Blood deficiency. Yuxing Liu. Academy of Oriental Medicine at Austin

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1 Blood deficiency Yuxing Liu Academy of Oriental Medicine at Austin

2 Key Symptoms Pale: tongue, nails, complexion, eyelids Dizziness; Floaters, blurred vision Poor concentration, memory Palpitations; Insomnia, dream disturbed sleep Dry, brittle nails hair losing T: pale P: thin

3 Etiology 1. Losing too much blood 2. Lack of producing blood 3. Over-thinking/.worry to much Organs related to Xue Xu LIV (LIV Xue Xu) HT (HT Xue Xu) SP (SP Qi Xu not controlling Xue, not producing Xue)

4 Single Herbs to Nourish Xue LIV KI HT LU SP Dang gui Dang gui Dang gui Shu di Shu di He shou wu He shou wu Bai shao Bai shao E jiao E jiao E jiao Long yan rou Long yan rou Herbs in other category may nourish blood: xian he cao, ji xue teng, da zao, lu jiao jiao, zi he che, gui ban, ye jiao teng, sang shen zi Precautions: When nourishing xue, must move Qi to promote proper xue circulation: i.e.: mu xiang, sha ren, chen pi And also add small doses of move xue herbs

5 Representative formula for Xue Xu Si Wu Tang 四物汤 four substance decoctions Shu di Bai shao Dang gui Chuan xiong General Xue xu: dose of shu di More liver related problems (LIV Xue Xu, irritability, etc.): bai shao Menstrual problems (dysmenorrhea, irregular menses, etc.): dang gui (estrogen containing, also good to regulate uterus) Ancient time: four herbs use the same dosage Modifications: Diarrhea, loose stools: remove dang gui, or some people use chao Dang gui Gas / bloating: remove shu di or add herbs to strengthen SP: bai zhu. Also add: shen qu or sha ren, chen pi, mu xiang

6 Xue Xu and Fever due to Xue Xu Dang Gui Bu Xue Tang 当归补血汤 angelica tonify the blood decoction Huang qi 5 (30 g) Dang gui 1 (6g) Tonify Qi Nourish blood 1) Tonify Qi to Tonify Xue vs. Si Wu Tang which directly Tonify Xue 2) Rep Rx for fever d/t Xue xu history of loss of xue: trauma, child birth, heavy menstruation, etc. fever typically low-grade Xue Xu Qi floating sweating thirst (prefers to drink room or hot water) [not d/t Shi, but d/t Qi Xu not holding the sweat] not enough blood in vessels P: big but weak

7 HT Xue Xu general blood Xu: Pale face, lips, nails, etc. HT Sx: palpitations, discomfort in the chest area Shen disorder Sx: insomnia, poor memory, poor concentration, anxiety, etc. T: pale P: thin, (weak) Formula: Si Wu Tang + calm shen herbs: + long yan rou, bai zi ren, suan zao ren, yuan zhi, fu shen

8 LIV BLOOD DFECIENCY 1. Eyes: blurred vision, floaters, night blindness, dizzy 2. Tendons: muscle twitching, numbness of extremities,tremor 3. Menstruation: cramps, scanty menstruation, delayed menstruation 4. Mental: insomnia, anxiety

9 LIV BLOOD DFECIENCY Eyes: blurred vision, floaters, night blindness Si Wu Tang + Gou Qi Zi, Sang Shen, Nu Zhen Zi (Ju Hua ) Tendons: muscle twitching, numbness of extremities Si Wu Tang + Ji Xue Teng, Mu Gua Menstruation: cramps, scanty menstruation, delayed menstruation Si Wu Tang (pain: Yan Hu Suo) Mental: insomnia, anxiety Suan Zao Ren Tang (see next page)

10 Suan zao ren tang 酸枣仁汤 zizyphus decoction (chao) Suan zao ren 15-18g (or 30g) Fu ling 6g Zhi mu 6-9g Chuan xiong 6g Gan cao 3g 以水 8 升, 煮酸枣仁得 6 升, 内诸药, 煮取 3 升, 分温三服 Functions: Nourish blood, calms shen, clear heat, relieve irritability Indications: Deficiency of the LIV blood and Yin failing to nourish the HT manifested as insomnia, palpitation, irritability, dizziness, blurred vision, night sweats, dry mouth and throat. T: pale or red tongue with thin coat. P: a wiry, thin or rapid pulse.

11 Key symptoms Blood stasis Pain: sharp, stabbing pain Swollen/Bruises Nodules cyst Color: purple Choppy pulse Purple tongue (or purple spots) Etiology

12 Xue Fu Zhu Yu Tang remove stasis from the mansion of blood decoction Tao hong si wu tang Tao ren 12g Hong hua 9g Chai hu 3g Niu xi 9g Dang gui 9g Sheng di 9g Zhi ke 6g Jiegeng5g Chuan xiong 5g Chi shao 6g Gan cao 3g Functions: Promotes circulation of blood and Qi, removes blood stasis, relieves pain Indications: Blood stasis in the chest with LIV qi stagnation manifested as prolonged chest pain or headache marked by piercing and fixed in location, or chronic hiccups, dry heaves, and choking when drinking water, palpitation, insomnia, irritability, easily to get angry, or increased body temperature in the evening, purplish lips, darkness around eyes, dark red or purple tongue, a hesitant, wiry, or tight pulse.

13 Formula Ingredients Function Location Xue Fu Zhu Yu Tang Tong Qiao Huo Xue Tang Unblock the Orifices & Invigorate the Blood Decoction Ge Xia Zhu Yu Tang Remove Blood Stasis Below the Diaphragm Decoction Shao Fu Zhu Yu Tang Remove Blood Stasis in the Lower Abdomen Decoction Chi shao 3g Chuan xiong 3g Tao ren 6g Hong hua 9g Chi shao 6g Chuan xiong 6g Tao ren 9g Hong hua 9g Dang gui 9g (chao)wu ling zhi 6g Chi shao6g Dang gui 9g Chuan xiong 3g Yanhusuo3g Mo yao 3g Lao cong 6g Sheng jiang 9g Da zao 5pc She xiang 0.15g Huang jiu 125ml Mu dan pi 6g Wu yao 6g Yanhusuo3g Xiang fu 5g Zhi ke 5g Gan cao 9g Pu huang 9g (chao) wu ling zhi 6g Xiao hui xiang 1.5g Gan jiang 3g Rou gui3g Move Xue, Remove Xue Stasis, Stop pain Chest (upper jiao) Head 前 7 味煎好, 将麝香入酒内再煎二沸, 临卧服 Below diaphragm (middle jiao) (including: hypochondriac area, abdominal masses) Lower abdominal (lower jiao) Warm channel, Stop pain for Xue Stasis w/ Cold accumulation Shen Tong Zhu Yu Tang Remove Blood Stasis from a Painful Body Decoction Tao ren 9g Hong hua 9g Dang gui 9g Chuan xiong 6g Gan cao 6g Xiang fu 3g Di long 6g Mo yao 6g (chao) wu ling zhi 6g Niu xi 9g Qiang huo 3g Qin jiao 3g Channels (extremities) Fu Yuan Huo Xue Tang Hong hua 6g Dang gui 9g Tao ren 9g Chai hu 9g (old time 15g) Gua lou gen 9g Gan cao 6g Chuan shan jia 6g Da huang 12g Hypochondriac Da huang, tao ren soak with alcohol

14 blood disorders blood deficiency blood stasis blood deficiency fever due to blood deficiency; qi and blood deficiency insomnia due to LIV blood deficiency general blood stasis blood stasis in chest blood stasis at head blood stasis blow diaphragm blood stasis at lower abdomen blood stasis in channels blood stasis at hypochondriac area

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