CHAPTER 25 Epistaxis or Haemoptysis at Period Time
), i.e. ‘rebellious period’, or dao jing (
), i.e. ‘reverse period’.Aetiology
Emotional stress
Longstanding emotional problems such as anger, frustration, worry, guilt, hatred or resentment cause Liver-Qi to stagnate: after some time, stagnant Liver-Qi easily turns into Liver-Fire. If Qi rebels upwards due to a Penetrating Vessel (Chong Mai) pathology, it carries Fire with it; Fire agitates Blood and Liver-Fire, especially because the Liver stores Blood; rebellious Qi in the Penetrating Vessel becomes particularly evident during periods because of this vessel’s activity at this time, hence this causes bleeding upwards, i.e. epistaxis or haemoptysis. This type of bleeding usually occurs before or during the period.
Overwork, emotional stress
Overwork may weaken both Lung- and Kidney-Yin, Yin deficiency gives rise to Empty-Heat, this rises to damage the Lung’s Blood-Connecting channels and causes either epistaxis or haemoptysis (both of which are related to the Lung channel). This situation is aggravated if the patient suffers also from emotional problems which weaken the Lungs such as sadness, grief and worry.
Pathology
The pathology of epistaxis and/or haemoptysis at period time is mostly related to the Liver channel and the Penetrating Vessel. The Liver stores Blood, this is abundant at the time when the period is due, and it percolates down to the Sea of Blood of the Penetrating Vessel, giving rise to the period. When women are affected by emotional stress such as anger, frustration or resentment, Liver-Qi, and therefore Blood also, stagnates. Since the Liver’s pathology in women is closely related to the Penetrating Vessel, when the Qi of this vessel rebels upwards, Liver-Qi also rebels upwards. When Liver-Fire is formed from stagnant Liver-Qi, Fire follows rebellious Qi upwards; it damages the Blood-Connecting channels and causes bleeding from the nose or lungs.
Thus, the essential pathological conditions in this problem are Fire (or Empty-Heat) and rebellious Qi: the treatment principles to be adopted are therefore to drain Fire (or clear Empty-Heat), subdue rebellious Qi and attract blood downwards. Such principles of treatment apply to both excess or deficiency patterns causing this condition: thus, in Lung- and Kidney-Yin deficiency one must also pacify the Liver and subdue rebellious Qi.
Thus, the main pathological factors in this condition are:
Identification of patterns and treatment
The formulae discussed below are all aimed at stopping bleeding: however, they do so by treating also the underlying pattern causing the bleeding. They can therefore be administered throughout the menstrual cycle and especially during the period itself. However, it may not be necessary for the patient to take the prescription throughout the month as she could time the therapy according to the four phases of the menstrual cycles discussed in Chapter 2. Thus, in this case, the patient could take the prescription only during the fourth and first phases, i.e. in the pre-menstrual phase and during the period itself.
Stagnant Liver-Qi turning into Fire
Clinical manifestations
Epistaxis or haemoptysis before or during the period, heavy period, red face, irritability, pre-menstrual tension, feeling of heat, red eyes, thirst. Tongue: red sides. Pulse: Wiry and Rapid.
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