By Eric Brand

Generally speaking, the spleen, kidney, and liver are the three viscera that receive most of the attention in Chinese medical gynecology. While the spleen, kidney, and liver are indeed often the most important organs to assess in gynecology, the role of the heart and the lung should not be completely overlooked. What pathomechanisms in TCM gynecology relate to the heart and lung, and what diseases do these pathomechanisms commonly manifest in?

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Heart Pathomechanisms

The heart governs the spirit as well as the blood and vessels. The uterine vessels are ascribed to the heart and net the womb. If the heart is harassed by anxiety, thought, and preoccupation, heart qi is unable to descend. This causes the uterine vessels to be blocked, leading to menstrual block, menstrual irregularities, or infertility. When heart fire is hyperactive, kidney water fails to ascend. Water and fire not helping each other may lead to heart vexation in pregnancy, visceral agitation, or postpartum emotional depression.

Lung Pathomechanisms

The lung governs qi and governs depurative downbearing. It faces the hundred vessels and regulates the waterways (the Nei Jing statement that the “lung faces the hundred vessels” is often said to mean that the blood of the whole body must pass through the lung channel and the lung proper). In cases of yin vacuity with effulgent fire, when yin-blood pours downward to the chong and ren vessels during menstruation, the lung yin becomes even more vacuous. Vacuity fire then scorches the network vessels of the lung, which causes blood ejection and spontaneous external bleeding during menstruation. If the lung fails to diffuse downward and regulate the waterways, it may cause pregnancy swelling, pregnancy cough, or inhibited urination during pregnancy or after childbirth.