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This issue’s guide
Among the currently popular nine types of constitutions, there is no “blood deficiency constitution,” yet many individuals exhibit characteristics of this constitution. Especially for women, their lives are closely tied to blood, and nurturing a blood deficiency constitution often becomes the key to health and happiness.
The Overlooked “Blood Deficiency Constitution”
In Traditional Chinese Medicine (TCM), the concept of blood is not significantly different from that in modern medicine; both serve to nourish and moisten the body and are the material basis for mental activities.
If we refer to modern medicine’s description that “blood carries oxygen for the body’s use,” TCM would express it as “blood carries clear qi for the body’s use.”
We also note that the current popular classification of constitutions does not include a “blood deficiency constitution,” which may not be entirely reasonable.
From a diagnostic perspective, the body’s deficiencies can be categorized into five major types: qi deficiency, blood deficiency, yin deficiency, yang deficiency, and kidney essence deficiency.
Most syndromes arise from a constitutional background, making it hard to imagine a blood deficiency syndrome without a constitutional basis.
I suspect that the initial decision not to include blood deficiency in the constitutional classification was based on the belief that blood deficiency is akin to what Western medicine describes as anemia, which is a pathological state.
Generally speaking, constitution leans more towards physiology, so blood deficiency should not be included in the constitutional classification.
In fact, since constitution serves as the background for syndromes, sometimes the two are not easily separated. If blood deficiency tends to lead to disease, then the phlegm-damp constitution prevalent in popular classifications often has elevated blood lipids; while the stasis constitution frequently accompanies cardiovascular issues or menstrual disorders; and the special constitution includes congenital diseases and allergic constitutions, which also mix in pathological elements.
If these can enter the constitutional classification, then logically, the blood deficiency constitution, which affects women more broadly, should also be included.
At the same time, blood deficiency constitution does not equate to anemia; the definition of blood deficiency should be: a state where the body’s blood is slightly insufficient, or the nourishing function is reduced.
The insufficiency of blood in the body is generally close to what Western medicine describes as anemia; however, if we talk about the reduction of blood’s nourishing function, it may not necessarily indicate anemia in the Western sense, but rather the manifestation of TCM blood deficiency, with laboratory indicators showing no abnormalities.
Thus, “blood deficiency” and “anemia” are closely related concepts, yet not entirely equivalent.
In this sense, blood deficiency constitution is more about the reduction of blood’s nourishing function, resulting in a set of symptoms indicative of blood deficiency, yet not severe.
It is also necessary to explain why blood deficiency is more common in women.
Blood is important for both genders, but due to women’s physiological characteristics, they use blood more and are prone to blood loss throughout their lives:
Monthly menstruation depletes blood, during pregnancy blood accumulates to nourish the fetus, childbirth involves blood loss, and postpartum lactation is believed in TCM to be derived from blood, which also depletes blood.
Therefore, comparatively speaking, women are more prone to blood deficiency.
Causes and Manifestations of Blood Deficiency Constitution
1. Causes of Blood Deficiency
Insufficient congenital endowment; or spleen and stomach weakness leading to malnutrition; or insufficient kidney essence, making it difficult to transform marrow into blood, resulting in a lack of source for blood production; or various types of bleeding, such as excessive menstruation, postpartum blood loss, etc.
2. Manifestations of Blood Deficiency Constitution
Pale or sallow complexion without luster, pale lips, pale nails, pale tongue; dizziness, easy insomnia, vivid dreams, forgetfulness; dry eyes, or blurred vision, limbs prone to numbness; scanty menstruation with light color; hair lacking vitality; generally thin physique; thin pulse.
Let’s analyze this set of manifestations.
a. Blood deficiency leads to a weakened nourishing and moistening function of blood throughout the body, so externally, we see various parts of the body lacking color, resulting in a pale or sallow complexion, pale nails, pale lips, and a pale tongue.
b. If the organs are not nourished: blood does not nourish the spirit, leading to easy insomnia, vivid dreams, and forgetfulness;
blood does not nourish the eyes, leading to dry eyes or blurred vision;
blood does not nourish the muscles, leading to limb numbness;
blood deficiency reduces the blood supply to the uterus, leading to scanty and light-colored menstruation, often delayed;
blood does not nourish the body, leading to a thin physique;
blood is insufficient to fill the vessels, resulting in a feeling of a thin pulse.
In summary, the characteristic of this constitution is: “deficient” while simultaneously lacking the appearance of blood color.
Dietary Therapy and Medicinal Nourishment for Blood Deficiency Constitution
1. Common Foods for Blood Deficiency Constitution
Longan, jujube, milk, pig liver, chicken liver, pig heart, pig blood, eggs, goji berries, sweet potatoes, tomatoes, black fungus, peaches, mulberries, grapes, black sesame, peanuts, etc.
Let’s talk about a common ingredient—longan, also known as dragon eye meat.
It has a sweet flavor and is slightly warm, with the effects of nourishing the heart and spleen, nourishing blood, and calming the spirit,indicated for both qi and blood deficiency, especially for insomnia and forgetfulness due to blood deficiency. It can be prepared by soaking 10 grams of longan meat with a small amount of sugar in water, then decocting it for consumption. If there is restlessness, you can add about 10 grams of lily.
2. Recommended Dishes for Nourishing Blood Deficiency
The first is pig liver and egg soup.
Pig liver is sweet and bitter, warm, and its effects include nourishing the liver and improving vision, supplementing qi and blood, indicated for liver deficiency leading to blurred vision and night blindness.
Use one piece of pig liver, 2-3 eggs, and an appropriate amount of green onion to make soup.
The second is spinach and pig liver soup.
The ratio is approximately one tael of spinach to three taels of pig liver, with appropriate seasonings, simmered into soup.
Here, spinach is sweet, cool, and smooth, with the effects of nourishing blood and moistening dryness, and it pairs well with pig liver, which nourishes blood and supports the liver.
Thus, the effect of this soup is to nourish blood, support the liver, moisten dryness, and promote bowel movements. It is suitable for those with blood deficiency presenting as a pale complexion, dry eyes, blurred vision, and constipation.
Those with blood deficiency constitution should be cautious with all types of cooling, cold, and raw foods.
3. Common Medicinal Herbs and Si Wu Decoction
Rehmannia, angelica, prepared fleeceflower root, white peony, goji berries, sour jujube seed, biota seed, chicken blood vine, donkey-hide gelatin, turtle shell gelatin, deer antler gelatin, and purple river car are commonly used.
We will not explain each herb individually, but we can explain a commonly used blood-nourishing formula—Si Wu Decoction.
Si Wu Decoction consists of rehmannia, angelica, white peony, and ligusticum.
Here, rehmannia nourishes blood, replenishes essence, and nourishes yin; angelica nourishes blood and invigorates blood circulation; white peony nourishes both yin and blood; ligusticum primarily invigorates blood.
The overall effect of this formula is to nourish blood while invigorating blood circulation, treating blood deficiency and blood stasis syndromes or constitutions. It also embodies the principle that “old blood must be removed for new blood to be generated.”
Next, let’s discuss modifications.
Considering that qi can generate blood, adding astragalus can nourish qi and generate blood, and astragalus also has a lifting effect; when qi rises, blood rises, which can alleviate symptoms of blood not nourishing the body; if you add astragalus to angelica in a 5:1 ratio, it is called angelica blood-nourishing decoction, which has a better blood-nourishing effect;
If there is restlessness, insomnia, or vivid dreams, generally add sour jujube seed and longan meat, which have blood-nourishing and calming effects;
If there are dry eyes and blurred vision, generally add goji berries and ligustrum, which nourish yin and brighten the eyes;
If there is numbness in the hands and feet or joint stiffness, add chicken blood vine to nourish blood, invigorate blood circulation, and relax the muscles and joints;
If hair lacks vitality, you can add mulberry leaf, prepared fleeceflower root, and drought lotus grass to nourish blood and darken hair.
In addition to qi generating blood, TCM also has a concept of mutual generation of essence and blood. Therefore, theoretically, we should also add herbs that nourish essence, but since rehmannia and goji berries already have essence-nourishing effects, there is no need to add more.
4. Common Chinese Patent Medicines for Blood Deficiency Constitution
Shandong donkey-hide gelatin paste, blood treasure capsules, compound donkey-hide gelatin syrup, biota heart-nourishing pills (tablets), Tian Wang Bu Xin Wan (pills), Ba Zhen Yi Mu Wan, Ba Zhen Wan (granules), Wu Ji Bai Feng Wan, Ren Shen Gui Pi Wan, Ren Shen Yang Rong Wan.
I will not explain these medicines individually; generally, patent medicines have basic efficacy descriptions on their labels.
Since “essence and blood share the same source” and “fluid and blood share the same source,” blood deficiency is related to the deficiency of kidney essence and body fluids, so while treating blood deficiency, it is important to combine foods and formulas that nourish essence and tonify yin.
Blood-nourishing herbs are often quite rich and greasy; consuming too much can easily harm the spleen and generate dampness, and can also easily obstruct qi movement, leading to poor appetite, abdominal bloating, and diarrhea.
Therefore, blood-nourishing should often be accompanied by herbs like dried tangerine peel that regulate qi and strengthen the spleen. Especially in the south, where many people have spleen deficiency and excess dampness, this aspect should be particularly noted.
Daily Precautions for Blood Deficiency Constitution
Since blood and sweat share the same source, those with blood deficiency constitution should prevent heat and excessive sweating in summer, and should avoid activities like sauna that are said to detoxify, as excessive sweating can easily deplete blood and injure body fluids.
Those with blood deficiency constitution are generally weaker and should avoid strenuous labor that causes excessive sweating and depletes qi and blood.
Moreover, since blood is the material basis for mental activities, excessive mental strain can easily injure blood and also harm the spleen and stomach, which is the source of qi and blood production, so those with blood deficiency constitution should especially avoid excessive thinking and mental strain.
People with blood deficiency constitution should not engage in excessive exercise, as too much exercise can lead to excessive sweating.
At the same time, as mentioned earlier, blood has the function of carrying oxygen.Individuals with blood deficiency constitution have a lower tolerance for fatigue and poor oxygen-carrying capacity, so aerobic exercise is emphasized.
Qigong, Tai Chi, Ba Duan Jin, Wu Qin Xi, and yoga generally require breath regulation, which is beneficial for nourishing qi and replenishing qi, thereby enhancing the qi’s ability to generate blood.
From the perspective of modern exercise, it is advisable to adopt low-intensity, high-frequency exercise methods, such as walking, slow jogging, cycling, and dance fitness, remembering to exercise moderately and aerobically, “exerting oneself without fatigue.”
Blood not only nourishes the organs, internally enriching the body, but also nourishes and moistens the skin.
Women naturally care more about beauty than men, and physiologically, their blood is more easily depleted, so the constitution that deserves the most attention from women is the blood deficiency constitution.
*Note: The medicines and formulas mentioned in this article should be used under the guidance of a physician based on diagnosis; do not take them indiscriminately.
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