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TCM Book Club Issue 2909
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IIntroduction:The author combines the wisdom of predecessors with clinical differentiation and treatment, emphasizing the use of Fuzi (Aconite) to stop bleeding in cases of true Yang deficiency and internal cold, achieving satisfactory results. (Editor/Yan Qifeng)
Application of Fuzi in Stopping Bleeding
Author/Hu Yuping
Fuzi possesses a warm and hot nature, embodying a strong and fierce energy, and has historically been used as a key herb for restoring Yang, supplementing fire, dispelling cold, and eliminating dampness. The “Textbook of Chinese Herbal Medicine” compiled by Chengdu University of Traditional Chinese Medicine states: “All syndromes caused by Yang deficiency can be treated with it.” This indicates the broad application of Fuzi.
There is a wealth of experience in treating blood-related syndromes with Fuzi. As early as the “Shennong Bencao Jing,” it was mentioned that Fuzi can break “blood stasis.” Zhang Zhongjing treated blood loss due to Yang deficiency using the Si Ni Jia Ren Shen Tang (Four Reversal Decoction with Ginseng). The formula Shenfu Decoction in “Zhengti Lei Yao” is a simple yet effective remedy for treating blood loss due to Yang collapse. In the Qing Dynasty, physician Tang Rongchuan, in his work “On Blood Syndromes,” proposed the view that “blood and fire are originally one family” and that “treating fire is treating blood,” recognizing that to treat “blood cold,” one must use herbs that embody fire energy to warm and circulate it.
Based on the above discussion, the author combines clinical differentiation and treatment, emphasizing the use of Fuzi to stop bleeding in cases of true Yang deficiency and internal cold. Here are two cases for reference.
【Case One】Thrombocytopenic Purpura
Zhang ××, male, 20 years old, diagnosed by Western medicine as secondary thrombocytopenic purpura.
Symptoms included pale complexion, mild edema, pale skin, numerous scattered petechiae, ranging from the size of a soybean to a coin, sluggish movement, cold extremities, aversion to cold, clear and prolonged urination, a swollen and tender tongue, pale body, with tooth marks on the edges, thin white coating, and a deep, slow, weak pulse (previously treated with water buffalo horn and other cooling herbs without effect).
This case belongs to the category of Yin excess and Yang deficiency, and only the heavy use of Fuzi to restore Yang and warm the interior can be effective. Therefore, 20 grams of processed Fuzi (first decocted) was combined with ginseng and astragalus in three doses. The patient was advised to take it cold and slowly to prevent rejection. After taking the medicine, symptoms improved, appetite increased, and the skin purpura gradually faded. After taking a total of nine doses, the purpura completely disappeared, and the patient was given Gui Pi Wan (Restore the Spleen Pill) for follow-up care.
【Case Two】Nosebleed
Wang ××, male, 52 years old, diagnosed by Western medicine with rheumatic heart disease, accompanied by mild heart failure.
Nosebleed for one week, having used various Western hemostatic medications without effect, he sought a TCM consultation. Symptoms included sallow skin, shortness of breath upon movement, slightly cyanotic nails and lips, aversion to cold and curled up posture, cold extremities, nosebleed with a small amount of dark red blood, no thirst, loose stools, slightly dark tongue, thin white coating, and a deep, slow, weak pulse. This indicates Yang deficiency and internal cold excess, and treatment should focus on restoring Yang and benefiting Qi, thus 30 grams of processed Fuzi (first decocted) was combined with the Four Gentlemen Decoction and other ingredients. After three doses, the patient reported a reduction in nosebleeds, warming of the extremities, and improved spirit. After a total of nine doses of the original formula, the nosebleed stopped, and other symptoms significantly improved.
Note:
For all bleeding syndromes, the cause must be examined, which generally falls into categories of heat evil forcing blood to flow recklessly, Qi deficiency unable to contain blood, or blood stasis obstructing the flow. Blood flows well and moves with heat.
For instance, regarding nosebleeds, “Zhengzhi Huibu” states, “The lungs open to the nose, and the Yangming channel intersects at the nose, thus nosebleeds often arise from heat in the lungs and stomach.” Using methods to clear heat and cool the blood for bleeding syndromes is commonly practiced in clinical settings. However, in internal injuries, bleeding caused by deficiency and cold is not uncommon.
As Yang Renzhai stated in “Zhi Zhi Fang”: “There is Qi deficiency with cold, Yin and Yang do not support each other, the Qi is weak, and the blood also flows incorrectly, hence the saying that when Yang is deficient, Yin must escape.” This shows that both Qi deficiency and Yang deficiency can cause blood to flow incorrectly, leading to bleeding syndromes. In both cases presented, the bleeding was due to Yang deficiency, and the heavy use of Fuzi was appropriate, thus achieving satisfactory therapeutic results.
Fuzi is pungent, warm, and toxic; however, when processed and prepared as mature Fuzi slices, the toxicity can be eliminated. Therefore, patients were instructed to decoct the Fuzi slices for one hour. In case one, 180 grams of Fuzi was used, and in case two, 270 grams were used, with no adverse reactions observed.
Recommended Reading
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Treating Damp-Heat, Does Adding Fuzi Improve the Effect?
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Fuzi in large doses warms Yang, though it may deplete Yang Qi over time.
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Fuzi warms the Yang of the whole body, discussing my seven methods of use.
I Copyright Statement
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This article is excerpted from “Jiangxi Traditional Chinese Medicine“,1984 Issue 2, Author/Hu Yuping.Editor/Yan Qifeng.Copyright belongs to the relevant rights holders. If there are any improper uses, please feel free to contact us.
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