I hope everyone had a great week! I’m finishing off my discussion on the four Vital Substances today with Blood and Body Fluids. I have been focusing a lot on theory the past couple of weeks and I promise I will be writing more on the practical application of these theories. It is important to have a basic understanding of the fundamentals, and if you forget, you can always refer back to these posts!
Blood in Chinese Medicine is slightly different from what we recognize in Western Medicine. Blood itself is a form of Qi, but a dense and material form. Qi and blood have an interconnected relationship. Blood is inseparable from Qi. Without Qi, blood is inert. That is, Qi moves blood. In Western medicine, this is equivalent to our cardiovascular system where blood moves through our arteries and veins. Qi is more yang relative to blood (it is more insubstantial) and blood is more yin relative to Qi (it is more dense). Its main function is to nourish the body and nourish Qi. It also has a moistening function, which Qi does not possess and ensures that our tissues stay hydrated. Finally our blood provides the material foundation for the Mind. It houses and anchors the Mind or Spirit.
There are three basic cases of Blood pathology:
1) Blood deficiency – Blood becomes deficient when not enough is made. This is usually caused by Spleen Qi deficiency (or weak digestion), since Spleen Qi is the catalyst of transforming Food Qi into Blood (review the foods that correct Spleen Qi deficiency here). It is also caused by inadequate intake of nutrients, inability to absorb those nutrients, and loss of blood through gastro-intestinal bleeding or heavy menstrual flow.
Signs of blood deficiency include pale lips, nailbeds, tongue, and complexion, thinness, spots in the field of vision, unusual hair loss, premature graying and thinning hair, dry hair, dry skin, and numbness in the arms or hands. Disorders of blood deficiency are anemia, nervousness, low back pain, headaches, painful periods, or amenorrhea (absence of periods).
- Iron, folic acid, and vitamin B12 are the nutrients most often needed to reverse blood deficiency, where iron is the most common cause of anemia. Copper, B vitamins, and vitamin C aid in absorption of iron. Protein intake is also important.
- Iron sources: dark leafy greens like spinach and swiss chard, legumes, nuts, and seeds.
- Folic acid sources: dark leafy greens and sprouts, should be eaten either raw or lightly steamed.
- Vitamin C sources: cabbage, bell peppers, broccoli, sprouts, parsley, and rose hip tea.
- Cooling Vitamin C sources: Tomatoes, citrus fruits, and most other fruits are cooling sources of vitamin C. Use with caution by those with cold signs or deficiency symptoms.
- Other Blood Builders: blackberries, grapes, protein (beef, lamb, mussel, pork liver), mulberry, raspberry, turnips, and watercress.
Note: Our hair is an indicator of blood quality and is considered an extension of blood in Chinese medicine. Healthy hair has a shine and thickness to it. Hair loss and premature graying is a sign of deficient blood as well as weak spleen and kidneys. (Hair is directly affected by the kidneys, which I will discuss later).
2) Bleeding – In Western medicine, bleeding is caused by weak blood vessels and poor clotting function while Chinese medicine views bleeding as the failure of the spleen to hold the blood in the vessels. (Remember from last week’s post on Qi – Spleen Qi holds blood in the vessels.) This makes sense as Spleen Qi extracts nutrients from our food to maintain the integrity of our blood and blood vessels.
Bleeding can be caused by heat in the Blood or deficiency of yin (our cooling power). Blood becomes hot when heat in our system invades deeply into the body, disrupting blood and increasing the potential to hemorrhage. Signs of blood heat include scarlet tongue, skin rashes, fever, thirst, and fast pulse. Bleeding from heat is bright red. Chronic bleeding from heat in the blood is treated by increasing cooling foods and minimizing foods that may increase heat (meat, alcohol, tobacco, coffee, hot spices, and warming foods).
Cooling food remedies for bleeding from Heat in the Blood should be eaten raw or lightly cooked by simmering or steaming.
- spinach and swiss chard have hemostatic properties (stops bleeding)
- raspberry leaf can specifically treat excessive menstrual bleeding
- eggplant for anal and urinary tract bleeding
- persimmon for urinary bleeding and vomiting blood
- celery and lettuce treat blood in the urine, but don’t have other hemostatic properties
Signs of deficient yin include a red tongue, night sweats, and fast thin pulse. This is treated with yin strengthening foods such as millet, mung bean, seaweed, tofu, barley, beets, persimmon, grapes, blackberry, raspberry, mulberry, banana, and watermelon.
Bleeding can also be caused by deficiency with cold signs or deficiency symptoms. Blood is pale or dark-colored. The blood and its vessels are malnourished and weak, allowing blood to leak out of the vessels. This needs to be treated with warming or neutral foods.
Neutral or warming food remedies for Deficiency Bleeding can be moderately cooked. (Note: Neutral rememdies, marked with * may be used for bleeding from Heat in the blood as well.
- *olives treat hematemesis (coughing up of blood)
- leeks and guava have hemostatic properites
- cayenne pepper is a good first-aid remedy for internal or external bleeding from injuries. It can be directly applied to an external wound or taken internally as well. (Internal use: 1 teaspoon cayenne with 1 cup boiling water or 400-500mg capsules)
- chestnut is helpful for vomiting blood, nosebleed, and blood in the stool
3) Stagnant Blood or Blood stasis – Stagnant blood is blood that coagulates or congeals and is caused by either tissue injury or insufficient Qi energy (usually Liver Qi) to push blood through the vessels (i.e. the blood doesn’t move). Signs of stagnant blood include stabbing pain that is fixed in location, frequent bleeding, bleeding dark purple clots (especially with menstruation), dark purple tongue with red spots, and an unnaturally dark complexion. Stagnant blood will also tend to develop clots and chronic stagnation develops tumors, cysts, nodules, and hard immobile lumps.
Gynecological problems are related to stagnant blood. Diseases caused by stagnant blood include amenorrhea (absence of menstruation), dysmenorrhea (painful menstruation), uterine hemmorhage, uterine tumors (fibroids and cancer), and ovarian cysts. , it will stagnate, which is mainly caused by Qi stagnation (mainly Liver), Heat, or Cold.
Foods and spices that disperse and move Stagnant Blood include:
- warming foods – turmeric, chives, garlic, vinegar, basil, scallion, leek, ginger, chestnut, rosemary, cayenne, nutmeg, kohlrabi, sweet rice, spearmint, butter
- cooling foods – eggplant, white pepper (eggplant especially relieves stagnant blood in the uterus)
- neutral foods – aduki beans, peach seed
Finally, the fourth Vital Substance is Body Fluids. Body Fluids originate from food and drink. Once they enter our bodies, they are separated into “clean or pure fluids” and “dirty or impure fluids.” The pure fluids are transported by the Spleen to the Lungs, through the skin and down to the kidneys. The impure fluids are taken to the Small Intestine where they are separated again into pure and impure parts (pure parts going to Bladder and impure parts going to the Large Intestine where some of the water is reabsorbed). The Bladder further separates into pure and impure (pure part going to the exterior of the body to form sweat and impure part downward to form urine).
There are two types of body fluids in Chinese Medicine:
Jin is Fluids in Chinese
Ye is Liquids in Chinese
Jin fluids are clear, light, thin-watery and circulate with our Defensive Qi and the Exterior (skin and muscles). These fluids move quickly and are controlled by our Lungs, which spread the fluids to the skin. Jin fluids hydrate, moisten, and partially nourish our skin and muscles. This is not part of our sweat, but is a part of our tears, saliva and mucus. Jin fluids are also a component of the fluid part of Blood. They thin the Blood to prevent stasis (stagnation) of Blood.
Ye liquids are heavier and denser. They move with our Nutritive Qi in the Interior, moving slowly (compared to Jin fluids. They are controlled by our Spleen and Kidneys and hydrate and moisten our joints, spine, brain, and bone marrow. Our sense organs (eyes, ears, nose, and mouth) are lubricated by Ye liquids.
The pathology associated with Body Fluids are either Deficiency in Body Fluids or Accumulation of Body Fluids (edema or excess phlegm) in the body. We will talk more about pathology of body fluids especially related to Qi in later posts.
The Take Home Message — eat enough dark leafy greens and fruits (at least 5-7 servings per day), which most people do not! Dark leafy greens build, tonify, strengthen our blood, and potentially stop bleeding. The fluids from fruits keep us hydrated and the Vitamin C from citrus fruits aid in iron absorption. Win-win!
Have a great weekend!
In health and wellness,
The Foundations of Chinese Medicine by Giovanni Maciocia
Healing with Whole Foods by Paul Pitchford