Bleeding+Disorders

=Bleeding Syndromes/Xuè Zhèng= Bleeding Syndromes/Xuè Zhèng refers to any blood issuing outside the proper pathways, whether from the nose or mouth, whether past with the feces or urine, or whether it extravasates into the skin. Pathological bleeding can be acute or chronic and result from a variety of biomedical conditions.

Diagnosis
Identify the site of bleeding. Determine the zang-fu involved or, in cases of febrile diseases causing bleeding, determine the energetic depth (i.e., Ying or Xue level). Clearly differentiate excess from deficiency, Hot from Cold (Heat patterns are more common than Cold patterns). Excess and deficiency may coexist, so determining which is predominant is crucial.

Treatment Principles
-//Excess fire:// clear fire and cool blood -//Deficiency fire:// nourish Yin, clear empty fire, cool blood -//Excess type (Qi stagnation & rebellion):// Descend Qi -//Deficiency type:// Tonify Qi -Cool blood, stop bleeding -Astringe blood, stop bleeding -Move blood, stop bleeding
 * 1. Treat the fire**
 * 2. Treat the Qi**
 * 3. Treat the blood**

Nose Bleeding/Bi Nu Manifesting as Lung Heat
[Sang Ye (Morus Leaf) 9g, Ju Hua (Chrysanthemum) 6g, Bo He (Field Mint) 6g, Xing Ren (Apricot Seed) 9g, Jie Geng (Platycodon) 9g, Lian Qiao (Forsythia) 9g, Lu Gen (Phragmites) 9g, Gan Cao (Licorice Root) 6g]
 * Main Symptoms:** Nose bleed with bright red blood, dryness of nose, mouth and throat
 * Additional Symptoms:** Fever, cough with scanty sputum
 * Tongue:** Red, thin yellow coating
 * Pulse:** Rapid
 * Treatment Principles:** Clear heat from the Lung, cool blood, stop bleeding
 * Herbal Treatment:** Sang Ju Yin (Morus Leaf & Chrysanthemum Decoction)

Nose Bleeding/Bi Nu Manifesting as Stomach Heat
[Shi Gao (Gypsum) 15g, Shu Di Huang (Cooked Rehmannia Root) 15g, Mai Men Dong (Ophiopogon 6g, Zhi Mu (Anemarrhena) 6g]
 * Main Symptoms:** Nose bleed with fresh red blood, bleeding gums
 * Additional Symptoms:** Thirst for cold drinks, dry nose and mouth, bad breath, restlessness, irritability, constipation
 * Tongue:** Red, yellow coating
 * Pulse:** Rapid
 * Herbal Treatment:** Yu Nu Jian (The Fair Maiden Decoction)

Nose Bleeding/Bi Nu Manifesting as Liver Fire
[Long Dan Cao (Gentian Root) 6g, Huang Qin (Scutellaria Root) 9g, Shan Zhi Zi (Gardenia Fruit) 9g, Ze Xie (Alisma Tuber) 12 g, Mu Tong (Mutong Stem) 9g, Dang Gui (Tangkuei) 3g, Che Qian Zi (Plantago Seed) 9g, Sheng Di Huang (Rehmannia Root) 9g, Chai Hu (Bupleurum Root) 6g, Gan Cao (Licorice Root) 6g]
 * Main Symptoms:** Nose bleed with bright red blood, worse with emotional stress/anger
 * Additional Symptoms:** Headache, tinnitus, irritability, short temper, red eyes and face, bitter taste in mouth
 * Tongue:** Red
 * Pulse:** Wiry, rapid
 * Treatment Principles:** Clear and drain Liver fire, cool blood, stop bleeding
 * Herbal Treatment:** Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction)

Nose Bleeding/Bi Nu Manifesting as Vacuity of Qi and Blood
[Huang Qi (Astragalus Root) 9g, Ren Shen (Ginseng) 9g, Bai Zhu (Ovate Atractylodes Root) 9g, Fu Shen (Poria Root) 9g, Long Yan Rou (Longan Fruit) 9g, Suan Zao Ren (Spiny Jujube Kernel) 9g, Mu Xiang (Saussurea Root) 6g, Dang Gui (Tangkuei) 6g, Yuan Zhi (Polygala Root) 3g, Zhi Gan Cao (Honey-fried Licorice Root) 6g, Shang Jiang (Fresh Ginger) 3g, Da Zao (Jujube Fruit) 5 pc]
 * Main Symptoms:** Nose bleed with light red blood, bleeding gums, bleeding from other sites
 * Additional Symptoms:** Pale complexion, fatigue, dizziness, palpitations, insomnia
 * Tongue:** Pale
 * Pulse:** Thready, forceless
 * Treatment Principles:** Tonify Qi to control blood, nourish Blood, stop bleeding
 * Herbal Treatment:** Gui Pi Tang (Spleen-Returning Decoction)

Bleeding Gums/Chi Nu Manifesting as Stomach Fire
[Huang Lian (Coptis Root) 9g, Sheng Di Huang (Rehmannia Root) 12g, Mu Dan Pi (Moutan Root Bark) 9g, Sheng Ma (Cimifuga Root) 6g, Dang Gui (Tangkuei) 3g]
 * Main Symptoms:** Bleeding gums with bright red blood, swollen, red & painful gums
 * Additional Symptoms:** Headache, dry nose and mouth, bad breath, thirst for cold drinks, constipation
 * Tongue:** Red, yellow coating
 * Pulse:** Rapid, flooding
 * Treatment Principles:** Clear Stomach heat, drain fire, cool blood, stop bleeding
 * Herbal Treatment:** Qing Wei San (Stomach-Clearing Powder)

Bleeding Gums/Chi Nu Manifesting as Yin Vacuity with Empty Fire
[Qian Cao Gen (Madder Root) 12g, Huang Qin (Scutellaria Root) 9g, E Jiao (Ass Hide Glue) 9g, Ce Bai Ye (Biota Leaf) 12g, Sheng Di Huang (Rehmannia Root) 30g, Gan Cao (Licorice Root) 6g]
 * Main Symptoms:** Intermittent bleeding gums with light red blood, swollen gums, loose teeth
 * Additional Symptoms:** Chronic bleeding gums, five-centers heat, night sweating, tinnitus, malar flush, dizziness, fatigue, sore and weak low back and knees, dry mouth
 * Tongue:** Red, scanty coating
 * Pulse:** Rapid, thready, thin
 * Treatment Principles:** Nourish Yin, drain fire, cool blood, stop bleeding
 * Herbal Treatment:** Qian Gen San (Madder Root Powder)

Coughing Blood/Ke Xue Manifesting as Damage to the Lung by Wind, Heat & Dryness
[Sang Ye (Mulberry Leaf) 9g, Xing Ren (Apricot Kernel) 9g, Sha Shen (Glehnia Root) 9g, Zhe Bei Mu (Fritillaria Bulb) 9g, Dan Dou Chi (Fermented Soybean) 9g, Shan Zhi Zi (Gardenia Fruit) 6g, Li Pi (Pear Skin) 6g]
 * Main Symptoms:** Cough with blood-tinged sputum or pure blood, itchy throat
 * Additional Symptoms:** Dryness of the nose and mouth, thick phlegm which is difficult to expectorate, chills, fever, aversion to wind, headache
 * Tongue:** Red, dry, thin yellow coating
 * Pulse:** Rapid, floating
 * Treatment Principles:** Clear heat, moisten the Lung, stop bleeding
 * Herbal Treatment:** Sang Xing Tang (Mulberry Leaf & Apricot Kernel Decoction)

Coughing Blood/Ke Xue Manifesting as Liver Fire Invading the Lung
[Sang Bai Pi (Mulberry Root Bark) 9g, Di Gu Pi (Lycium Root Bark) 12g, Jing Mi (Rice) 15g, Zhi Gan Cao (Honey-fried Licorice Root) 6g] + [Qing Dai (Indigo) 3g, Hai Ge Ke (Clamshell) 12g]
 * Main Symptoms:** Recurrent cough, blood-streaked sputum or pure blood, pain in the chest when coughing, symptoms aggravated by emotional stress/anger
 * Additional Symptoms:** Irritability, bitter taste in mouth, dryness of the throat, dry stools, dark yellow urine, distending pain in chest and hypochondiac regions
 * Tongue:** Red, thin yellow coating
 * Pulse:** Wiry, rapid
 * Treatment Principles:** Clear heat from the Liver and Lung, cool blood, stop bleeding
 * Herbal Treatment:** Xie Bai San (White draining powder)+ Dai Ge San (Clamshell Powder)

Coughing Blood/Ke Xue Manifesting as Vacuity of Lung Yin with Empty Fire
[Sheng Di Huang (Rehmannia Root) 9g, Shu Di Huang (Cooked Rehmannia Root) 9g, Mai Men Dong (Ophiopogon Tuber) 9g, Bai He (Lily Bulb) 9g, Bai Shao Yao (White Peony Root) 9g, Dang Gui (Tangkuei) 6g, Chuan Bei Mu (Sichuan Fritillaria Bulb) 9g, Xuan Shen (Scrophularia Root) 9g, Jie Geng (Platycodon Root) 6g, Gan Cao (Licorice Root) 6g]
 * Main Symptoms:** Dry cough with small amounts of blood-streaked sputum or recurrent coughing of bright red blood
 * Additional Symptoms:** Tidal fever, night sweats, five-center heat, malar flush, dryness of the mouth and throat, emaciation
 * Tongue:** Red, scanty coating
 * Pulse:** Thready, rapid
 * Treatment Principles:** Nourish Yin, moisten the Lung, stop bleeding
 * Herbal Treatment:** Bai He Gu Jin Tang (Lily Bulb Metal-Securing Decoction)

Vomiting Blood/Tu Xue Manifesting as Stomach Heat
[Da Huang (Rhubarb) 12g, Huang Lian (Coptis Root) 9g, Huang Qin (Scutellaria Root) 9g] + [Da Ji (Cirsium) 9g, Xiao Ji (Cephalanoplos) 9g, He Ye (Lotus Leaf) 9g, Ce Bai Ye (Biota Leaf) 9g, Bai Mao Gen (Imperata Root) 9g, Qian Cao Gen (Madder Root) 9g, Shan Zhi Zi (Gardenia Fruit) 9g, Da Huang (Rhubarb) 9g, Mu Dan Pi (Moutan Root Bark) 9g, Zong Lu Pi (Trachycarpus Fiber) 9g]
 * Main Symptoms:** Vomiting bright red or dark purple blood mixed with undigested food, distension and pain of epigastrium and abdomen
 * Additional Symptoms:** Foul breath, constipation, black colored stools
 * Tongue:** Red, yellow greasy coating
 * Pulse:** Rapid, slippery
 * Treatment Principles:** Clear Stomach heat, drain fire, invigorate blood, stop bleeding
 * Herbal Treatment:** Xie Xin Tang (Heart-Draining Decoction) + Shi Hui San (Ten Cinders Powder)

Vomiting Blood/Tu Xue Manifesting as Liver Fire invading the Stomach
[Long Dan Cao (Gentian Root) 6g, Huang Qin (Scutellaria Root) 9g, Shan Zhi Zi (Gardenia Fruit) 9g, Ze Xie (Alisma Tuber) 12 g, Mu Tong (Mutong Stem) 9g, Dang Gui (Tangkuei) 3g, Che Qian Zi (Plantago Seed) 9g, Sheng Di Huang (Rehmannia Root) 9g, Chai Hu (Bupleurum Root) 6g, Gan Cao (Licorice Root) 6g]
 * Main Symptoms:** Vomiting bright red or dark purple blood, bitter taste in the mouth, pain in the hypochondriac region
 * Additional Symptoms:** Irritability, dream-disturbed sleep, insomnia, dark yellow and scanty urine
 * Tongue:** Dark red
 * Pulse:** Rapid, wiry
 * Treatment Principles:** Drain the Liver and Stomach fire, cool blood, stop bleeding
 * Herbal Treatment:** Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction)

Vomiting Blood/Tu Xue Manifesting as Qi Vacuity failing to control the blood
[Huang Qi (Astragalus Root) 9g, Ren Shen (Ginseng) 9g, Bai Zhu (Ovate Atractylodes Root) 9g, Fu Shen (Poria Root) 9g, Long Yan Rou (Longan Fruit) 9g, Suan Zao Ren (Spiny Jujube Kernel) 9g, Mu Xiang (Saussurea Root) 6g, Dang Gui (Tangkuei) 6g, Yuan Zhi (Polygala Root) 3g, Zhi Gan Cao (Honey-fried Licorice Root) 6g, Shang Jiang (Fresh Ginger) 3g, Da Zao (Jujube Fruit) 5 pc]
 * Main Symptoms:** Vomiting blood of varying degree over a long period of time where blood is pale red, epigastric pain that is relieved with heat & pressure
 * Additional Symptoms:** Loss of appetite, fatigue and lassitude, pale complexion, shortness of breath, palpitations
 * Tongue:** Pale
 * Pulse:** Thready, weak, deep
 * Treatment Principles:** Strengthen the Spleen, tonify Qi to control blood, stop bleeding
 * Herbal Treatment:** Gui Pi Tang (Spleen-Returning Decoction)

Bloody Stool (Hemafecia)
Refers to blood produced together with the stool. Generally speaking, bleeding before the bowel movement comes from the rectum and the anus. Bleeding soon after the bowel movement comes from more distant areas, such as the small intestine and the stomach.

Bloody Stools/Bian Xue Manifesting as Damp-Heat in the Intestines
[Di Yu (Sanguisorba Root) 12g, Qian Cao Gen (Madder Root) 12g, Huang Qin (Scutellaria Root) 9g, Huang Lian (Coptis Root) 9g, Shan Zhi Zi (Gardenia Fruit) 9g, Fu Ling (Poria) 12g]
 * Main Symptoms:** Fresh red blood in the stool, feeling of incomplete defecation, loose stools
 * Additional Symptoms:** Burning sensation of the anus, abdominal distension and pain, bitter taste in the mouth
 * Tongue:** Yellow greasy coating
 * Pulse:** Rapid, slippery
 * Treatment Principles:** Clear heat, drain dampness, cool blood, stop bleeding
 * Herbal Treatment:** Di Yu San (Sanguisorba Powder)

Bloody Stools/Bian Xue Manifesting as Spleen & Stomach Qi Vacuity
[Huang Qi (Astragalus Root) 9g, Ren Shen (Ginseng) 9g, Bai Zhu (Ovate Atractylodes Root) 9g, Fu Shen (Poria Root) 9g, Long Yan Rou (Longan Fruit) 9g, Suan Zao Ren (Spiny Jujube Kernel) 9g, Mu Xiang (Saussurea Root) 6g, Dang Gui (Tangkuei) 6g, Yuan Zhi (Polygala Root) 3g, Zhi Gan Cao (Honey-fried Licorice Root) 6g, Shang Jiang (Fresh Ginger) 3g, Da Zao (Jujube Fruit) 5 pc]
 * Main Symptoms:** Red or dark purplish blood in the stool for a prolonged period of time with varying degree of severity
 * Additional Symptoms:** Pain in the epigastrium which is relieved by pressure, loss of appetite, fatigue and lassitude, shortness of breath, pale complexion, palpitations
 * Tongue:** Yellow greasy coating
 * Pulse:** Rapid, slippery
 * Treatment Principles:** Strengthen Spleen, tonify Qi to control blood, stop bleeding
 * Herbal Treatment:** Gui Pi Tang (Spleen-Returning Decoction)

Bloody Stools/Bian Xue Manifesting as Spleen & Stomach Yang Vacuity
[Fu Long Gan (Oven Earth) 30g, Shu Di Huang (Cooked Rehmannia Root) 9g, Bai Zhu (Atractylodes Root) 9g, Zhi Fu Zi (Aconite Accessory Tuber) 9g, E Jiao (Ass Hide Glue) 9g, Huang Qin (Scutellaria Root) 9g, Gan Cao (Licorice Root) 9g]
 * Main Symptoms:** Dark red or tarry stool, dull abdominal pain, desire for warm liquids
 * Additional Symptoms:** Lusterless complexion, fatigue, lethargy, loose stools, disinclination to speak
 * Tongue:** Pale, white coating
 * Pulse:** Weak, thready
 * Treatment Principles:** Strengthen Spleen, warm the middle burner, nourish blood, stop bleeding
 * Herbal Treatment:** Huang Tu Tang (Yellow Earth Decoction)

Urinary Bleeding/Bian Xue Manifesting as Heat in the Lower Burner
[Sheng Di Huang (Rehmannia Root) 30g, Xiao Ji (Cephalanoplos) 15g, Mu Tong (Mutong Stem) 6g, Hua Shi (Talcum) 15g, Chao Pu Huang (Typha Pollen) 9g, Dan Zhu Ye (Bamboo Leaf) 9g, Ou Jie (Lotus Root Node) 9g, Dang Gui (Tangkuei) 9g, Shan Zhi Zi (Gardenia Fruit) 9g, Zhi Gan Cao (Honey-fried Licorice Root) 6g]
 * Main Symptoms:** Dark, scanty urine containing fresh red blood
 * Additional Symptoms:** May or may not be a burning pain with urination, irritability, great thirst, sores on the tongue or in the mouth, restless sleep or insomnia
 * Tongue:** Red
 * Pulse:** Rapid
 * Treatment Principles:** Clear heat, drain fire, cool blood, stop bleeding
 * Herbal Treatment:** Xiao Ji Yin Zi (Cephalanoplos Drink)

Urinary Bleeding/Bian Xue Manifesting as Vacuity of Spleen Qi
[Huang Qi (Astragalus Root) 9g, Ren Shen (Ginseng) 9g, Bai Zhu (Ovate Atractylodes Root) 9g, Fu Shen (Poria Root) 9g, Long Yan Rou (Longan Fruit) 9g, Suan Zao Ren (Spiny Jujube Kernel) 9g, Mu Xiang (Saussurea Root) 6g, Dang Gui (Tangkuei) 6g, Yuan Zhi (Polygala Root) 3g, Zhi Gan Cao (Honey-fried Licorice Root) 6g, Shang Jiang (Fresh Ginger) 3g, Da Zao (Jujube Fruit) 5 pc]
 * Main Symptoms:** Blood in the urine, history of chronic illness
 * Additional Symptoms:** Pale and sallow complexion, fatigue and lassitude, epigastric pain which is relieved by pressure, palpitations, shortness of breath
 * Tongue:** Pale
 * Pulse:** Thready, weak
 * Treatment Principles:** Strengthen Spleen, tonify Qi to control blood, stop bleeding
 * Herbal Treatment:** Gui Pi Tang (Spleen-Returning Decoction)

Urinary Bleeding/Bian Xue Manifesting as Vacuity of Kidney Yin with Empty Fire
Treatment Principles: Nourish Kidney Yin, clear fire, cool blood, stop bleeding [Shu Di Huang (Cooked Rehmannia Root) 24g, Shan Zhu Yu (Cornus Fruit) 12g, Shan Yao (Dioscorea Root) 12g, Ze Xie (Alisma Tuber) 9g, Fu Ling (Poria) 9g, Mu Dan Pi (Moutan Root Bark) 9g, Zhi Mu (Anemarrhena Root) 9g, Huang Bai (Phellodendron Bark) 9g]
 * Main Symptoms:** Dark scanty urine with blood, no pain
 * Additional Symptoms:** Dizziness and vertigo, tinnitus, night sweats, tidal fever, malar flush, fatigue, nocturnal emissions, weak and sore low back and knees
 * Tongue:** Red, scanty coating
 * Pulse:** Rapid, thready
 * Herbal Treatment:** Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron & Rehmannia Decoction)

Urinary Bleeding/Bian Xue Manifesting as Kidney Vacuity failing to consolidate the Lower Burner
[Shan Yao (Dioscorea Root) 30g, Rou Cong Rong (Cistanche Stem) 15g, Shu Di Huang (Cooked Rehmannia Root) 12g, Shan Zhu Yu (Cornus Fruit) 12g, Fu Shen (Poria Root) 9g, Tu Si Zi (Cuscuta Seed) 9g, Wu Wei Zi (Schisandra Berry) 6g, Chi Shi Zhi (Halloysite) 12g, Ba Ji Tian (Morinda Root) 12g, Ze Xie (Alisma Tuber) 9g, Du Zhong (Eucommia Bark) 12g, Niu Xi (Achyranthes Root) 9g]
 * Main Symptoms:** Urine with light red blood, history of chronic illness
 * Additional Symptoms:** Dizziness and vertigo, fatigue, weak and sore low back and knees
 * Tongue:** Pale
 * Pulse:** Deep, weak
 * Treatment Principles:** Tonify Kidney, stabilize the lower burner, stop bleeding
 * Herbal Treatment:**Wu Bi Shan Yao Wan (Matchless Dioscorea Pill)

Subcutaneous Bleeding
Subcutaneous bleeding is bruising. It is common in old people. In young people it occurs in leukemia. It also occurs at the blood level stage of an acute febrile disease and indicates blood-heat.

Subcutaneous Bleeding/Zi Ban Manifesting as Heat in the Blood
[Shui Niu Jiao (Water Buffalo Horn) 3g, Sheng Di Huang (Rehmannia Root) 30g, Bai Shao Yao (White Peony Root) 12g, Mu Dan Pi (Moutan Root Bark) 9g]
 * Main Symptoms:** Sudden appearance of petechiae or subcutaneous bleeding
 * Additional Symptoms:** possible nose and gums bleeding, bloody stools, urinary bleeding, fever, thirst, constipation, dark urine
 * Tongue:** Deep red, yellow coating
 * Pulse:** Rapid, wiry
 * Treatment Principles:** Clear heat, relieve toxicity, cool blood, stop bleeding
 * Herbal Treatment:** Xi Jiao Di Huang Tang (Rhinoceros Horn & Rehmannia Decoction)

Subcutaneous Bleeding/Zi Ban Manifesting as Vacuity of Yin with Empty Fire
[Qian Cao Gen (Madder Root) 12g, Huang Qin (Scutellaria Root) 9g, E Jiao (Ass Hide Glue) 9g, Ce Bai Ye (Biota Leaf) 12g, Sheng Di Huang (Rehmannia Root) 30, Gan Cao (Licorice Root)]
 * Main Symptoms:** Intermittent periods of petechiae or subcutaneous bleeding, tidal fever, five-center heat
 * Additional Symptoms:** Bleeding from other locations such as the nose, heavy menses, malar flush, night sweats, fatigue, sore and weak low back and knees, dry mouth
 * Tongue:** Red, scanty or no coating
 * Pulse:** Rapid, thin, thready
 * Treatment Principles:** Nourish Yin, eliminate empty fire, stop bleeding
 * Herbal Treatment:** Qian Gen San (Madder Root Powder)

Subcutaneous Bleeding/Zi Ban Manifesting as Qi Vacuity failing to control the Blood
[Huang Qi (Astragalus Root) 9g, Ren Shen (Ginseng) 9g, Bai Zhu (Ovate Atractylodes Root) 9g, Fu Shen (Poria Root) 9g, Long Yan Rou (Longan Fruit) 9g, Suan Zao Ren (Spiny Jujube Kernel) 9g, Mu Xiang (Saussurea Root) 6g, Dang Gui (Tangkuei) 6g, Yuan Zhi (Polygala Root) 3g, Zhi Gan Cao (Honey-fried Licorice Root) 6g, Shang Jiang (Fresh Ginger) 3g, Da Zao (Jujube Fruit) 5 pc]
 * Main Symptoms:** Chronic or recurrent petechiae or subcutaneous bleeding, fatigue, lassitude
 * Additional Symptoms:** Bleeding from other locations such as the nose, gums, intestines, fatigue and lethargy, shortness of breath, reduced appetite, pale complexion
 * Tongue:** Pale, flabby, thin white coating
 * Pulse:** Thready, weak
 * Treatment Principles:** Strengthen Spleen, supplement Qi to control the Blood, stop bleeding
 * Herbal Treatment:** Gui Pi Tang (Spleen-Returning Decoction)

The Treatment of Bleeding With Acupuncture
//Basic Points:// 1) **Blood heat:** SP-10, BL-17, SP-6 2) **Qi Xu:** DU-20, ST-36 3) **Yin Xu:** SP-6, KI-3

//Modification Based on syndrome://
 * LU Heat:** LU-6, LU-5, LU-11, LI-11, LI-1
 * Wind-Heat-Damp in the Lung:** LI-11, LI-4, BL-12, LU-6, LU-5
 * Stomach Fire:** ST-44, ST-45, LI-11, CV-13, ST-34
 * Liver fire invading Lung:** BL-13, LU-10, PC-8, LV-2, GB-43, GB-34
 * Liver fire invading Stomach:** ST-34, PC-8, LV-3/LV-2, GB-43, GB-034, PC-6
 * Intestinal damp-heat:** BL-32, BL-57, ST-37, BL-25, DU-1, Er Bai
 * Spleen Qi Xu:** CV-12, BL-20, ST-36. SP-1, SP-8, SP-3, DU-20
 * Lung Yin Xu:** LU-9, BL-13, KI-3, SP-6, BL-43
 * Spleen and Stomach Yang Xu:** Spleen Qi Xu + CV-4, DU-20, CV-8
 * Kidney Yin Xu:** SP-6, KI-3, BL23, KI-6
 * Kidney (Yang) Xu + SPleen (Yang) Xu:** ST-36, CV-4, CV-6, CV-8, Du-20, DU-14, BL-23, BL-20, Sp-3, KI-3
 * Bladder heat:** CV-3, BL-67, BL-28, ST-28

Clinical Tips
In cases of acute bleeding, also blood is the highest priority and treatment should be focused on the branch (i.e., stopping the bleeding). In chronic cases, treat the root exclusively or treat the root and branch simultaneously. Medicinals with ascending characteristics are contraindicated in cases of bleeding from the upper orifices. In such cases, it is appropriate at small amount of down bearing medicinals such as Niu Xi or Dai Zhe Si. Conversely, medicinals with the sending characteristics are contraindicated in bleeding from the lower orifices. In such cases, up bearing medicinals such as Sheng Ma, Huang Qi, and Jing Jie Tan