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The Second Stagnation: Blood Stasis, Part 2

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In Part 1 we learned about the many signs and symptoms of Blood Stasis and its effects on health. Now, we’ll cover how to treat and prevent Blood Stasis. Of course you’ll be immediately interested in the herbs and formulas to use, but first I’ll cover other therapies that are integral, even essential, to preventing and treating this issue.

Note that because Blood Stasis is frequently an underlying factor in many health problems, it’s important to not only focus on moving Blood but also on resolving the causative factors. Further, because there’s an interdependent relationship between Blood and Qi, it’s important to promote the movement of Qi when moving Blood and vice versa.

Therapies for Blood Stasis

Diet Therapy

Eat: A balanced diet of protein, complex carbs and fats of cooked foods and warm drinks.

Avoid: Raw and cold foods and iced foods and drinks (review the list in Part 1). As an example of the power of diet in moving Blood Stasis, a patient I treated didn’t tell me about her menstrual pain, but when she changed her diet and stopped cold and raw foods, her menstrual pain went away!

Emotional Therapy

Express and release your emotions appropriately; work with your limiting patterns.

Lifestyle Therapies

Enjoy movement and exercise such as brisk walking, jogging, running, swimming; yoga, tai chi, and qi gong. Those with Blood Deficiency should avoid hot tubs and saunas, particularly during or right after menses, as these further deplete the Blood. If there’s Internal Cold, hot tubs and saunas are fine IF immediately followed by a cold plunge or shower to lock the heat in (otherwise it dissipates your body heat, which depletes Yang over time).

Other Therapies

Moxibustion is one of the best techniques to move localized Blood Stasis and to warm the Interior. Other warm applications such as hot stones, heat lamps, hot water bottles, heating herbal patches and warming liniments, massage, dermal hammer, or cupping also apply. Buffing, the application of a gentle power tool covered with a cotton cover and gently moved across the skin is fabulous to increase localized skin circulation.

Herbal Therapy

In TCM, Blood-moving herbs are divided into four groups according to their ascending order of strength:

ACTION                                                                    HERB

 Harmonize the Blood                                       white peony root

Promote the movement of Blood                        vaccaria seed

Dispel Blood Stasis                                          red peony root

Break up Blood Stasis                                      turmeric root, peach seed

In general, an herb may be termed "Blood invigorating," a generic term for moving Blood. In Western herbalism, herbs that move Blood are considered emmenagogues. Most Blood-moving herbs have a warm energy with an acrid and bitter flavor. All enter the Liver organ and meridian along with other possible organs and channels.

Contraindications

 Blood-moving herbs should be avoided during pregnancy and menses; in those who have a tendency toward excessive menstrual bleeding; in people who bleed easily; and anyone on blood-thinner medications (Warfarin, Coumadin, etc.).

Blood-moving Herbs

  • Angelica (Angelica archangelica)
  • Vervain (Verbena officinalis)
  • Lovage (Ligusticum levisticum)
  • Corydalis (Corydalis formosa)
  • Tien qi (Panax notoginseng)
  • Turmeric (Curcumae longa)
  • Motherwort (Leonurus cardiaca)
  • Bugleweed (Lycopus virginicus, L. lucidi, ze lan)
  • Peach seed (Prunus persica, tao ren)
  • Safflower (Carthamus tinctorius, hong hua)
  • Saffron (Crocus sativus, fan hong hua)
  • Calendula (Calendula officinalis)
  • Frankincense (Boswellia carterii, ru xiang)
  • Myrrh (Commiphora myrrha, mo yao)
  • Blue Cohosh (Caulophyllum thalictroides)
  • Rue (Ruta graveolens)
  • Szechuan lovage root (Ligusticum chuanxiong)
  • Red sage root (Salvia miltiorrhizae)
  • Corydalis (Corydalis yanhusuo)
  • Red peony (Paeonia veitchii)
  • Achyranthes (Achyranthes bidentata, niu xi)
  • Vaccaria seed (Vaccaria segetalis, wang bu liu xing)
  • Dang gui (Angelica sinensis)
  • White peony (Paeonia lactiflora, bai shao)

Blood-moving Formulas

Many formulas move the Blood. However, there are four main blood-moving formulas, one for each Warmer and one for the collaterals and channels.

Upper Warmer

Decoction for Removing Blood Stasis in the Chest (Xue Fu Zhu Yu Tang)

This formula is for pain in the head and/or chest due to Blood Stasis or poor circulation. The pain could be chronic, fixed and piercing. Other symptoms include irritability, insomnia, emotional upset, and increased body temperature, especially in the afternoon. The pulse is hesitant, or wiry and tight, and the tongue is dark red with purple spots.

  • Persica (tao ren)                          9-12 g
  • Carthamus (hong hua)                   6-9 g
  • Angelica sinensis (dang gui)            6-9 g
  • Ligusticum (chuan xiong)                3-6 g
  • Red peony (chi shao yao)               6-9 g
  • Cyathula (chuan niu xi)                  6-9 g
  • Bupleurum (chai hu)                      3-6 g
  • Platycodon (jie geng)                    3-6 g
  • Bitter orange (zhi ke)                     6-9 g
  • Licorice (gan cao)                         3-6 g

Middle Warmer

Decoction to Remove Blood Stasis below the Diaphragm (Ge Xia Zhu Yu Tang)

This formula is used for masses below the diaphragm, fixed abdominal pain, hypochondriac pain, irritability, indigestion, constipation, abdominal tumors, and menstrual issues.

  • Angelica sinensis (dang gui)           6-9 g
  • Ligusticum (chuan xiong)               6-9 g
  • Persica (tao ren)                          6-9 g
  • Safflower (hong hua)                    6-9 g
  • Lindera (wu yao)                          6-9 g
  • Corydalis (yan hu suo)                   3-9 g
  • Cyperus (xiang fu)                        3-6 g
  • Red peony (chi shao yao)               6-9 g
  • Moutan peony (mu dan pi)              6-9 g
  • Bitter orange (zhi ke)                     3-6 g
  • Licorice (gan cao)                         1-3 g
  • Pteropus excrement (wu ling zhi)      6-9 g

Lower Warmer

Decoction for Removing blood Stasis in the Lateral Abdomen (Shao Fu Zhu Yu Tang)

This formula treats abdominal pain with no lumps, or with lumps but no pain, abdominal distention, back pain during menses, irregular menses with purplish-black blood and clots, uterine bleeding with abdominal pain, dysmenorrhea, and amenorrhea.

  • Angelica sinensis (dang gui)          6-9 g
  • Ligusticum (chuan xiong)              3-6 g
  • Red peony (chi shao yao)             6-9 g
  • Fennel (xiao hui xiang)                  3-6 g
  • Corydalis (yan hu suo)                  3-6 g
  • Myrrh (mo yao)                           3-6 g
  • Cinnamon bark (rou gui)                3-6 g
  • Dry ginger (gan jiang)                    3-6 g
  • Bulrush pollen (pu huang)              6-9 g
  • Pteropus excrement (wu ling zhi)    6-9 g

Channels and Collaterals

Decoction to Relieve Muscle Ache (Shen Tong Zhu Yu Tang)

This formula treats general body and limb aches and pains including the muscles of the neck, back, legs, shoulder or whole body due to Qi Stagnation and Blood Stasis in the channels. It also treats rheumatoid arthritis and arthralgia.

  • Persica (tao ren)                           6-9 g
  • Carthamus (hong hua)                    6-9 g
  • Angelica sinensis (dang gui)             6-9 g
  • Ligusticum (chuan xiong)                 3-6 g
  • Notopterygium (qiang huo)               3-6 g
  • Gentiana (qin jiao)                          3-6 g
  • Earthworm (di long)                        3-6 g
  • Myrrh (mo yao)                              3-6 g
  • Cyperus (xiang fu)                           1-3 g
  • Cyathula (chuan niu xi)                     6-9 g
  • Licorice (gan cao)                            3-6 g
  • Pteropus excrement (wu ling zhi)        6-9 g

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