Herbs that stop bleeding are used to treat cases of vomiting blood, epistaxis, and cough with blood, bloody stools, bloody urine, uterine bleeding, or traumatic bleeding.
The herbs stop bleeding by different methods, including cooling the blood, astringing, resolving blood stasis, and warming the channels. Based on the cause of bleeding and the accompanying manifestations, the appropriate herb should be selected in combination with other herbs. For example, if bleeding is due to extravasations of blood by heat, herbs that clear heat and cool the blood are used together. If bleeding is due to Yin deficiency, herbs that tonify Yin and subside Yang should be chosen. If bleeding is due to Yang deficiency and cold, herbs that warm Yang, promote Qi, and strengthen the spleen should be combined. In cases of great blood loss leading to collapse of Qi, herbs must be added to tonify the source Qi, so as to prevent further collapse.
Prescriptions for arresting bleeding are chiefly composed of herbs with styptic action and are suitable for treating hemorrhage at various locations of disease as the result of extravasations of blood. It is important to remember that blood stagnation can be a factor in bleeding. In such cases, herbs that invigorate the blood and resolve stasis should be added.
Herbs for Stopping Bleeding（止血剂）
(i) Japanese thistle (Da Ji, 
)
Pharmaceutical Name: Herba seu Radix Cirsii japonici
Part Used: Aerial parts
Properties: Sweet, bitter, and cool
Channel Tropism: Heart and liver
| Functions: | (a) | To cool blood and stop bleeding; |
| (b) | To reduce swelling and resolve stagnation. |
Applications:
(a)Hemorrhage due to extravasation of blood by heat, manifested as cough with blood, epistaxis, uterine bleeding, and hematuria. Japanese thistle (Da Ji, 
) is used with Small thistle (Xiao Ji, 
) and Biota tops (Ce Bai Ye, 
).
(b)Boils, carbuncles, and swelling. Japanese thistle (Da Ji, 
) is used both externally and internally.
(c)Dosage: 9–15 g.
(ii) Small thistle (Xiao Ji, 
)
Pharmaceutical Name: Herba Cirsii segeti
Part Used: Aerial parts of the plant and rhizomes
Properties: Sweet and cool
Channel Tropism: Heart and liver
| Functions: | (a) | To cool blood and stop bleeding; |
| (b) | To promote urination. |
Applications:
(a)Hemorrhage due to extravasation of blood by heat. Small thistle (Xiao Ji, 
) is used with Imperata rhizome (Bai Mao Gen, 
), Cattail pollen (Pu Huang, 
) and Biota tops (Ce Bai Ye, 
).
(b)Bloody urine and painful urination. Small thistle (Xiao Ji, 
) is used with Lotus node (Ou Jie, 
), Talc (Hua Shi, 
), and Clematis stem (Mu Tong, 
).
(c)Dosage: 4.5–9 g.
(iii) Burnet root (Di Yu, 
)
Pharmaceutical Name: Radix Sanguisorbae
Part Used: Root
Properties: Bitter, sour, and slightly cold
Channel Tropism: Liver, stomach, and large intestine
| Functions: | (a) | To cool blood and stop bleeding; |
| (b) | To promote the healing of ulcers. |
Applications:
(a)Hemorrhages due to extravasation of blood by heat: (1) uterine bleeding — Burnet root (Di Yu, 
) is used with fried Cattail pollen (Pu Huang, 
), Scutellaria root (Huang Qin, 
), and Fresh Rehmannia root (Sheng Di Huang, 
); (2) hemorrhages, bleeding, and dysentery — Burnet root (Di Yu, 
) is used with Sophora flower (Huai Hua, 
), Coptis root (Huang Lian, 
), and Costus root (Mu Xiang, 
).
(b)Burns, eczema, and ulcers of the skin. Burnet root (Di Yu, 
) is used with Coptis root (Huang Lian, 
) and applied externally.
Cautions and Contraindications: This herb is contraindicated for large burns. The ointment made from the herb may cause a toxic infection after absorption by the body.
(iv) Sophora flower (Huai Hua, 
)
Pharmaceutical Name: Flos Sophorae
Part Used: Bud
Properties: Bitter and slightly cold
Channel Tropism: Liver and large intestine
Function: To cool blood and stop bleeding.
Applications:
(a)Hemorrhage due to extravasation of blood by heat: (1) dysentery and bleeding due to hemorrhoids — Sophora flower (Huai Hua, 
) is used with Burnet root (Di Yu, 
); (2) cough with blood and epistaxis — Sophora flower (Huai Hua, 
) is used with Biota tops (Ce Bai Ye, 
, Imperata rhizome (Bai Mao Gen, 
), and Agrimony (Xian He Cao, 
).
(b)Dosage: 5–9 g.
(v) Bletilla tuber (Bai Ji, 
)
Pharmaceutical Name: Rhizoma Bletillae
Part Used: Rhizome
Properties: Bitter, sweet, astringent, and slightly cold
Channel Tropism: Liver, lung, and stomach
| Functions: | (a) | To stop bleeding; |
| (b) | To reduce swelling and promote healing. |
Applications:
(a)Hemorrhage: (1) cough with blood due to deficient yin of the lungs — Bletilla tuber (Bai Ji, 
) is used with Donkey hide gelatin (E Jiao, 
), Lotus node (Ou Jie, 
) and Loquat leaf (Pi Pa Ye, 
); (2) vomiting with blood — Bletilla tuber (Bai Ji, 
) is used alone. (3) hemorrhage due to external injury — Bletilla tuber (Bai Ji, 
) can be applied alone for external use.
(b)Boils, carbuncles, and swelling: (1) affected areas with redness, swelling, a sensation of heat, and pain — Bletilla tuber (Bai Ji, 
) is used with Honeysuckle flower (Jin Yin Hua, 
), Tendrilled fritillary bulb (Chuan Bei Mu, 
), Trichosanthes root (Tian Hua Fen, 
), and Honey-locust thorn (Zao Jiao Ci, 
); (2) chronic non-healing ulcers — The powder of Bletilla tuber (Bai Ji, 
) is applied directly to the wounds.
(c)Chapped skin or cracked hands or feet. The powder of Bletilla tuber (Bai Ji, 
) is mixed with sesame oil for external use.
(d)Dosage: 3–6 g
Cautions and Contraindications: It counteracts Sichuan aconite root (Wu Tou, 
).
(vi) Carbonized human hair (Xue Yu Tan, 
)
Pharmaceutical Name: Crinis carbonisatus
Part Used: Human hair, prepared by carbonization
Properties: Bitter and neutral
Channel Tropism: Liver and stomach
Function: To stop bleeding and release blood stagnation.
Application:
(a)Hemorrhage: (1) bleeding in the upper part of the body — Carbonized human hair (Xue Yu Tan, 
) is used with the juice of Lotus node (Ou Jie, 
); (2) bleeding in the lower part of the body.
(b)Dosage: 1.5–3 g.
(vii) Notoginseng (San Qi, 
)
Pharmaceutical Name: Radix Notoginseng
Part Used: Roots
Properties: Sweet, bitter, and warm
Channel Tropism: Liver and stomach
| Functions: | (a) | To stop bleeding and release stagnation; |
| (b) | To invigorate blood circulation and stop pain. |
Applications:
(a)Hemorrhage in the interior or at the surface of the body. The powder of Notoginseng (San Qi, 
) is taken alone, or it may be used with Carbonized human hair (Xue Yu Tan, 
).
(b)Hemorrhage and swelling due to external injury. Powdered Notoginseng (San Qi, 
) is used alone externally.
(c)Dosage: 1–3 g.
(viii) Cattail pollen (Pu Huang, 
)
Pharmaceutical Name: Pollen Typhae
Part Used: Pollen
Properties: Sweet and neutral
Channel Tropism: Liver and pericardium
| Functions: | (a) | To stop bleeding; |
| (b) | To release stagnation and stop pain. |
Applications:
(a)Hemorrhage manifested as coughing with blood, vomiting with blood, hematuria, bloody stools, and uterine bleeding. Cattail pollen (Pu Huang 
) is used with Agrimony (Xian He Cao, 
) and Biota tops (Ce Bai Ye, 
).
(b)Hemorrhage caused by external injury. Cattail pollen (Pu Huang, 
), used alone and dry, is applied externally.
(c)Blood stagnation manifested as cardiac pain, abdominal pain, dysmenorrhea or postpartum abdominal pain. Cattail pollen (Pu Huang, 
) is used with Trogopterus dung (Wu Ling Zhi, 
).
Cautions and Contraindications: The carbonized herb is effective in stopping bleeding; the raw herb releases stagnation and stops pain.
(d)Dosage: 5–9 g.
(ix) Mugwort leaf (Ai Ye, 
)
Pharmaceutical Name: Folium Artemisiae Argyi
Part Used: Leaf
Properties: Bitter, pungent, and warm
Channel Tropism: Liver, spleen, and kidney
| Functions: | (a) | To warm the channels and stop bleeding; |
| (b) | To dispel cold and stop pain. |
Applications:
(a)Hemorrhage due to deficiency and cold, especially uterine bleeding. Mugwort leaf (Ai Ye, 
) is used with Donkey hide gelatin (E Jiao, 
).
(b)Deficiency and cold in the lower Jiao, manifested as abdominal cold pain, irregular menstruation, amenorrhea, and leukorrhagia. Mugwort leaf (Ai Ye, 
) is used with Chinese Angelica root (Dang Gui, 
), Cyperus tuber (Xiang Fu, 
), Chuan Xiong rhizome (Chuan Xiong, 
), and Lindera root (Wu Yao, 
).
(c)Dosage: 3–9 g.
Note: This herb is used for moxibustion and can be formed into moxa sticks or cones. It warms meridians and promotes the circulation of Qi and blood.
Prescriptions for Stopping Bleeding
(i) Kexue Fang 
(Decoction for Hemoptysis)
| Composition: | Natural indigo (Qing Dai,  ) |
6 g |
Trichosanthes fruit (Gua Lou,  ) |
9 g | |
Cape jasmine fruit (Zhi Zi,  ) |
9 g | |
Chebula fruit (He Zi,  ) |
6 g | |
Costazia bone (Hai Shi,  ) |
9 g |
Administration: The herbs are ground into powder, then mixed with honey and ginger juice and made into pills. Dissolve 9 g in the mouth twice daily. It is also possible to decoct the above herbs with proper dosages.
| Functions: | (a) | To clear fire and resolve phlegm; |
| (b) | To astringe the lungs and stop cough. |
Indications: Hemoptysis due to liver-fire invading the lung with the following manifestations: cough, thick sputum with bloody streaks, difficult expectoration, vexation and irritability, chest and hypochondriac pain, dry throat and bitter mouth, flushed face, constipation, a reddened tongue with a yellow coating, and a taut rapid pulse.
Formula Analysis: This is the commonly used formula for treating hemoptysis due to liver-fire invading the lung, which leads to the lung’s failure to diffuse and downbear, giving rise to cough. The treatment for all the disorders should be to clear heat from the liver and lung, and cool blood to stop bleeding. Qing Dai 
with salty and bitter properties and Zhi Zi 
with bitter and cold properties are used as the chief herbs to clear heat from the liver and cool blood to stop bleeding. Gua Lou 
clears heat from the lung, eliminates phlegm, moistens the lung, and relieves cough, while Hai Shi 
clears heat from the lung and eliminates phlegm. They both function as assistant herbs. He Zi 
with bitter sour and astringent properties, the adjuvant herb, has an astringent effect on the lung-Qi and stops cough so as to stop bleeding. The combination could produce the action of clearing heat from the liver and lung, and cooling blood to arrest bleeding.
Applications in Bio-medicine: Hemoptysis as seen in bronchiectasis and tuberculosis, which pertain to liver-fire invading the lung.
Modifications:
(a)For severe deficiency of Yin and blood, add Ophiopogon root (Mai Dong, 
), Glehnia root (Sha Shen, 
), and Trichosanthes root (Tian Hua Fen, 
).
(b)In cases of severe cough, add Aster root (Zi Wan, 
), Tussilago flower (Kuan Dong Hua, 
), and Apricot seed (Xing Ren, 
).
(c)For cough with profuse blood, add Stemona root (Bai Bu, 
).
(ii) Xiao Ji Yinzi 
(Small Thistle Decoction)
| Composition: | Fresh Rehmannia root (Sheng Di Huang,  ) |
30 g |
Small thistle (Xiao Ji,  ) |
15 g | |
Talc (Hua Shi,  ) |
15 g | |
Clematis stem (Mu Tong,  ) |
9 g | |
Cattail pollen (Pu Huang,  ) |
9 g | |
Lotus node (Ou Jie,  ) |
9 g | |
Bamboo leaf (Zhu Ye,  ) |
9 g | |
Chinese Angelica root (Dang Gui,  ) |
6 g | |
Cape jasmine fruit (Zhi Zi,  ) |
9 g | |
Licorice (Gan Cao,  ) |
6 g |
Administration: The herbs are decocted with water for drinking.
| Functions: | (a) | To remove heat from the blood so as to arrest bleeding; |
| (b) | To induce diuresis so as to treat stranguria. |
Indications: Bloody strangury, and bloody urine due to heat accumulation in the lower energizer marked by hematuria, frequent dribbling and painful urination, or bloody urine, a reddened tongue, and a rapid pulse.
Formula Analysis: This is the commonly used formula for heat accumulation in the lower energizer, which injures blood vessels of the bladder, causing disturbance of Qi transformation of the urinary bladder. All the disorders should be treated by removing heat from the blood to arrest bleeding, and treating diuresis to treat stranguria. Xiao Ji 
with bitter and cool properties cools blood to stop bleeding and promote diuresis to treat strangury, Sheng Di Huang 
with sweet and bitter properties cools blood to arrest bleeding, nourishes Yin, and clears heat; both function as the chief herbs. Ou Jie 
and Pu Huang 
not only clear heat from the blood, but also remove blood stasis and act as the assistant herbs. Hua Shi 
, Mu Tong 
, and Zhu Ye 
clear and purge heat and promote diuresis to treat strangury, while Zhi Zi 
purges fire from the san Jiao and descends heat. Dang Gui 
nourishes Yin and blood, harmonizes blood, and guide blood to blood vessels, in combination with Sheng Di Huang 
, so as to induce diuresis without impairing Yin; its warm nature prevents the composition with a cold or cool nature from causing blood stasis. These five herbs together play the part of adjuvant herbs. Gan Cao 
relaxes tension to relieve pain, and harmonizes the middle Jiao and all the other herbs’ properties.
Applications in Bio-medicine: Acute urinary infection and calculi of the urinary system with the above syndromes, which pertain to heat syndrome of the urinary bladder.
Modifications:
(a)In cases of severe pain, add Amber (Hu Po, 
) and Lygodium spores (Hai Jin Sha,
)
(b)For excessive heat, add Phellodendron bark (Huang Bai, 
) and Pyrrosia leaf (Shi Wei, 
).
(iii) Huangtu Tang 
(Yellow Earth Decoction)
| Composition: | Baked yellow earth (Zao Xin Tu,  ) |
30 g |
Licorice (Gan Cao,  ) |
9 g | |
Dried Rehmannia (Gan Di Huang,  ) |
9 g | |
White Atractylodes (Bai Zhu,  ) |
9 g | |
Prepared aconite root (Fu Zi,  ) |
9 g | |
Donkey hide gelatin (E Jiao,  ) |
9 g | |
Scutellaria root (Huang Qin,  ) |
9 g |
Administration: Zao Xin Tu 
is boiled first to get the decoction, then the other herbs except for E Jiao in the decoction. Finally, infuse E Jiao into the decoction for drinking.
| Functions: | (a) | To warm Yang and strengthen the spleen; |
| (b) | To nourish blood and stop bleeding. |
Indications: Bleeding due to deficiency of spleen-Yang, marked by stools followed by bleeding, or hematemesis, epistaxis, or metrorrhagia with dark-red blood, cold limbs, a sallow yellow complexion, a pale tongue with a whitish coating, and a deep thready feeble pulse.
Formula Analysis: This is the commonly used formula for deficiency of spleen-Yang, deficien of Yang-Qi of the middle Jiao, and dysfunction of the spleen in controlling blood. All the disorders should be treated by warming the spleen-Yang and nourishing the blood to stop bleeding. Zao Xin Tu 
functions as the chief herb, warming and nourishing the middle Jiao and stopping bleeding with astringency. Bai Zhu 
and Fu Zi 
, the assistant herbs, warm the spleen-Yang, and invigorate the spleen to restore its function of controlling blood. Gan Di Huang 
and E Jiao 
act as the adjuvant herbs, nourishing Yin and blood so as to counteract the deficiency of both Yin and blood as the result of bleeding. They function together with Huang Qin 
to restrict the excessively warm and dry nature of Bai Zhu 
and Fu Zi 
, preventing the disturbance or impairment of blood. Meanwhile, Bai Zhu 
and Fu Zi 
restrict the greasy nature of Gan Di Huang 
and E Jiao 
. They are both opposite and supplementary to each other. Gan Cao 
is used as the guiding herb to supplement Qi, invigorate the spleen, and coordinate the actions of the other herbs. All the herbs in combination, warming Yang without dryness and nourishing Yin without greasiness, could produce the actions of warming Yang to invigorate the spleen, nourishing blood, and arresting bleeding.
Applications in Bio-medicine: Functional uterine bleeding and bleeding due to gastric ulceration, which are attributable to deficiency of spleen-Yang.
Modifications:
(a)In cases of cold manifestation due to Yang deficiency, add Baked ginger (Pao Jiang, 
) and Mugwort leaf (Ai Ye, 
).
(b)For severe Qi deficiency, add Ginseng (Ren Shen, 
) and Astragalus root (Huang Qi, 
).
(c)For severe blood deficiency, add Longan aril (Long Yan Rou, 
) and Chinese Angelica root (Dang Gui, 
).
(d)In cases of profuse bleeding, add Notoginseng (San Qi, 
), and Cuttlefish bone (Hai Piao Xiao, 
).