Blood deficiency

At times of great stress and high emotion, or of severe physical exertion and tiredness, the body becomes more sensitive, and herbs should be prescribed at lower dosages than normal. For instance, to treat severe tiredness due to Spleen-Qi and Heart-blood deficiency, herbs that tonify the Qi and blood should be used in the formula but their doses should be very low because any strong stimulation and tonification may cause further disorder in the body. If the patient suffers from insomnia and anxiety, formulas that calm the mind and sedate the Heart-spirit should be used first. At the time of menstruation, or if the patient has a bleeding... 

If an exterior syndrome arises during the treatment of a chronic disorder, the exterior syndrome should be dealt with first. For example, if a patient contracts an acute wind-heat invasion while having treatment for blood deficiency syndrome, the wind-heat invasion should be prioritized and treated first. 

The first strategy is using animal products to nourish the Yin and blood in a severe condition of Yin and blood deficiency. Because animals have blood and flesh and are closer to humans than plants, they can tonify the human body directly and strongly. 

In many conditions, when the Qi is obstructed, cold sensation can also appear. When the Yin is too weak to nourish the tendons and muscles, cramp of limbs may also appear. Many patients with blood deficiency also have Yin deficiency with heat in the blood they are often afraid of cold since the Qi is not strong. A clear and correct differentiation of the syndrome is therefore required at the outset. 

The Qi and blood deficiency is manifested as a lusterless complexion, palpitations, a pale tongue and a thready pulse. 

This formula is able to warm the meridians and expel cold, tonify the blood and promote blood circulation. It is used to treat cold and painful joints and muscles due to Yang deficiency and blood deficiency with invasion of external cold. A pale tongue with a white coating and a very thready and deep pulse are the important signs of this syndrome. 

The main substances of the body are the Qi and essence that further generate blood, body fluids, Yin and Yang. In pathological conditions, the deficiency often shows four aspects, namely deficiency of the Qi, deficiency of the blood, deficiency of the Yin and deficiency of the Yang. The deficiency can be found in specific organs, such as Kidney-Yin deficiency, Spleen-Qi deficiency or Heart-blood deficiency. A deficiency syndrome also exists in patients with a weak constitution or those in the recovery period of disease, in elderly people or in children. In those situations, it is difficult to determine which organ is weak and which part should be tonified, as the general condition of the patient is weak. 

Hu Tao Ren is sweet and warm, and enters the Kidney and Lung meridians. E Jiao is sweet and neutral, and enters the Liver and Kidney meridians. Both are moist in nature and are able to moisten the Lung and tonify the Kidney-essence and blood. They are mainly selected in formulas to treat chronic conditions of Lung-Qi deficiency where Kidney deficiency is obviously involved. The difference between these two substances is that Hu Tao Ren is more suitable for treating Kidney-Yin and Kidney-essence deficiency E Jiao is better suited for use in cases of blood deficiency. 

Heart-Qi deficiency is often seen in conditions of Spleen-Qi deficiency and acute or chronic blood deficiency. 

Suan Zao Ren is sweet, sour and neutral, and enters the Heart and Liver meridians. It nourishes the blood of the Heart and Liver and improves sleep. It is very useful in formulas to treat restlessness and insomnia caused by blood deficiency. 

The causes of blood deficiency are linked directly with deficiency of these four organs. It is often seen in chronic diseases, improper diet or in conditions of starvation. It can also occur following heavy blood loss. Long-term stress and overwork can directly weaken the Heart, Spleen, Liver and Kidney, causing blood deficiency. 

When the blood cannot support the head, dizziness and vertigo may present. If the blood is too weak to circulate, one will feel tingling of the limbs. When the blood fails to nourish skin, muscles and tendons, the skin becomes dry and itchy, muscles and tendons become stiff or numb, and patients may feel tired. Since normal menstruation is directly supported by blood, irregular menstruation and amenorrhea may occur in conditions of blood deficiency. If the blood is unable to nourish the Heart, the Heart-shen becomes rootless, and insomnia, palpitations, shortness of breath, restlessness and anxiety arise. If the Liver-blood is not able to support... 

Bai Shao Yao is bitter, sour and slightly cold. It enters the Liver and Spleen meridians. Its sour and cold property can nourish the Yin directly and generate the substantial part of the blood. It is particularly effective for softening the Liver, thereby relieving cramp of the muscles and tendons. It can also effectively moisten the internal organs and the orifices, so it can treat the symptoms of dryness of skin and eyes caused by Liver-blood deficiency. 

Dang Gui and Bai Shao Yao are very often used together as a pair of herbs in the formula, as Dang Gui concerns the functional aspect of blood and Bai Shao Yao concerns the substantial aspect of blood. The former is called a Yang herb and the latter a Yin herb in this situation. They can effectively treat Liver-blood deficiency. 

Assistant Treat the symptoms caused directly by blood deficiency... 

Ji Xue Teng is bitter, slightly sweet and warm, and enters the Kidney and Liver meridians. It is a special herb for tonifying the blood as it is also able to promote the blood circulation and relax the tendons. It is therefore selected in formulas to relieve stiffness, tingling, numbness, pain and an uneasy feeling in the body, such as in Bi syndrome and in restless leg disorder due to blood deficiency with Qi and blood stagnation. 

Mu Gua is sour and warm, and enters the Liver and Spleen meridians. It has no function to tonify the blood, but is able to nourish the tendons, expel dampness and open the meridians. It is selected in formulas to relieve spasm and stiffness of the limbs due to Yin and Liver-blood deficiency. 

This is a formula to treat hypomenorrhea, prolonged menstrual cycle and amenorrhea due to Liver-blood deficiency. 

Furthermore, Suan Zao Ren and Bai Shao Yao can calm the mind and improve sleep, and are also effective in treating restless sleep and an uneasy feeling of the body during sleep due to Liver-blood deficiency. 

These are two sweet fruits. Long Yan Rou is neutral and Da Zao is warm. Both enter the Heart and Spleen meridians. They can gently tonify the Spleen-Qi, nourish the Heart-blood and calm the mind. As they taste nice and have few side effects, they are often selected in formulas or added to the diet for long-term use in a mild case or a chronic condition of Heart-blood deficiency, such as after a surgical... 

Heart-Yin deficiency with blood deficiency add Long Yan Rou (Longanae arillus) and Bai Shao Yao (Paeoniae radix lactiflora) to nourish the blood. 

The Liver-Yin deficiency often follows Liver-blood deficiency. In conditions where Yin and blood are both deficient, they are unable to house the soul, to spread the Qi and to regulate the blood, dream-disturbed sleep, depression, irregular menstruation and tiredness may arise. 

Shu Di Huang is sweet and slightly warm, and enters the Kidney and Liver meridians. It is a strong herb for tonifying the essence and blood, and can therefore nourish the Yin vigorously. It is often used in conditions of Liver-Yin deficiency where blood deficiency arises at the same time. As this herb is rich and cloying in nature and may bring an extra burden to the Stomach, herbs that promote Qi movement in the Middle-Jiao are required. 

SangJi Sheng is bitter, sweet and neutral, and enters the Liver and Kidney meridians. It can nourish the blood, strengthen the tendons and expel the wind-dampness. It is particularly useful for recurrent or chronic muscular disorders, such as chronic stiffness and heaviness of muscles in a condition of Liver-Yin and blood deficiency. 

Generally speaking, blood, Yin and essence all belong to the Yin because of their substantial form. In a syndrome of Liver-Yin deficiency, liver-blood deficiency is often the initial stage of Liver-Yin deficiency liquid-Yin deficiency is the second stage, and essence deficiency of the Liver and Kidney is the last stage. Thus, to tonify the Liver-Yin, herbs that tonify the blood and nourish the liquid-Yin and the essence are all selected. 

Yin deficiency may directly cause dryness and blood deficiency, constipation may exist and menstruation may become irregular or with little menstrual flow. 

Suo Yang is sweet and warm, and enters the Kidney and Liver meridians. It is able to tonify the Kidney-Yang, and nourish the essence and blood. It can moisten the intestines and treat constipation due to Yin and blood deficiency. It is suitable for treating constipation in elderly people or people with chronic diseases. 

Liver-blood and Yin deficiency add Dang Gui (Angelicae sinensis radix) and Bai Shao Yao [Paeoniae radix lactifiora). Since Yin deficiency is often accompanied by blood deficiency,... 

This formula primarily treats Spleen-Qi and Yang deficiency. In fact, it treats a chronic syndrome of deficiency of the Middle-Jiao, where the Yin and blood are also deficient due to long-term Yang and Qi deficiency. The Yang and Qi deficiency are manifested as intermittent, spasmodic abdominal pain that responds favorably to local application of warmth and pressure, reduced appetite, and cold and sore extremities. The Qi and blood deficiency are manifested as a lusterless complexion, palpitations, a pale tongue and a thready pulse. The Yin deficiency shows in low-grade fever, dry mouth, dry throat and irritability. 

These three substances are able to nourish blood and moisten dryness. E Jiao can directly stop bleeding. Bai Shao Yao can stabilize the blood due to its sour and cold properties. These substances are often used in the formula to treat bleeding due to blood deficiency. 

Bai Shao Yao is the most commonly used herb to soften the Liver. It is sour, bitter and slightly cold. It is able to nourish the Yin and blood of the Liver, and its cold and bitter nature can reduce heat, which is caused by deficiency of blood and stagnation of the Liver-Qi. It is often used in a formula to treat Liver-Qi stagnation, which is caused by Yin and blood deficiency. As well as the common symptoms of Qi stagnation, a thready and wiry pulse is often an indication for using this herb in the formula. 

Since each of the three aspects - deficiency of blood, deficiency of Spleen-Qi and stagnation of Liver-Qi - can be the cause or the consequence of each other, the roles and the dosages of the three groups of herbs that tonify the blood, tonify the Spleen and disperse the Liver-Qi can be changed according to the syndrome. 

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