Library

If a person's diet and daily routine are not in accordance with proper guidelines, it can all lead to blood stasis and obstruction. Therefore, many diseases arise from "stagnant blood" (referring to pathological, stagnant blood). However, medical texts categorize diseases into the "Seven Qi" patterns but do not include "Blood Accumulation" (Xue Xu) as a distinct category; thus, I have added this discussion.

Nosebleeds indicate Blood Accumulation in the Upper Jiao (Upper Burner). Severe pain below the heart where the area is tender to touch indicates Blood Accumulation in the Middle Jiao (Middle Burner). Swelling and pain around the umbilicus and abdomen indicate Blood Accumulation in the Lower Jiao (Lower Burner). In cases of Blood Accumulation across the Three Jiaos, the pulse is consistently found at the middle position of the left hand.

For Blood Accumulation in the Upper Jiao, use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) from *Qianjin Yifang* (or *Ren Shu*). For Blood Accumulation in the Middle Jiao, use Tao Ren Cheng Qi Tang (Persimmon Seed and Rhubarb Decoction) by Zhang Zhongjing. For Blood Accumulation in the Lower Jiao, use Dangdang Tang (Dangdang Decoction) or Wanji by Zhang Zhongjing, or Han Shi Dihuang Tang (Han's Rehmannia Decoction), or Shengqi Tang (Raw Lacquer Decoction).

Zhang Yuansu (styled Haicang) stated: Blood Accumulation can be treated with Zhang Zhongjing's Dangdang Tang or Wanji. However, one must fear that mediocre physicians may not understand the properties of these drugs and use them excessively, leading to conditions of uncontrolled bleeding or damage to healthy blood; therefore, they are contraindicated for the elderly, weak, and deficient. Thus, he established Shengdi Huang Tang, which contains Ting Chong (Tinglizi/Mayfly), Shui Zhi (Leech), Da Huang (Rhubarb), and Tao Ren (Peach Seed), adding Sheng Di Huang (Fresh Rehmannia Root), Gan Qi (Dried Lacquer), Sheng Ou (Fresh Lotus Rhizome), and Lan Ye (Isatis Leaf). He also mentioned the Shengqi Tang formula, again fearing that Dangdang Tang/Wanji might be too purgative. Hence, it is known that Gan Qi is a blood-breaking agent; its action is milder than Dangdang Tang. It is used heavily for promoting circulation, and even more heavily for breaking accumulations and treating food stagnation. Drugs like Gan Qi and Sha (Sand/Mineral drugs) should not be used unless the patient has strong Qi.

If teeth decay and fall out over several years without healing, it should be treated as Yangming Channel Blood Accumulation. Use Tao Ren Cheng Qi Tang, ground into fine powder, mixed with refined honey to form pills the size of paulownia seeds, and taken orally. Those who enjoy drinking alcohol often suffer from this condition, and repeated administration is effective.

In cases of falls from heights, blows from heavy objects, or injuries from arrowheads and blades, causing stagnant blood to accumulate in the chest, abdomen, and heart without dispersing, differentiate by the Upper, Middle, and Lower Jiao regions. Treat with purgatives such as Yi Lao's Xijiao Dihuang Tang, Tao Ren Cheng Qi Tang, and Dangdang Tang/Wanji. Some treat this by decocting with urine and wine. Others add Sheng Di Huang and Dang Gui to the decoction. Some add Da Huang. Another method: for deficient patients who cannot tolerate purgative therapy, Si Wu Tang (Four Substances Decoction) combined with Chuan Shan Jia (Pangolin Scales) decocted and taken orally yields excellent results. Some use Hua Rui Shi San (Flower Core Stone Powder), decocted with child's urine or taken with wine. This medicine contrasts with cold-natured medicines, representing Yin and Yang respectively; this distinction must not be overlooked.