The origins of Stagnated Blood

Stagnated Blood has many origins, including:
1 Blood’s retention in its vessels, caused by condensation of Cold following the invasion of one of the six external pathogens.

2 Blood’s slow flow, caused by Qi stagnation. Qi circulation may be inhibited by:
– External Cold and Damp;
– Liver Qi’s impedance following Qi stagnation caused by brooding over one        of the seven internal emotional pathogens, or disrupted Qi circulation                  induced by internal Phlegm and Turbidity. For example, stagnated Liver Qi          may lead to Blood stasis in the vessels, and cause a palpable mass, which              may manifest as hypo-chondriac pain.

3 Other factors that cause Qi stagnation include:
– Qi that is too deficient to drive Blood. The Qi deficiency may be caused by hypo-function of the Zang-Fu, injury, overwork, improper food intake, chronic diseases, or birth labor. When Qi deficiency and Blood stasis follow prolonged illness, regular treatment may be insufficient. Qi tonification and Blood activation may be the only effective treatment to expel external pathogens, eliminate symptoms, and nourish and activate Qi and Blood.
– Blood that is too Cold to flow quickly. Cold Blood may be induced by:

External Cold pathogens invading Blood vessels;
Yang-Qi damaged from prolonged Damp, or
Yuan Yang weakened by the decline of Minmen (Life Gate) Fire.
For example, Cold in a woman’s uterus may lead to stagnated Blood, manifest as lower abdominal pain during menstruation, purplish black menses or clots in menses, delayed menstruation, or amenorrhea.

– Blood too hot to coalesce may flow out of its vessels, clump, and form stagnated Blood. Overheated Blood may consume body fluid, and lead to Blood condensation and stagnation. For example, Shanghan Lun introduced the Taiyang syndrome of Blood accumulation in Taiyang Jin. In this syndrome, Blood and Heat merge in the lower abdomen, and cause acute abdominal mass and mania. It is treated with the Taohe Chengqi Decoction to activate Blood, eliminate stagnated Blood, and descend stagnated Heat.

– External injury may damage blood vessels, and lead to Blood stasis. A local hematoma indicates Blood stagnation in external injury.

– Blood that is going out of its vessels, where it can no longer follow Qi, and may accumulate in the local area. Some reasons for this bleeding are Qi deficiency, the Spleen’s dysfunctional control of Blood, the Liver’s failure to store Blood, Blood’s Heat-induced outflow, external injury, and emotions transforming Fire (inducing overacting Blood).

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