Blood stagnation

In each chapter of Part II, the text generally follows the same structure and sequence. However, because of the characteristics of some syndromes, I have deviated slightly from this structure and sequence in order to make it easier to study and to compose formulas (e.g. in Chapter 11, Syndrome of blood stagnation and formula composition). 

This method is used to treat blood stagnation. It is carried out by using pungent, aromatic herbs that enter the Heart, Pericardium, Liver and Gall Bladder meridians. These ingredients can directly stimulate blood circulation. To enhance their effect, they are combined with herbs that activate the Qi. 

When Qi, Yang, fire and wind are ascending in an acute pathological condition, herbs that move Qi, blood or Yang upwards and outwards should be used with caution. Relevant formulas here are those which treat Bi syndrome or exterior syndrome caused by wind, damp and cold, formulas that disperse and spread the Liver-Qi and formulas that treat headache caused by Qi and blood stagnation. 

Formulas that cool the blood and stop bleeding may cause blood stagnation as many herbs are cold, astringent or partially charred. As soon as the bleeding stops, herbs that prevent congealed blood should be used. 

These therapies are mainly used for cancer treatment and are considered as heat-toxin in TCM. When the cancer cells are killed, the body is severely injured too. The Yin and the Qi in particular are seriously depleted and weakened by the extreme heat. Moreover, these therapies can cause further disturbances in the body such as deficiency of Kidney-essence and blood, blood stagnation, bleeding,... 

Deputy Increase the body fluids and Yin disperse the blood stagnation... 

Five herbs serve as assistants. Dan Shen cools the blood and disperses the blood stagnation, which are the common accompanying pathological changes when there is heat at the Yin level. Dan Zhu Ye and Huang Lian can clear heat and calm the mind. Jin Yin Hua and Lian Qiao can vent the heat to the Qi level as they are aromatic herbs. They clear heat that has been vented from the Ying level in order to eliminate the heat from... 

Third, herbs that are pungent or having a dispersing ability and can dissolve the stagnation of the blood or prevent blood stagnation should be used. 

As soon as the blood leaves its pathway, it accumulates in one place causing blood stagnation. 

Mu Dan Pi is bitter, pungent and slightly cold Chi Shao Yao is bitter and cold. They can clear heat and cool the blood. The strong points of these herbs are that they can also dissolve congealed blood and promote blood circulation. Blood stasis often occurs when heat consumes the blood and makes blood thick. In addition, heat makes blood move erratically ( like a river in a storm ) and also leads to blood stagnation. The cold herbs, which are used in the formula to cool the blood and stop bleeding, may also cause blood stagnation directly. Mu Dan Pi and Chi Shao Yao are particularly selected to treat these conditions. 

Dan Shen is bitter and slightly cold, and enters the Heart and Liver meridians. It can effectively clear heat and cool the blood, and is used as deputy when the Heart-fire disturbs the blood and causes blood stagnation. It treats warmth in the chest and restlessness due to the heat in the blood and blood stagnation. 

Dan Shen can be used as assistant in the formula of clearing heat from the Heart. When heat injures the Yin and consumes the blood of the Heart, it makes the blood thicker than normal. At the same time, heat can force the blood to move erratically ( like a river in a storm ). Both of these conditions may cause blood stagnation. Dan Shen can cool the blood, promote the blood circulation and remove the congealed blood, enabling recovery of the normal condition of blood and its circulation. 

This formula also demonstrates some other strategies, such as using Bai Shao Yao and Gan Cao to moderate the tension in the abdomen, and using Dang Gui and Rou Gui to protect the blood and prevent blood stagnation from the cold herbs. 

When the Heart-Qi is too weak to stimulate the blood, blood stagnation may appear, thus directly causing palpitations and restlessness. 

Sheng Jiang and Gui Zhi together with rice wine are assistants. They stimulate the Heart-Yang, and promote the Qi movement and blood circulation so as to treat the palpitations which are partially caused by the Qi and blood stagnation. 

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. 

Yu Jin is pungent, bitter and cold, and enters the Liver, Heart and Lung meridians. It can promote the Qi movement and blood circulation. It is suitable for treating tenderness of the breasts, hypochondriac pain and distension, irritability and irregular menstruation in the condition of Liver-Yin deficiency with Liver-Qi and blood stagnation. 

Liver-Yin deficiency with blood stagnation use Yu Jin (Curcumae radix) and Mu Dan Pi (Moutan cortex) to promote blood circulation. 

The formulas that stabilize and bind are only used in deficiency conditions. There should be no exterior pathogenic factors or phlegm, dampness or blood stagnation in the body. Otherwise, they may retain the pathogenic factors in the body. 

The use of Qian Cao Gen shows how to prevent and treat blood stagnation caused by astringent substances. 

He Ye, like Mu Dan Pi, serves as both helping and corrective assistant. The partially charred He Ye, like other herbs, can stop bleeding. However, its light fragrant smell can also disperse the Qi and blood stagnation caused by the astringent herbs and the cold herbs. 

Dang Gui and Chuan Xiong regulate the blood and dissipate the blood stagnation. 

These herbs are selected to promote blood circulation. Mei Gui Hua has the function of harmonizing the Qi of the Liver and Stomach, and treating the syndrome of Liver-Qi attacking the Spleen and Stomach. Its function is quite similar to that of Xiang Yuan (Citri fructus) and Fo Shou [Citri sarcodactylis fructus). However, this herb can promote both Qi and blood circulation and is an appropriate herb to treat disorders due to both Qi and blood stagnation, such as in irregular menstruation and dysmenorrhea. 

Chuan Xiong, Yu Jin and Yan Hu Suo are herbs that promote blood circulation. As they are able to move the Qi in the blood, they are considered as the Qi-moving herbs in the blood. In formulas that regulate the Liver-Qi, they may be selected in conditions of Qi and blood stagnation, or for the purpose of activating the blood in order to accelerate the Qi movement. As Chuan Xiong and Yan Hu Suo are warm in temperature and Yu Jin is cold, they should be selected according to the nature of the syndrome. 

This chapter introduces the principles, methods and strategies for the composition of formulas that regulate blood circulation and remove congealed blood. They are used to treat blood stagnation. 

The main manifestation of blood stagnation is localized pain of a deep, sharp and piercing nature. Patients who have suffered from stagnation of blood for a long period of time may have such symptoms as a dark complexion, purple lips and nails, fragile nails and hair, and dry skin, and some may suffer from mental confusion. In women, menstruation disorders may be present. 

Blood stagnation is often the result of Qi stagnation, which is frequently caused by emotional disturbance, such as stress, anger, brooding or depression for a long period. 

Trauma or fracture may cause blood stagnation directly in the local area. 

Wind, dampness and cold that lodges in the meridians can also cause blood stagnation, as... 

Select appropriate herbs from the strength scale to compose a formula for treating a specific syndrome of blood stagnation ... 

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