CHAPTER 8 Early Periods
Aetiology
Excessive physical work, irregular diet
Excessive physical work or a diet lacking in nourishment weaken the Spleen; when Spleen-Qi is deficient, it may fail to hold blood in the vessels and this may leak out giving rise to a period before the right time. This is an Empty type of bleeding.
Overwork, menopausal decline of Kidney-Qi
Overwork often causes Kidney-Yin deficiency; because the deficient Kidney cannot sustain and consolidate the Directing and Penetrating Vessels (Ren and Chong Mai), blood leaks out and the period occurs before time. This is also an Empty type of bleeding and is due to Kidney-Qi not holding blood.
Irregular diet, invasion of external Heat
Excessive consumption of hot, spicy foods and alcohol may lead to Blood-Heat which affects the Directing and Penetrating Vessels. The blood in these vessels is agitated, it overflows from the vessels and the period comes before the right time. This may also occur when external Heat penetrates the Interior and enters the Blood portion. This is a Full type of bleeding.
Emotional stress
Emotional stress deriving from anger, repressed anger, resentment, frustration or guilt results in stagnation of Liver-Qi and, over time, this may lead to Liver-Fire. Fire may invade the Blood portion (especially since the Liver stores Blood) and cause Blood-Heat. Hot Blood pushes out of the vessels and the period occurs before the right time. This is also a Full type of bleeding.
The periods may come early also when emotional stress affects the Heart and the Mind. As we have seen, the descending of Heart-Qi to the Uterus induces the start of menstrual bleeding. If the Mind is affected by emotional stress, it may induce Heart-Qi to descend prematurely. This may happen in case of shock, fear, worry and guilt.
Chronic illness, overwork, too many children, chronic bleeding
A long, chronic illness, overwork or having too many children too close together may cause Liver- and Kidney-Yin deficiency which eventually creates Empty-Heat. This enters the Blood portion and causes Blood-Heat so that the blood pushes out of the vessels and the period comes before time. This is a mixed Full and Empty type of bleeding: Full because of the Empty-Heat, Empty because it derives from Yin deficiency. This situation may also arise from chronic bleeding itself. For example, a woman may suffer from excessive bleeding from Qi deficiency; after many years, the excessive loss of Blood may lead to Yin deficiency and this to Empty-Heat. Empty-Heat makes the Blood reckless and causes the period to come early.
Pathology
Thus, the pathology of this condition falls into two broad groups, the first from Qi deficiency, the second from Blood-Heat. Within the first group is Spleen-Qi or Kidney-Qi deficiency; within the second group, Full-Heat or Empty-Heat (see Fig. 8.1). Deficient Qi (whether Spleen- or Kidney-Qi) fails to hold blood in the vessels. Blood-Heat (whether deriving from Full- or Empty-Heat) pushes the blood out of the vessels.
The aetiological factors under the first two situations given above lead to deficient Spleen-Qi and Kidney-Qi, respectively, not holding blood. The aetiological factors under the next two situations lead to Full-Heat and those under the last situation lead to Empty-Heat.
The pattern of Empty-Heat is more likely to occur in older women. The treatment can be given according to the four phases of the menstrual cycle. For example, in cases of Qi deficiency, treatment could be given only during and after the period (first and second phases); in cases of Full-Heat, it could be administered before and during the period (fourth and first phases); and in cases of Empty-Heat, it could be given during and at mid-cycle (first and third phases).
Identification of patterns and treatment
All the herbal prescriptions in the following chapters are detailed in Appendix 1 on p. 937.
Qi deficiency
Spleen-Qi deficiency
Clinical manifestations
Early period, pale and dilute menstrual blood, loose stools, epigastric distension, tiredness. Tongue: Pale. Pulse: Weak.
Treatment principle
Strengthen the Spleen, tonify and raise Qi, consolidate the Penetrating Vessel, contain blood.
Acupuncture
ST-36 Zusanli, SP-6 Sanyinjao, Ren-12 Zhongwan, BL-20 Pishu, Du-20 Baihui, Ren-4 Guanyuan, Ren-6 Qihai. All with reinforcing method, moxa is applicable.
Herbal treatment
a Prescription
b Prescription
c Prescription
Explanation
This well-known formula tonifies and raises Qi. It is suitable to treat Early Periods because it contains Dang Gui which enters the Blood portion.
Comparison of Gui Pi Tang, Ju Yuan Jian and Bu Zhong Yi Qi Tang
To compare and contrast these three formulae, Gui Pi Tang is particularly suitable if the patient also suffers from anxiety and palpitation deriving from emotional problems. The second formula, Ju Yuan Jian, is very similar to the third, Bu Zhong Yi Qi Tang, but it is more astringent than the latter and it is therefore suitable if the period, besides being early, is also heavy. Bu Zhong Yi Qi Tang, on the other hand, is better if the patient suffers from depression.
Modifications
These modifications apply to all three prescriptions.
Three Treasures remedies
This remedy is a variation of Bu Zhong Yi Qi Tang: it tonifies and raises Qi, enters the Blood portion and resolves Dampness. It is suitable if the patient suffers from depression. The tongue presentation appropriate to this remedy is a Pale body with a sticky, white coating.
This remedy is a variation of the formula Gui Pi Tang which tonifies Qi and Blood of the Spleen and Heart: it can be used to stop bleeding from Qi deficiency. The tongue presentation appropriate to this remedy is a Pale body.
Spleen-Qi deficiency
Clinical manifestations
Early period, pale and dilute menstrual blood, loose stools, epigastric distension, tiredness. Tongue: Pale. Pulse: Weak.
Treatment principle
Strengthen the Spleen, tonify and raise Qi, consolidate the Penetrating Vessel, contain blood.
Acupuncture
ST-36 Zusanli, SP-6 Sanyinjao, Ren-12 Zhongwan, BL-20 Pishu, Du-20 Baihui, Ren-4 Guanyuan, Ren-6 Qihai. All with reinforcing method, moxa is applicable.

Full access? Get Clinical Tree

