu Yu Tang (Drive Out Blood Stasis Below the Diaphragm Decoction) + Shi Xiao San (Sudden Smile Powder)

• Phlegm Stagnation

  Clinical manifestations
  
  • Abdominal mass, no pain yet distended and uncomfortable..
  • Mass is movable and soft, but patient dislikes touch.
  • T: Pale
  • P: soft and Slippery
  Formula
  
  • Bao He Wan (Preserve Harmony Pills)
  • Er Chen Tang (Two Aged Decoction)

• Zhong qi deficiency (sinking, or organ prolapse)

  Clinical manifestations
  
  • Pulling down, or bearing down sensation
  • qi deficiency symptoms
  Formula
  
  • Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)