Bleedingaccording to TCM
Symptom family: General Hemorrhage and Bleeding Issues
Sub-symptom(s): Acute Hemorrhages Frequent Bleeding Tendency To Bleed
What is Bleeding?
Bleeding, a medical condition characterized by the loss of blood from the circulatory system, can manifest through a variety of symptoms ranging from external bleeding from wounds to internal hemorrhage. This condition encompasses a wide array of clinical scenarios, such as acute hemorrhages, frequent bleeding episodes, and an individual’s tendency to bleed, indicating the disruption or failure of the body's hemostatic mechanisms. Understanding the underlying cause of bleeding is crucial for effective management and treatment, highlighting the importance of accurate diagnosis and timely intervention.
How does TCM view Bleeding?
Traditional Chinese Medicine (TCM) offers a holistic perspective on bleeding, viewing it as an imbalance or disharmony within the body's Qi (vital energy), Blood, and organ systems. TCM interprets bleeding as a symptom of underlying patterns of disharmony, emphasizing the need to identify and correct these imbalances to restore health. By focusing on the root causes rather than just the symptoms, TCM aims to harmonize the body's energies, strengthen the organs, and secure the Blood, providing a comprehensive approach to treating bleeding.
Root Causes of Bleeding in TCM
In TCM, bleeding is often attributed to various underlying patterns, such as Qi Sinking. Qi Sinking, especially Spleen Qi Sinking, reflects a condition where the body's vital energy is weakened and unable to hold Blood within the vessels, leading to symptoms like hemorrhage, lack of appetite, and slight abdominal distension after eating.
Another cause can be Heat in the Blood, where excessive heat causes Blood to move chaotically, resulting in bleeding. Understanding these patterns is essential for devising an effective treatment strategy that addresses the root cause of the bleeding.
Explore below more details about what might cause Bleeding according to TCM.
- By Syndrome
- By Organ
- Qi Sinking
- Blood Stasis
- Heat
- Spleen
Qi Sinking
Qi Sinking is a pattern of disharmony in TCM where the body's energy, or Qi, is thought to "sink" or drop down. Imagine a balloon slowly deflating and falling; that's similar to what happens with Qi Sinking. This can lead to feelings of heaviness, fatigue, and even physical symptoms like prolapse of organs or frequent urination. It's as if the body's energy, which usually supports and holds things in place, isn't able to do its job properly. TCM views this as an imbalance where the uplifting and supporting qualities of Qi are weakened.... see more
Qi Sinking Patterns That Can Lead to Bleeding
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Spleen Qi Sinking | Hemorrhage, Lack of appetite, Slight abdominal distension after eating | Bu Zhong Yi Qi Tang |
Blood Stasis
Blood Stasis in TCM is a concept where the blood flow in the body is not as smooth or efficient as it should be. Imagine a river that's supposed to flow freely, but instead, it's getting blocked or moving too slowly in some parts. This can lead to various health issues, like pain that feels sharp or stabbing, dark bruises, and a complexion that looks purplish. TCM believes that good health relies on the smooth and vibrant flow of Qi and blood throughout the body, so when blood gets stuck, it's like a traffic jam in your body, leading to discomfort or health problems.... see more
Blood Stasis Patterns That Can Lead to Bleeding
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Blood Stagnation | Frequent bleeding episodes, Tendency to bleed, Dark face, Purple lips, Stabbing fixed pain, Abdominal masses, Purple nails, Menstrual cramps, Dark menstrual clots, Dark menstrual blood, Lumps... see more | Tao He Cheng Qi Tang | Da Huang Mu Dan Pi Tang | Gui Zhi Fu Ling Wan | Di Dang Tang | Dan Shen Yin | Da Huang Zhe Chong Wan | San Zhong Kui Jian Tang | Hai Tong Pi Tang | Huang Qi Gui Zhi Wu Wu Tang |
Heat
In TCM "Heat" signifies an excess of Yang energy, leading to an imbalance where heat predominates over the body's cool Yin aspects. This condition is metaphorically akin to an internal over-heating. Symptoms indicative of Heat can include feelings of warmth, fever, sweating, irritability, red face, thirst with a preference for cold drinks, and a rapid pulse. The tongue may appear red with a yellow coating. Unlike the common interpretation of heat in terms of temperature, in TCM, it represents a state of hyperactivity or inflammation in the body.... see more
Heat Patterns That Can Lead to Bleeding
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Heat in the Blood | Frequent bleeding episodes, Frequent bleeding episodes in stools urine or vomit, Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia, Hematuria, Vomiting blood, Cough of blood, Nosebleeds, Excessive menstruation... see more | Xi Jiao Di Huang Tang | Gu Jing Wan | Shi Hui San | Bai He Di Huang Tang | Hua Ban Tang | Qing Ying Tang | Qing Re Gu Jing Tang |
Spleen
In TCM the Spleen plays a vital role in digestion and transformation, converting food into energy and nutrients, and overseeing the distribution of Qi and Blood. It's also crucial in maintaining the health of muscles and limbs and ensuring the blood remains within the vessels. When the Spleen malfunctions in TCM, it can lead to a variety of issues such as digestive disorders, fatigue, weak muscles, bloating, and a feeling of heaviness. It can also cause a pale complexion, poor appetite, and a tendency to bruise easily. Emotionally, a Spleen imbalance is often associated with excessive worry or overthinking, reflecting its role in the interplay between physical and mental health.... see more
Spleen Patterns That Can Lead to Bleeding
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Spleen Qi Sinking | Hemorrhage, Lack of appetite, Slight abdominal distension after eating | Bu Zhong Yi Qi Tang |
TCM Herbal Formulas for Bleeding
To address the underlying causes of bleeding, TCM employs specific herbal formulas tailored to the patient's pattern of disharmony. For Qi Sinking, the formula Bu Zhong Yi Qi Tang, with its key herb Milkvetch Roots (Huang Qi), is recommended to tonify Qi, particularly the Qi of the Spleen, enhancing its ability to hold Blood.
For Heat in the Blood, formulas like Xi Jiao Di Huang Tang might be used to cool the Blood and restore its proper movement within the vessels. These examples illustrate TCM's nuanced approach, utilizing herbal formulas to target the specific imbalances leading to bleeding, ultimately aiming to restore equilibrium and prevent further episodes.
Explore below some TCM herbal formulas used to address bleeding, organized by cause and by formula type.
- By Cause
- By Formula Type
- Qi Sinking
- Blood Stasis
- Heat
- Formulas that invigorate blood and dispel blood stagnation
- Formulas that clear nutritive-level heat
- Formulas that clear heat from deficiency
- Formulas that nourish yin and tonify
- Formulas that tonify qi
- Formulas that clear heat and resolve toxicity
- Formulas that clear internal abscesses and sores
- Formulas that clear external abscesses and sores
- External formulas for external disorders
- Formulas that warm the meridians and disperse cold
- Formulas that secure irregular uterine bleeding and stop vaginal discharge
- Formulas that stop bleeding
- Formulas that clear heat from qi and blood
Top Formula for Qi Sinking:
Bu Zhong Yi Qi Tang
Suitable for Qi Sinking patterns that may cause bleeding, such as Spleen Qi Sinking
Learn more
Top Formula for Blood Stasis:
Tao He Cheng Qi Tang
Suitable for Blood Stasis patterns that may cause bleeding, such as Blood Stagnation
Learn moreAll Formulas Recommended for Bleeding Caused by Blood Stasis
| Formula | Patterns Suitable For |
|---|---|
| Tao He Cheng Qi Tang | Blood Stagnation |
| Da Huang Mu Dan Pi Tang | Blood Stagnation |
| Gui Zhi Fu Ling Wan | Blood Stagnation |
| Di Dang Tang | Blood Stagnation |
| Dan Shen Yin | Blood Stagnation |
| Da Huang Zhe Chong Wan | Blood Stagnation |
| San Zhong Kui Jian Tang | Blood Stagnation |
| Hai Tong Pi Tang | Blood Stagnation |
| Huang Qi Gui Zhi Wu Wu Tang | Blood Stagnation |
Top Formula for Heat:
Xi Jiao Di Huang Tang
Suitable for Heat patterns that may cause bleeding, such as Heat in the Blood
Learn moreAll Formulas Recommended for Bleeding Caused by Heat
| Formula | Patterns Suitable For |
|---|---|
| Xi Jiao Di Huang Tang | Heat in the Blood |
| Gu Jing Wan | Heat in the Blood |
| Shi Hui San | Heat in the Blood |
| Bai He Di Huang Tang | Heat in the Blood |
| Hua Ban Tang | Heat in the Blood |
| Qing Ying Tang | Heat in the Blood |
| Qing Re Gu Jing Tang | Heat in the Blood |
Formulas that invigorate Blood and dispel Blood Stagnation
These formulas are suitable for some bleeding-causing patterns like Blood Stagnation.
One such formula is Tao He Cheng Qi Tang, with peach kernel as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that invigorate blood and dispel blood stagnation" recommended for bleeding
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Tao He Cheng Qi Tang | Blood Stagnation |
| Gui Zhi Fu Ling Wan | Blood Stagnation |
| Di Dang Tang | Blood Stagnation |
| Dan Shen Yin | Blood Stagnation |
| Da Huang Zhe Chong Wan | Blood Stagnation |
Formulas that clear nutritive-level Heat
These formulas are suitable for some bleeding-causing patterns like Heat in the Blood.
One such formula is Xi Jiao Di Huang Tang, with water buffalo horn as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear nutritive-level heat" recommended for bleeding
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Xi Jiao Di Huang Tang | Heat in the Blood |
| Qing Ying Tang | Heat in the Blood |
Formulas that clear Heat from Deficiency
These formulas are suitable for some bleeding-causing patterns like Heat in the Blood.
One such formula is Bai He Di Huang Tang, with lily bulb as a key herb.
Other formulas of this category are listed in the table below.
All "formulas that clear heat from deficiency" recommended for bleeding
| Formula | Patterns Suitable For (if applicable) |
|---|---|
| Bai He Di Huang Tang | Heat in the Blood |
| Qing Re Gu Jing Tang | Heat in the Blood |
Formulas that tonify Qi
These formulas are suitable for some bleeding-causing patterns like Spleen Qi Sinking.
One such formula is Bu Zhong Yi Qi Tang, with milkvetch root as a key herb.
Formulas that clear internal abscesses and sores
These formulas are suitable for some bleeding-causing patterns like Blood Stagnation.
One such formula is Da Huang Mu Dan Pi Tang, with rhubarb as a key herb.
Formulas that clear external abscesses and sores
These formulas are suitable for some bleeding-causing patterns like Blood Stagnation.
One such formula is San Zhong Kui Jian Tang, with phellodendron bark as a key herb.
External formulas for External disorders
These formulas are suitable for some bleeding-causing patterns like Blood Stagnation.
One such formula is Hai Tong Pi Tang, with erythrinae bark as a key herb.
Formulas that warm the Meridians and disperse Cold
These formulas are suitable for some bleeding-causing patterns like Blood Stagnation.
One such formula is Huang Qi Gui Zhi Wu Wu Tang, with milkvetch root as a key herb.
Formulas that secure irregular uterine bleeding and stop vaginal discharge
These formulas are suitable for some bleeding-causing patterns like Heat in the Blood.
One such formula is Gu Jing Wan, with tortoise plastron as a key herb.
Formulas that stop bleeding
These formulas are suitable for some bleeding-causing patterns like Heat in the Blood.
One such formula is Shi Hui San, with japanese thistle as a key herb.
Formulas that clear Heat from Qi and Blood
These formulas are suitable for some bleeding-causing patterns like Heat in the Blood.
One such formula is Hua Ban Tang, with gypsum as a key herb.
Formulas that nourish Yin and tonify
Bleeding can be treated by these formulas when it arises from a deficiency in Yin energy, needing nourishment and strengthening of the body's vital essence.
One such formula is Er Zhi Wan, with glossy privet fruit as a key herb.
Formulas that clear Heat and resolve toxicity
Bleeding can be treated by formulas that clear Heat and resolve toxicity if it arises from heat toxins affecting the body.
One such formula is Xie Xin Tang, with rhubarb as a key herb.
TCM Herbs for Bleeding
Explore below some TCM herbs used to address bleeding, organized by herb category.
- By Herb Category
- Herbs that stop bleeding
- Herbs that invigorate the blood
- Tonic herbs for yin deficiency
- Herbs that clear heat and dry dampness
- Herbs that cool the blood
- Herbs for external application
- Warm/Acrid herbs that release the exterior
- Herbs that clear heat and purge fire and/or clear summer heat
- Herbs that expel parasites
- Cool/Acrid herbs that release the exterior
- Herbs that stabilize and bind
- Tonic herbs for qi deficiency
- Purgative herbs that drain downward
- Herbs that drain dampness
- Herbs that dispel wind and dampness
- Tonic herbs for blood deficiency
Herbs that stop bleeding
Bleeding can be treated by these herbs in cases where it is due to internal or external bleeding, working to stabilize and constrict blood flow.
One such herb is Japanese Thistle (Da Ji), a key herb in some formulas recommended for bleeding, like Shi Hui San.
Other herbs of this category are listed in the table below.
"Herbs that stop bleeding" recommended for bleeding
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Japanese Thistle (Da Ji) | Shi Hui San |
| Agrimony (Xian He Cao) | Not applicable |
| Bletilla Rhizomes (Bai Ji) | Not applicable |
| Kaolinite (Bai Shi Zhi) | Not applicable |
| Lotus Roots (Ou Jie) | Not applicable |
Herbs that invigorate the Blood
Bleeding can be treated by these herbs when it stems from stagnation or poor circulation of blood, helping to improve blood flow and alleviate related discomfort.
One such herb is Peach Kernels (Tao Ren), a key herb in some formulas recommended for bleeding, like Tao He Cheng Qi Tang.
Other herbs of this category are listed in the table below.
"Herbs that invigorate the Blood" recommended for bleeding
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Peach Kernels (Tao Ren) | Tao He Cheng Qi Tang |
| Leeches (Shui Zhi) | Di Dang Tang |
| Tabanus Horseflies (Meng Chong) | Di Dang Tang |
| Red Sage Roots (Dan Shen) | Dan Shen Yin |
| Ground Beetles (Tu Bie Chong) | Da Huang Zhe Chong Wan |
Tonic herbs for Yin Deficiency
Bleeding can be treated by these herbs when caused by a lack of Yin, which is essential for cooling and moistening the body, thereby restoring balance.
One such herb is Glossy Privet Fruits (Nu Zhen Zi), a key herb in some formulas recommended for bleeding, like Er Zhi Wan.
Other herbs of this category are listed in the table below.
"Tonic herbs for Yin Deficiency" recommended for bleeding
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Glossy Privet Fruits (Nu Zhen Zi) | Er Zhi Wan |
| Eclipta Herbs (Mo han lian) | Er Zhi Wan |
| Tortoise Plastrons (Gui Ban) | Gu Jing Wan |
| Lily Bulbs (Bai He) | Bai He Di Huang Tang |
Herbs that clear Heat and dry Dampness
Bleeding can be treated by these herbs when caused by excessive dampness and heat within the body, aiming to restore balance by drying dampness and clearing heat.
One such herb is Baikal Skullcap Roots (Huang Qin), a key herb in some formulas recommended for bleeding, like San Zhong Kui Jian Tang.
Other herbs of this category are listed in the table below.
"Herbs that clear Heat and dry Dampness" recommended for bleeding
Herbs that cool the Blood
Bleeding can be treated by these herbs when it is a consequence of excess heat in the blood, helping to cool and detoxify the blood.
One such herb is Water Buffalo Horns (Shui Niu Jiao), a key herb in some formulas recommended for bleeding, like Xi Jiao Di Huang Tang.
Other herbs of this category are listed in the table below.
"Herbs that cool the Blood" recommended for bleeding
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Water Buffalo Horns (Shui Niu Jiao) | Xi Jiao Di Huang Tang | Qing Ying Tang |
| Field Thistles (Xiao Ji) | Shi Hui San |
| Unprepared Rehmannia (Di Huang) | Qing Re Gu Jing Tang |
Herbs for external application
Bleeding can be treated by these herbs when the condition is external or superficial, requiring topical treatment to alleviate symptoms or heal the affected area.
One such herb is Calomelas (Qing Fen), which is directly recommended for bleeding.
Other herbs of this category are listed in the table below.
"Herbs for external application" recommended for bleeding
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Calomelas (Qing Fen) | Not applicable |
| Catechu (Er Cha) | Not applicable |
Warm/Acrid herbs that release the Exterior
Bleeding can be treated by these herbs when there is a need to dispel external cold and warm the body, especially in cases where there is insufficient Yang energy internally.
One such herb is Cinnamon Twigs (Gui Zhi), a key herb in some formulas recommended for bleeding, like Gui Zhi Fu Ling Wan.
Other herbs of this category are listed in the table below.
"Warm/Acrid herbs that release the Exterior" recommended for bleeding
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Cinnamon Twigs (Gui Zhi) | Gui Zhi Fu Ling Wan | Huang Qi Gui Zhi Wu Wu Tang |
| Angelica Roots (Bai Zhi) | Hai Tong Pi Tang |
Herbs that clear Heat and purge Fire and/or clear Summer Heat
Bleeding can be treated by these herbs when it arises from excessive internal heat or fire, aiding in cooling the body and balancing internal temperature.
One such herb is Anemarrhena Rhizomes (Zhi Mu), a key herb in some formulas recommended for bleeding, like San Zhong Kui Jian Tang.
Other herbs of this category are listed in the table below.
"Herbs that clear Heat and purge Fire and/or clear Summer Heat" recommended for bleeding
| Herb | Formulas they belong to (if applicable) |
|---|---|
| Anemarrhena Rhizomes (Zhi Mu) | San Zhong Kui Jian Tang |
| Gypsum (Shi Gao) | Hua Ban Tang |
Herbs that expel parasites
Bleeding can be treated by these herbs if it arises from parasitic infections, utilizing their properties to eliminate parasites from the body.
One such herb is Male Fern Rhizomes (Guan Zhong), which is directly recommended for bleeding.
Cool/Acrid herbs that release the Exterior
Bleeding can be treated by these herbs when the body needs to harmonize with external environmental changes, particularly when there's a need to expel pathogenic factors like wind or cold without overly cooling the body.
One such herb is Rough Horsetail (Mu Zei), which is directly recommended for bleeding.
Herbs that stabilize and bind
Bleeding can be treated by these herbs if it is caused by a leakage of bodily fluids or energies, helping to consolidate and preserve the body's essential substances.
One such herb is Cuttlebones (Hai Piao Shao), which is directly recommended for bleeding.
Tonic herbs for Qi Deficiency
Bleeding can be treated by these herbs when stemming from a lack of vital energy or Qi, helping to boost energy and overall vitality.
One such herb is Milkvetch Roots (Huang Qi), a key herb in some formulas recommended for bleeding, like Bu Zhong Yi Qi Tang.
Purgative herbs that drain downward
Bleeding can be treated by these herbs in cases of severe constipation or internal heat, using strong downward movement to purge accumulation.
One such herb is Rhubarb (Da Huang), a key herb in some formulas recommended for bleeding, like Xie Xin Tang.
Herbs that drain Dampness
Bleeding can be treated by these herbs when caused by excessive dampness in the body, aiding in eliminating damp through diuretic action.
One such herb is Poria-Cocos Mushrooms (Fu Ling), a key herb in some formulas recommended for bleeding, like Gui Zhi Fu Ling Wan.
Herbs that dispel Wind and Dampness
Bleeding can be treated by these herbs when it is due to the invasion or accumulation of wind and dampness, which often affects the muscles and joints.
One such herb is Erythrinae Barks (Hai Tong Pi), a key herb in some formulas recommended for bleeding, like Hai Tong Pi Tang.
Tonic herbs for Blood Deficiency
Bleeding can be treated by these herbs in cases of blood deficiency, working to nourish and replenish the body's blood supply.
One such herb is White Peony Roots (Bai Shao), a key herb in some formulas recommended for bleeding, like Gu Jing Wan.