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Heart and abdominal pain refers to pain that radiates between the epigastrium (upper heart area) and the abdomen. Although both are termed "pain," the affected areas differ, much like how a Feng Shui master observes changing landscapes with every step; thus, the underlying principles must be analyzed meticulously and clearly.

The Heart is the Sovereign Ruler and houses the Spirit (Shen); it should not normally experience pain. What is currently referred to as "heart pain" is actually a disorder of the Pericardium Collateral (Xinbao Luo). Because the Pericardium cannot communicate laterally with the meridians, pain ensues.

Above the Heart vessels lies the chest and diaphragm; between the two breasts lies the anterior chest (Yingxiong). Pain in the chest and diaphragm results from the dysfunction of the Upper Jiao, which fails to distribute essence like mist and dew, leading to Chest Bi (Thoracic Obstruction) and pain. Herbs such as Allii Macrostemonis Bulbus (Xiebai), Trichosanthis Fructus (Gualou Ren), Rubiae Radix et Rhizoma (Qiancao), Fritillariae Cirrhosae Bulbus (Beimu), and Cardamomi Fructus Rotundus (Doukou) can open the Chest Bi to relieve pain.

Pain in the anterior chest arises from internal deficiency of Liver Blood, causing Qi to fail to fill the Qimen (LR14) acupoint. This prevents the blood of the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) from dispersing through the anterior chest, resulting in pain. Herbs such as Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Carthami Flos (Honghua), Lonicerae Japonicae Flos (Yinhua), Dipsaci Radix (Xuduan), and Akebiae Caulis (Mutong) can harmonize Qi and Blood to relieve pain.

In cases where the Zhongwan (CV12) area is painful and intolerant to touch, this indicates disharmony between interior and exterior. Externally, cold pathogen condenses in the skin and hair; internally, turbid matter stagnates in the Zhongwan. Treatment must assess the constitution's deficiency or excess. A suitable method is to ignite rush pith (Dengcao) and apply moxa-burning (explosive moxibustion) at the painful site for more than ten spots. This dispels cold congealation, unites the interior and exterior, and stops the pain.

Below Zhongwan, in the region corresponding to the Yangming Stomach Earth, intermittent pain indicates deficiency of the Middle Jiao Earth and disharmony of Stomach Qi. If excessive doses of Qi-moving and purgative agents have been taken, warming and tonifying methods should be employed instead. If heavy pressure alleviates the pain slightly, it confirms internal deficiency of the Middle Jiao Earth accompanied by deficiency-cold.

Pain at the ends of the ribs on both sides below the breasts indicates disharmony of upper and lower Yin and Yang, and impaired pivot function of Shaoyang. This pain frequently occurs in Shanghan (Cold Damage) diseases. Treatment should assist the pivot function, harmonize Qi and Blood, and regulate the upper and lower pathways to achieve recovery.

Pain in the greater abdomen belongs to the Taoyin Spleen Earth domain. If the pain is internal and dull/relaxed, it indicates deficiency-cold of Kun Earth (Spleen). If the pain involves both interior and exterior and is urgent/tight, it indicates obstruction of the Spleen collaterals. The great collateral of the Spleen is named Dabao (SP21), emerging from the meridian channels into the collaterals. When Spleen collaterals are stagnant and non-flowing, pain occurs both internally and externally. The Taiyang Chapter states: "In Cold Damage, if the Yang pulse is choppy and the Yin pulse is wiry, acute abdominal pain is expected according to the law. First administer Xiao Jian Zhong Tang; if ineffective, then administer Xiao Chai Hu Tang." This illustrates first tonifying the interior, then regulating the exterior pivot.

Pain around the umbilicus on either side indicates a disorder of the Chong Mai (Penetrating Vessel). The Chong Mai passes on both sides of the umbilicus. If congealed by cold pathogen, the blood of the Chong Mai cannot ascend or reach the exterior, causing pain around the umbilicus. Blood-invigorating herbs should be used to circulate blood from the Baozhong (Uterus/Energy Center) to the muscles and surface; Qi-regulating herbs would be of no benefit.

Pain below the umbilicus results from the Shaoyin Water Organ (Kidney) and Taiyang Water Bowel (Bladder) failing to receive Yang-heat Qi for transformation, leading to Yin-cold congealation and pain. For Shaoyin Kidney deficiency-cold, use Cinnamon Twig (Guizhi) and Prepared Aconite Root (Fuzi) to warm. For Taiyang Bladder deficiency-cold, also use Guizhi and Fuzi to warm. Taiyang and Shaoyin are exterior-interior pairs and share intermediate manifestations.

The lateral aspects of the lower abdomen are called Shaofu (Lesser Abdomen). Pain here belongs to the Jueyin Liver domain and is also the Sea of Blood of the Baozhong. While bladder water metabolism is governed by Shaoyin, the blood of the Baozhong is governed by Jueyin. Pain occurs when Jueyin Liver Qi fails to coordinate with the Baozhong blood to ascend upward. If the Liver is not deficient, dredge the pathways to facilitate ascent; if the Liver is deficient, tonify to assist ascent. Since Jueyin does not follow the standard root/branch theory but relies on its intermediate manifestation of Shaoyang, harmonizing Jueyin with Shaoyang will resolve the pain.

Pain in the hypochondriac regions on both sides indicates Liver Qi deficiency. Pain above the two flanks indicates disharmony of Shaoyang Qi. The location of pain reflects differences in Qi, Blood, Yin, and Yang. Treating all cases indiscriminately with Qi-moving and digestive methods under the assumption that "free flow prevents pain" is incorrect. The principle of "unblocking" versus "blockage" has logic, but the methods of unblocking vary. Regulating Qi to harmonize Blood, and regulating Blood to harmonize Qi, constitutes unblocking. Directing rebellious Qi upward and dispersing central knots laterally also constitute unblocking. Tonifying deficiency to promote flow and warming cold to promote flow are all methods of unblocking. To insist that only purgation constitutes "unblocking" is absurd!