The pattern of blood deficiency generating wind, also known as the pattern of blood deficiency generating wind, refers to a series of symptoms and signs of blood deficiency and wind stirring caused by the deficiency of nutrient-blood and the lack of nourishment to the tendons and vessels. It is often caused by internal damage Zabing, chronic blood deficiency, or acute or chronic loss of blood.

The main clinical manifestations include: vertigo, tinnitus, blurred vision, dull complexion, trembling hands and feet, or muscle twitching, numbness of limbs, stiffness of joints, dull nails, pale tongue texture, and thin and weak pulse.

The pattern of blood deficiency generating wind is commonly seen in diseases such as "vertigo," "apoplexy," and "convulsive disease."

This syndrome should be differentiated from the "pattern of internal stirring of liver wind," "pattern of extreme heat generating wind," and "pattern of yin deficiency and wind stirring."

bubble_chart Differentiation and Treatment

This syndrome is characterized by blood deficiency accompanied by signs of wind stirring. The pattern of blood deficiency generating wind often results from excessive loss of blood without timely replenishment, or due to spleen-stomach weakness leading to insufficient generation and transformation, or excessive mental strain causing hidden depletion of yin-blood, or static blood obstruction preventing the generation of new blood, leading to nutrient-blood deficiency and malnourishment of the sinews and vessels. The liver governs the storage of blood and controls the sinews and vessels. When liver blood is insufficient and fails to nourish the sinews and vessels, symptoms such as sinew spasms and hand-foot tremors may occur. This syndrome can be seen in various diseases, each with distinct clinical manifestations and differing treatment approaches, necessitating careful differentiation.

1. For example, in vertigo, the clinical presentation is characterized by dizziness, blurred vision, and a sensation of spinning, accompanied by a pale complexion, palpitations, and insomnia. This syndrome is often a combination of root deficiency and branch excess. Zhang Jing-yue particularly emphasized that vertigo is caused by deficiency, stating, "Without deficiency, vertigo cannot occur," and "In cases of vertigo, deficiency accounts for eight or nine out of ten, while cases involving fire or phlegm are only one or two out of ten" (Jingyue Quanshu‧Vertigo). The pathological changes in vertigo primarily involve the liver, spleen, and kidney among the zang-fu organs. Insufficient liver blood stirs liver wind, which rises to disturb the head and eyes, causing dizziness, blurred vision, and a spinning sensation. As stated in the Neijing‧Zhizhenyao Da Lun: "All wind with vertigo and shaking is ascribed to the liver." The Lingshu-Hai Lun chapter states, "Insufficiency of the sea of marrow leads to brain dizziness and tinnitus." The Lingshu‧Pathogenic Qi Zang-Fu Organs chapter states, "The twelve Jingmai and the 365 collaterals all send their blood and qi upward to the face and to the orifices." Therefore, when nutrient-blood is insufficient and fails to nourish the face and orifices, symptoms such as dizziness, blurred vision, and a pale complexion may occur. In treatment, the focus should be on tonifying deficiency. The approach should involve tonifying and nourishing qi and blood, using modified Returning to Spleen Decoction (Jisheng Fang).
2. In apoplexy, the pattern of blood deficiency generating wind presents with various clinical manifestations, including hemiplegia, facial deviation, stiff tongue with slurred speech or muteness, numbness on one side of the body, dysphoria, insomnia, vertigo, tinnitus, a pale tongue with thin or scant coating, and a thin or thin-rapid pulse. The Zhubing Yuanhou Lun‧Wind Hemiplegia chapter states, "Hemiplegia is caused by a deficiency of blood and qi, leading to the opening of the striae and interstices, which are then invaded by wind-dampness. Wind-dampness lodges in half of the body, in the spaces between the muscles, causing blood and qi to stagnate and fail to nourish the body. If this persists and vital qi departs, leaving only pathogenic qi, hemiplegia results." The Jingui Yaolue attributes the mechanism of apoplexy to "empty collaterals, allowing wind evil to invade." The liver stores blood and governs the sinews. Insufficient liver blood stirs liver wind, which carries phlegm-turbidity and static blood upward to disturb the seven orifices, leading to the sudden onset of the disease. Alternatively, nutrient-blood deficiency leads to empty collaterals, allowing wind evil to invade the meridians and collaterals, causing qi and blood obstruction and malnourishment of the muscles and sinews. Treatment should focus on emolliating the liver, nourishing blood, extinguishing wind, and unblocking the collaterals. Modified Four Substances Decoction (Hejiju Fang) combined with Yang-Tonifying Five-Returning Decoction (Yilin Gaicuo) can be used.
3. In convulsive disease, the pattern of blood deficiency generating wind is characterized by stiffness in the neck and back, wriggling of the limbs, numbness, muscle twitching, dizziness, tinnitus, palpitations, insomnia, a pale-red tongue with thin and dry coating, and a thin pulse. This often results from improper treatment or other conditions, such as excessive sweating, vomiting, or purging, leading to depletion of yin-blood, postpartum blood loss, or sweating syndrome, blood pattern, or general weakness, which damage essence and fluids, leading to liquid collapse, blood loss, seminal emission, and malnourishment of the sinews. Treatment should focus on tonifying qi and blood, relieving urgency, and stopping spasms, using Sage Cure Decoction (Yizong Jinjian).

The pattern of blood deficiency generating wind can be seen in various acute or chronic blood loss, blood deficiency, and yin deficiency stirring wind, such as postpartum "postpartum dizziness due to hemorrhage" or "eclampsia." If not treated during the deficient stage, the condition may worsen, leading to qi collapse following blood loss and resulting in severe manifestations of qi deficiency and blood collapse. Symptoms include palpitations, shortness of breath, a pale complexion, profuse sweating, and a faint, thready pulse on the verge of extinction.

bubble_chart Differentiation of Similar Patterns

1. Pattern of internal stirring of liver wind and pattern of blood deficiency generating wind: Both belong to the category of wind-stirring syndromes. When liver disease presents with wind-stirring symptoms, it is often an acute and severe condition, but their disease cause mechanisms and clinical manifestations differ. The pattern of internal stirring of liver wind is mostly caused by emotional distress, qi depression transforming into fire damaging yin, or pre-existing liver and kidney yin deficiency, where yin fails to subdue yang, leading to prolonged yang hyperactivity, which eventually transforms into fire, resulting in a deficiency-excess complex with upper excess and lower deficiency. The main symptoms include vertigo with a tendency to fall, stiff neck and trembling limbs, numbness in the hands and feet, sudden fainting, facial distortion, hemiplegia, and stiff tongue with difficulty speaking. The pattern of blood deficiency generating wind arises from spleen-stomach weakness, insufficient transformation and production, or due to blood loss or chronic illness leading to liver blood deficiency and malnutrition of the sinews. The former may present as a complex deficiency-excess syndrome, while the latter is primarily a deficiency syndrome.
2. Pattern of extreme heat generating wind and pattern of blood deficiency generating wind: The pattern of extreme heat generating wind is caused by exposure to intense heat pathogens, where pathogenic heat is exuberant, damaging fluids and leading to malnutrition of the sinews, manifesting as a wind-stirring syndrome. In the defense-qi-nutrient-blood pattern identification, it belongs to the blood aspect syndrome. Symptoms include high fever with dysphoria, restlessness resembling mania, convulsions in the hands and feet, stiff neck, even opisthotonos, clenched jaw, unconsciousness, a crimson tongue with yellow and dry coating, and a wiry and rapid pulse. The pattern of blood deficiency generating wind is mainly due to liver blood deficiency, failing to nourish the sinews, manifesting as a syndrome of yin deficiency and wind stirring. The former is an excess heat syndrome, characterized by high fever accompanied by wind-stirring symptoms, commonly seen in external contraction diseases. The latter is a deficiency syndrome, characterized by blood deficiency accompanied by wind-stirring symptoms, often seen in internal miscellaneous diseases or after chronic illness.
3. Pattern of yin deficiency and wind stirring and pattern of blood deficiency generating wind: Both are caused by yin and blood deficiency leading to malnutrition of the sinews. Clinically, they share the common features of numbness in the hands and feet, tremors, or writhing, and both belong to deficiency syndromes, which can develop from internal damage due to chronic illness. However, the former can also result from the late stage of external-contraction febrile disease, where yin fluids are depleted, leading to malnutrition of the sinews; while the latter is more often due to acute or chronic blood loss, resulting in nutrient-blood deficiency and malnutrition of the sinews. The former presents with yin deficiency, vexing heat in the chest, palms, and soles, dry throat, red tongue, and thin rapid pulse; the latter presents with blood deficiency, dull complexion, pale nails, pale tongue, and thin pulse.

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bubble_chart Documentation

1. Jingyue Quanshu‧Convulsive Disease: "I believe that the disease of convulsion is characterized by rigidity and opisthotonos. The disease lies in the tendons and vessels; the tendons and vessels are tense, hence the opisthotonos. The disease lies in the blood; the blood is dry and withered, hence the muscular spasm."