Disorders of blood refer to physiological abnormalities in blood function, primarily manifested as insufficient blood production or excessive consumption, irregular blood circulation, and reduced nourishing function of blood. Blood disorders include xue xu (blood deficiency), xue yu (blood stasis), xue re (blood heat), and chuxue (hemorrhage).
Xue Xu (Blood Deficiency)
Blood deficiency refers to a pathological change characterized by insufficient blood and reduced nourishing function. The causes include: first, excessive blood loss, such as from vomiting blood, nosebleeds, heavy menstruation, or traumatic bleeding, leading to significant loss of blood without timely replenishment; second, insufficient biochemical production of blood, where the piwei (spleen and stomach) are the source of qi and blood production; weakness of the spleen and stomach results in reduced materials for blood generation or weakened function of blood production; third, chronic illness or prolonged consumption leading to depletion of ying xue (nutritive blood); fourth, blood stasis obstructing the flow, where stasis prevents the generation of new blood, ultimately leading to systemic blood deficiency.
Blood is one of the essential substances maintaining life activities in the human body and has a nourishing effect. Therefore, insufficient blood cannot nourish the organs and tissues, inevitably leading to systemic or local malnutrition and gradual decline in physiological functions. Clinical manifestations include dizziness, pale complexion, and pale lips, tongue, and nails as significant features.
Treatment principle: tonify qi and nourish blood; main formula: zi xue tang (Nourishing Blood Decoction).
Xue Yu (Blood Stasis)
Blood stasis refers to a pathological change characterized by obstructed blood flow. Qi stagnation can lead to obstructed blood flow, or qi deficiency can slow down blood circulation, or phlegm-dampness can obstruct the vessels, or cold pathogens can invade the blood, causing blood to congeal, or heat pathogens can invade the blood, causing blood to boil, all of which can lead to blood stasis. Severe cases can result in blood clots forming stasis. Thus, stasis is a pathological product of blood stasis, and once stasis forms, it can further obstruct the vessels, becoming a cause of blood stasis.
The main mechanism of blood stasis is obstructed blood flow. When stasis obstructs a specific organ or meridian, it can cause pain, which is localized and does not alleviate with temperature changes, and can even form lumps, referred to as symptoms. Additionally, it may present with a dark complexion, rough skin, purple lips and tongue, and stasis spots, indicating slow blood flow and blood stasis.
Blood stasis can exacerbate qi stagnation, creating a vicious cycle where qi stagnation leads to blood stasis, and blood stasis leads to qi stagnation. Due to the interrelated effects of blood stasis with qi deficiency, qi stagnation, blood cold, and blood heat, blood stasis often presents with pathological changes such as blood stasis combined with qi deficiency, blood stasis combined with qi stagnation, and blood stasis combined with blood deficiency.
Treatment principle: invigorate blood and resolve stasis, stabilize the Chong vessel and stop bleeding; main formula: zhu yu zhi xue tang (Blood Stasis and Bleeding Stopping Decoction).
Xue Re (Blood Heat)
Blood heat refers to a pathological change characterized by heat in the blood, leading to accelerated blood flow and even obstruction. Blood heat is often caused by external heat pathogens invading the body, or external cold pathogens transforming into heat internally, injuring the blood, or emotional stagnation leading to fire, which then injures the blood.
Since warmth promotes blood flow, in cases of blood heat, blood circulation accelerates, potentially scorching the vessels and causing blood to flow erratically. Heat can also consume yin blood and body fluids; thus, the pathological changes of blood heat are characterized by the presence of heat signs, blood consumption, erratic blood flow, and injury to yin.
Treatment principle: soothe the liver, clear heat, cool the blood, and regulate menstruation; main formula: dan zhi xiao yao san (Dan Zhi Free and Easy Wanderer Decoction).
Chuxue (Hemorrhage)
Hemorrhage refers to a pathological change where blood spills outside the vessels. This can occur due to fire qi reversing upwards, heat pathogens forcing blood to flow erratically, qi deficiency failing to contain blood, blood stasis obstructing flow, or external trauma damaging the vessels, preventing normal circulation and causing blood to spill outside the vessels. Hemorrhage can manifest in various forms depending on the location, cause, volume, and color of the blood.
Excessive hemorrhage can lead to blood deficiency and qi weakness, developing into both qi and blood deficiency, thereby impairing the function of organs and tissues. Sudden significant blood loss can also lead to qi escaping with blood, potentially resulting in a critical condition or death.
Additionally, blood disorders also include blood cold, which refers to a pathological change characterized by cold in the blood and slow blood flow, often caused by cold pathogens invading or yang deficiency leading to internal cold, presenting with symptoms such as numbness and cold pain in the limbs, fear of cold in the heart and abdomen, abdominal masses, and alleviation with warmth, with women experiencing amenorrhea as a characteristic symptom.