Ch. 10a: Regulate Blood, Stop Bleeding

What are the Stasis Transforming Herbs?

1) Pu Huang

2) San Qi

3) Qian Cao

Pu Huang*** Names & Parts used

Pharm: Typha Pollen

English: Cattail pollen, Typha pollen, Bulrush

Parts used: pollen

Pu Huang*** Properties & Channels

Properties: Sweet, acrid, neutral

Channel(s): Liver, Heart, Spleen

Pu Huang*** Dosage and Cautions/Contras

Dosage: 3-9g; (wrapped in tea bag)

Cautions/Contraindications: Use with caution during pregnancy

What makes Pu Huang great to use?

It is balanced:

--Stops bleeding w/o creating stasis.

--Neutral temp, used for hot or cold patterns.

--Especially good at treating depletion conditions complicated by stasis

Pu Huang*** Pao Zhi Methods

1) “Slippery” in its unprepared form

“If used medicinally to break up blood and reduce swelling, choose the unprepared form”

2) Astringent when dry-fried

Becomes slightly warm and makes it appropriate for bleeding associated with symptoms of cold.

3) Can also be mixed with wine or vinegar and then dry fried to promote blood movement, stop pain.

4) Can also be charred to emphasize astringency.

Pu Huang*** Actions & Indications

1. Stops bleeding, for external and internal bleeding. (Very astringent, quite effective in stopping bleeding) For external bleeding due to trauma, internal bleeding such as nosebleed, vomiting blood, hematuria, blood in the stool, uterine bleeding. Can be taken alone or with other blood stanching herbs, and it can be applied externally.

2. Invigorates the blood and dispels blood stasis: for chest pain postpartum abdominal pain, and menstrual pain due to blood stasis.

3. Promotes urination and stops bleeding: for hot painful urinary dribbling. Pu Huang is very good at helping to treat this. (think about its marshy origin)

Pu Huang*** Combos

+ honey as a topical for pain and swelling associated with sores

+ flying squirrel feces (wǔ líng zhī) for chest and abdominal pain due stop blood stasis. This combination is called “Sudden Smile Powder”

San Qi*** Names and parts used

Pharm: Notoginseng Radix

English: Notoginseng root, Pseudoginseng root

Parts used: root

San Qi*** Properties and Channels

Properties: Sweet, slightly bitter, warm

Channel(s): Liver, Stomach

San Qi*** Dosage and Cautions/Contras

Dosage: 3-9g in decoctions; 1-1.5g in pills and powders up to three times a day. For severe bleeding, each dose can be as much as 3-6g.

Cautions/Contraindications: Use with caution during pregnancy

Why is San Qi great to use?

-It stops bleeding without causing stasis.

-It's sweet and warm so it "gently moves" and uses bitter to drain.

San Qi*** Pao Zhi

– Uncooked San Qi quickens the blood, dispels stasis, and stops bleeding.

– Steamed San Qi nourishes the blood and is not effective for either quickening the blood or stopping bleeding.

Impt. Note: If San qi is cooked by adding it together with other decocting medicinals, its ability to quicken the blood and stop bleeding is lost. Therefore, for these indications, San Qi is more efficient when administered in its powdered form.

San Qi*** Actions & Indications

1. Stops bleeding and transforms blood stasis: for internal and external bleeding: vomiting blood, nosebleed, and blood in the urine and stool.

2. Reduces swelling and alleviates pain: for traumatic injury

San Qi*** Combos

--Yunnan Baiyao, a formula that powerfully stops bleeding, is supposed to contain San Qi

--The Y.B. red pill taken for extreme emergency blood loss cases, it is a concentrated form of herbs

Qian Cao*** Names and Parts Used

Pharm: Rubiae Radix

English: Madder root, Rubia root

Parts Used: Root

Qian Cao*** Properties and Channels

Properties: Bitter, cold (acrid)

Channel(s): Heart, Liver

Qian Cao*** Dosage and Cautions/Contras

Dosage: 9-15g

Cautions/Contraindications: Use with caution in those with cold from deficiency of the Spleen and Stomach, diminished blood, and fire from yin deficiency. Do not use long term.

How does Qian Cao work to stop bleeding?

-Removes the stasis that forces blood out of its normal pathways.

-In many cases the stasis itself is due to heat drying the fluids within the blood, thereby slowing its flow.

Difference: Qian Cao Charred vs. Unprepared forms

Charred: Stops bleeding

Unprepared: Cools blood and dispels blood stasis

Qian Cao*** Actions & Indications

1. Cools the blood and stops bleeding:

--For any bleeding due to chaotic movement of hot blood or blood stasis as well as trauma.

--Can be used for any part of the body.

--“The Heart expels blood while the Liver accepts blood just like the Lung expels qi while the Kidneys grasp qi.”

2. Invigorates the blood and dispels blood stasis:

--For the pain associated with blood stasis, especially chest and flank pain.

--Also used for retained lochia (bits of placenta remain inside body after birth), pain from trauma, joint pain, or the early stages of carbuncles.

Note: Mentioned in the Huang Di Nei Jing to treat amenorrhea.

What are the Blood-Cooling Herbs?

1) Bai Mao Gen

2) Di Yu

3) Huai Hua

4) Ce Bai Ye

5) Da Ji

6) Xiao Ji

Bai Mao Gen*** Names and Parts Used

Pharm: Imperatae Rhizoma

English: Imperata rhizome, Cogongrass, woolly grass, white grass

Parts Used: Root

Bai Mao Gen*** Properties and Channels

Properties: Sweet, cold

Channel(s): Lung, Stomach, Small Intestine, Bladder

Bai Mao Gen*** Dosage and Cautions/Contras

Dosage: 9-30g

Cautions/Contraindications: Use with caution in those with cold from deficiency of the Spleen and Stomach.

Bai Mao Gen*** Actions & Indications

1. Cools the blood and stops bleeding: for chaotic movement of hot blood—nose bleeding, vomiting blood, coughing of blood, and blood in the urine.

2. Clears heat and promotes urination: for hot painful urinary dribbling and other heat patterns with edema and urinary difficulty.

3. Clears heat from the Stomach and Lungs: for nausea and thirst due to Stomach heat or wheezing due to Lung heat. It “benefits the Stomach and alleviates thirst.”

Bai Mao Gen's relationship with fire

--It promotes forest fires since it grows really densely. HOWEVER, it's rhizomes are fire-proof (moist?) so as soon as fire clears area it sprouts right back up!

--This relates to its ability to cool blood, clear heat and promote urination...the underground portion is kind of like an underground aqueduct network that can put out a fire ...or heat

Bai Mao Gen*** Combos

+ Lu Gen for thirst, vexation, vomiting from stomach heat and cough and heat effusion from lung heat

+ Mu Tong for hot painful urinary dribbling

+ Che Qian Zi for edema with inhibited urination

Dì Yú** Names and Parts Used

Pharm: Sanguisorbae Radix

English: Sanguisorba, burnet, bloodwort root

Parts Used: Root

Dì Yú** Properties and Channels

Properties: Bitter, sour, slightly cold

Channel(s): Liver, Large Intestine, Stomach

Dì Yú** Dosage and Cautions/Contras

Dosage: 9-15g

Cautions/Contraindications: Used with caution in those with cold from deficiency or blood stasis.

Dì Yú** Actions & Indications

1. Cools the blood and stops bleeding: especially for bleeding in the lower burner due to damp-heat—blood in the stool, bleeding hemorrhoids, bloody dysenteric disorders, and excessive uterine bleeding. Also used for vomiting blood and nosebleed.

2. Clears heat and generates flesh: applied topically for sores, ulcers, and injuries from burns. It is an important medicinal for burns and scalds. It is applied in powder form, mixed with sesame seed oil, or combined with powdered da huang and/or huang lian.

What burner does Dì Yú particularly work on? For what related symptoms?

Lower burner

Symptoms = Hemorrhoids, bloody stool, blood in the urine, and flooding and spotting.

Huái Mǐ / Huái Huā** Names and Parts Used

Pharm: Sophorae Flos immaturus

English: Sophora bud

Parts used: bud

Huái Mǐ / Huái Huā** Properties and Channels

Properties: Bitter, cool

Channel(s): Liver, Large Intestine

Huái Mǐ / Huái Huā** Dosage and Cautions/Contras

Dosage: 4.5-9g

Cautions/Contraindications: Use with caution in those with cold from deficiency of the Spleen and Stomach.

Huái Mǐ / Huái Huā** Actions & Indications

1. Cools the blood and stops bleeding: for damp-heat patterns of the Large Intestine when bleeding is present. Especially important for bleeding hemorrhoids and bloody dysenteric disorders. Also used for coughing of blood, nosebleed, or uterine bleeding.

2. Cools the Liver: for red eyes (blood is stored in the liver, and “eyes, obtaining blood, are then able to see”), headache, and dizziness due to Liver heat. Can be taken as a daily beverage for this purpose.

What is the major function of Huai Mi/Huai Hua?

A major herb in the treatment of bleeding from the lower burner, specifically the intestines, and for hemorrhoids.

Huai Mi/Hua vs. Di Yu?

Huai Mi/Hua:

--Cools blood to stop bleeding, esp in LI.

--Cools Liver (red eyes etc.)

Di Yu:

--Restrains and inhibits

--Cools blood and drains fire

--Resolves toxicity

--Generates flesh

Both: Cooling blood in lower burner

Ce Bai Ye** Names and Parts Used

Pharm: Platycladi Cacumen

English: Oriental arborvitae leafy twig, arborvitae

Parts used: dried branch tips and leaves

Cè Bǎi Yè** Properties and Channels

Properties: Bitter, astringent, slightly cold

Channel(s): Lung, Liver, Large Intestine

Cè Bǎi Yè** Dosage and Cautions/Contras

Dosage: 6-15g

Cautions/Contraindications: Must be combined with appropriate herbs for bleeding with deficiency.

Cè Bǎi Yè** Actions & Indications

1. Cools the blood and stops bleeding: widely used for various bleeding disorders.

2. Stops cough and expel phlegm: for Lung heat patterns with cough and accumulation of phlegm. Especially important in cases of viscous, difficult-to-expectorate sputum streaked with blood. (use the fresh leaves)

3. Promotes healing of burns: used topically in powdered form for the early stages of burns over a small to moderate surface area. (use the fresh leaves) Also used for hair loss.

What kind of bleeding can Ce Bai Ye treat?

All forms of bleeding.

–> Since it is slightly cold it is often used for bleeding of a hot nature!

What does Ce Bai Ye do besides stop bleeding?

1) Stop cough and expel phlegm

2) Helps heal burns

3) Recently used for whooping cough and chronic bronchitis

How to remember Ce Bai Ye stops coughs?

-The genus of Ce Bai Ye (Platycladi) sounds like the genus of Jie Geng (Platycodon)

-Jie Geng stops cough

*Note: "Platy" means flat in Latin, describing flat leaves of Ce Bai Ye and the wide/flat flower of Jie Geng

Dà Jì** Names and Parts Used

Pharm: Cirsii japonica Herba sive Radix

English: Large thistle, Japanese Cirsium, Japanese thistle

Parts used: aerial or root

Dà Jì ** Properties and Channels

Properties: Sweet, cool

Channel(s): Liver, Spleen, Heart

Dà Jì ** Dosage and Cautions/Contras

Dosage: 9-15g

Cautions/Contraindications: Should not be used for cold from deficiency of the Spleen and Stomach.

Dà Jì ** Actions & Indications

1. Cools the blood and stops bleeding: for chaotic movement of hot blood—nosebleed, vomiting blood. It is especially effective in alleviating vomiting or coughing of blood.

2. Reduces swelling and generates flesh at sores: for carbuncles, sores, and swellings. Use fresh herb. Drink juice. Apply paste on skin (+di yu, jin yin hua). For intestinal abscess use with jin yin hua. Use alone for lung abscess.

3. Benefits the Gallbladder and reduces jaundice: Jaundice due to damp-heat. (+yin chen)

4. Treats hypertension: especially for Liver heat. (+xi xian cao, xia ku cao)

Xiǎo Jì ** Names and Parts Used

Pharm: Cirsii Herba

English: Small thistle, field thistle, Cephalanoplos

Parts used: usually the aerial

Xiǎo Jì ** Properties and Channels

Properties: Sweet, cool

Channel(s): Liver, Heart

Xiǎo Jì ** Dosage and Cautions/Contras

Dosage: 9-30g

Cautions/Contraindications: Use with caution in those with cold from deficiency of the Spleen and Stomach.

Xiǎo Jì ** Actions & Indications

1. Cools the blood and stops bleeding: for any kind of bleeding due to heat in the blood leading to chaotic movement.

2. Resolves toxicity and reduces abscesses: for sores and abscesses due to heat toxin. Used both internally and topically.

3. Recently used for damp-heat jaundice, hepatitis, and hypertension.

How is Xiǎo Jì different from Da Ji?

-Xiao Ji is weaker, but it is

better at promoting urination

-Da Ji is stronger and can treat sores and abscesses

What kind of combination are Da Ji and Xiao Ji?

Mutual accentuation

What are the Channel-Warming herbs that stop bleeding?

1) Ai Ye

2) Zao Xin Tu

Ai Ye*** Names and Parts Used

Pharm: Artemisiae argyii Folium

English: Mugwort leaf, Artemesia

Parts used: Leaf

Ai Ye*** Properties and Channels

Properties: Bitter, acrid, warm

Channel(s): Spleen, Liver, Kidney

Ai Ye*** Dosage and Cautions/Contras

Dosage: 3-9g

Cautions/Contraindications: Use with caution in those with heat from yin deficiency.

Ai Ye*** Actions & Indications

1. Warms the Womb and stops bleeding: for prolonged menstrual bleeding and uterine bleeding due to cold from deficiency, threatened miscarriage. Also used for infertility due to cold Womb.

2. Disperses cold and alleviates pain: for cold abdominal pain. Especially menstrual pain.

3. Eliminates dampness and stops itching: external wash for a variety of skin problems marked by dampness and itching.

Ai Ye*** Combos

+ Xiang Fu: For irregular menstruation d/t Qi stagnant and cold obstructing; Infertility d/t cold womb; Abdominal pain d/t cold from deficiency and stagnant Qi

+ Rou Gui: Both alleviate abdominal pain d/t cold

Ai Ye vs. Rou Gui

Ai Ye: Especially for abdominal pain d/t damp-cold

Rou Gui: Esp. for abdominal pain d/t cold from deficiency where extremities are cold (Yang and Yin/Yang deficiency)

Both: Help abdominal pain d/t cold

Zao Xin Tu* Names and Parts Used

Pharm: Terra flava usta

English: Oven earth, ignited yellow earth

Zao Xin Tu* Actions & Indications

1. Warms the blood and stops bleeding: for bleeding associated with patterns of cold from deficiency, especially of the Stomach and Intestines.

2. Warms the Stomach and stops vomiting: Stomach cold, morning sickness.

3. Stops diarrhea: for chronic Spleen deficiency diarrhea.

What are the astringent stop-bleeding herbs?

1) Xian He Cao

2) Bai Ji

3) Ou Jie

4) Xue Yu Tan

5) Zong Lu Pi

Xian He Cao*** Names and Parts Used

Pharm: Agrimoniae Herba

English: Agrimony

Parts used: Aerial portion

Xian He Cao*** Properties and Channels

Properties: Bitter, astringent, neutral

Channel(s): Lung, Liver, Spleen

Xian He Cao*** Dosage and Cautions/Contras

Dosage: 6-12g

Cautions/Contraindications: As an astringent, binding herb, it is appropriate for chronic forms of diarrhea, but not for those with active pathogens.

Xian He Cao*** Actions & Indications

1. Restrains leakage of blood and stops bleeding: widely used for various types of bleeding. Depending on its particular combination with other herbs, it can be used for bleeding due to heat, cold, excess or deficiency.

2. Alleviates diarrhea and dysenteric disorders: for chronic problem.

3. Kills parasites: for trichomonas vaginitis and tapeworm, as well as malarial disorders. For malaria administer 9g in powder form with warm grain-based liquor and a large quantity of water 1x/day for 3 days. Used topically for trichomonas vaginitis.

Xian He Cao*** Combos

For coughing blood: + huang qin, zhi zi

For heat dysentery: + di yu, huai hua, mu xiang, huang lian, huang bai, bai tou weng, ma chi xian

For profuse menstrual bleeding: + qi and blood boosting herbs

Bai Ji*** Names and Parts Used

Pharm: Bletillae Rhizoma

English: Bletilla rhizome

Parts used: Root

Bai Ji*** Properties and Channels

Properties: Bitter, sweet, cool

Channel(s): Lung, Stomach, Liver

Bai Ji*** Dosage and Cautions/Contras

Dosage: 3-15g. under unusual circumstances, up to 30g can be used. If taken orally as a powder, the dosage is 1.5-3g.

Cautions/Contraindications: Used with caution whenever there is a coughing of blood due to externally-contracted disease, early stage Lung abscess, or the involvement of excessive heat of fire toxin.

Bai Ji*** Actions & Indications

1. Restrains leakage of blood and stops bleeding: mainly for bleeding from the Lungs and Stomach—vomiting blood, coughing of blood, and nosebleed.

2. Reduces swelling and generates flesh: applied topically for sores, ulcers, and chapped skin. Bai Ji “eliminates putrefaction, engenders flesh, closes sores.”

Ou Jie** Names and Parts Used

Pharm: Nelumbinis Nodus rhizomatis

English: Lotus Rhizome node

Parts used: Root node

Ou Jie** Actions & Indications

1. Stops bleeding: for many types of bleeding. Most often used for bleeding associated with heat in the Lungs or Stomach with vomiting or coughing of blood. Also for chronic bleeding when combined with other appropriate substance.

Xue Yu Tang* Names and Parts Used

Pharm: Crinis carbonisatus

English: Charred human hair

Parts used: Hair

Xue Yu Tang* Actions & Indications

1. Restrains leakage of blood and stops bleeding: for many kinds of bleeding, especially uterine bleeding and nosebleed.

2. Promotes urination: for painful dribbling, especially with blood in the urine.

3. Generates flesh and resolves sores: used topically for sores or burns that have already ulcerated.

Zong Lu Pi* Names and Parts Used

Pharm: Trachycarpi Petiolus

English: Trachycarpus stiple fiber

Parts used: Leaf sheath fiber

Zong Lu Pi* Actions & Indications

1. Binds and stops bleeding: for coughing or spitting of blood, nosebleed, blood in the stools, and excessive uterine bleeding.