(chapter55)Stomach Heat Leading to Blood Stasis

A robust woman (Mrs. Niu) suddenly experienced amenorrhea (absence of menstrual periods). Initially suspected as pregnancy, but later developed abdominal pain. Tonics were administered but worsened her condition. After several months, she presented with:

• Severe abdominal distention resembling a drum
• Complete loss of appetite

Diagnostic Process

1. ​Pulse diagnosis: Strong, wiry pulse at both Guan positions (middle section of the radial artery)
2. ​Thirst pattern: Intense morning thirst improving by afternoon
3. ​Medical history: Recurrent episodes of:
   • Burning sensation in chest/stomach (described as “internal fire”)
   • Productive cough with thick sputum

Diagnosis
Stomach heat with blood stagnation – Excessive stomach heat causing blood coagulation and menstrual blockage.

Treatment Protocol

Phase 1: Blood Stagnation Removal

​Formula: Sanhuang Siwu Tang (Three-Yellow Four-Ingredient Decoction)

Scutellaria baicalensis (huang qin)

Coptis chinensis (huang lian)

Phellodendron amurense (huang bai)

Rehmannia glutinosa (di huang)

Angelica sinensis (dang gui)

Paeonia lactiflora (bai shao)

Ligusticum chuanxiong (chuan xiong)

​Result: After 2 doses, expelled >10 purple blood clots with reduced abdominal distention

     Phase 2: Heat Clearance & Yin Nourishment

​Modified formula: Liangdi Dihuang Tang (Double-Land Rehmannia Decoction)

• • Added:
    • Gardenia jasminoides (zhizi)
    • Forsythia suspensa (lianqiao)
    • Tetrapanax papyrifer (tongcao)

      ​Duration: 1 month of continuous use
      ​Outcome: Menstrual cycle resumed but remained irregular

Long-term Regulation

• ​Maintenance formula: Guishao Dihuang Tang (Angelica-Paeonia Rehmannia Decoction)
• ​Result: Regular menstruation restored within months, followed by successful pregnancy

Key Formula Functions

1. Sanhuang Siwu Tang: Heat-clearing + blood-activating
2. Liangdi Dihuang Tang: Yin-nourishing + fire-reducing
3. Guishao Dihuang Tang: Blood-tonifying + cycle-regulating

Treatment Principle

1. Eliminate pathogenic factors (stagnant blood & heat) →
2. Restore fundamental balance (yin nourishment) →
3. Maintain reproductive health