Chapter Twelve. Herbs that stop bleeding
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1. What are the characteristics of herbs that stop bleeding?
Herbs that stop bleeding are used for acute bleeding conditions and they treat the manifestations rather than the cause of the syndrome. Therefore, when the bleeding is stopped, the patient should be treated according to the differentiation of the syndromes.
Herbs that stop bleeding have the following characteristics.
Sour or astringent
Sour and astringent substances possess an astringent property—that is, they reverse abnormal leakage of blood and their tendency of action is inwards. They treat the symptom of bleeding rather than its cause and are often used in different bleeding conditions as a first aid procedure. The commonly used substances are Bai Ji ( Bletillae tuber)**, Ou Jie ( Nelumbinis nodus rhizomatis), Zong Lü ( Stipulae trachycarpi fibra), Hua Rui Shi ( Ophicalcitum) and Zao Xin Tu ( Terra flava usta).
Cold and bitter
Coldness can clear Heat and bitterness can reduce Fire. Since bleeding is often caused by Heat, especially in acute cases, there exist herbs that not only can stop bleeding, but also can clear Heat. They are used as herbs that treat both the cause and the symptoms of the disorder. They are Da Jì ( Cirsii japonici herba seu radix), Xiao Ji ( Cirsii herba), Ce Bai Ye ( Platycladi cacumen), Huai Hua ( Sophorae flos), Di Yu ( Sanguisorbae radix) and Bai Mao Gen ( Imperatae rhizoma).
Promoting the Blood circulation and stopping bleeding
It does not sound logical that the functions of moving the Blood and stopping bleeding should coexist in one herb. Nevertheless, these herbs do exist and they are particularly used when bleeding is caused by obstruction due to congealed Blood, such as in menorrhagia caused by trauma, hysteromyoma or heavy bleeding due to retained placenta. The herbs that can remove congealed Blood and stop bleeding are San Qi ( Notoginseng radix), Qian Cao Gen ( Rubiae radix), Pu Huang ( Typhae pollen), Xue Yu Tan ( Crinis carbonisatus) and Hua Rui Shi.
Usage of charred herbs
In TCM, it is considered that bleeding will be stopped by the use of black, charred herbs. In clinical practice, as good results with this method have substantiated the concept, many herbs are charred particularly for the purpose of stopping bleeding. The commonly used herbs are Da Jì, Xiao Ji, Pu Huang, Ou Jie, Zong Lu and Xue Yu Tan.
2. What precautions should be observed when using herbs that stop bleeding?
Herbs that stop bleeding are particularly used in acute conditions so as to control the bleeding in time. However, after the bleeding has stopped, or even when there is still some bleeding present, herbs that treat the cause should also be used. For example, if the bleeding is caused by Heat, such as in colitis, dysentery and enteritis, herbs that clear Heat and cool the Blood should be used. If the bleeding is caused by Qi deficiency, herbs that tonify the Qi should be prescribed to hold the Blood, such as in thrombocytopenia. If the bleeding is caused by Yin deficiency with Yang rising, such as in cerebrovascular accident, herbs that direct the Yang downwards must be added.
Herbs that stop bleeding are effective for treating many kinds of bleeding conditions. However, when the bleeding is very heavy and presents a danger to the patient, the person should be sent to hospital immediately. If it is impossible to reach a hospital, a large dose of Ren Shen ( Ginseng radix) should be applied, together with the herbs that stop bleeding, to hold the Qi in order to control the Blood and stop bleeding.
Since most of these herbs have a sour, astringent or cold nature that may cause stagnation of Blood, these herbs should be used for a short period of time only or combined with herbs that can gently disperse the stagnation.
3. What are the differences between Da Jì ( Cirsii japonici herba seu radix) and Xiao Ji ( Cirsii herba)?
Da Jì and Xiao Ji are sweet and cold, and both enter the Liver and Heart meridians. The fresh or raw herbs are able to cool the Blood and stop bleeding. If they are charred, they acquire an astringent property, and then they can also stabilize the Blood and stop bleeding. In clinical practice, they are often used in combination to enhance the effect of stopping the bleeding. These two herbs are also effective for treating jaundice and other disorders of bile secretion, and hypertension.
Da Jì is colder than Xiao Ji and has a stronger action in reducing Heat, cooling the Blood and stopping bleeding. It is used for bleeding caused by Heat, such as seen in pulmonary tuberculosis, gastric ulcer, menorrhagia or diseases of the liver.
Xiao Ji is not so cold, and its function of cooling the Blood and stopping bleeding is gentler than that of Da Jì. It is especially effective for reducing Heat in the Lower Jiao and in treating bleeding caused by Damp-Heat in the Lower Jiao, such as seen in acute urinary tract infection, cystitis and pyelonephritis.
4. Xiao Ji ( Cirsii herba) and Bai Mao Gen ( Imperatae rhizoma) can both treat blood in the urine. What are the differences between them when they are used in clinical practice?
Xiao Ji and Bai Mao Gen are sweet and cold. Both can cool the Blood and stop bleeding. They can also promote urination and eliminate Damp-Heat from the Lower Jiao. They are especially effective for treating bloody urine caused by Damp-Heat in the Lower Jiao, which injures the local blood vessels and disturbs the local Blood circulation. However, there are some differences between these two herbs in clinical practice.
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