Blood-stanching agents

Blood-stanching medicinals check internal or external bleeding.

Subcategories

Blood-stanching medicinals fall into four categories:

• Blood-cooling blood-stanching agents that treat bleeding (nosebleed, vomiting of blood, bloody stool, bloody urine, or flooding and spotting) due to frenetic movement of hot blood (blood heat).
• Stasis-transforming blood-stanching agents that treat bleeding with signs of blood stasis.
• Astringent blood-stanching agents that treat bleeding patterns not associated with vacuity cold, blood heat, or stasis.
• Channel-warming blood-stanching agents, which treat bleeding associated with vacuity cold.

The properties of blood-stanching medicinals vary. Some are warm in nature, and some are cool. Flavors include sour/astringent, bitter, and acrid. Most enter the heart and liver channels (since the heart and liver are the viscera most closely related to the blood).

Properties

Nature: Varying. Most blood-stanching medicinals with a blood-cooling action are cold. Those that transform stasis or warm the channels are warm. Those that are astringent are mostly balanced in nature.

Flavor: Some are sour or astringent. Blood-stanching medicinals with a blood-cooling action are mostly bitter (and cold). Those that transform stasis or warm the channels are usually acrid (and warm).

Channel entry: Most enter the liver and heart channels (the liver stores the blood; the heart governs the blood).

Actions

Blood-cooling blood-stanching agents are used for blood heat patterns, i.e., frenetic movement of hot blood.

Stasis-transforming blood-stanching agents are used for bleeding with signs of blood stasis.

Astringent blood-stanching agents are used for external injury or in any other conditions where pronounced signs of heat, vacuity cold, and blood stasis are absent. Because they tend to detain blood stasis and other evils (prevent them from being dispelled), they are usually combined with stasis-transforming blood-stanching or blood-moving medicinals. When there are signs of right qì vacuity, they are combined with supplementing medicinals.

Channel-warming blood-stanching agents are used for vacuity cold patterns. They warm and free the blood and vessels, disperse stagnation, and assist yáng qì. They mainly address spleen yáng vacuity with the spleen failing to control the blood, or vacuity cold bleeding due to insecurity of the thoroughfare (chōng) and controlling (rèn) vessels. Note that in the term channel-warming (温经 wēn jīng), the word 经is largely associated specifically with the thoroughfare (chōng) and controlling (rèn) vessels. Because the word is also an abbreviation for 月经 yuè jīng, menstruation, warming the channels can also be thought of as warming the menses.

According to modern research, many blood-stanching medicinals produce their effect by accelerating blood clotting.

Indications

Symptoms

Coughing of blood, expectoration of blood, and nosebleed are attributed to damage to the network vessels of the lung (i.e., the blood vessels of the lung and the parts that the lung governs).

Vomiting of blood is attributed to damage to the network vessels of the stomach, in some cases traceable to liver qì invading the stomach.

Bloody stool is due to stomach or intestinal disease.

Bloody urine is attributed to kidney or bladder disease.

Flooding and spotting (heavy and light bleeding via the vagina occurring outside of the normal menstrual cycle) is a gynecological condition attributed to liver-kidney yīn vacuity, intense liver fire, or spleen failing to control the blood.

Bleeding is associated with blood stasis, repletion heat, vacuity heat, qì vacuity, or vacuity cold. The color and consistency of the blood are correlated with other signs to determine the nature of the condition. Below are several representative patterns.

Bleeding from Frenetic Movement of Hot Blood

Pathomechanism: Occurs in external contractions when heat enters the blood, or in miscellaneous disease when affect-mind excesses cause depression that transforms into fire or when yīn vacuity gives rise to effulgent fire.

Signs: Vomiting of blood, expectoration of blood, bloody stool, bloody urine, nosebleed, or flooding and spotting. Bleeding is often profuse and the blood is either bright red or purple-black in color. General signs include heart vexation, thirst, a red or deep red tongue, and a rapid pulse.

Treatment method: Cooling the blood and stanching bleeding.

Bleeding From Blood Stasis

Pathomechanism: Blood stasis results from a) qì stagnation, b) cold stagnating in the vessels, c) heat evil entering the blood aspect and binding with the blood, or d) qì vacuity.

Signs: Bleeding characterized by dark purple blood, sometimes with clots. Other signs of blood stasis include stabbing pain; swellings; purple patches; green-blue or purple tongue, lips, and nails; and a rough pulse.

Treatment method: Transforming stasis and stanching bleeding.

Bleeding From Vacuity Cold

Pathomechanism: Spleen yáng vacuity with spleen failing to control the blood or insecurity of the thoroughfare (chōng) and controlling (rèn) vessels.

Signs: Spleen failing to control the blood can manifest in bloody stool, bloody urine, nosebleed, bleeding gums, profuse menstruation, or flooding and spotting. Accompanying signs are reduced eating, sloppy stool, lassitude of spirit and lack of strength, shortage of qì, laziness to speak, a pale tongue with white fur, and a weak pulse. Insecurity of the thoroughfare and controlling vessels is a breakdown of the retentive function of qì that occurs specifically in women. It manifests in profuse menstruation, flooding and spotting, miscarriage, or vaginal discharge.

Treatment method: Warm the channels and stanch bleeding. For bleeding due to spleen failing to control the blood with pronounced spleen-stomach vacuity cold signs (vomiting, diarrhea, reduced eating, stomach pain, and other cold signs), channel-warming blood-stanching medicinals are combined with yáng-warming, qì-boosting, and spleen-fortifying medicinals. For lower burner vacuity cold with incessant bleeding that is accompanied by lesser abdominal cold pain, menstrual pain, and/or menstrual irregularities, add kidney-warming, liver-warming, and thoroughfare-securing medicinals.

Bleeding may also arise from qì vacuity or vacuity heat.

Bleeding from External Injury

Pathomechanism: Knocks and falls.

Signs: Bruising (green-blue or purple swellings).

Treatment method: Stanching bleeding with astringency.

Combinations With Other Categories

Qì deserting with blood: Massive bleeding can lead to qì deserting with blood. In such cases, it is necessary to drastically supplement original qì in order to stem the desertion.

Exuberant fire-heat: Combine blood-stanching medicinals with heat-clearing, fire-draining, and blood-cooling medicinals.

Yīn vacuity with effulgent fire: Combine with medicinals that enrich yīn, downbear fire, and subdue yáng.

Bleeding with blood stasis: Combine with medicinals that quicken the blood and dispel stasis.

Vacuity cold bleeding: Combine with medicinals that warm the interior, and with medicinals that assist yáng.

Qì vacuity bleeding: Combine with medicinals that supplement qì.

Regulating qì: When using blood-stanching medicinals, attention must be paid to regulating qì (moving qì, downbearing qì). When the bleeding is in the upper body, qì-downbearing medicinals should be used. For persistent bleeding in the lower body with signs of damage to right qì, combine the blood-stanching medicinals with agents that upbear yáng and raise the fall.

Method Of Use

In the past it was generally believed that char-frying (stir-frying until charred) could enhance any blood-stanching medicinal. Ginger and human hair have a blood-stanching action only in the form of pào jiāng (Zingiberis Rhizoma Praeparatum) and xuè yú tàn (Crinis Carbonisatus), respectively. Zào xīn tǔ (Terra Flava Usta) is by definition a substance that has been exposed to high temperatures.

Generally, char-frying reduces or eliminates the coldness of cold-cool medicinals, turning them into astringent blood-stanching medicinals and thus expanding their scope of application. However, some medicinals have the strongest blood-stanching action when used raw or fresh, and some modern practitioners believe that charring can actually reduce the blood-stanching action of certain medicinals.

Warnings

Avoid detaining stasis. Astringent blood-stanching medicinals and blood-cooling blood-stanching medicinals tend to detain stasis and other evils. When using such medicinals in large quantities, blood-quickening medicinals should always be added.

Beware of qì deserting with blood. Massive bleeding can lead to qì deserting with the blood. In such cases, it is necessary to drastically supplement original qì in order to stem the desertion.