Empty-Heat from Yin deficiency leads to bleeding in two ways. First of all, Yin-Qi is a type of
Qi and just as deficient Qi fails to hold Blood, so deficient-Yin may also fail to hold Blood.
Secondly, Empty-heat deriving from Yin deficiency may invade the Blood portion rather as
Full-Heat makes Blood reckless so that it pushes out of the blood vessels.
Bleeding from Empty-Heat is usually scanty (as there is Yin deficiency and Blood is part of
Yin). The colour of the blood is fresh-red or scarlet-red. It may occur in coughing, from the nose,
under the skin (petechiae), in the stools, from the uterus or in the urine.
Stasis of Blood
Stasis of Blood may also lead to bleeding. This may seem strange as stasis implies congealing of
Blood. However, when Blood stagnates in the vessels and the Blood-Connecting channels, it
obstructs them so that the new Blood which is continuously formed cannot enter the vessels and
leaks out.
Bleeding from Blood stasis is characterized by dark blood with clots and by pain. It may occur
from the uterus, intestines, bladder or under the skin.
It is easy for Full conditions causing bleeding to turn into Empty conditions. For example,
prolonged loss of blood from Blood-Heat may lead to Blood and Qi deficiency (which, in itself,
may be a further cause of bleeding). It may also happen that prolonged bleeding from
Blood-Heat leads to Yin deficiency as Blood is part of Yin. Yin deficiency may cause
Empty-Heat which may become a further cause of bleeding, thus giving rise to a complex
pathological condition.
Treatment
Treatment Principles
Bleeding must always be treated by attending to the underlying cause, i.e. Heat, Empty-Heat, Qi
deficiency or Blood stasis and never by simply using herbs which stop bleeding.
The principles of treatment of bleeding were outlined in great detail by Dr Tang Zong Hai in his
book "A Discussion of Blood Syndromes" (1884). In this book he outlines a fourfold strategy to
treat bleeding.1(532) The four principles of treatment which are aimed at harmonizing Blood,
are:
- Harmonize Blood