Welcome to Chinese Medicine Bristol's official blog! Here, Acupuncture and TCM pracitioner Sandra Arbelaez will share information about Acupuncture and Chinese Herbal Medicine, how they work, and the latest research and developments related to TCM. You will also find knowledge and ideas on how to enjoy a full, healthy life that she has picked up over the course of 15 years of exploring the world of natural health

Thursday 25 October 2012

TCM substances: Blood (Xue)

This is the second post on the series on basic body substances in Traditional Chinese Medicine. The basic substances are Qi, Blood (Xue), Essence (Jing), Spirit (Shen), and Body Fluids (Jin Ye). You will find out about the concept and functions of each substance as well as ways to maintain their health and balance within the body.

In TCM, Blood (Xue) is not just the red viscous liquid that flows through the vessels oxygenating cells and removing toxins. Blood is in fact a denser form of Qi, enriched with nutrients and Body fluids which, propelled by Qi, brings nourishment to all organs and tissues of the body and provides the “substance” needed for normal mental activity and emotional stability. While Qi fuels every single bodily function, Blood’s nourishing qualities support the actual physical substance of the body. It could be said that Qi provides energy while Blood provides form. 
TCM Blood: much more than a red viscous fluid

Blood is produced in two different ways:
  • From the Kidney Essence (Jing), Marrow is produced to fill the bones, spinal cord and the brain. Marrow also has the function of originating Blood. The efficacy of this function depends on our constitution and the Essence inherited from our parents, as well as on the health of our Kidneys.
  • Like Qi, Blood is made from the food and drink that we consume. Having plentiful and healthy Blood thus depends on the quality of the food that we eat, and the ability of the Spleen to process this food and convert it into usable substances. The energy of the Kidneys also plays a role here as it serves as the catalyst to the transformation of food and drink into Qi and Blood.  
 The circulation of Blood depends on the following TCM organs:
  • The Heart "governs the Blood“ and is in charge of the flow of Blood throughout the body. Strong Heart Qi is needed to propel the Blood, and nutritious Blood is a requirement for good Heart health. “Heart Blood” is the type of Blood whose main function is to provide nourishment to the Heart so that the Mind (our cognitive functions) and Spirit (emotional and psychological integrity) are both smooth and balanced. An adequate supply of Heart Blood enables us to be sharp in our thinking and speech, to be emotionally stable, and to attain restorative sleep at night. 

  • The Liver “stores the Blood”: When we are at rest the Blood gets stored in the Liver, and when we are active this organ controls the amount of Blood in circulation. Disharmonies of the Liver can thus affect the circulation of Blood. “Liver Blood” is the particular type of Blood which enables the Liver to nourish the eyes, joints, tendons and ligaments, and which supplies the womb both during the monthly cycle and during pregnancy. 

  • The Spleen is not only in charge of making Blood but it has the function of maintaining the Blood within the Blood vessels. When strong, the energy of this organ rises up to hold all organs and Blood in their place against the gravitational force. Symptoms such as bruising easily, bleeding, and haemorrhoids may result from the Spleen not being strong enough to hold the Blood within the Blood vessels.

Maintaining the health of the organs that make and circulate Blood, will by extension have a beneficial effect on the supply and flow of Blood within our body. Refer to my previous posts on the Spleen, Kidneys, Heart and Liver to find out how to do this.

Functions of Blood 

The Blood is closely related to Yin (substance) and Qi to Yang (activity). While Qi provides the basis to all movement and activity in the body, Blood provides the nurturing that supports this activity through the following functions:
    Cognitive function needs good Blood
  • Nourishes the whole body, the sensory organs, the internal organs, the skin and all tissues.
  • Moistens the whole body providing suppleness to the tendons, ligaments and joints, and to all other tissues and all the organs
  • Provides the material foundation to the mind. This is accomplished through the “Heart Blood” which is the substance that provides the basis to our Mind (cognitive function) and to our emotional stability.

Blood disharmonies 

When the amount or quality of our Blood are low, or its circulation is impaired, we may experience discomfort or symptoms of disease. The table below shows the TCM diagnoses and possible symptoms resulting from Blood disharmonies:

TCM diagnosisPossible symptomsActions
Blood DeficiencyPale lustreless complexion
Dizziness on standing
Blurry vision, dry or tired eyes
Dry skin/hair
Poor memory and concentration
Numbness/stiffness/cramping in limbs
Scanty periods
Low immunity
- Establish a balance between the amount of activity and the amount of rest that you get
- Ensure a highly nutritious diet, including Blood-nourishing foods
- Maximise rest and good quality sleep
- Avoid stimulants such as caffeine, alcohol, and drugs
- Avoid exercise during the menstrual period
- Practise relaxation techniques to calm the mind
Severe Blood deficiency requires treatment with acupuncture to strengthen the body’s Blood-building mechanisms and herbal remedies to build up the quantity and quality of Blood
Blood stagnationSharp stabbing pain in fixed locations anywhere in the body
Masses and growths
Dark complexion
Purple lips/nails
Bleeding with clots
A doctor should always be consulted in the presence of masses and severe/constant pain.
When symptoms are mild, regular moderate exercise such as walking, swimming and cycling can contribute to move Qi and Blood. Stretching and yoga can also be helpful.
Ensure a diet free of harmful chemicals, additives and preservatives, and avoid red meat and difficult to digest foods. Maximise the intake of leafy green vegetables and other detoxifying foods.
Acupuncture can be helpful in cases of unremitting pain and Chinese herbal remedies can be used to unblock the Blood vessels and Channels.
Heat in the BloodBleeding in any part of the body: blood in stools, nose, vomiting blood, etc.
Short menstrual cycle or excessive menstrual bleeding
Excessive thirst
Skin rashes
Always consult your doctor when experiencing any type of irregular bleeding, no matter how light.
Avoid exposure to heat and to anything that heats up the body such as stimulants and spices which can worsen symptoms.
Acupuncture can be used to promote the cessation of mild bleeding. There are also Chinese herbal remedies designed to cool and astringe the Blood and target specific areas of the body to stop bleeding.

Nourishing Blood and ensuring its smooth flow

The Blood is closely related to Yin and Qi to Yang. Just like Yin and Yang, Qi and Blood have a relationship of mutual support and balance so if Qi is weak or blocked Blood may become weak and blocked too, and vice-versa. Thus, nourishing, promoting and preserving Qi are basic requirements for a healthy supply of Blood. For more on how to do this click here.

The health of our Blood depends on what we eat and how we spend our physical and mental energy. Diet, exercise, and promoting mental and emotional balance are thus the basic ingredients of a healthy supply of Blood and good Blood circulation.

Although ensuring strong Qi is a way to have healthy Blood, specifically nourishing Blood can become necessary not only when we develop symptoms of Blood deficiency but also in any of these situations:
  • When recovering from any type of illness or operation
  • During pregnancy
  • In the postpartum period and while lactating
  • In the week following the menstrual cycle.
  • During the menopause
  • When taking the contraceptive pill
  • After experiencing any type of bleeding 
 In terms of diet, the health of our Blood will benefit by following basic advice about how to eat in a way that we promote digestion and the transformation of food into Qi and Blood. In order to have a healthy supply of Blood that flows smoothly through the Blood vessels we also need the following:

  - Protein: The adequate supply of protein is determined by your metabolism and by the amount of activity that you perform. The more energy you burn (particularly in the form of sweat), the more Blood you are using and the more protein you will need. Extra-nourishment is needed if you are a breast-feeding mother, experience any kind of bleeding including heavy periods, have a chronic illness, or are recovering from an acute disease.

Adequate amounts of good quality protein are needed to make Blood
If you’re a meat eater in need of nourishing your Blood, make sure you regularly have small amounts of good-quality red meat. Eggs are also good sources of nourishment, and can be had more regularly. If you are a vegetarian or vegan you will need some form of protein with every meal. Nuts, seeds, beans and pulses and natural soya products (not processed ones such as soya mince) can all provide good nourishment for the Blood.

- Naturally dark foods: Dark green leafy vegetables such as curly kale, spinach, dark cabbages, black soya beans, kidney beans, aduki beans, watercress and nettles are all considered in TCM to be specially nourishing to the Blood, and are "coincidentally" rich in iron.

- Naturally sweet foods Beetroot, grapes, molasses, dates, figs, and unsulfured apricots are also iron rich and excellent Blood nourishers. Note that consuming excessive amounts of sweet foods can have a detrimental effect on the digestive energy of the Spleen!

- Go easy on spicy foods and stimulants: Very hot spices such as chilli and black pepper and stimulants such as alcohol, caffeine, and drugs can scatter the Blood and heat up the Heart affecting Blood circulation. Stimulants can not only affect Blood flow but also impair its ability to soothe the mind and emotions which can result in insomnia, dream-disturbed sleep, difficulty concentrating, and emotional instability amongst other things.

Strenuous exercise and profuse sweating deplete the Blood
Both excessive exercise and profuse sweating are considered to take toll on the Blood; thus, although moderate exercise can contribute to proper flow of Qi and Blood, strenuous exercise or exercise that is too heavy for the individual constitution is always harmful to the Blood. Sweating in excess such as when exercising heavily or spending long periods in saunas or steam baths can be detrimental to the quality and quantity of our Blood. As always, it all depends on the individual constitution so it is important to determine what your energetic needs are before assuming that something is either good or bad for you.

Heavy cardiovascular exercise can overwork the Heart which in turn will affect how the Blood flows around the body. I often see people who over-exercise suffering from circulatory problems from cold hands and feet to full-blown Raynaud’s disease and chest pain. Moderate exercise such as walking, swimming and cycling can do a good job at improving circulation without putting strain in the Heart. Tai Chi, Qi Gong, and gentle Yoga also aid the movement of Qi and Blood throughout the body.

When there are symptoms of Blood deficiency, the body will naturally want to rest more. It is important to go with this as only rest will allow resources to be rebuilt, even when you are taking herbs or receiving treatment for Blood deficiency. You can’t fill a bath without putting the plug in, or fill your tank with the engine on. It’s the same with the body!

Looking after the mind and emotions 

The state of our Blood has a direct influence on our Mind and Spirit (Shen), which in TCM relate to our mental acuity, our speech, and to our psychological and emotional integrity. Because this relationship is reciprocal, keeping our mind and emotions clear and flowing smoothly is in turn a way of preserving the Blood and keeping it flowing smoothly. Maintaining such calm and peaceful disposition does not come naturally to most of us and we may need regular practise of meditation, deep breathing, or relaxation techniques is a good way of cultivating emotional and mental balance.

TCM Treatment

In the same way as Acupuncture directly affects the flow of Qi, it has an impact on Blood circulation. This is because Qi is the actual propeller of Blood. Acupuncture can be very effective at treating mild to moderate Blood stagnation patterns. When symptoms are more stubborn or chronic, Chinese herbal formulae especially design to break up stagnation and promote Blood circulation can be used. If you are taking medication, a fully qualified Chinese herbal medicine practitioner will take this into account to make you a formula without herbs that may interfere with your medication, and recommend a suitable safe dosage as well as the best foods and types of exercise to support your treatment.

Acupuncture can be effective at mild cases of Blood deficiency as it can regulate and strengthen the digestive system so that Blood production is efficient. However, Blood deficiency is more likely to require herbal remedies as they can more quickly augment the quantity and quality of Blood as well as promoting its production. A suitable diet and enough rest should be encouraged so that Blood resources can be built up.

In the case of Heat in the Blood producing bleeding or rashes, Acupuncture again can be effective for mild to moderate cases for which points indicated to stop bleeding, and cool the Blood can be used. In more severe cases Chinese herbal remedies can be used to cool and rebuild Blood and to clear the skin.

In TCM, disharmonies of the Blood can disturb the balance and integrity of our body, mind, and emotions and can become severe and even life-threatening if left unattended. Cultivating an awareness of our needs at different times of our life and ensuring a nutritious diet could help us prevent many of these problems and provide us with the basis for good health and strength in our body, mind and emotions.