Qì stagnation and blood stasis

A disease pattern chiefly characterized by localized distension and fullness; stabbing pain that refuses pressure; dark facial complexion; a tongue that is purple or bears stasis speckles; a pulse that is stringlike and rough.

Description: Oppression, distension, and scurrying pain in the chest and rib-side or glomus lump under the ribs with stabbing pain that refuses pressure; bruising and lumps (from external injury); in some cases, prominent green-blue veins (varicose veins or caput medusae) or red thread marks on the skin or encrusted skin; impatience, agitation, and irascibility; menstruation at irregular intervals; amenorrhea; dark-purple clotted menstrual discharge; menstrual pain; persistent flow of the lochia after childbirth; distension and pain in the breasts. The tongue is dull purple, with stasis macules. The sublingual network vessels are green-blue or purple, and varicose. The pulse is stringlike and rough, in some cases bound or intermittent.

Biomedical correspondence: This pattern frequently occurs in conditions described by Western medicine as chronic nephritis and ulcerative diseases.

Pathogenesis: Stagnant qì failing to move the blood or, less commonly, static blood obstructing the qì dynamic. This results from any of the following factors:

• affect-mind depression or frustration impairing the liver’s free coursing action, causing liver qì to become depressed and stagnant;
• phlegm turbidity or cold evil causing internal obstruction of the qì dynamic;
• contusion, wrenching, or other external injuries.

Analysis of signs

• Qì stagnation: Oppression, distension, and scurrying pain in the chest and rib-side; and impatience, agitation, and irascibility.
• Blood stasis: Glomus lump under the rib-side with stabbing pain of fixed location that refuses pressure; in the case of external injury, bruises and lumps in the affected area.
• Women: Menstruation at irregular intervals; amenorrhea; dark-purple clotted menstrual discharge; menstrual pain; persistent flow of the lochia after childbirth; distension and pain in the breasts.
• Tongue: Dull purple tongue with stasis macules, varicose sublingual network vessels, and rough pulse, all reflecting blood stasis.
• Pulse: Stringlike and rough; in some cases, bound or intermittent, due to stasis hampering the movement of blood.

Treatment

Medicinal therapy: Dual patterns of qì stagnation and blood stasis are treated with blood-quickening and qì-rectifying medicinals. Toosendan Powder (金铃子散 jīn líng zǐ sǎn), commonly used to relieve pain, is a representative formula.

Acumoxatherapy: Base treatment mainly on back transport points, SP, LR, CV, PC, and GB. BL-17 (Diaphragm Transport, 膈俞 gé shù), SP-10 (Sea of Blood, 血海 xuè hǎi), LR-3 (Supreme Surge, 太冲 tài chōng), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), CV-6 (Sea of Qì, 气海 qì hǎi), PC-6 (Inner Pass, 内关 nèi guān), LI-4 (Union Valley, 合谷 hé gǔ), TB-6 (Branch Ditch, 支沟 zhī gōu), and GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán) can be selected as main points; and needle with even supplementation and drainage or bleed with a three-edged needle to rectify qì and disperse stasis.

Point selection according to signs: For amenorrhea, add CV-3 (Central Pole, 中极 zhōng jí) and SP-8 (Earth’s Crux, 地机 dì jī). For menstrual pain, add CV-3 (Central Pole, 中极 zhōng jí), and ST-29 (Return, 归来 guī lái). For painful distension of the breasts, add CV-17 (Chest Center, 膻中 shān zhōng), ST-18 (Breast Root, 乳根 rǔ gēn), and LR-14 (Cycle Gate, 期门 qī mén). For external injury, add local points.