Library

There is often a sensation of heat in the abdomen, as if scalded by boiling water or fire; this has nothing to do with Qi transformation. It is neither internal heat due to Excess Fire nor internal heat due to Yin Deficiency, but rather caused by Blood Stasis (Yu Xue). The manifestation includes a dry mouth that does not thirst, yet an internal sensation of thirst leading to excessive water intake. Generally, among all substances in the human body, Blood is the hottest. Why? Because the nature of Qi is hot, and Blood serves as the residence of Qi and the locus where heat attaches. The heat of Qi is dispersed and unaggregated, its flame spreading thinly; whereas the heat of Blood accumulates and becomes concentrated, its body burning intensely. Fire is like a flame, while Blood is like charcoal; is a flame hotter than charcoal, or is charcoal hotter than a flame? Therefore, when patients feel as though a stream of hot soup is pouring over them, it indicates Heart Qi Deficiency causing Blood to flow downward; when they feel as though fire rushes from the chest and abdomen up to the throat, it indicates Liver and Spleen Qi Stagnation and Rebellion causing Blood to rush upward. In both cases, the pathology remains within the pathways where Blood should circulate, thus avoiding the hazard of extravasation. Additionally, there may be a warm, fiery sensation along a path inside the hypochondrium or across the chest; a spicy, pungent sensation in the epigastrium akin to Sichuan pepper and cinnamon; a painful, distending sensation resembling broken skin; or a bloody odor in the throat. All these indicate the accumulation of Blood Stasis at those locations. Etiologies may include sequelae of Cold-Heat diseases, sudden ingestion of cold water after extreme thirst, severe anger, strenuous exertion, abrupt rest after labor, prolonged food stagnation, excessive consumption of fried or roasted foods, or incomplete menstruation in women. Treatment must incorporate herbs that promote Blood circulation and remove stasis, such as Tao Ren (Persicae Semen) and Hong Hua (Carthami Flos), continuing until purple clots are vomited or black stools are passed. If mistakenly diagnosed as Excess Fire and treated with cold-clearing methods, or as Yin Deficiency and treated with tonifying-nourishing methods, the Blood Stasis will become more entrenched, potentially evolving into Dry Blood Syndrome (Gan Xue Zheng). In early stages of Blood Stasis, the pulse is often wiry (Xian); cases with a simultaneous surging (Hong) pulse are easier to treat, as are those with thirst and desire to drink, indicating the presence of vital Qi (Sheng Qi). Conversely, cases with a short and choppy (Duan Se) pulse or without thirst are difficult to treat, as vital Qi is absent. When the sensation resembles hot soup rushing up and down, although Blood is stagnant, it still flows; when sensations resemble spiciness or broken skin fixed in one place, Blood has coagulated within the collaterals and membranes and ceased to flow. For flowing Blood stasis, resolve it using cooling methods assisted by Qi-tonifying herbs; for coagulated Blood stasis, resolve it using warming methods assisted by Qi-moving herbs. Materia Medica states that San Leng (Sparganii Rhizoma) can dissolve knife handles, exaggerating its ability to break down blood masses devoid of vital Qi.