Have you ever wondered why — when you feel physically weak, exhausted, and short of breath — a bowl of tonic soup only makes your head and face feel more clouded and heavy, as if a wet towel were pressing down on your forehead and chin? This leaves many people baffled: deficiency should be treated with tonics, so why does more tonifying fail to help, and instead create new blockage? This precisely shows that your problem is not "deficiency," but rather a disorder of "ascending and descending." In Chinese medicine clinical practice, dragging pain in both the forehead and chin often signals that the ascending–descending mechanism of the middle burner has gone awry: clear yang fails to rise, turbid yin fails to descend, and tonics merely add obstruction, becoming a burden.
The forehead and chin — one above, one below — belong, along the meridian pathways, respectively to the Yangming Stomach Meridian and the junction where the Conception and Governor Vessels exchange qi. Forehead dragging pain is mostly related to failure of yangming stomach qi to descend and counterflow of turbid qi upward; chin dragging pain involves disharmony of the Chong and Conception Vessel qi and failure of kidney qi to secure. When the two occur together as simultaneous dragging pain above and below, it is as though the body were sounding a longitudinal imbalance alarm: the pivot of the spleen and stomach in the middle burner is stuck, yang qi that should rise cannot rise, and turbid yin that should descend cannot descend. The reasoning behind this must begin with the Huangdi Neijing.
"When clear qi is in the lower, it produces undigested diarrhea; when turbid qi is in the upper, it produces abdominal distension." — Huangdi Neijing · Suwen · Chapter 5: The Great Treatise on the Correspondence of Yin and Yang
This passage speaks of the harm caused by the inversion of clear and turbid. Clear yang qi should rise to the head and face, warming the skin and opening the orifices; turbid yin qi should descend to be excreted through urine and stool. Once the spleen and stomach lose their ascending–descending function, clear yang stagnates in the middle and lower, while turbid yin invades the head and face instead — leading to dizziness, head heaviness, and a dragging, distended sensation in the forehead. Chin dragging pain is often related to failure of stomach qi to descend and turbid yin attacking upward — both are manifestations of blockage along this longitudinal pathway.
I. One Heavens, One Earth: The "Territory" of the Forehead and Chin in the Meridians
In the Lingshu · Meridians, the Stomach Meridian's pathway is clearly described: "It originates at the root of the nose, at the point where it meets the Bladder Meridian, then runs beside the nose." The character "nasal root" (è) refers to the nasal root region between the two eyes, and from there it ascends to the forehead. One could say that the forehead is important territory of the Yangming Stomach Meridian. The Yangming meridians are rich in qi and blood, and their most essential characteristic is "descending" — stomach qi moves smoothly by descending, and the yangming meridian qi should likewise flow downward from the head. If there is heat in the stomach meridian that attacks upward along its pathway, the forehead bears the brunt; if stomach qi stagnates and turbid qi fails to descend, the forehead becomes heavy, dragging, and distended.
The chin, on the other hand, is closely related to the junction of the Conception and Governor Vessels. The Conception Vessel runs along the anterior midline of the body, beginning at the Chengjiang point below the lower lip and ascending straight to the throat; the Governor Vessel runs from the perineum up the spine to the vertex, then descends along the forehead to the nasal column. The chin lies precisely at the region where the Conception Vessel begins and intersects with the Yangming meridian. The Nanjing · Difficulty 28 states that the Conception Vessel "originates below Zhongji, ascends through the pubic region, runs along the interior of the abdomen, passes Guanyuan, and reaches the throat." The chin is thus the "upstream dock" of this sea of yin meridians. The Conception Vessel governs the yin of the entire body. If chin dragging pain is accompanied by insufficiency of yin fluids and floating of deficient fire, it is often inseparable from imbalance of Conception Vessel qi movement.
The forehead belongs to Yangming, the chin to the Conception Vessel — one yang meridian, one yin meridian, with the spleen and stomach middle burner lying exactly between them. This is like a building: the forehead is the rooftop terrace, the chin is the basement, and the spleen and stomach are the load-bearing walls and elevator shaft in between. Once the load-bearing walls deform and the elevator stops, the terrace loses its sunlight and the basement cannot drain water — the upper and lower levels alarm together. Clinically, dragging pain in both the forehead and chin commonly involves failure of yangming meridian qi to descend and loss of nourishment of the Conception Vessel. Under the pincer attack of the two, the ascending–descending pivot of the spleen and stomach middle burner is the first to suffer. At such a time, locking onto the word "deficiency" and taking tonics is like adding more cargo to an already jammed elevator shaft — naturally, the more you tonify, the more distended and dragging it becomes.
II. Dragging Pain Does Not Arise from Nowhere: Which Constitutions Are Prone to "Heavy Above, Light Below"?
A dragging, falling kind of pain is called "heavy pain" in Chinese medicine, and it is different in nature from distending pain, stabbing pain, or throbbing pain. Heavy pain is mostly related to "dampness" and "deficiency." Dampness is heavy and turbid, easily trapping yang qi; qi deficiency with sinking fails to lift and hold, so the head feels as though it carries a block of lead weighing it down. But merely saying "dampness" and "deficiency" is not enough; what needs to be distinguished clinically is whether dampness obstruction or qi sinking predominates. The two, one excess and one deficiency, call for entirely opposite treatment directions.
In people whose condition is mainly dampness obstructing the middle burner, the forehead and chin dragging pain is often accompanied by a feeling of the head being wrapped, chest tightness and sticky mouth, poor appetite, and loose stools. Dampness from unregulated water metabolism accumulates in the body like damp clothes hanging on a rainy day. The clear yang qi is pressed down by water vapor and cannot rise, so the head naturally feels dizzy, heavy, and dragging. Their tongues tend to be swollen with teeth marks on the edges and a white greasy coating. This is an excess pattern, requiring "resolving dampness," not "nourishing tonics."
In people whose condition is mainly qi deficiency with sinking, the dragging pain often worsens after exertion and lessens with rest, accompanied by shortness of breath, fatigue, a weak low voice, and a pale complexion. The spleen governs the ascending of the clear. When spleen qi is deficient, it lacks the strength to "lift" clear yang qi to the head. The head, deprived of nourishment by clear qi, feels empty, fatigued, and dragging. Their tongue body tends to be pale with teeth marks, and the pulse is weak. This is a deficiency pattern, but even supplementing qi requires "tonifying while keeping the movement free." Blindly using heavy tonics can stick the middle burner qi movement and may actually worsen the heaviness in the head and face.
A third, even more common mixed state involves both dampness trapping and qi deficiency, creating a pattern of "excess–deficiency complex." The Song-dynasty physician Li Dongyuan emphasized this point in his Treatise on the Spleen and Stomach. He believed that people with deficient spleen and stomach qi are most prone to producing damp turbidity, which, if it lingers, in turn aggravates the burden on the spleen and stomach — a vicious cycle in which clear yang finds it even harder to rise.
"When the spleen and stomach are weak and deficient, original qi is insufficient, and the heart fire alone blazes. Heart fire is yin fire, arising from the lower burner... When spleen and stomach qi is deficient, it flows downward into the kidney and liver, allowing yin fire to ride on the earth position." — Li Dongyuan, Treatise on the Spleen and Stomach · On Damage by Diet and Overexertion Becoming Heat in the Middle
Li Dongyuan's words describe what happens when the spleen and stomach become deficient: clear yang sinks down into the liver and kidneys, while yin fire leaps upward instead. Ponder this picture carefully: the original qi that should rise has dropped down, while the fire that should not rise has jumped up. When your forehead and chin feel dragging pain, the question to consider is precisely this "ascending–descending" issue — is clear yang dropping, or is turbid yin leaping up? These are two entirely different paths. Take the wrong fork, and every subsequent step goes astray.
III. When Clear Yang Fails to Rise: Why Does the Forehead "Complain" First?
The forehead is the territory of the Yangming meridian and the highest point where the body's "clear yang gathers." The Suwen · The Great Treatise on the Correspondence of Yin and Yang states, "Clear yang emerges from the upper orifices." The "upper orifices" here include the eyes, ears, mouth, nose, and the entire head. When clear yang qi is abundant, a person feels clear-headed, bright-eyed, and quick-minded. Once clear yang cannot keep up, the first place to perceive it is the forehead — a feeling of drowsiness, stuffiness, emptiness, and dragging, like insufficient water pressure on the top floor of a building.
1. Spleen–Stomach Deficiency Cold with Insufficient Middle Qi
The spleen and stomach are the "source" of clear yang. The food you eat is decomposed by the stomach and transported by the spleen to become refined grain essences, which are then sent upward by spleen qi to the heart and lungs, and finally distributed to the head, face, and four limbs. The spleen governs ascending the clear. When spleen qi is deficient, the pumping force for this "upward transmission" is insufficient. The forehead, being the highest point and farthest from the pump, is the first to feel an empty, dragging sensation when qi, blood, and fluids fail to reach it. Such people often have a sallow complexion, drowsiness after meals, loose stools, and easy fatigue. On the tongue, the body is pale or puffy-soft with teeth marks on the edges.
2. Turbid Dampness Shrouding the Clear Orifices, Blocking Clear Yang
Another type of forehead pain is not a "lack" of clear yang, but rather clear yang being blocked on its way by damp turbidity. It is like a water plant supplying water normally, but the delivery pipes are clogged with silt, so the top floor still has no water. Such people often feel their head as if wrapped in a cloth, with the forehead like a wet patch — most obvious on waking in the morning, and somewhat relieved after activity. A thick greasy tongue coating, a sticky unpleasant mouth feel, and sticky, sluggish stools are all collateral evidence of internal damp turbidity obstruction.
Clinically, deficiency and dampness are often intertwined. The more deficient the middle qi, the weaker the ability to transport and transform water dampness, and the more water dampness accumulates; the more water dampness accumulates, the more trapped the spleen qi becomes, and the less clear yang can rise — forming a vicious cycle. If one blindly takes tonics at this point, the tonics assist dampness and create stagnation, adding frost to snow. This is the most common mechanism behind "the more you tonify, the more deficient you become" and "the more you tonify, the more it drags."
IV. When Turbid Yin Fails to Descend: Dragging Pain in the Chin Is Actually the "Two Yins" Sounding the Alarm
Failure of clear yang to rise is only half of the problem. The other half is failure of turbid yin to descend. The chin, being the lowest part of the face, is governed by the Conception Vessel and adjacent to the Yangming meridian. The Suwen · The Great Treatise on Taiyin and Yangming states clearly: "Yang is heaven qi and governs the exterior; yin is earth qi and governs the interior." Just as the earth receives all things, the lower body must be able to "hold and receive." If turbid yin cannot descend and instead accumulates in the middle and upper burners, it will surge upward like a backed-up sewer.
Dragging pain in the chin — which Chinese medicine would describe as similar to "submental dragging pain" — is closely related to counterflow of chong qi and failure of stomach qi to descend. As an analogy: the chin is like the drain outlet of a building's water tank. When the drain pipe is clear, wastewater flows down smoothly; once the pipe is blocked by rubbish (phlegm, dampness, food stagnation), wastewater overflows upward. Turbid yin attacks the face from below, so the chin — the lowest hollow — feels pressure first, manifesting as distension, dragging, and stuffiness.
1. Stomach Qi Fails to Descend, and the Fu-Organs Are Not Free
The stomach governs receiving and takes descending as its normal function. If one eats irregularly, overeats, or consumes too much rich, fatty, sweet, raw, cold, or sticky food, the stomach fu-organ becomes congested. Food putrefies and ferments, turbid qi rushes upward, and may rise to the throat, mouth, nose, and even the head and face. In this case, the chin dragging pain is often accompanied by halitosis, belching, epigastric distension, and dry or sticky stools. The tongue coating is often yellow-greasy or dirty-greasy — a typical signal of "fu-qi obstruction and turbid yin counterflow upward."
2. Liver Qi Stagnation Attacking the Stomach Horizontally
Emotional frustration and stress cause liver qi to stagnate and attack the stomach horizontally, likewise preventing stomach qi from descending. When turbid yin overflows upward, the head and face feel heavy and dragging. In such people, the dragging pain tends to worsen with emotional swings or after long sighs, and is more likely to occur before or during menstruation in women. The pulse is often wiry, the tongue edges somewhat red, and the coating thin-white or slightly greasy.
When clear yang fails to rise, it presses on the forehead and the orifices; when turbid yin fails to descend, it pushes against the chin and the lower face. The two often occur together because the spleen and stomach are one and the same central axis: once the spleen and stomach are blocked, the upper part lacks the "clothing" of clear yang for protection, while the lower part has "garbage" of turbid yin overflowing upward — and the head and face naturally cannot be at peace.
V. The Pivotal Role of the Middle Burner: Chenpi and Gegen — One Descends, One Ascends
So, what can you eat to make this central "axis" turn again? Traditional Chinese medicine speaks of "medicine and food sharing the same origin," and many ordinary kitchen ingredients happen to regulate the ascending and descending movement of qi. But a reminder is necessary here: dietary therapy cannot replace medical diagnosis and treatment. Each person's constitution is different, and the safest course is to consult a licensed Chinese medicine practitioner in person for a personalized plan. Below, from the perspective of Chinese medicinal food theory, we discuss two representative ingredients.
1. Gegen (Pueraria Root) — Releases the Muscles and Raises Yang, Guiding Clear Yang to the Head
Gegen is the dried root of the leguminous plant Pueraria lobata or Pueraria thomsonii. It is both a commonly used Chinese medicinal material and a substance officially listed by the National Health Commission as medicinal and edible. Chinese medicine considers it cool in nature, sweet and pungent in taste, and attributive to the spleen and stomach meridians. The Shennong Bencao Jing lists Gegen as a medium-grade herb, recording that it "governs wasting-thirst, high fever of the body, vomiting, all bi-impediments, raises yin qi, and resolves various toxins." Later physicians especially valued its function of "ascending and disseminating clear yang." Li Dongyuan, one of the four great masters of the Jin–Yuan period, regarded Gegen in his Treatise on the Spleen and Stomach as an essential herb for ascending stomach qi and invigorating clear yang to rise — often used for head and face discomfort due to failure of clear yang to rise.
Its mechanism can be understood through the metaphor of "irrigation": the intestines are like a city's water plant, the spleen and stomach are the water pump, and Gegen is responsible for pumping the water from the plant up to the high floors — the head. Note here that although Gegen has the effect of ascending clear yang, it is somewhat cool in nature, so people with spleen–stomach deficiency cold and loose stools should use it with caution. Gegen is commonly used in the kitchen — adding a few slices to soup gives it a slightly white color and a sweet, mild taste, a home-style practice in the Lingnan region.
"The herbal literature says: the qi and flavor of Gegen are both thin; it is light and floating, ascending in action, and serves as a guiding herb." — Bencao Biandu
2. Chenpi (Aged Tangerine Peel) — Regulates Qi and Resolves Dampness, Giving Turbid Yin a Way Down
Compared with Gegen, Chenpi is more biased toward "descending," while Gegen is more biased toward "ascending." Chenpi is the dried, aged peel of ripe tangerine; only after being stored for more than three years may it be called "Chenpi." It is warm in nature, bitter and pungent in taste, attributive to the spleen and lung meridians, with the functions of regulating qi and strengthening the spleen, drying dampness and transforming phlegm. In Chinese medicine formulas, Chenpi is a common supporting herb for "harmonizing ascending and descending": used with qi-tonifying herbs, it prevents tonics from causing stagnation; used with qi-descending herbs, it allows the qi mechanism to flow freely.
Chenpi's "descending" and Gegen's "ascending" form a natural pair of responses. Clear yang relies on Gegen to be guided upward; turbid yin needs Chenpi's help to move downward. Chenpi's pungent aroma can awaken the spleen and stomach trapped by dampness, allowing the qi mechanism to become active again. In daily life, a few slices of Chenpi can be steeped with an appropriate amount of tea leaves as a beverage; its fragrant aroma relaxes the chest and diaphragm. People with heat in the spleen and stomach, or dry mouth and throat, should not drink too much, lest its warmth aggravate dryness.
Notice the different personalities of these two ingredients: Gegen is like a diligent mail carrier, delivering the "clear qi" package all the way upstairs; Chenpi is like a pipe unblocker, gradually clearing away the damp-turbid waste stuck at the pipe mouth. One sends upward, the other frees the downward path — between the one rise and one fall, the pivot of the middle burner becomes active again. Yet, good as these two ingredients are, which aspect to emphasize for each individual, and what other foods to combine them with, still depends on the person and the pattern — precisely the wisdom of "treating the same disease with different methods" in Chinese medicine.
VI. Examining Lifestyle: The Body's Own Code of Ascending and Descending
Medicinal foods are external support; truly lasting "ascending–descending power" must come from one's own daily routine and rest. For readers suffering from dragging pain in both the forehead and chin, rather than rushing to seek traditional formulas, it is wiser to first examine a few aspects of daily life. Today, instead of discussing "what to eat," let us talk about "what to do" and "how to think."
1. Diet: Neither Too Hungry, Nor Too Full, Nor Too Greasy
Excessive hunger depletes the source of clear yang generation — like a reservoir running dry; excessive fullness congests the spleen and stomach and impairs transformation and transport — like a river channel silting up; excessive greasiness generates internal damp-heat, and turbid dampness shrouds clear yang. Eating regular meals, staying about 70–80% full, and reducing greasy and sweet foods is itself the simplest yet most effective way to maintain the ascending–descending function of the middle burner. Even the best medicinal food ingredients cannot work if you keep regulating qi on one hand while piling on more greasy stagnation on the other.
2. Daily Routine: The Hour-Based Rhythm of Nourishing "Stomach Qi"
The Stomach Meridian is most vigorous during the chen hour (7–9 a.m.), when food is easily digested; the Spleen Meridian is most vigorous during the si hour (9–11 a.m.), when transformation and transport are most effective. Conversely, staying up late, skipping breakfast, and eating late-night snacks force the spleen and stomach to work overtime during their "off hours." Over time, the spleen and stomach's ascending–descending wheel can no longer turn: clear yang cannot rise, turbid yin cannot descend, and head–face dragging pain naturally visits frequently. Try taking breakfast seriously and reducing nighttime eating, and observe for a while — you may find that your face thanks you in action.
3. Emotions: Anger Makes Qi Rise; Worry Makes Qi Knot
The relationship between emotions and the ascending–descending movement of qi was already articulated in golden sentences in the Huangdi Neijing:
"Anger makes qi rise; joy makes qi slacken; grief makes qi dissipate; fear makes qi descend... worry makes qi knot." — Huangdi Neijing · Suwen · Chapter 39: The Great Treatise on Painful Distension
Anxiety and excessive rumination tend to make qi "knot" in the middle burner, impairing its rotation; great anger makes qi rush violently upward, carrying turbid pathogens straight to the facial orifices. Clinically, many patients with recurrent forehead–chin dragging pain, upon closer inquiry, have a background of long-term overthinking and emotional tension. This is not to simply advise "cheer up," but rather to recognize that being aware of one's emotional patterns is itself a good medicine for regulating the ascending and descending of qi.
4. Exercise: The Middle Burner Is a "Wheel and Axle"
In traditional health cultivation practices such as Baduanjin and Taijiquan, the core movements mostly revolve around rotation of the waist and abdomen. When the body turns left and right, the internal organs are gently "massaged," helping to awaken the spleen and stomach's functions of ascending the clear and descending the turbid. Gentle aerobic exercises such as walking and brisk walking can likewise promote gastrointestinal motility and allow turbid qi to move downward. The key to exercise is consistency, not intensity. Sweating profusely actually damages qi and yin, which is detrimental to ascending and descending.
VII. The Wisdom of "Movement" in Yanglao Fengqin Shu
The Yanglao Fengqin Shu (Book of Respecting the Elderly) by the Song-dynasty physician Chen Zhi is one of the earliest extant monographs on geriatric health care. It places greater emphasis on the spleen and stomach than many contemporary works. Chen Zhi believed that as people age, yang qi declines daily, and "their qi is weak, and grain qi also declines." He particularly stressed that even slight dietary irregularity can easily trigger diseases such as "distension and fullness, obstruction, and phlegm-rheum." One core principle he proposed was: "Food for the elderly should generally be warm, hot, cooked, and soft; sticky, hard, raw, and cold foods should be avoided." This may seem simple, but it contains the deeper principle of "protecting the yang qi of the middle burner" — when middle-burner yang qi is sufficient, ascending and descending have the power to move.
Dragging pain in both the forehead and chin: looking forward in life, it may be a sign of qi and blood dual deficiency in the elderly with failure of clear yang to rise; looking backward, it may also indicate disordered daily rhythm and disturbed ascending–descending in middle-aged people. If you are young and already feel heaviness and dragging in the head and face, consider this: did you sit still for more than six hours today? Did you immediately lie face down on the desk to sleep after lunch? Such tiny habits of life, accumulating day after day, are enough to make a once well-functioning ascending–descending system slowly fail.
VIII. The Disease Is Located in the Head, but the Pathomechanism Is in the Middle
Once you see the whole chain clearly, you will understand: dragging pain in both the forehead and chin has its disease location in the head and face, but the root of the pathomechanism lies in the spleen and stomach middle burner. First, clear yang fails to rise, so the head and face lose nourishment; second, turbid yin fails to descend, so turbid pathogens overflow upward; third, the two mutually cause and reinforce each other, forming a vicious cycle. Clinically, we must distinguish whether deficiency predominates, dampness predominates, or both are present; we must also assess whether liver qi stagnation, stomach qi counterflow, and other conditions coexist. Each person's proportions differ, and the treatment strategy changes accordingly. Never assume that any "dragging pain" is necessarily "deficiency" and plunge into a pile of tonics — that is precisely the crux of "the more you tonify, the more it hurts."
"Ascending, descending, exiting, and entering — there is no organ without them. Thus the organ is the abode of transformation and birth." — Huangdi Neijing · Suwen · Chapter 68: The Great Treatise on the Subtle Principles of the Sixfold Qi
The "organ" is the human body; ascending, descending, exiting, and entering are the rhythms of life within that body. The dragging pain in the forehead and chin is precisely the signal the body sends to the external world when this rhythm has been disturbed. Reading this signal is far more important than suppressing it.
References:
1. The original text of the Huangdi Neijing · Suwen can be consulted in the TCM ancient literature database: https://tcmdata.cintcm.com/
2. WHO strategy document on traditional medicine: https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine
3. Official website of the National Administration of Traditional Chinese Medicine: https://www.satcm.gov.cn/
Related Knowledge Q&A
1. What causes "One Heavens, One Earth"?
In Chinese medicine, "One Heavens, One Earth" must be assessed from a holistic pattern-differentiation perspective, using the four diagnostic methods (inspection, auscultation–olfaction, inquiry, and palpation) in combination with the individual's constitutional characteristics. It cannot be reduced to a single cause. The specific direction of treatment should be determined by a licensed Chinese medicine practitioner through in-person consultation.
2. How long is the treatment course for "Dragging Pain Does Not Arise from Nowhere"?
The treatment course varies from person to person and is related to factors such as the individual's constitutional foundation and adherence to lifestyle adjustments. Chinese medicine emphasizes gradual progress; the specific course should be assessed by a licensed Chinese medicine practitioner in person based on the individual condition. This material does not provide a specific course commitment.
3. What should be noted in daily life regarding "When Clear Yang Fails to Rise"?
In terms of daily care, it is recommended to maintain a regular daily routine, a balanced diet, moderate exercise, and emotional stability. Specific precautions should be flexibly adjusted according to individual constitution and seasonal changes. You may consult a licensed Chinese medicine practitioner for targeted recommendations.