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Excessive joy, fear or anxiety These often disturb the physiological functions of the Heart, leading to retardation of Qi and Blood circulation in the Heart, causing chest pain, heart pain, and pain in the shoulder along the Heart channel; palpitation and insomnia also occur. A point of distinct tenderness is typically found along the Heart channel, especially at HT-3 Shaohai. Needling or even simple massage at this point can greatly relieve the chest, heart or shoulder pain. Since the Heart is in charge of promoting the circulation of Blood in the body and housing the Mind, disturbance of the Heart by these pathogenic factors

could cause stagnation of Blood in general, which lead to pain not only in the Heart region or in the chest, but also in the general body. Failure of the Heart in housing the Mind could result in oversensitivity to pain. In this case, there is often pain somewhere in the body, but no clear physical impairment could be identified. When the method to promote the Blood circulation, regulate the emotions and calm the Mind is applied to treat such kind of pain in practice, it improves quickly. Moreover, fear and anxiety in TCM are particularly considered to be chief causes, which could weaken

the Kidney, leading to deficiency of KidneyEssence, headache, lower back pain, pain at knee, etc. Excessive anger Anger may cause dysfunction of the Liver, impeding its free flow of Qi, and leading to a condition of stagnation of Liver-Qi. In TCM anger in fact includes other emotions such as frustration and irritation, which also may cause disharmony of the Liver leading to stagnation of Liver-Qi. Liver-Qi stagnation gives rise to symptoms such as headache, hypochondriac pain and distension, depression, abdominal pain and distension, and low back pain, as well as various kinds of

gynaecological pain and pain at the genital. Such pain is characterised by being wandering and distending in nature, or intermittent, or fluctuating in intensity and location. Another characteristic is that the pain often occurs or gets aggravated at times of strong emotion, especially anger, stress, nervousness or irritability. Stagnation of Liver-Qi can also be traced to emotions arising from being mistreated during childhood (e.g. from being beaten, lack of love, limitation of freedom, sexual abuse, or difficulties with friends, parents, brothers or sisters). Stagnation of Liver-Qi originating in childhood may cause either conscious or subconscious

blockage in the Liver, bringing on pain at a later date due to severe psychological and physiological problems. The Liver is in charge of promoting Qi circulation both in the Liver itself and generally in the body. If there is Liver Qi stagnation due to emotional disturbance, the Liver fails to maintain the free flow of Qi in the channels, muscles, and Zang-Fu organs as well. Stagnation of Liver-Qi is one of the main causative factors for various kinds of pain, especially chronic pain resulting from disorder of Internal ZangFu organs. The consequences of stagnation of Liver-Qi can be summarised as follows. Blood stagnation

Because Qi is the commander of the Blood, Qi circulation leads to Blood circulation, and Qi stagnation causes Blood stagnation. Hence, Liver-Qi stagnation may soon or later bring about Blood stagnation in various degrees, which results in a more severe pain, stabbing pain, or a constant pain with fixed location. Generation of Liver-Fire In TCM It is considered that prolonged stagnation could generate Heat (Fire), therefore, prolonged Liver-Qi stagnation may also generate Fire, leading to flaming up of Liver-Fire, and symptoms such as headache, painful ears or painful eyes. A further development of this is hyperactivity of Liver-Yang, which can

develop into internal stirring of Liver-Wind, which causes severe headache, facial pain, neck pain, or stiffness of the neck. If Liver-Fire persists it eventually can consume the Yin of the Liver, and even the Yin of the Kidney, resulting in failure of the Liver and the tendons to be nourished, and consequently in hypochondriac pain, headache, muscle pain with cramp, dizziness, constipation, or abdominal pain. When there is Liver-Yin deficiency, the Yang of the Liver will not be properly controlled, leading to hyperactivity of Liver-Yang; thus a mixture of Deficiency and Excess appears, which is not easy to deal with. 14 general introduction Disorder of Gallbladder

Bile is stored in the Gallbladder, but its formation depends on the normal circulation of Liver-Qi. Once bile is formed it must be distributed, with the help of Liver-Qi, into the Stomach and Intestines in order to help the digestion. However, if there is LiverQi stagnation there is either insufficient bile secretion or abnormal bile distribution, so the digestion is disturbed, leading to stomach pain, belching, abdominal pain and distension, or constipation, etc., resulting from the dysfunction of the digestive action of the Stomach and Intestine. Moreover, stagnation of Liver-Qi could cause disorder

of the Gallbladder and disharmony of the Gallbladder channel, resulting in hypochondriac pain, abdominal pain, jaundice, headache, and neck pain, as well as lower back pain and blockage, pain in the inguinal region and pain at lower legs, etc. For instance, lower back pain referring to the leg along the Gallbladder channel from the hip to the toe is often caused by stagnation of Liver-Qi with disharmony of the Gallbladder channel. When the therapeutic method to smooth the Liver, regulate the Qi circulation, harmonise the Gallbladder channel is applied for this case, such kind of lower back pain can be gradually brought under control. Dysfunction of Spleen

To produce Qi and Blood, the Spleen also needs the help from the Liver, as the latter maintains the free circulation of Qi not only in the Liver itself, but also over the whole body. Without LiverQi circulation, the Spleen would find it impossible to maintain its physiological function of transportation and transformation. Where there is stagnation of LiverQi, there could also be stagnation of Spleen-Qi. In this situation the Spleen cannot transport and transform food and water, and excessive water forms in the body, causing pain resulting from blockage of the Zang-Fu organs, channels, joints and muscles by Damp-Phlegm. Moreover, Liver-Qi stagnation

often attacks the Spleen, leading to formation of so-called disharmony between the Liver and Spleen; this manifests in symptoms such as abdominal pain, loose stool or diarrhoea when nervous, or flatulence. This condition in TCM is also called invasion of the Earth by the Liver-Wood. Irritable bowel syndrome, for instance, is often the result of this pathology. Thus, to smooth the Liver, strengthen the Spleen, eliminate Damp-Phlegm and to stop the diarrhoea will be the chief principles of its treatment. Blockage of the channels Liver-Qi stagnation is one of the direct causes of stagnation of circulation in the channels generally. In addition, stagnation of Blood and formation of

Damp-Phlegm resulting from stagnation of Liver-Qi may also impede circulation in the channels; in such cases blockage occurs in the channels, followed by pain, numbness, diminished skin and muscle sensitivity, and joint pain, etc. Excessive grief and melancholy The Lung is situated at the Upper Burner, known as the Upper source of Water in the body. The main physiological functions of the Lung are to disperse the Lung-Qi and the Qi of the general body, to descend the LungQi, as well as to disperse and descend the Body Fluid to all the parts of the body. When the physiological functions

of the Lung are impaired by such emotion, the Lung will fail to disperse and descend the Qi and Body Fluid, there will be stagnation of Qi in the Lung or somewhere in the body, and accumulation of Excessive Fluid in the body, various kinds of pain due to Qi stagnation or accumulation of DampPhlegm occur. Excessive grief and melancholy in TCM may particularly cause dysfunction of the Lung, leading to Qi and Blood stagnation in the Lung and its channel. The symptoms of this include: throat pain, chest pain and shoulder pain, accompanied by cough, difficulty in breathing out, and a sensation of oppression across the

chest area. Dysfunction of the Lung may also cause shoulder pain, which often occurs in the interior aspect of the shoulder, down the biceps muscle. Patients with such pain often admit that they might have experienced enormous grief prior to the onset of the pain. Points of tenderness along the Lung channel may be found at LU-1 Zhongfu, LU-2 Yunmen, LU-3 Tianfu, LU-4 Xiabai, LU-5 Chize and LU-6 Kongzui. Puncture at some of these points could not only improve the shoulder pain, but also harmonise the emotions and relieve the grief and melancholy. Excessive worry Although excessive worry could cause impairment to the different Zang-Fu organs and channels, it is particularly

considered in TCM that this excessive emotion brings about Qi stagnation in the Spleen and Stomach, leading to dysfunction in the functions of transportation and transformation. This may cause the following four kinds of pathological changes.