bubble_chart Concept

Blood deficiency pattern refers to a general term for systemic weakness symptoms and signs caused by insufficient blood in the body, leading to the lack of nourishment in the limbs and zang-fu organs. It is often caused by overstrain internal damage, excessive contemplation, which depletes yin blood; spleen-stomach weakness, insufficient generation and transformation of qi and blood, or excessive loss of blood. Prolonged illness or the late stage [third stage] of warm disease can also lead to this condition.

The main clinical manifestations include: pale or shallow yellow complexion, pale lips, dizziness, blurred vision, palpitations, insomnia, numbness in the hands and feet, scanty menstruation, delayed periods, or even amenorrhea in women. The tongue texture is pale, and the pulse is deep, thin, and weak.

Blood deficiency pattern is commonly seen in diseases such as "palpitation," "deficiency fatigue," "vertigo," "headache," "convulsive disease," "blood pattern," "constipation," "fever," "menstrual irregularities," "amenorrhea," and "infertility."

This syndrome should typically be differentiated from "yin deficiency pattern" and "blood collapse pattern."

bubble_chart Differentiation and Treatment

Blood deficiency pattern can appear in various diseases, with each having certain clinical characteristics and different treatment methods, necessitating careful differentiation.

1. For example, in palpitation disease with blood deficiency pattern, the clinical manifestations are characterized by palpitation, dizziness, insomnia dreamfulness, pale complexion without luster, fatigue and lack of strength, pale red tongue texture, and thin and weak pulse. This is caused by excessive contemplation, overexertion injuring the heart and spleen, or a weak constitution due to illness, insufficient qi and blood, or excessive loss of blood leading to the heart losing its function. Treatment should focus on tonifying blood and nourishing the heart, replenishing qi and tranquilizing the spirit, using Returning to Spleen Decoction(Jisheng Fang) or Prepared Liquorice Decoction(Shanghan Lun).
2. If blood deficiency pattern is seen in deficiency fatigue disease, the clinical manifestations are mainly symptoms of heart and liver blood deficiency:
   1. Heart blood deficiency: characterized by palpitation, severe palpitation, forgetfulness, insomnia dreamfulness, dull complexion, pale tongue, and thin or irregular pulse. This is mostly due to congenital insufficiency, weak essence and blood, contemplation consuming heart blood, lack of proper care after a major illness, deficiency of yin blood, long-term unrecovery, and accumulation of deficiency leading to damage. Treatment should focus on nourishing blood and tranquilizing the spirit, using Heart-Nourishing Decoction(Zhengzhi Zhunsheng) or Returning to Spleen Decoction(Furen Liangfang formula).
   2. Liver blood deficiency: characterized by dizziness, dizzy vision, tinnitus, hypochondriac pain, fright and vigilance, menstrual irregularities, amenorrhea, and even scaly skin, pale complexion, pale tongue texture, and wiry thin pulse. This is caused by emotional depression, hidden consumption of liver blood, or excessive loss of blood, lack of proper care after a long illness, deficiency of yin blood, and even blood deficiency transforming into dryness, long-term unrecovery, and accumulation of deficiency leading to fatigue. Treatment should focus on tonifying blood and nourishing the liver, using Four Ingredients Decoction(Taiping Huimin Heji Jufang) with modifications.
3. If blood deficiency pattern is seen in vertigo disease, the clinical manifestations are characterized by vertigo occurring or worsening after exertion, pale complexion without luster, pale lips and nails, often accompanied by mental fatigue, lack of strength, shortness of qi, reluctance to speak, palpitation, and insomnia. This is caused by long-term illness leading to deficiency of both the heart and spleen, or Rebing consuming and damaging yin blood, blood deficiency failing to nourish the body, blood not ascending to the brain, or blood deficiency and yin deficiency leading to deficient heat disturbing the seven orifices. Treatment should focus on tonifying qi and nourishing blood, using Returning to Spleen Decoction(Furen Liangfang) with modifications.
4. If blood deficiency pattern is seen in headache disease, the clinical manifestations are characterized by headache, dizziness, dull pain, worsening with fatigue, palpitation, insomnia, mental fatigue, lack of strength, and poor appetite. This is caused by long-term illness leading to deficiency, or excessive loss of blood, insufficient middle qi, clear yang failing to ascend, and nutrient-blood deficiency failing to nourish the brain. Treatment should focus on tonifying and nourishing qi and blood, using Eight Precious Ingredients Decoction(Zhengti Leiyao) with modifications.
5. If blood deficiency pattern appears in constipation disease, the clinical manifestations are characterized by severe constipation, straining with lack of strength, dull complexion, pale lips and tongue, dizziness, dizzy vision, palpitation, and thin pulse. This is caused by long-term illness leading to deficiency, aging and physical decline, postpartum blood loss, or blood deficiency leading to insufficient fluids, large intestine losing its moistening function, or blood deficiency leading to yin deficiency with internal heat. Treatment should use Intestine-Moistening Pill(《沈氏尊生書》).
6. If blood deficiency pattern is seen in bleeding diseases, the clinical manifestations are characterized by epistaxis, gingival hemorrhage, or even purpura, pale complexion, dizziness, palpitation, and mental fatigue with lack of strength. This is caused by excessive loss of blood, blood deficiency leading to qi deficiency, failure of qi to control blood, hence continuous bleeding. Treatment should focus on tonifying qi and controlling blood, using Ginseng Returning to Spleen Decoction(Furen Liangfang).
7. If blood deficiency pattern appears in fever disease, the clinical manifestations are characterized by fever, worse at night and lighter during the day, palpitation, lack of strength, dull complexion, pale tongue, and thin rapid pulse. This is mostly due to long-term heart-liver blood deficiency, or spleen failing to produce blood, or excessive loss of blood. Treatment should focus on clearing heat and nourishing blood, using Angelica Blood-Tonifying Decoction(Lanshi Micang).

In summary, although the symptoms and signs are the same, in different diseases, their manifestations have their own characteristics, and clinically, treatment can be based on the characteristics of each disease.

Blood deficiency pattern occurs more frequently in women. This is because menstruation and pregnancy are fundamentally dependent on blood. Its clinical manifestations include delayed menstruation, scanty menstruation, pale color, thin and clear quality, empty pain in the lower abdomen, and even amenorrhea. It can also lead to conditions such as blood deficiency infertility and habitual abortion. Elderly and physically weak individuals also commonly experience blood deficiency pattern, mainly due to the decline of essence and blood with age. Clinical manifestations include listlessness, dull complexion, palpitations and insomnia, dizziness, tinnitus, deafness, or constipation.

Blood is yin, qi is yang. Blood is the mother of qi, and qi is the commander of blood. The two are interdependent and mutually supportive. Qi has the functions of warming the muscles, generating essence and blood, and controlling blood circulation; while blood has the roles of transporting yang qi and nourishing the muscles. The relationship between the two is close, so blood deficiency pattern often accompanies two conditions in its disease progression mechanism:

• First, blood deficiency fails to carry qi, leading to a deficiency of both qi and blood. This manifests as a pale complexion, palpitations, insomnia, shortness of qi, reluctance to speak, lack of strength, spontaneous sweating, a pale and tender tongue, and a thin, weak pulse.
• Second, due to chronic or sudden massive loss of blood, the Blood Sea becomes empty and true yin is insufficient, leading to blood collapse pattern. Symptoms include a pale and dull complexion, dizziness, blurred vision, cold limbs, and an empty pulse.

Due to excessive loss of blood and blood collapse, qi loses its foundation and collapses suddenly, forming the pattern of qi collapse following bleeding. Symptoms include a pale complexion, cold sweat, cold limbs, and even syncope, with a faint or hollow pulse. In treatment, based on the theory that "tangible blood cannot be quickly regenerated, while intangible qi should be urgently secured," it is advisable to tonify qi and secure collapse to prevent yang exhaustion.

bubble_chart Differentiation of Similar Patterns

1. Yin deficiency pattern and blood deficiency pattern: Both are deficiency pattern. Blood belongs to yin, and essence, fluid, and body fluids also belong to yin, with "essence and blood from the same source" and "fluid and blood from the same source." The scope of yin deficiency pattern is broader than that of blood deficiency pattern. In terms of disease cause, blood deficiency pattern is caused by spleen-stomach weakness, insufficient transformation source, stagnation of seven emotions, hidden consumption of yin-blood, prolonged illness, and excessive loss of blood. Blood deficiency cannot nourish the head and eyes, leading to dizziness and blurred vision; it does not flourish in the face, resulting in a pale or shallow yellow complexion and pale lips; insufficient nutrient-blood causes the heart to lose nourishment, leading to palpitations and insomnia; blood deficiency causes the tendons and vessels to lose nourishment, resulting in numbness of the hands and feet, and even convulsions; insufficient Blood Sea causes the Chong and Ren meridians to be empty, leading to menstrual irregularities, or even amenorrhea; blood deficiency does not flourish in the tongue, resulting in a pale tongue; and the pulse pathway loses fullness, leading to a thin and weak pulse. On the other hand, yin deficiency pattern is mostly caused by prolonged illness with insufficient yin, Rebing damage to fluid, or excessive sweating, vomiting, and diarrhea. Yin deficiency leading to internal heat causes vexing heat in the chest, palms, and soles, and afternoon tidal fever; internal heat forcing body fluids to leak out causes night sweats; lack of body fluids in the body causes dry mouth and throat, and scanty dark urine; yin deficiency with effulgent fire results in a red tongue with little or no coating, and a thin and rapid pulse. In summary, the main difference between blood deficiency pattern and yin deficiency pattern is that blood deficiency pattern emphasizes the "color," such as a pale complexion, pale lips, and dull nails, while yin deficiency pattern emphasizes the "heat," such as feverish feeling in the palms and soles, tidal fever, and night sweats. This can be used for differentiation.
2. Blood collapse pattern and blood deficiency pattern: Both belong to the category of blood deficiency in the body. Blood collapse pattern is more severe than blood deficiency pattern and can be a further development of blood deficiency pattern, or it can be caused by sudden massive bleeding. Due to the mutual rooting of yin and yang, damage to yin can affect yang, and excessive loss of blood causes qi to lose its attachment, leading to sudden collapse of qi following blood collapse. Therefore, after blood collapse, symptoms of qi collapse following blood loss often appear, such as a pale complexion, cold limbs, spontaneous sweating, cold skin, weak breath, a faint or hollow pulse, and even syncope. This is clearly different from the manifestations of blood deficiency pattern and is not difficult to distinguish.

bubble_chart Documentation

1. 《Danxi's Method for Treating Palpitations Due to Fright‧Severe Palpitation》: "Severe palpitation is due to blood deficiency; severe palpitation without a specific time often indicates insufficient blood."
2. Zhengyin Maizhi ‧Volume 1: "The symptom of blood aspect fever is characterized by calmness during the day and fever at night, dry lips and mouth, yet not drinking water, and night sweats during sleep. This is the manifestation of blood aspect fever. The cause of blood aspect fever may be due to heat lingering in the blood after Rebing, or due to a congenital deficiency of yin blood, where blood deficiency leads to excessive fire. Both conditions can result in blood aspect fever."
3. Zhengzhi Huibu ‧Upper Orifices Section: "Blood is paired with qi; where qi resides, blood flourishes. Conditions such as vomiting, nosebleeds, menorrhagia and metrostaxis, postpartum yin exhaustion, and the liver's inability to regulate the nourishing qi, causing various blood disorders to act recklessly, all lead to vertigo due to blood deficiency."
4. Zhengzhi Huibu ‧Blood Pattern: "The symptoms of blood deficiency include feeling cool in the morning and hot in the evening, feverish feeling in palms and soles, dry and scaly skin, pale lips, irregular menstruation in women, and a fine and weak pulse. The treatment should focus on tonification."