Bloodletting Therapy in Traditional Chinese Medicine
Beijing Tongrentang TCM Hospital, Acupuncture Department, Yu Zhenzhong
Bloodletting therapy, historically known as “Qimai” (启脉), “Ciluo” (刺络), and also referred to as “Bloodletting Therapy” (刺血疗法), is an ancient and unique acupuncture treatment method in Traditional Chinese Medicine (TCM). The specific method involves using three-edged needles, sewing needles, plum blossom needles, and thick needles to puncture superficial collaterals or acupuncture points, releasing a certain amount of blood to adjust the organs, qi, blood, and meridians, thereby treating diseases.
The primary therapeutic mechanism of bloodletting therapy is to puncture the “blood collaterals” to achieve therapeutic effects. As stated in the “Su Wen: On Regulating the Menstrual Cycle” (《素问•调经论》), “Observe the blood collaterals and puncture to release the blood,” indicating that the fundamental elements of bloodletting therapy are blood and meridians.
1. Abnormalities of Blood: Abnormalities include Blood Deficiency (血虚), Blood Stasis (血瘀), Blood Heat (血热), and Blood Cold (血寒).
1. Blood Stasis:
Blood stasis refers to a condition where blood circulation is slow and obstructed. There are many causes of blood stasis: first, internal bleeding caused by trauma, falls, or other reasons, where the blood that has deviated from its normal path has not been expelled or dissipated in time, leading to accumulation and forming stasis. Second, qi stagnation can obstruct blood flow, or qi deficiency can slow down blood circulation, resulting in blood stasis. Third, blood cold can cause blood vessels to congeal. Fourth, pathogenic heat entering the blood can cause blood flow to be obstructed or the blood to be scorched, all of which can lead to blood stasis. Therefore, stasis is a pathological product of blood stasis, and once blood stasis forms, it can obstruct the meridians, becoming a pathogenic factor for further blood stasis.
Prominent symptoms of blood stasis include stabbing pain, fixed location, and tenderness upon pressure.
2. Blood Heat:
Blood heat refers to a pathological state where there is heat in the blood and accelerated blood flow. Blood heat is often caused by pathogenic heat entering the blood, but it can also result from emotional stagnation or excessive fire from the five emotions.
Symptoms of blood heat include: coughing blood, vomiting blood, blood in urine, women experiencing early menstruation with heavy flow, dark red color, blood clots, irritability, thirst, and fever, as well as local sores and boils that are red, swollen, and burning.
3. Blood Cold:
Blood cold refers to a condition where cold pathogens invade the blood vessels, obstructing qi movement, leading to poor blood circulation. This is mainly due to external cold pathogens or yang deficiency causing cold, which cannot warm and move the blood vessels.
Symptoms of blood cold include: cold pain in the hands and feet or lower abdomen, preference for warmth and aversion to cold, pain alleviated by warmth, cold limbs, women experiencing late menstruation, dysmenorrhea, and dark purple menstrual blood with clots.
Bloodletting therapy is based on the ancient principle that “blood should be released when it is excessive” as stated in the “Su Wen: On Yin and Yang Correspondences” (《素问•阴阳应象大论》). “When it is stagnant, it should be removed” as per the “Ling Shu: Nine Needles and Twelve Origins” (《灵枢•九针十二原》). “When pathogenic qi accumulates, it causes swelling and heat, which can be released by needling” as mentioned in the “Nan Jing: The Twenty-Eighth Difficult” (《难经•第二十八难》).
Bloodletting therapy can treat many diseases, including those related to excessive heat, wind pathogens, qi stagnation, phlegm accumulation, blood stasis, and various difficult and miscellaneous diseases. Although the causes of these diseases may differ, they share common pathological changes.
2. Effects of Bloodletting Therapy.
As one of the acupuncture treatment methods, bloodletting therapy primarily works through expelling pathogens, relieving exterior conditions, emergency resuscitation, dissipating heat and detoxifying, removing stasis and unblocking meridians, harmonizing qi and blood, and draining pus and reducing swelling, thereby adjusting the functions of the body’s organs, meridians, and qi and blood, achieving therapeutic effects.
1. Expelling Pathogens and Relieving Exterior Conditions:
As stated in the “Su Wen: On True and False Pathogens” (《素问•离合真邪论》), “When a new pathogen invades, it has not yet settled, puncturing to release blood can immediately expel it.” Bloodletting can timely expel pathogens, preventing internal transmission. The “Rumen Shiqin” (《儒门事亲》) states: “Bleeding and sweating, although named differently, are essentially the same.” This method can be used for conditions like colds, headaches, breast abscesses, wind rash, and edema, which are categorized as exterior excess conditions.
2. Emergency Resuscitation:
As mentioned in the “Ling Shu: On Puncturing True Pathogens” (《灵枢•刺节真邪》), “In cases of extreme heat throughout the body, with madness and delusions, puncturing the foot yangming and major collaterals can release blood and alleviate the condition.” Throughout history, many physicians have discussed this, and the “Great Compendium of Acupuncture” (《针灸大成》) refers to this method as “a miraculous technique for reviving the dead.” It is believed that in cases of sudden death or severe throat obstruction, one must use a three-edged needle to puncture the twelve jing points on the fingers to release the bad blood. Currently, this method is used clinically to treat heat stroke, convulsions, coma, and high blood pressure.
3. Dissipating Heat and Detoxifying:
Fire is a yang pathogen, characterized by heat and redness. When fire heat invades the blood, it often causes acute and violent symptoms, manifesting as local redness, swelling, and pain. Bloodletting can help expel the fire toxin along with the blood, achieving the effect of dissipating heat and detoxifying. This is applicable in cases like erysipelas and shingles.
4. Removing Stasis and Unblocking Meridians:
The qi and blood in the meridians are interdependent; qi leads blood, and when qi flows, blood flows. Qi stagnation can lead to blood stasis. For diseases characterized by qi and blood stagnation, the “Neijing” (《内经》) points out the principles of “when it is stagnant, it should be removed” and “blood should be released when it is excessive,” with the specific method of “observing the blood collaterals and releasing the blood.” For various stubborn pains, arthralgia, and limb numbness caused by internal injuries or external trauma leading to qi and blood obstruction, bloodletting therapy can be used for treatment.
Due to the simplicity of the operation of acupuncture point bloodletting therapy, its wide clinical application, and its safety and reliability, bloodletting therapy often refers specifically to acupuncture bloodletting therapy.
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