Pain Belongs to the Heart?

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The Chinese medical tradition, going back 2,000 years or more, and of which acupuncture forms a part, is fond of pithy sayings and proverbs. One of these is zhu tong shu xin -“All pain belongs to the Heart”.

This seems decidedly odd to western ears. If you have a pain in your knee, for instance, it is not likely to have anything to do with your heart. But this proverb may start to make some sense if we understand that for the Chinese medical tradition (or at least for a large part of it), the Heart is the seat of something called the ‘Shen’, usually translated as either ‘Mind’ or ‘Spirit’.  As in many traditional cultures, the Heart is viewed as the seat of that more or less mysterious entity which makes us who we are, whether we call it mind, spirit, soul or whatever. Of course to our modern way of understanding, the heart is just a glorified pump, and if the mind or spirit is anywhere it is in the brain. But leaving that aside for the moment, we can say that what the proverb is saying is that pain is subjective, it belongs to consciousness or mind; it is an experience in other words.

Modern scientific medicine sees pain indeed as a rather complex experience, reflecting not just  damage, to the knee say, but also numerous other things such as our general mood, the state of our social connections, our general health etc. Indeed sometimes there may seem to be nothing wrong with the knee whatsoever, but it still hurts. Pain cannot be measured in the way that blood pressure, cholesterol or body temperature can be measured. No one can tell us how much pain we are really in; only we can know that.

One consequence of this is that in the treatment of pain it is sometimes helpful to treat the Shen. Of course treatment will usually be aimed at the knee, if we have a painful knee, or aimed at least at the tissues responsible for the knee pain – it might come from trigger points in the quadriceps muscles of the thigh perhaps. But sometimes as well it may be helpful to remember that ‘All pain belongs to the Heart’, and seek to calm the Shen, calm the Mind, soothe the person who is suffering the pain. All the more so if the pain is very great, if it is precluding sleep for instance. A human being is not a machine, after all. It’s not just a matter of fixing some faulty mechanics, it is important to remember that we are people, and that our pain belongs in some sense to the Heart as well as to the knee.