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Menstrual blood ejection

经行吐血 〔經行吐血〕jīng xíng tù xuè

One form of counterflow menstruation. Blood ejection occurring at the time of menstruation, sometimes with reduction in menstrual flow. Menstrual blood ejection is mostly attributable to blood heat and upsurge of qì causing frenetic movement of the bloodbut may also result from upsurge of qì and vacuity fire. The main patterns are intense stomach heat, depressed liver channel fire, and yīn vacuity.

Biomedical correspondence: vicarious menstruation.

Patterns

Intense stomach heat (胃热炽盛 wèi rè chì shèng) tends to cause vomiting of copious amounts of blood when periods are about to come or have already started. It is associated with advanced menstruation and copious menstrual flow. Other signs include dry mouth and throat with desire to drink, a red tongue with yellow fur, and a large surging or rapid surging pulse.

Medicinal therapy: Clear and discharge stomach heat and conduct the blood downward. For repletion heat patterns, use Four Agents Decoction (四物汤 sì wù tāng) plus rhubarb (Rhei Radix et Rhizoma, 大黄 dà huáng), coptis (Coptidis Rhizoma, 黄连 huáng lián), and scutellaria (Scutellariae Radix, 黄芩 huáng qín). For vacuity heat patterns, use Rhinoceros Horn and Rehmannia Decoction (犀角地黄汤 xī jiǎo dì huáng tāng).

Acumoxatherapy: Base treatment mainly on CV, ST, LI, and PC. For repletion heat, select CV-13 (Upper Stomach Duct, 上脘 shàng wǎn), ST-44 (Inner Court, 内庭 nèi tíng), LI-11 (Pool at the Bend, 曲池 qū chí), PC-6 (Inner Pass, 内关 nèi guān), SP-10 (Sea of Blood, 血海 xuè hǎi), and PC-4 (Cleft Gate, 郄门 xī mén); needle with drainage. For vacuity heat, drain the points for repletion heat and supplement KI-2 (Blazing Valley, 然谷 rán gǔ) and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo).

Depressed liver channel fire (肝经郁热 gān jīng yù rè) tends to cause vomiting of copious amounts of bright red blood before or after periods and is associated with advanced menstruation. There is heart vexation, irascibility, distension and pain in both rib-sides, bitter taste in the mouth, dry throat, clouded head, tinnitus, yellow urine and bound stool, a red tongue with yellow fur, and a rapid stringlike pulse.

Medicinal therapy: Course the liver and resolve heat; conduct blood downward. Use Liver-Clearing Channel-Conducting Decoction (清干引经汤 qīng gān yǐn jīng tāng), which is composed of Chinese angelica fine root (Angelicae Sinensis Radicis Tenuis, 当归须 dāng guī xū), white peony (Paeoniae Radix Alba, 白芍药 bái sháo yào), dried/fresh rehmannia (Rehmanniae Radix, 生地黄 shēng dì huáng), moutan (Moutan Cortex, 牡丹皮 mǔ dān pí), gardenia (Gardeniae Fructus, 山栀子 shān zhī zǐ), scutellaria (Scutellariae Radix, 黄芩 huáng qín), toosendan (Toosendan Fructus, 川楝子 chuān liàn zǐ), madder (Rubiae Radix, 茜草根 qiàn cǎo gēn), achyranthes (Achyranthis Bidentatae Radix, 牛膝 niú xī), licorice (Glycyrrhizae Radix, 甘草 gān cǎo), and imperata (Imperatae Rhizoma, 白茅根 bái máo gēn).

Acumoxatherapy: Base treatment mainly on CV, ST, and LR. Select LR-3 (Supreme Surge, 太冲 tài chōng); LR-2 (Moving Between, 行间 xíng jiān), LR-14 (Cycle Gate, 期门 qī mén), CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), PC-8 (Palace of Toil, 劳宫 láo gōng), ST-34 (Beam Hill, 梁丘 liáng qiū), BL-18 (Liver Transport, 肝俞 gān shù), and BL-17 (Diaphragm Transport, 膈俞 gé shù); needle with drainage.

Yīn vacuity (阴虚 yīn xū) tends to cause vomiting of scant bright red blood during or at the end of periods and is associated with scant menstrual flow and, in some cases, advanced menstruation. Other signs include dizziness and tinnitus, heat in the heart of the palms and soles, reddening of the cheeks, tidal heat, dry cough with scant phlegm, dry throat and thirst, red or crimson tongue with a peeling fur or no fur, and a rapid fine pulse.

Medicinal therapy: Enrich yīn and moisten the lung; conduct blood downward. Use formulas such as Menstruation-Normalizing Decoction (顺经汤 shùn jīng tāng).

Acumoxatherapy: Base treatment mainly on KI, SP, ST, and LR. Select KI-6 (Shining Sea, 照海 zhào hǎi), ST-44 (Inner Court, 内庭 nèi tíng), PC-4 (Cleft Gate, 郄门 xī mén), LR-3 (Supreme Surge, 太冲 tài chōng), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with even supplementation and drainage.

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