🌿 Folk Prescriptions

A woman experienced menstruation and simultaneously caught a cold, presenting with headache, alternating chills and fever, lower abdominal distension and pain, poor appetite, no thirst or minimal thirst. Diagnosed at a hospital as “common cold,” she received intravenous Western medicine for several days with no improvement. She then tried traditional Chinese medicine with little effect, prompting her to seek my treatment. Upon reviewing previous prescriptions, I found they were modified versions of Yin Qiao San. Current presentation: headache, dizziness, alternating chills and fever, sweating followed by fever reduction, mild thirst, lower abdominal distension and pain, restlessness, insomnia, chaotic dreams, chest and rib fullness, palpitations, scanty menstrual flow with prolonged bleeding, short and red urine, red tongue, wiry pulse. Diagnosis: exogenous infection during menstruation, residual pathogen, heat entering the blood chamber, heat and blood stasis intermingling. Treatment: harmonize Shaoyang, clear heat, calm spirit, activate blood, regulate menstruation. Formula: Bupleurum 10g, Scutellaria 10g, Cortex Moutan 10g, Gardenia 10g, Honeysuckle 10g, Forsythia 10g, Dandelion 15g, Motherwort 15g, Eclipta Prostrata 10g, Safflower 10g, Angelica 10g, Red Peony 10g, Hematite 30g (boiled first). After three doses, symptoms improved; fever subsided, menstrual flow increased with clots, menstruation ended. Continuing for three more doses, all symptoms disappeared.
This condition stems from contracting external pathogens during menstruation, falling under the category of “heat entering the blood chamber” in TCM. Regarding “heat entering the blood chamber,” both *Treatise on Cold Damage Disorders* and *Essential Prescriptions from the Golden Chamber* describe similar cases, placing it within the scope of exogenous diseases. The term “blood chamber” has varied interpretations throughout history—some say it refers to the Chong channel, others to the liver, and still others to the uterus. Synthesizing various views and clinical practice, the blood chamber for women essentially refers to a comprehensive functional concept centered on the uterus, including connected channels like Chong and Ren, and related organs involved in menstruation. Since Chong is the sea of blood and Ren governs the uterus, forming the foundation of female reproduction, and since the liver channel connects to the genitalia and stores blood, the concept of the blood chamber must be understood comprehensively to match clinical reality—not reduced to a single anatomical organ.
The etiology and pathogenesis of “heat entering the blood chamber” involve pre-existing emotional distress, depression, and stagnation of liver qi. When menstruation occurs or shortly after childbirth, when qi and blood are depleted, the blood sea becomes empty, allowing wind-cold or wind-heat pathogens to invade. The pathogenic heat combines with menstrual blood, leading to conflict between righteous and evil qi, unable to resolve externally, causing stagnation in the uterus. Clinical manifestations include fever, headache, no thirst or minimal thirst, normal appetite, silence, mental confusion, delirium as if seeing ghosts, constipation.
Treatment approaches:
1. Initial invasion of heat: Symptoms include alternating chills and fever resembling malaria. Treat with Xiao Chai Hu Tang, and acupuncture at Qimen point.
2. Heat invading internally in warm-heat diseases: Use Tao’s Xiao Chai Hu Tang or Gui Zhi Hong Hua Tang with modifications. ① If menstruation just began and wind-cold invaded, transforming into heat, leading to heat entering the blood chamber, initially showing alternating chills and fever, followed by malaria-like episodes, with menstruation interrupted—use Yi Chai Hu Yin for mild cases or weak constitutions. ② If accompanied by blood clots or lower abdominal distension and pain, indicating blood stasis, add Motherwort, Angelica, Eclipta Prostrata, Safflower to activate blood and regulate menstruation, promoting circulation. ③ Due to exogenous wind-heat or heavy heat, combined with dysfunction of Chong and Ren channels, liver failing to store blood, heat forcing blood to flow, resulting in prolonged or sudden profuse bleeding—treat by clearing heat, cooling blood. Add Rehmannia, Cortex Moutan, Artemisia, Lycium, Dandelion, Honeysuckle to the Xiao Chai Hu Tang to cool blood, nourish yin, and clear heat. ④ If Chong and Ren channels are weak and bleeding is heavy, add Astragalus, Persimmon Leaf, Lotus Pod Charcoal to consolidate Chong and Ren channels, and Sanqi to stop bleeding. ⑤ If heat is severe, blood blocked by heat, stagnating in the uterus, heat and blood stasis combining, rising upward via Chong and Ren channels to affect Yangming, presenting with dry mouth, thirst, headache, flushed face, restlessness—add Coptis and Gardenia for mild cases; if constipation, add Rhubarb or modify Da Chai Hu Tang.
⑥ If menstruation is ending or postpartum with empty blood sea, contracting external pathogens leading to internal heat stagnation and uterine stasis—use Chai Hu Si Wu Tang, Xiao Yao San, or Dan Zhi Xiao Yao San with modifications.
3. Even as the disease improves, if the constitution is weak and heat remains or bleeding hasn’t stopped, treatment should focus on tonifying qi and nourishing yin, such as Bu Qi Yi Yin Jian.
4. If spleen qi is weak, use Gui Pi Tang.
5. If both qi and blood are deficient, use Shi Quan Da Bu Tang.
6. If blood heat is stagnant, use Xiao Chai Hu Tang with Cortex Moutan, Safflower, Angelica, etc.
In summary, “heat entering the blood chamber” in clinical practice rarely presents with all textbook characteristics in a typical manner. Therefore, one must base diagnosis and treatment on actual clinical conditions, grasp the etiology and pathogenesis, apply syndrome differentiation flexibly, and adjust prescriptions accordingly to achieve better results.