Library

Xu Shuwei said: Someone asked, why does heat entering the Blood Chamber (Xue Shi) result in Jie Xiong (Chest Binding)? The answer is: Pathogenic factors enter the meridians and struggle with healthy Qi, circulating up and down. When menstruation is just starting or has just stopped, pathogenic factors take advantage of the deficiency to enter the Blood Chamber. The blood is forced by the pathogens to move upward into the Liver Meridian. When the vessels are affected by pathogens, delirium and hallucinations occur. If the pathogens re-enter the Dan Zhong (Chest Center), blood coagulates in the chest. Why is this so? In women, Water nourishes Wood (Liver). Before pregnancy, this manifests as menstrual blood; during pregnancy, it is retained to nourish the fetus; after childbirth, it rises to become milk. All these are transformations of blood. Now, pathogens chase the blood and merge with it, returning to the Liver Meridian, gathering at Dan Zhong, and knotting below the breasts. Therefore, touching it causes pain, which medicine cannot reach; one should puncture the Qimen (LR14) acupoint.

Wu Shuqing said: Xiao Chai Hu Tang (Minor Bupleurum Decoction) treats diseases transmitted from the Taiyang (Greater Yang) stage. Since visceral blood arrives, the Blood Chamber becomes empty, allowing pathogens to enter due to deficiency, forming a Yue Jing Zheng (Transgressing Meridian Syndrome). However, the Blood Chamber and the Stomach Fu have distinctions between Qi and Blood; thus, delirium differs between day and night. "Seeing ghosts" occurs because the Liver is invaded by pathogens, causing the Hun (Ethereal Soul) to be unsettled, which is a disease of the Ben Shen (Root Spirit). Using Xiao Chai Hu Tang resolves exterior and interior pathogens, while Di Huang (Rehmanniae Radix) cools heat within the blood. Recovery is assured, along with the method of puncturing Qimen. Adding Tao Ren (Persicae Semen) and Hong Hua (Carthami Flos), or using Cheng Qi Tangs (Bowel-Regulating Decoctions) and Di Dang Tang, depends on the severity to purge accordingly.

Yang Renzhai said: For any miscarriage or abortion where heat enters the Blood Chamber, if Xiao Chai Hu Tang is insufficient, add Wu Ling Zhi (Trogopteri Dung) internally, assisted by Huang Lian (Coptidis Rhizoma) and Chi Fu Ling (Poria with Red Coir). Since the Heart governs blood, Huang Lian and Fu Ling are agents that clear the Heart and cool the blood, thereby achieving success. To drain blood toxins, Tao Ren Cheng Qi Tang from *Huo Ren Shu* (Book of Saving Lives) is sufficiently potent.

Zhang Luyu said: Chong Mai (Penetrating Vessel) is the Sea of Blood, which is the Blood Chamber. When Chong Mai receives heat, it forces blood downward. Men can also have this syndrome, not just women.

Shen Zhai commented: The above five passages describe the syndrome of heat entering the Blood Chamber in women suffering from Shang Han (Cold Damage). The Blood Chamber is the Sea of Blood, connected to the Chong and Ren vessels, serving as the place for storing essence and conceiving the fetus. Because women have an abundance in the Sea of Blood, when contracting Shang Han pathogens during menstruation, heat pathogens take advantage of the Blood Chamber's emptiness to invade and contend with the blood. The Liver stores the Hun; when the Blood Chamber is empty, the Liver lacks support. When the Liver receives heat pathogens, it causes delirium and hallucinations because the Hun cannot settle. Therefore, the treatment method is solely to clear heat and promote blood circulation. Severe cases use Tao Ren Cheng Qi Tang; mild cases use Di Huang, Mu Dan Pi (Moutan Cortex), Tao Ren, Hong Hua, Chi Shao Yao (Red Peony Root), Wu Ling Zhi, Gan Cao (Licorice), Mu Tong (Akebia Caulis), and Dan Shen (Salvia Miltiorrhiza), which can be used universally. One must not rigidly adhere to Xiao Chai Hu Tang as the fixed prescription for treating heat entering the Blood Chamber in Shang Han. Xiao Chai Hu Tang is a formula for resolving exterior and interior conditions when Shang Han transmits to the Shaoyang (Lesser Yang) stage. If one insists on using it for heat entering the Blood Chamber, do they not know that Chai Hu releases the exterior, Huang Qin (Scutellariae Radix) clears heat, and Ban Xia (Pinelliae Tuber) moves phlegm—all contraindicated for blood disorders? Ren Shen (Ginseng Radix) tonifies Qi and aids pathogens, unsuitable for blood heat. Nowadays, upon encountering heat entering the Blood Chamber, people immediately apply Xiao Chai Hu Tang as a fixed rule, claiming to follow Zhang Zhongjing's writings. Do they not know that Zhang Zhongjing's first case states: "In women with Wind Strike, chills and fever occur intermittently, resembling malaria," which clearly belongs to the Shaoyang Meridian syndrome, hence "Xiao Chai Hu Tang governs it." Thus, Xiao Chai Hu Tang was originally established for the Shaoyang Meridian. As for the subsequent four cases, it only says "will heal itself," "should puncture Qimen," and "purge according to its excess." Excess refers to hot blood knotting in the chest. Purging means draining the excess pathogen. There is no mention of "Xiao Chai Hu Tang governs it." Therefore, we know Xiao Chai Hu Tang is used only because women with Shang Han have persistent chills and fever resembling malaria, so it treats the Shaoyang malaria-like condition, but it is not originally for treating heat entering the Blood Chamber. People today who do not carefully study Zhang Zhongjing's original texts casually claim that for women with heat entering the Blood Chamber, Xiao Chai Hu Tang should always be used. Is this not laughable? Therefore, for women with heat entering the Blood Chamber who have persistent chills and fever occurring intermittently like malaria, Xiao Chai Hu Tang can be used. It must also include Tao Ren, Mu Dan Pi, and Wu Ling Zhi to promote blood circulation. If heat enters the Blood Chamber without chills and fever resembling malaria, Xiao Chai Hu Tang absolutely must not be used. The world is ignorant of this; I hereby highlight and clarify it.