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Concept of stagnant blood

Stagnant blood is a pathological product resulting from disturbance and stagnation of blood circulation, including abnormal flow of blood, or stagnated blood in meridians or viscera due to disturbed blood flow. In traditional Chinese medicine literature, it is variously termed as malignant blood, blood accumulation, lochioschesis etc.

Once it is formed, stagnant blood will become a new pathogenic factor. Stagnant blood is different from blood stasis. The latter refers to a pathological condition marked by unsmooth or stagnant blood flow and is a concept of pathogenesis, while the former is a pathological product which can give rise to a new disease, and a concept of etiology.

Formation of stagnant blood

Dysfunction of the heart, lung, liver and spleen caused by six excesses, seven emotions, or traumatic injuries, can result in the unsmooth flow of blood or extravasation of blood inside the body, thus causing stagnant blood.

1. Traumatic injury

Traumatic injury, strain and contusion, incised or gun wound and operation can all lead to bleeding due to breakage of vessels. And this kind of bleeding belongs to extravasation of blood and when it cannot be removed from the interior of the body timely, it will become stagnant blood.

2. Qi deficiency

Qi deficiency makes it difficult for qi to propel the blood, so blood flows slowly and unsmoothly, hence causing stagnant blood; it deficient qi fails to control blood, blood will escape from the blood vessels and can not dissolve immediately, thus causing stagnant blood.

3. Qi stagnation

Emotional depression, fluid retention, and calculus can block the vessels and hinder qi movement, leading to unsmooth flow of blood or stagnation of blood in local areas, thus stagnant blood is formed.

4. Fluid consumption

Exogenous pathogenic heat scorching fluids, excessive sweating, vomiting and diarrhea leading to loss of body fluids, can make blood viscous, causing unsmooth circulation, and thus stagnant blood is formed.

5. Phlegm-turbidity

Phlegm-turbidity, a substantial pathogenic qi, is apt to obstruct qi movement and stagnate meridians, leading to unsmooth flow of blood. For example, the stagnation of phlegm-turbidity in limbs, causing obstructed flow of qi and blood, resulting in numbness of limbs, difficult flexing and stretching, even hemiplegia.

6. Blood-cold

Exogenous cold pathogen, or interior exuberance of yin-cold gives rise to the constriction of blood vessels, which makes blood congealed so that it can not circulate smoothly, thus leading to stagnant blood in some parts of body.

7. Blood-heat

There are exogenous warm-heat pathogenic qi, and transformation of fire due to exuberance of yang. All these fire-heat pathogens decoct body fluids in the blood and make blood viscous, leading to unsmooth blood circulation; heat entering nutrient-blood resulting in mixture of blood with heat; heat scorching vessels drive the blood outside the vessels to form stagnant blood.

Etiology and pathogenesis of formation of stagnant blood
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Pathogenic characteristics of stagnant blood

Stagnant blood not only loses the normal function of blood, and as the secondary cause of disease, but also gives rise to new diseases.

1. Tending to stagnate qi movement

Stagnant blood, a substantial pathogen, tends to cause stagnation of qi movement, which further worsen stagnant blood, forming the vicious circle as a result of interaction between movement stagnation and stagnant blood. Such as stagnant blood caused by trauma, in this case, there may appear purplish swelling and pain at the traumatized surface area.

2. Affecting blood circulation

Stagnant blood which stays in or out of blood vessels can lead to abnormal blood circulation in local area or all over the body. Stagnant blood in heart vessles may cause heart vessels obstructed, manifested as angina pectoris; stagnant blood in the liver may cause its vessles blocked, manifested as painful abdominal mass; stagnant blood in meridians may cause unsmooth circulation of qi and blood; stagnant blood blocking the body constituent, sensory organs, orifices and vessels may cause purplish lips and nails, petechiae, and tongue with ecchymoses and petechiae etc.

3. Affecting the generation of new blood

As a pathological product, stagnant blood has lost its nourishing and moistening function. Stagnant blood, especially that stays long in the body may cause malfunction of zang-fu organs, and thus affecting the generation of new blood. Therefore, there is another way of saying it. "If stagnant blood cannot be dispelled, new blood will not be generated. " So a patient suffering from prolonged blood stasis may appear with squamous and dry skin, unlustrous hair as the clinical manifestation of blood deficiency and loss of moistening function of blood.

4. Causing various syndromes with fixed location

Stagnant blood, which has various causes and affects different locations, can lead to complicated stagnant blood syndromes. Such as stagnant blood caused by blood cold, is often manifested as pain, purplish limbs; stagnant blood caused by blood heat, red complexion and eyes; deep red tongue; stagnant blood in the heart can cause palpitations, shortness of breath, or even purplish lips and tongue, sweating and cold limbs; stagnant blood in the lung may cause disturbance of dispersion and descent manifested as chest pain, short breath and hemoptysis; stagnant blood in the liver may cause hypochondriac pain, abdominal distention and anorexia, and thus gradually forming abdominal mass and swelling; stagnant blood in the uterus may cause unsmooth menstrual flow manifested as dysmenorrhea, amenorrhea, deep colored menstrual flow with clots, metrorrhagia and metrostaxis; stagnant blood blocking the body surface may cause swelling, pain and bruise; stagnant blood blocking the brain may cause obstruction of brain collateral manifested as headache and dizziness.

Although syndromes caused by stagnant blood are complicated, once it stagnates in some zang-fu organs, and mostly cannot be dispersed in time, therefore, it can cause symptoms marked by fixed location, such as fixed stabbing pain in a local location, or abnormal masses.

Clinical features of diseases due to stagnant blood

Although diseases caused by stagnant blood are complicated, their clinical features have the following common aspects:

① Pain: usually a fixed stabbing pain which is aggravated by pressure or at night and is alleviated by day.

② Swelling: generally fixed. Local bruise in the body surface or hard and palpable abdominal mass inside the body cavity can occur.

③ Bleeding: generally manifested as scanty in quantity with unsmooth flow, purplish in color with clots.

④ Cyanosis: dark complexion, purplish lips and nails.

⑤ Tongue manifestation: a dark purplish tongue with ecchymoses and petechiae etc.

⑥ Pulse manifestation: choppy pulse or knotted and intermittent pulse.

Moreover, they can be accompanied by deep colored complexion, squamous and dry skin, and amnesia. If the entire clinical course is quite long, or the disease can not be cured, or the case is with trauma, bleeding, delivery, and operation history, although there is no ohvious symptom of stagnant blood, it may exist.