Clinical Cases of Blood Mansion Expelling Stasis Decoction (Part 2)
8. Dizziness. Patient Sun: Female, 38 years old, visited on April 19, 1999. Six months ago, due to mental stress, she felt depressed and then experienced unsteadiness when standing, followed by spinning vision, dizziness, recurrent episodes. Sometimes, she felt nauseous and had the desire to vomit, palpitations, forgetfulness. Menstruation was irregular with normal flow and the presence of clots. She had previously undergone head CT and electrocardiogram at another hospital, and no abnormalities were found. The tentative diagnosis was "neurosis". Examination: Red borders on the tongue with blood clots, thin white coating, thin and stringy pulse. The pattern was caused by emotional imbalance, Qi stagnation and blood stasis, obstruction of the clear and spiritual aspects, resulting in mental dysfunction. Blood Mansion Expelling Stasis Decoction was prescribed without Chi Shao and Zhi Ke, and 20g of Chong Wei Ming was added, along with 24g of Ci Shi (pre-decocted). After 3 doses, the patient returned for follow-up and reported improvement in dizziness compared to before. She continued to take the formula for 20 doses, and all symptoms disappeared. According to ancient texts, "dizziness can be caused by blood stasis not circulating" and "blood stasis accumulating and counter-flowing can also cause dizziness". If the patient has clots in their menstrual flow, blood stasis spots on the tongue, and thin and stringy pulse, these are all signs of blood stasis. Treatment should focus on soothing the liver, relieving depression, promoting blood circulation, eliminating stasis, calming and nourishing the spirit. Blood Mansion Expelling Stasis Decoction promotes blood circulation and eliminates stasis, relaxes Qi and relieves depression. Adding Ci Shi and Chong Wei Ming calms and nourishes the spirit, resulting in self-healing of dizziness.
9. Insomnia. Patient Zhao, male, 52 years old, visited on October 21, 1999. The patient had a history of insomnia for more than 10 years, often experiencing difficulty falling asleep and frequent nightmares. Current symptoms included melancholy, dizziness, and severe right-sided headaches. The patient had a dark complexion, accompanied by palpitations and dry mouth with no desire to drink. The tongue was dark with a thin yellow and slightly greasy coating, and the pulse was stringy and thin. For 10 years, the patient had intermittently taken tranquilizers and Chinese herbal medicines for calming and nourishing the spirit, with poor results. The pattern was Qi stagnation and blood stasis, resulting in the loss of nourishment to the spirit. Treatment focused on promoting blood circulation, eliminating stasis, soothing the liver, relieving depression, and calming the spirit. Blood Mansion Expelling Stasis Decoction was prescribed without Sheng Di Huang and added 25g of Chao Zao Ren and 3g of Hu Po (decocted). After 3 doses, the patient felt mentally relaxed, and was able to sleep for 4-5 hours. The headache was relieved. The original formula was continued for 14 doses, and all symptoms were basically eliminated. The patient continued taking the formula for 2 more weeks, and the insomnia was cured. According to ancient texts, "if sleeplessness cannot be cured by nourishing the blood and calming the spirit, this formula is effective". The liver houses the soul and regulates emotions, while the heart houses the spirit and regulates the blood vessels. If the patient's desires are not fulfilled and they have mental depression, the liver Qi will not flow smoothly. If the blood and Qi do not circulate smoothly, blood stasis will obstruct the blood vessels, and the spirit of the heart will not be nourished, resulting in insomnia. The formula combines Si Ni San to regulate Qi and soothe the liver, and Tao Hong Si Wu Tang to promote blood circulation and eliminate stasis, with Jie Geng to guide Qi upward, and Niu Xi to guide blood downward, balancing Yin and Yang. Adding Hu Po and Zao Ren calms the spirit and stabilizes the soul, resulting in the cure of the disease.
10. Intractable Insomnia. Patient Shi, female, 39 years old. Visited due to insomnia for more than 7 years, worsening for over a month. The patient complained of frequent insomnia and vivid dreams, accompanied by dizziness and fatigue. The symptoms varied in severity, and sometimes she could not sleep all night. Occasionally, she experienced chest tightness, restlessness, and dull pain in the lower abdomen. The patient had a poor memory, but her appetite and bowel movements were normal. Menstruation was light, with a dark color and clots. The tongue was dark and had little coating, and the pulse was stringy and thin. The patient had been taking sedatives and calming herbal medicines for a long time, but the recent effect was poor, and she could only sleep for 2-3 hours at night. It was observed that the patient had chronic insomnia, and simple sedatives were not effective. In addition, she had symptoms such as chest tightness, light menstrual flow with a dark color and clots, dark tongue, and stringy and thin pulse, which indicated blood stasis. Therefore, treatment focused on promoting blood circulation, eliminating stasis, soothing the liver, relieving depression, and nourishing the spirit. Blood Mansion Expelling Stasis Decoction was prescribed without Sheng Di Huang and added 30g of Chai Hu, 15g each of Tao Ren, Mu Gua, and Zhi Ke, and 10g each of Hong Hua, Ju Hua, and Mu Xiang. The decoction was taken once a day. After 5 doses, the patient felt a reduction in restlessness and chest discomfort, and could sleep for 4-5 hours each night. The original formula was continued for 5 doses (once every other day), and all symptoms were eliminated.
11. Sequelae of cerebral contusion and laceration. Patient Wu, male, 15 years old. Two months ago, he suffered a head injury to the occipital region in a car accident. At that time, he was unconscious for more than 3 hours, with dizziness, headaches, frequent nausea, vomiting, blurred vision, inability to stand or walk. He was treated in the hospital and discharged after improvement. However, for more than 2 months, he continued to experience dizziness, headaches, blurred vision, inability to stand for long periods, and trembling in both legs when taking steps. CT scan revealed cerebral contusion and intracranial hematoma. The tongue was dark purple, with a thin coating, and the pulse was thin and stringy. The pattern belonged to intracranial injury and blood stasis blocking the collaterals. Treatment involved promoting blood circulation, eliminating stasis, opening the meridians, and promoting blood absorption in the intracranial hematoma, restoring brain function, and eliminating sequelae. Blood Mansion Expelling Stasis Decoction was prescribed without Sheng Di Huang and added 15g each of Dang Gui, Chuan Xiong, Chi Shao, and Sheng Di, 12g each of Di Long, Tao Ren, Niu Xi, Gou Teng, and Chai Hu, 10g each of Di Bie Chong, Quan Jie, Ze Lan, and Ban Xia, 5g each of Hong Hua and Xi Xin, and 3g of Gan Cao. The decoction was taken once a day. After 5 doses, the symptoms gradually reduced. The original formula was adjusted by reducing Di Bie Chong, Quan Jie, Ban Xia, and Xi Xin to once every two days. After 10 doses, the patient recovered to normal. CT recheck showed the disappearance of the intracranial hematoma.
12. Infertility. Patient Yuan, female, 25 years old. Married for 5 years without pregnancy. Since the first menstruation at the age of 14, the patient experienced pain in the lower abdomen and waist during menstruation, which worsened after menstruation. Menstruation was light, sometimes accompanied by dribbling, with a dark purple-black color and clots. The patient often experienced chest tightness, discomfort in the ribs, and breast pain. The tongue was dark with blood stasis spots, and the pulse was deep and stringy. The color, pulse, and pattern all indicated blood stasis. The infertility was caused by primary dysmenorrhea, and treatment should focus on regulating the menstrual cycle and promoting fertility. Blood Mansion Expelling Stasis Decoction was prescribed with modifications: 20g each of Dang Gui, Chuan Xiong, Chi Shao, and Sheng Di, 15g each of Tao Ren, Niu Xi, Chai Hu, Ju Geng, Xuan Hu Suo, 12g each of Ru Xiang, Mo Yao, Mu Xiang, Zhi Ke, Hong Hua, and 5g of Gan Cao. The decoction was taken once a day, starting two weeks before the menstrual cycle. After taking the formula, the pain significantly reduced in the same month. Chest tightness and breast and rib pain disappeared, and menstruation increased with a red color and fewer clots. The treatment was effective, so the original formula was continued. After the second visit, all symptoms disappeared, and menstruation became normal. The patient gave birth to a daughter the following year.
13. Thrombotic Phlebitis. Patient Yi, male, 38 years old. Complained of numbness and cold pain in both lower limbs for over 5 years, which worsened in cold weather. The skin appeared purplish and dark, with twisted and blue-purple veins. The tongue was dark with a thin coating, and the pulse was deep and stringy. The pattern manifested in the limbs due to repeated invasion of cold pathogen, poor circulation of Qi and blood, obstruction of blood vessels, and lack of nourishment to the limbs. Treatment should focus on warming the meridians, dispelling cold, promoting blood circulation, and opening the collaterals to dissolve blood clots, dilate blood vessels, and unblock the meridians. Blood Mansion Expelling Stasis Decoction was prescribed with modifications: 30g of Huang Qi, 20g each of Dang Gui, Chuan Xiong, Niu Xi, and Ji Xue Teng, 15g each of Chi Shao, Tao Ren, Di Long, Gui Zhi, Chai Hu, and Mu Gua, 12g each of Ru Xiang, Mo Yao, and Zhi Ke, 10g each of Hong Hua, Di Bie Chong, and Xi Xin, and 5g of Gan Cao. The decoction was taken once every two days, and one month was considered one course of treatment. After 5 doses, the numbness and cold pain significantly reduced, and the skin temperature increased. The original formula was continued, and starting from the second course of treatment, the dark purple color of the skin and veins gradually reduced. The patient received a total of three courses of treatment, and all symptoms were basically eliminated.
14. Intractable Migraine. Patient X, female, 55 years old, first visited on September 1, 2004. The patient reported frequent left-sided headaches for nearly 5 years. Each episode was preceded by numbness in the left side of the head, followed by pain. Sometimes, there were sudden needle-like pains. During the attacks, she could only temporarily relieve the pain by taking analgesics. The patient had sought medical examinations and treatments in many hospitals, but significant results were difficult to achieve. Prior to the current visit, the patient's headaches had become more frequent, and the pain was difficult to relieve even with analgesics. On examination, the patient had a dull complexion and a painful expression. She reported pain and numbness in the left side of the head, and occasional nausea, restlessness, bitter taste in the mouth, and a sense of heat in the upper abdomen. The tongue was pale red, and the pulse was stringy and astringent. The diagnosis was blood stasis obstructing the collaterals. The treatment involved using Blood Mansion Expelling Stasis Decoction with modifications: 6g of Chai Hu, 9g each of Chi Shao and Zhi Ke, 3g of Gan Cao, 15g of Sheng Di, 9g each of Dang Gui and Hong Hua, 6g of Tao Ren, 15g of Chuan Xiong, 30g of Dan Shen, 10g of Chuan Niu Xi, 6g of Ju Geng, 10g of Di Long, 15g of Ji Xue Teng, and 30g of Pu Gong Ying. The patient took the formula for 5 doses. On August 23, 2005, the patient returned for follow-up due to recurring headaches. She reported that after taking the formula for 5 doses, the pain completely disappeared. However, she did not return for follow-up because she believed the disease was cured. This time, she returned for treatment due to a recurrence of the pain caused by emotional distress. The symptoms were similar to the previous ones. The formula from the first visit was prescribed for another 5 doses. After finishing the doses, the headache disappeared. Another 5 doses were given for consolidation. The patient was also given a copy of the formula and advised to take it if the symptoms recurred. In recent years, the patient has often brought her relatives or neighbors to seek treatment. She reported that sometimes the pain occurred due to emotional distress or fatigue, and a few doses of the formula were effective in relieving the pain. The patient considered the formula a secret remedy and kept it for future use. According to clinical experience, Blood Mansion Expelling Stasis Decoction can be used to treat many diseases. The key lies in how the practitioner differentiates and uses the formula. This case of migraine headaches was treated with a focus on Chuan Xiong due to its prominence in the pattern. Dan Shen was added to enhance the blood circulation and blood stasis elimination. This formula has been used for many years in clinical practice and is often used for the following symptoms: 1) a history of head trauma; 2) headaches that are unresponsive to various treatments; 3) fixed location of headaches; 4) severe headaches that feel like cutting or stabbing pain, accompanied by nausea and vomiting; 5) when headaches do not have obvious external manifestations, heat patterns, or deficiency of Qi and excess of phlegm; 6) long-term or persistent headaches that come and go.
