HEMATEMESIS

Clinical Manifestations
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Hematemesis
  • Red eyes
  • Sore throat
  • Mouth, tongue and lip ulcerations
  • Urinary difficulty
  • Diarrhea
  • Papules
  • Sores
  • Prickly Heat
  • Ocular pain
  • Dark urine
  • Chest pain
  • Hemoptysis
  • Epistaxis
  • Oliguria with dark urine
  • Scanty urine
  • Swelling of the throat
  • Fever
  • Thirst
  • Irritability
  • Nausea
  • Vomiting
  • Lassitude due to Summerheat
  • T: Normal
  • C: Yellow and greasy
  • P: Soggy and rapid
Treatment Principle
  • Clear Heat
  • Relieve toxicity
  • Promote urination
  • Eliminate Summerheat
  • Tonify Qi
  • Cool the Blood
Herb Formulas
Points
Clinical Manifestations
  • Alternating chills and fever
  • Bitter taste in mouth
  • Thirst
  • Dry throat
  • Rib pain (doesn't like touch)
  • Hypochondriac pain
  • Nausea
  • Vomiting
  • Hematemesis
  • Hypogastric pain and distension
  • T: Red
  • C: Yellow
  • P: Rapid and wiry
Treatment Principle
  • Relieve Gall Bladder Heat
  • Pacify the Liver and Gall Bladder
Herb Formulas
Points
Clinical Manifestations
  • Hematemesis (acute, violent vomiting of fresh Blood)
  • High fever
  • Red face
  • Red eyes
  • Red lips
  • Dry mouth
  • Thirst
  • Restlessness
  • Irritability
  • Insomnia
  • Confusion of mind
  • Delirium
  • Mania
  • Dark yellow urine
  • Excessive skin rashes all over body
  • Hemoptysis
  • Epistaxis
  • Hemafecia
  • Hematuria
  • Constipation or
  • Sticky, dark, tarry stools
  • T: Deep red, dry or Scarlet with red spots on the edges or Purple red
  • C: None
  • P: Rapid or Thready and rapid or Thready and feeble or Flooding, big and rapid
Treatment Principle
  • Cool the Blood
  • Dispel Heat and Toxins from the Xue Stage
  • Promote Blood Circulation
Herb Formulas
Points
Clinical Manifestations
  • Intense fever
  • Strong thirst
  • Dry heaves
  • Severe, stabbing headache
  • Extreme irritability
  • Delirious speech (severe)
  • Rash (severe)
  • Epistaxis (severe)
  • Maculae
  • Mania
  • Convulsions
  • Lips chapped, dark and scorched
  • Coma
  • Hematemesis
  • Extreme coldness of the extremities
  • Restlessness
  • Spasms or convulsions
  • Blurred vision
  • T: Dark red
  • C: Dry or prickly
  • P: Deep, thin and rapid or Floating, large and rapid
Treatment Principle
  • Clear Heat
  • Relieve toxicity
  • Cool the Blood
  • Drain Fire
  • Stop bleeding
Herb Formulas
Points
Clinical Manifestations
  • Vomiting of small quantities of pink or Blood tinged saliva, pale or fresh red Blood, or purplish or dark, clotted Blood
  • Intermittent, dull abdominal pain, which is relieved by warmth and pressure and is worse with Cold and when the patient is tired or run down
  • Waxy pale or Sallow complexion
  • Fatigue
  • Weakness
  • Dizziness
  • Light-headedness
  • Anorexia
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Easily satiated
  • Nausea
  • Maybe acid regurgitation or vomiting
  • Loose stools or
  • Diarrhea
  • Sticky, tarry black stools
  • Occult hemafecia
  • Shortness of breath on exertion
  • Spontaneous sweating
  • Maybe heavy menstruation
  • Maybe bruising easily
  • T: Pale and flabby - may have teethmarks
  • C: White
  • P: Even, forceless and deficient or Thready and weak or Moderate
Treatment Principle
  • Strengthen the Spleen
  • Benefit Qi
Herb Formulas
Points
Clinical Manifestations
  • Mild bleeding of dark, purplish Blood or, less commonly, red Blood preceding or following defecation or
  • Black, tarry, sticky stools or occult Blood discovered in testing
  • Intermittent dull abdominal pain, alleviated by pressure
  • Easily satiated
  • Nausea
  • Waxy, sallow or pale complexion
  • Anorexia
  • Fatigue
  • Weakness
  • Four limbs feel tired and heavy
  • Physical and mental exhaustion
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose or unformed stools or
  • Diarrhea
  • Shortness of breath
  • Spontaneous sweating
  • Dizziness
  • Light-headedness
  • Palpitations
  • Functional Uterine Bleeding
  • Purpura
  • Epistaxis
  • Hemafecia
  • Hematuria
  • Menorrhagia
  • Metrorrhagia
  • T: Pale and flabby - may have toothmarks
    With Blood Deficiency: Pale and thin
  • C: White
  • P: Thready and weak or Moderate
Treatment Principle
  • Strengthen the Spleen
  • Benefit Qi
  • Nourish the Blood
  • Stop bleeding
Herb Formulas
Points
Clinical Manifestations
  • Spitting light red blood
  • Chronic poor appetite
  • Loose stools
  • Weakness
  • Facial pallor
  • Abdominal bloating and/or pain relieved by warmth and pressure
  • Maybe insomnia
  • Sallow complexion
  • Anorexia (maybe with vomiting)
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools or watery stools containing undigested food
  • Shortness of breath
  • Pain in the epigastrium with cold sensations (pain is relieved by warmth)
  • Cold limbs
  • Feeling chilled
  • Frequent, clear urination
  • Mental fatigue
  • Maybe scanty urine with edema
  • Maybe clear, watery vaginal discharge
  • T: Pale with teethmarks
  • C: Thin and white
  • P: Deep and weak or Soft or Deep and thready
Treatment Principle
  • Warm the Center
  • Dispel Cold
  • Strengthen the Spleen
  • Guide the Blood to the vessels
Herb Formulas
Points
Clinical Manifestations
  • Diarrhea with watery stools
  • Nausea and vomiting
  • No thirst
  • Anorexia
  • Abdominal and/or epigastric fullness (likes pressure)
  • Abdominal pain
  • Gastrointestinal weakness
  • Pale face
  • Frequent urination
  • Tends toward fatigue
  • May have cold limbs
  • May have headache with fever
  • Body aches
  • Epistaxis
  • Hematemesis
  • Shortness of breath
  • Lassitude
  • Epigastric pain
  • All Blood from bleeding is pale
  • Maybe scanty urine with edema
  • Edema
  • Insomnia
  • Hemoptysis
  • Intestinal bleeding
  • Chronic bleeding
  • Hemafecia
  • Uterine bleeding
  • Rectal bleeding
  • Profuse menstrual flow
  • Chest fullness and pain
  • Hypochondriac pain that shoots toward the Heart
  • Intolerance of Cold
  • Rigid focal distention in the Heart region
  • Excessive production or drooling of foamy saliva
  • Emaciation
  • T: Pale, may be moist
  • C: White or None
  • P: Deep, weak and slow or Deep and thready or Big and weak
Treatment Principle
  • Warm the Middle Jiao
  • Dispel Cold
  • Strengthen the Spleen and Stomach
  • Tonify Qi
Herb Formulas
Points
Clinical Manifestations
  • Vomiting, possibly violent, of red, brown or purple blood or Blood mixed with undigested food
  • Constipation or dry stools or
  • Black, tarry stools
  • Burning Heat and pain in the epigastrium
  • Abdominal and epigastric distention
  • Irritating thirst: drinks copious fluids and prefers cold drinks
  • Excessive appetite: hungry again quickly after eating (as if food vanishes)
  • Swelling, pain, ulceration and bleeding of gums
  • Foul breath
  • Belching
  • A bitter taste in the mouth
  • Toothache
  • Irritability
  • Restlessness
  • Maybe vomiting right after eating
  • Vomiting acid or undigested food
  • Heartburn
  • Maybe scanty, red urine
  • T: Red and dry
  • C: Thick, yellow and dry
  • P: Slippery, big, Excess and rapid or Wiry and rapid
Treatment Principle
  • Clear and Purge Stomach Fire
  • Stop bleeding
Herb Formulas
Points
Clinical Manifestations
  • Vomiting of dark, purplish, coffee ground like material
  • Sharp, stabbing epigastric pain with fixed location
  • Pain is severe after eating
  • Dislike of pressure and Heat on epigastrium
  • Right-sided hypochondriac pain
  • Pain predominates over distention or
  • Pain but no distention
  • Epigastric rumbling
  • Stools with Blood like tar (melaena)
  • May be abdominal or epigastric lumps or masses
  • Dark or purplish spider naevi or broken vessels on the trunk and around the inner ankles and knees
  • Dark, ashen, sallow or purplish complexion
  • Dark, purplish lips and conjunctiva
  • Dark rings around the eyes
  • Maybe irregular menstruation with dark, purple Blood or clots
  • T: Dark purple with purple spots or dots
  • P: Wiry and choppy or Thready and choppy or Wiry
Treatment Principle
  • Invigorate the Blood
  • Adjust Qi
  • Transform Stagnation
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • Sallow or pale complexion
  • Anorexia
  • Four limbs feel tired and heavy
  • Physical and mental exhaustion
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose or unformed stools
  • Shortness of breath
  • Dizziness
  • Palpitations
  • Functional Uterine Bleeding
  • Purpura
  • Epistaxis
  • Hemafecia
  • Hematuria
  • Menorrhagia
  • Metrorrhagia
  • T: Pale and flabby - may have teethmarks
  • C: White
  • P: Thready and weak
Treatment Principle
  • Benefit Qi
  • Conserve Blood
Herb Formulas
Points
Clinical Manifestations
  • Vomiting of fresh red Blood or undigested, blood streaked food material
  • The hematemesis may be provoked by a particularly large or indigestible meal
  • Epigastric and abdominal fullness, distention and pain worse with pressure and eating and which is alleviated by defecation, belching or vomiting
  • Belching with rotten food smell
  • Foul flatulence
  • Acid regurgitation
  • heartburn
  • Detests food or
  • Vomits after eating
  • Anorexia
  • Unformed stools or
  • Diarrhea or
  • Knotted constipation or
  • Black, tarry, sticky stools
  • T: Pink
  • C: Thick and greasy, maybe yellow
  • P: Slippery, maybe rapid
Treatment Principle
  • Clear Food
  • Conduct Stagnation
Herb Formulas
  • Bao He Wan modified
  • For severe Food Stagnation with Heat, start with a dose or two of: Tiao Wei Cheng Qi Tang
  • Chinese Patent Medicines: Bao He Wan
    For bleeding: +
    Sheng Tian Qi Pian
    Yun Nan Bai Yao
Points
Clinical Manifestations
  • Vomiting of fresh, red Blood that may be either copious or scant
  • No appetite or
  • Famished but with no desire to eat or
  • Indeterminate gnawing hunger
  • Persistent, dull, nagging epigastric pain
  • Heartburn
  • Morning nausea
  • Abdominal distention after meals
  • Black, sticky or tarry, dry stools
  • Irritability with low grade fever
  • Maybe dry retching or
  • Hiccups
  • Thirst
  • Dry skin, hair and mucous membranes
  • Tendency toward constipation or pellet-like stools
  • Facial flushing
  • Malar flush
  • Nightsweats
  • Five-Sole-Heat
  • With Kidney Yin Deficiency:
    Dizziness
    Tinnitus
    Low back and knee weakness and pain
  • T: Red or Slightly red with a peeled center or Red and dry
  • C: Little and dry or Peeled in the center or Shiny
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Clear Heat
  • Nourish the Stomach
  • Cool the Blood
  • Stop bleeding
Herb Formulas
  • Yu Nu Jian modified
  • Chinese Patent Medicines:
    With Stomach Qi and Yin Deficiency: Gu Ben Wan
    With marked Deficient Heat: Zhi Bai Ba Wei Wan
    With Stomach Qi and Yin Deficiency: Sheng Mai San Wan
    With Kidney Yin Deficiency: Liu Wei Di Huang Wan
    With bleeding:
    + Yun Nan Bai Yao
    + Sheng Tian Qi Pian
      
Points
Clinical Manifestations
  • Abdominal pain and distention
  • Flank pain and distention
  • Epigastric pain and distention
  • Hypochondriac pain
  • Maybe hematemesis
  • Maybe hemoptysis
  • Chest distention
  • Vomiting
  • Regurgitation of sour fluids
  • Epigastric pain (worse when emotionally upset)
  • Belching with acid regurgitation
  • Nausea
  • Vomiting
  • Anorexia
  • Suffocating sensation in the chest
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • T: Pink
  • C: Thin and white
  • P: Wiry or Tight
Treatment Principle
  • Soothe the Liver
  • Harmonize the Stomach
  • Regulate Qi
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • Abdominal masses which are visible when lying down
  • Piercing hypochondriac pain
  • Irritability
  • Indigestion
  • Constipation
  • Dysmenorrhea
  • Amenorrhea
  • Chronic diarrhea
  • Hematemesis
  • Daybreak diarrhea
  • Palpable abdominal masses
  • Irregular menstruation
  • Breast distention
  • Abdominal tumors
  • Hypochondriac distention
  • T: Purple with purple spots on the side
  • C: Normal
  • P: Wiry, choppy and tight
Treatment Principle
  • Invigorate the Blood
  • Dispel Blood Stasis
  • Move Qi
  • Alleviate pain
  • Stop bleeding
Herb Formulas
Points
Clinical Manifestations
  • Severe, splitting headaches with dizziness
  • Sudden tinnitus or
  • Sudden deafness
  • Flushed face
  • Red, swollen, painful eyes
  • Irascibility with violent angry outbursts
  • Dry mouth
  • Bitter taste in mouth
  • Thirst
  • Vomiting sour or bitter liquid
  • Insomnia
  • Restlessness
  • Constipation or dry stools
  • Maybe rib pain
  • In severe cases:
    Mania
    Hemoptysis
    Hematemesis
    Epistaxis
  • Liver Fire Attacks the Lungs:
    Hemoptysis
    Rib pain which is severe when coughing
  • Liver Fire Attacks the Stomach:
    Hematemesis
  • T: Red tip and edges
  • C: Thick, yellow, dry and rough
  • P: Wiry, Excess and rapid
Treatment Principle
  • Clear the Liver
  • Purge Fire
Herb Formulas
Points
Clinical Manifestations
  • Vomiting of fresh red or purple Blood or
  • Vomitus stained with Blood or
  • Vomitus containing Blood clots
  • Episodes will often be associated with stress or emotional turmoil
  • Hypochondriac distention and pain
  • Insomnia
  • Restlessness
  • Emotional problems
  • Irritability
  • Dream disturbed sleep
  • A quick temper
  • Pounding temporal headaches
  • Red, sore eyes
  • Chest pain
  • A bitter taste in the mouth
  • T: Deep red or Red edges
  • C: Yellow or None
  • P: Wiry and Rapid
Treatment Principle
  • Reduce Liver Fire
  • Stop bleeding
Herb Formulas
Points
Clinical Manifestations
  • Steaming bone disorder
  • Afternoon fever
  • Tidal fever
  • Night sweats
  • Spontaneous seminal emissions
  • Irritability
  • Heat and pain in the knees (maybe with weakness)
  • Atrophy and weakness of the knees and legs
  • Red face
  • Restless fever
  • Hematemesis
  • Sore knees
  • Sore lower back
  • Maybe hemoptysis
  • May be constant hunger
  • Maybe constipation
  • Hot flashes
  • Restlessness
  • Fidgeting
  • Insomnia with frequent dreams
  • Productive bloody cough
  • Easily angered
  • Nightmares
  • Sore feet with flaccidity
  • Tinnitus
  • Burning sensation over Kidneys
  • Dizziness or vertigo
  • Five Sole Heat
  • Cough
  • T: Red
  • C: Little or None
  • P: Thready, Excess and rapid in the Chi position
Treatment Principle
  • Nourish Yin
  • Descend Fire
Herb Formulas
Points
Clinical Manifestations
  • Bruising, swelling and pain accompanying traumatic injuries
  • Fractures
  • Torn sinews
  • Bleeding due to laceration
Treatment Principle
  • Invigorate the Blood
  • Dispel Blood Stasis
  • Promote the movement of Qi
  • Reduce swelling
  • Alleviate pain and bleeding
Herb Formulas
Points
Clinical Manifestations
  • High fever
  • Confusion of mind
  • Delirium (mania)
  • Dark yellow urine
  • Excessive skin rashes all over body
  • Hemorrhage
  • Hematemesis
  • Hemoptysis
  • Epistaxis
  • Hemafecia
  • Hematuria
  • T: Deep red, dry or purple red.
  • C: None
  • P: Rapid or Thready and rapid or Thready and feeble
Treatment Principle
  • Clear Heat
  • Cool the Blood
  • Invigorate the Blood
Herb Formulas
Points
Clinical Manifestations
  • Pain
  • Swelling in the joints
  • Fever
  • Chills
  • Headache
  • Fatigue
  • Severe muscle aches
  • Conjunctivitis
  • Hemorrhages
  • Jaundice
  • Kidney and Liver dysfunction
  • Hematemesis
  • T: Red
  • C: Slimy or greasy yellow
  • P: Floating and rapid
  • End-stage:
    Dementia
    Confusion
    Memory loss
    Delusions
    Eventually, complete neurological breakdown
Treatment Principle
  • Cool the Blood
  • Clear Heat
  • Relieve Toxicity
Herb Formulas
Points
Clinical Manifestations
  • Swelling of the affected area
  • Hardening of the affected area
  • Stomach ache with tenderness
  • Pain in the affected area
  • Hematemesis with purplish discharge
  • No change in skin color in the early stages
  • T: Dark
  • C: White and smooth
  • P: Choppy
Treatment Principle
  • Warm Cold
  • Dissolve Phlegm
  • Disperse Dampness
  • Dispel Stagnation
  • Open the channels and collaterals
Herb Formulas
Points
Clinical Manifestations
  • High fever
  • Irritability
  • Fidgeting
  • Dry mouth
  • Dry throat
  • Incoherent speech
  • Insomnia
  • Dark urine
  • Deep-rooted boils
  • Maculae
  • Carbuncles
  • Hematemesis
  • Hemoptysis
  • Palpitations
  • Furuncles
  • Tinnitus
  • Purpura
  • Red face
  • Rashes
  • Deep-rooted boils
  • Red eyes
  • Itchy skin
  • Fidgeting
  • Dry lips
  • Delirium
  • Dysentery with fever
  • Jaundice
  • Epistaxis
  • Hematuria
  • Cloudy mind
  • Diarrhea
  • T: Red
  • C: Yellow
  • P: Rapid and forceful
Treatment Principle
  • Clear Heat
  • Drain Fire
  • Relieve toxicity from all three Jiaos
  • Relieve inflammation
  • Stop bleeding
  • Purge Damp-Heat
  • Purge the Gallbladder
Herb Formulas
Points