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HEMORRHAGE

NESA Int Med HEMORRHAGE

QuestionAnswer
What is hemorrhage? Abnormal emission of blood from the blood vessels and organs with seepage into surrounding tissues or discharge through the orifices
What are the major etiological factors in hemorrhage? External pathogens, emotional strain, improper diet, overexhaustion, chronic illness or aftermath of a febrile disease
What are the pathologies involved in hemorrhage due to external pathogenic factors? External evil qi attacking the body may injure blood connecting channels and cause bleeding. This can be upper body (wind, heat and dryness) causing nosebleed or coughing or vomiting blood; or lower body (damp-heat) causing bleeding in stools or urine.
What are the pathologies involved in hemorrhage due to emotional strain? Excessive emotion causes qi stagnation which over time generates fire. Fire entering the blood causes "recklessness" and forces it out of the vessels. Also, Liver fire can attack the Lung (nosebleed, coughing blood) or Stomach (vomiting blood).
What are the pathologies involved in hemorrhage due to improper diet? Improper diet leads to heat or damp-heat which damages the blood vessels and forces blood out. Also Spleen xu may fail to hold blood in the vessels and lead to bleeding.
What are the pathologies involved in hemorrhage due to overexhaustion? Overwork impairs qi and depletes yin (esp. HT qi and yin, SP qi and KD yin). Qi xu fails to govern blood and yin xu causes empty fire which may cause bleeding.
What are the pathologies involved in hemorrhage due to chronic illness or aftermath of a heat disease? They can injure qi, deplete yin and form blood stasis which leads to blood failing to stay in the channels.
What are the three MAJOR pathologies involved in hemorrhage? Deficient qi fails to hold blood in the vessels. Heat damages the blood-connecting channels, makes the blood reckless and causes extravasation. Blood stasis obstructs the blood-connecting channels so new blood cannot enter the vessels and leaks out.
What are the crucial points in diagnosing hemorrhage? Identify exact location of bleeding; identify the organ or meridian involved; identify the nature of the bleeding (cold, heat, xu, shi)
What are the general treatment principles in treating hemorrhage? Treat the underlying cause and stop bleeding
What are the four patterns associated with epistaxis? Heat attacking the Lung, Vigorous Stomach heat, Liver fire rising, Qi and blood xu
What are the s/s, treatment principle and formula for nosebleed due to Heat attacking the Lung? Nasal dryness and bleeding, dry mouth and throat, fever, coughing w/scanty sputum, T:red, tyc, P:rapid; Clear and drain Lung heat, cool blood and stop bleeding with Sang Ju Yin plus Mu Dan Pi, Bai Mao Gen, Han Lian Cao and Ce Bai Ye
What are the s/s, treatment principle and formula for nosebleed due to Vigorous Stomach heat? Nasal bleeding of fresh, red blood, dry mouth, bad breath, thirst for cold drinks, irritability, constipation, T:red ytc, P:rapid; Clear and drain Stomach heat, cool the blood and stop bleeding with Yu Nu Jian
What are the s/s, treatment principle and formula for nosebleed due to Liver fire rising? Nasal bleeding, h/a, dizziness, bitter taste, red eyes, irritability, short temper, tinnitus, T:red, P:wiry, rapid; Clear and drain Liver fire, cool the blood and stop bleeding with Long Dan Xie Gan Tang
What are the s/s, treatment principle and formula for nosebleed due to Qi and blood xu? Nasal bleeding of light, red blood or bleeding gums and subcutaneous and mucosal bleeding, pale face, insomnia, dizziness, palpitations, fatigue, T:pale, P:thin, forceless; Tonify qi and blood, strengthen the Spleen and stop bleeding with Gui Pi Tang
What are the three patterns associated with bleeding gums? Vigorous Stomach heat, Yin xu with vigorous fire, Qi and blood xu
What are the s/s, treatment principle and formula for bleeding gums due to Vigorous Stomach heat? Bleeding gums of fresh, red blood, red, swollen, painful gums, h/a, bad breath, constipation, T:red w/ytc, P:flooding, rapid; Clear the Stomach, drain fire, cool the blood and stop bleeding with Jia Wei Qing Wei San plus Xie Xin Tang
What are the s/s, treatment principle and formula for bleeding gums due to Yin xu with vigorous fire? Bleeding gums of light red blood, swollen gums, loose teeth, chronic recurrent bleeding and 5-palm heat, T:red w/little coat, P:thin, rapid; Nourish yin, clear heat, cool the blood and stop bleeding with Liu Wei Di Huang Wan plus Qian Gen San
What are the s/s, treatment principle and formula for bleeding gums due to qi and blood xu? Chronic bleeding gums of light red blood, pale face, insomnia, dizziness, palpitations, fatigue, T:pale, P:thin, forceless; Tonify qi and blood, strengthen the Spleen and stop bleeding with Gui Pi Tang
What are the three patterns associated with hemoptysis? Dryness and heat injuring the Lung; Liver fire invading the Lung; Yin xu with heat in the Lung
What are the s/s, treatment principle and formula for hemoptysis due to dryness and heat injuring the Lung? Acute onset of cough, scratchy throat, small volume of blood mixed w/sputum, dry mouth and nose, fever, aversion to wind, h/a, T:dry, red, tyc, P:rapid; Clear heat, moisten the Lung and stop bleeding with Sang Xing Tang
What are the s/s, treatment principle and formula for hemoptysis due to Liver fire invading the Lung? Acute onset cough w/blood-tinged sputum, vertex h/a, red face and eyes, tinnitus, irritability, bitter taste, worse with emotions/stress, T:red,tyc, P:wiry,rapid; Clear heat from Liver and Lung, cool the blood, stop bleeding w/ Xie Bai San plus Dai Ge San
What are the s/s, treatment principle and formula for hemoptysis due to yin xu with heat in the Lung? Dry cough w/blood-tinged sputum, dry mouth and throat, malar flush, tidal fever, night sweats, sx worse at night, T:red w/little coat, P:thin, rapid; Nourish yin, moisten the Lung, clear heat and stop bleeding with Bai He Gu Jin Tang
What are the three patterns associated with hematemesis? Excessive Stomach heat; Liver fire invading the Stomach; Spleen qi xu
What are the s/s, treatment principle and formula for hematemesis due to excessive Stomach heat? Vomiting blood, acid reflux, heartburn, gnawing hunger, constipation, red face, thirst for cold drinks, sweating face, T:red w/greasy ytc, P:slippery, rapid; Clear Stomach heat, drain fire, cool the blood, stop bleeding w/Xie Xin Tang plus Shi Hui San
What are the s/s, treatment principle and formula for hematemesis due to Liver fire invading the Stomach? Vomiting blood, bitter taste, hypochondrial pain, irritability, insomnia, T:dark red, P:wiry, rapid; Drain the Liver, clear the Stomach, cool the blood, stop bleeding with Long Dan Xie Gan Tang
What are the s/s, treatment principle and formula for hematemesis due to Spleen qi xu? Intermittent vomiting of light-colored blood, pale face, palpitations, SOB, fatigue, low appetite, irregular BMs, T:pale, P:thin, weak; Strengthen the Spleen, tonify qi and blood and stop bleeding with Gui Pi Tang
What are the three patterns associated with hematochezia? Damp-heat in the intestine; Spleen qi xu; Spleen and Stomach yang xu
What are the s/s, treatment principle and formula for hematochezia due to damp-heat in the intestine? Fresh blood and mucus in stool, freq, inc. or loose BMs, abd distension/pain, bitter taste, thirst w/out desire to drink, T:greasy ytc, P:slippery, rapid; Clear heat, resolve dampness, cool blood, stop bleeding w/Di Yu San or Huai Hua San or Huai Jiao Wan
What are the s/s, treatment principle and formula for hematochezia due to Spleen qi xu? Chronic, mild bleeding aggravated by poor diet and overexertion, palpitations, pale face, light menses, insomnia, T:pale, P:thin, weak; Strengthen the Spleen and stop bleeding with Gui Pi Tang
What are the s/s, treatment principle and formula for hematochezia due to Spleen and Stomach yang xu? Black stools, abdominal pain and coldness, desire for warmth, cold body, worse in cold weather, pale face, fatigue, T:pale w/twc, P:thin, weak; Strengthen the Spleen, warm the middle jiao, nourish blood and stop bleeding with Huang Tu Tang
What is the difference between hematuria and Lin Syndrome? There is no pain with hematuria.
What are the four patterns associated with hematuria? Heat accumulating in the lower burner; Kidney yin xu with heat; Spleen qi xu; Kidney qi xu
What are the s/s, treatment principle and formula for hematuria due to heat accumulating in the lower burner? Dark urine w/fresh blood, urgency, inc urination, irritability, thirst, red face, mouth sores, insomnia, T:red, P:rapid; Clear heat, drain fire, cool the blood and stop bleeding with Xiao Ji Yin Zi
What are the s/s, treatment principle and formula for hematuria due to Kidney yin xu with heat? Scanty urine w/blood, dizziness, tinnitus, hot flashes, tidal fever, weight loss, T:red w/little coat, cracked, dry, P:thin, rapid; Nourish Kidney yin, clear heat, cool the blood and stop bleeding with Zhi Bai Di Huang Wan
What are the s/s, treatment principle and formula for hematuria due to Spleen qi xu? Small volume of light-colored blood in urine, sinking in lower abdomen, dribbling or inc urination, weak stream, pale face, fatigue, SOB, T:pale, P:thin, weak; Tonify Spleen qi to control blood and stop bleeding with Gui Pi Tang
What are the s/s, treatment principle and formula for hematuria due to Kidney qi xu? Small volume of pink blood in urine, aggravated by overexertion and sex, tinnitus, dizziness, fatigue, sore low back and knees, T:pale, P:deep, weak, KD↓; Tonify the Kidney, strengthen retention and stop bleeding with Wu Bi Shan Yao Wan
Created by: rswain