Eight Treatment Methods For Complicated Patterns of Qi and Blood

Yufang Xue

Qi and blood form the substantial basis of the human body. They share a very close relationship and play a critical role in physical activity. As Chinese medicine says “Qi is the commander of blood and blood is the mother of qi”. Disorders of qi can give rise to diseases of blood, and vice versa. As a result, qi or blood disorders will eventually result in disorders of both qi and blood, giving rise to a variety of diseases seen in clinical practice. Harmonising qi and blood - i.e. treating both qi and blood - is one of the central treatment methods for a many diseases. Generally speaking, there are eight treatment methods for complicated patterns of qi and blood. Tonifying both Qi and Blood This treatment method is suitable for the pattern of deficiency of both qi and blood. Aetiologies: i. bleeding resulting in deficiency of qi, ii. physical taxation leading to the impairment of qi and damage to the qi function of transforming blood, and iii. prolonged disease which damages both qi and blood. This pattern is often seen in cases of insomnia, painful obstruction of the chest, atrophy disorder (wei-syndrome) etc. Main manifestations: dizziness, blurred vision, general lassitude, shortness of breath, reluctance to speak, palpitations, insomnia, pale or sallow complexion, pale lips and nails, pale, scanty menstrual flow or even amenorrhoea, pale and tender (nen) tongue, fine and weak pulse. Acupuncture prescription: Qihai REN-6, Zusanli ST-36, Xuehai SP-10, Gongsun SP-4, Pishu BL-20, Zhongwan REN-12. Apply reinforcing method on all points. Explanation: Qihai REN-6, Zusanli ST-36 and Xuehai SP-10 tonify qi and nourish blood directly. Zusanli ST-36, Gongsun SP-4, Zhongwan REN-12 and Pishu BL-20 fortify the Spleen and regulate the Stomach to strengthen the root of qi and blood. Tonifying Qi to Hold Blood This treatment method is suitable for the pattern of bleeding due to qi deficiency. Aetiology: i. physical taxation leading to the impairment of Spleen qi, ii. haemorrhage resulting from failure of deficient Spleen qi to hold blood in the blood vessels. This pattern is often seen in cases of petechiae, uterine bleeding, miscarriage, etc. Main manifestations: nosebleed, bleeding gums, petechiae, vomiting of blood, coughing of blood, blood in the urine and stool, heavy or trickling menstruation in women, shortness of breath, general lassitude, bright white complexion, pale lips and tongue, fine and weak pulse. Acupuncture prescription: Guanyuan REN-4, Taiyuan LU-9, Baihui DU-20, Gongsun SP-4, Yinbai SP-1, Diji SP-8, Liangqiu ST-34. Apply reinforcing method on all points. Explanation: Baihui DU-20 treated with direct moxibustion raises qi. Guanyuan REN-4 and Taiyuan LU-9 consolidate and tonify qi. These points further strengthen the holding and astringent functions of qi in order to stop bleeding. Both Diji SP-8 and Liangqiu ST-34 are xi-cleft points, used in bleeding disorders. Gongsun SP-4 stops bleeding under the skin. Yinbai SP-1 is an empirical point and is used to treat bleeding due to Spleen qi deficiency. Tonifying Qi and Invigorating Blood This treatment method is suitable for the pattern of deficiency of qi with blood stasis. Aetiology: deficiency of qi fails to move blood. It can be caused by any common pathogenic factors of qi deficiency, such as improper diet, prolonged disease, taxation, weak constitution, aging, etc. This pattern is often seen in wind stroke, painful obstruction (bi syndrome), painful obstruction of the chest, etc. Main manifestations: fixed stabbing pain which is worse on pressure and at night and is often felt in the hypochondrium and chest, numbness of the limbs or hemiplegia, deviation of the mouth and eye, drooling, spirit fatigue, lassitude, bright white complexion, purplish tongue with ecchymosis, white tongue coating, deep, weak and choppy pulse. Acupuncture prescription: Zusanli ST-36, Zhongwan REN-12, Pishu BL-20, Weishu BL-21, Qihai REN-6, Xuehai SP-10, Geshu BL-17, Hegu L.I.-4, Taichong LIV-3. Apply reinforcing method on Zusanli ST-36 and Qihai REN-6, and even method on the other points. Explanation: There are three effects of qi on the blood: transforming blood, moving blood, and holding blood. Zusanli ST-36 and Qihai REN-6 tonify qi in general, and thus can invigorate blood and expel blood stasis indirectly. Zhongwan REN-12, Pishu BL-20 and Weishu BL-21 regulate the Spleen and Stomach to strengthen the root of qi and blood, since both qi and blood deficiency may result in blood stasis. Geshu BL-17 which is the hui-meeting point of blood, together with Xuehai SP-10, can treat almost any kind of blood disorder. In this case, they move and nourish blood. The Liver is responsible for the free flow of qi, and the yangming channel is rich in qi and blood. Hegu L.I.-4 and Taichong LIV-3, the “four gates”, therefore promote the free flow of qi and blood throughout the entire body. Warming Channels and Dispersing Cold This treatment method is suitable for the pattern of obstruction of both qi and blood. Aetiology: invasion of exogenous pathogenic cold which penetrates into the blood level. This pattern is often seen in painful obstruction, Raynaud’s disease, shan disorder, etc. Main manifestations: cold, fixed stabbing pain which is worse on exposure to cold and pressure, cold limbs, aversion to cold, deep and slow pulse, or wiry and tight pulse, cold pain in the hypogastrium, dysmenorrhoea, blood clots in the menstrual flow; cold pain in the genital region which radiates to the inner thigh, retraction of the scrotum, localised purplish swollen sores with coldness, numbness or discharge of blood and pus, etc. Acupuncture prescription: Guanyuan REN-4, Mingmen DU-4, Shenshu BL-23, Shixuan (M-UE-1), Sanyinjiao SP-6, Yanglingquan GB-34, Xuanzhong GB-39, Shousanli L.I.-10, Waiguan SJ-5, Xuehai SP-10, Geshu BL-17, Hegu L.I.-4, Taichong LIV-3. Apply reinforcing method on Guanyuan REN-4, Mingmen DU-4, Shenshu BL-23 and Sanyinjiao SP-6, and reducing method on the other points. Explanation: Guanyuan REN-4, Mingmen DU-4 and Shenshu BL-23 warm yang to disperse cold. Shixuan (M-UE-1) expels cold from the channels. Xuehai SP-10, Geshu BL-17, Hegu L.I.-4 and Taichong LIV-3 move qi and blood. Other points such as Yanglingquan GB-34, Xuanzhong GB-39, Shousanli L.I.-10 and Waiguan SJ-5 are mainly used in accordance with the involved channels. Shousanli L.I.-10 with Hegu L.I.-4, and Yanglingquan GB-34 with Xuanzhong GB-39 are also chain and lock point association combinations. Tonifying Qi to Rescue Collapse This treatment method is suitable for the pattern of collapse of both qi and blood. Aetiologies: many pathogenic factors can cause heavy bleeding, such as vomiting blood due to an enlarged and hard liver, bleeding due to peptic ulcer, coughing up blood due to pulmonary tuberculosis, severe and heavy menstrual flow, bleeding after child birth, bleeding related to traumatic injury, etc. Heavy bleeding can result in exhaustion of qi and this pattern is often seen in severe and urgent conditions. Main manifestations: severe haemorrhage, sudden pallor, copious cold sweating, cold counterflow of the limbs, coma, pale tongue, scattered or faint pulse. Acupuncture prescription: Renzhong DU-26, YongquanKID-1, Shenque REN-8, Guanyuan REN-4, Baihui DU-20. Explanation: All of these points are important points for resuscitation. Apply moxibustion to Shenque REN-8 and Baihui DU-20. Needle Renzhong DU-26, Yongquan KID-1 and Guanyuan REN-4 with strong manipulation. Moving Qi and Invigorating Blood This treatment method is suitable for the pattern of qi stagnation and blood stasis. Aetiologies: i. emotional stress resulting in stagnation of Liver qi and subsequent blood stasis, and ii. traumatic injury giving rise to stagnation of qi and blood. Qi stagnation and blood stasis can set up a vicious circle, both eventually causing stagnation of both qi and blood. This pattern is often seen in headaches, painful obstruction of the chest, stomachache, flank pain, painful obstruction, dysmenorrhoea, etc. Main manifestations: fixed and stabbing pain or distending pain which is often felt in the chest and hypochondrium, propensity to anger, dark complexion, chapped skin, cyanotic lips, dark purplish tongue with ecchymosis, wiry and choppy pulse, purplish menstrual flow with blood clots, amenorrhoea in women. Acupuncture prescription: Qihai REN-6, Xuehai SP-10, Geshu BL-17, Hegu L.I.-4, Quchi L.I.-11, Sanyinjiao SP-6, Taichong LIV-3, Ahshi points. Apply reducing or even method on all points. Explanation: Ahshi points are important local points in this case. Manipulating them with reducing method moves both qi and blood directly, and activates the channels to alleviate pain. Hegu L.I.-4 and Taichong LIV-3 move qi and blood. Xuehai SP-10 and Geshu BL-17 move blood but also help to move qi; since blood carries qi, the smooth flow of blood helps the movement of qi. Qihai REN-6 and Quchi L.I.-11 strengthen the function of the above points. Sanyinjiao SP-6 regulates the functions of the Liver, Spleen and Kidney. All of them promote the smooth flow of blood, since the Liver stores blood and is responsible for the free flow of the qi throughout the body, the Spleen transforms qi and blood, and the Kidney transforms the blood. Clearing Heat, Detoxifying Fire Poison and Cooling Blood This treatment method is suitable for the pattern of toxic heat at both qi and blood levels. Aetiology: penetration of pathogenic fire into the qi and blood levels in warm-febrile diseases. This pattern can be seen in many warm-febrile diseases, damp warm-febrile diseases, purulent sores, carbuncles, etc. Main manifestations: high fever, great thirst, restlessness, convulsion of the limbs, coma, delirium, petechiae, rashes, vomiting of blood, bleeding gums, nosebleed, red tongue with yellow coating or scanty coating, rapid or fine and rapid pulse. Acupuncture prescription: Dazhui DU-14, Quchi L.I.-11, Hegu L.I.-4, Neiting ST-44, Xingjian LIV-2, Shixuan (M-UE-1). Apply reducing method on all points Explanation: Dazhui DU-14 is a meeting point of the Governing vessel with the six yang channels of the hand and foot and is therefore especially effective at clearing yang heat from the qi and blood. Neiting ST-44 and Xingjian LIV-2 are ying-spring points that work well at clearing heat. Shixuan (M-UE-1) detoxifies fire poison. Quchi L.I.-11, Hegu L.I.-4 and Neiting ST-44 belong to yangming channels of hand and foot, which are rich in qi and blood. Stimulate all points with reducing manipulation to quickly clear heat and poisonous fire from qi and blood. Subduing Rebellious Yang, and Regulating and Pacifying both Qi and Blood This treatment method is suitable for the pattern of rebellious qi and blood. Aetiology: rebellious qi and blood rush upward to the head and face due to anger or invasion of pathogenic factors. This pattern is often seen in windstroke, epilepsy, trigeminal neuralgia, etc. Main manifestations: distending headache, red complexion, high fever, propensity to anger, forgetfulness, coma, delirium, deviation of the mouth and eye, drooling, wiry and rapid pulse. Acupuncture prescription: Baihui DU-20, Xingjian LIV-2, Xiaxi GB-43, Fengchi GB-20, Taiyang (M-HN-9), Xuanlu GB-5, Feiyang BL-58. Apply reducing method on all points. Explanation: Baihui DU-20 is the uppermost point of the body and descends rebellious qi and blood. Fengchi GB-20, Taiyang (M-HN-9) and Xuanlu GB-5 are all located on the head, and direct and regulate qi and blood downwards. Feiyang BL-58 (“soaring upwards”), as its name implies, pacifies rebellious qi and blood. Xingjian LIV-2 and Xiaxi GB-43 are ying-spring points which drain excess via the lower. The last three points belong to the treatment principle of “selecting points below to treat diseases above”. Dr. Yufang Xue, Ph.D., is a professor of Chinese medicine diagnostics and internal medicine at the American Academy of Acupuncture and Oriental Medicine (AAAOM). Dr. Xue has received his bachelor’s degree at Nanjing University of TCM, a masters degree from Shandong University of TCM, and his Ph.D from Guangzhou University of TCM where he acted as the associate professor.

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AuthorYufang Xue

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