Creating, Storing, and Circulating Blood — An Eastern Medicine Map for "Anxious and Can't Sleep" or "Looking Pale"
My sleep is shallow. My anxiety won't go away. My nails break easily. My hair has become dry.
It is only when people list these small ailments that they realize, "Oh, they've actually been piling up." Even when blood tests are normal, the body is clearly sending out signs—Eastern medicine has explained this gap as a disturbance in "Blood (Ketsu)".
This is the second installment of the "Qi, Blood, and Body Fluids Connection" series, following the "Detailed Explanation of Qi" I wrote last time. In contrast to Qi, which is the protagonist of movement, this time we are talking about content and foundation. Blood is the very nourishment that sustains the body, and in Eastern medicine, it is also a vessel that supports mental stability.
▶ Click here for all articles in the Eastern Medicine series → Summary Magazine
What is Blood? — A Review of the Basics
"Blood (Ketsu)" is the red liquid that Eastern medicine considers to be circulating inside the body. While it overlaps significantly with "blood" in Western medicine, blood in Eastern medicine has one other important role.
Nourishing: Sustains the whole body and moisturizes hair, skin, nails, eyes, and muscles
Housing the spirit: Creates the foundation for stable thinking, sleep, and emotions
Old sayings like "Hair is the surplus of blood" and "The Liver opens into the eyes" are expressions that accurately describe this function of blood. This time, we will look at where this blood is made, who stores it, and where it circulates as a collaborative diagram of the Five Organs.
Collaboration Diagram with the Five Organs — Blood is a joint effort of the "Organ that makes it, the Organ that circulates it, and the Organ that stores it"
Blood is formed through the cooperation of three organs.
Spleen — Makes blood and prevents it from leaking
Just like with Qi, it is the job of the Spleen to create the materials for blood. It digests food and drink to create the source of Qi and blood, and sends it throughout the body. It has long been called the source of Qi and blood production.
Another important role is "Tong She" (governing/controlling). This is the power to keep blood contained so it does not leak out of the blood vessels. When the Spleen weakens, this control becomes lax, appearing as bleeding tendencies such as subcutaneous bleeding, irregular bleeding, or nosebleeds.
Heart — The pump that circulates blood throughout the body
It is the role of the Heart to push the created blood throughout the body. "The Heart governs the blood vessels"—this is the representative function of the Heart in Eastern medicine.
The Heart is also the center of mental activity called Shen Zhi (spirit/consciousness). That is why the Heart and blood have an inseparable relationship, and we believe that when blood is abundant, the mind is stable, and when blood is thin, anxiety and insomnia are more likely to occur. Many complaints such as "I feel uneasy" or "I wake up with heart palpitations" are matters of the balance between the Heart and blood.
Liver — The storage warehouse that keeps blood and distributes it where needed
And it is the role of the Liver to store excess blood. This function is called "Zang Xue" (storing blood), and it acts as a manager of storage and distribution, sending blood to the whole body when active and having it return to the Liver when resting.
"The Liver opens into the eyes"—this is why eye problems (blurriness, fatigue, dry eyes) are diagnosed in Eastern medicine by linking them to the state of the blood in the Liver.
Coordination with the Six Fu Organs — The Small Intestine Separates the 'Materials'
The small intestine is the first to receive the materials for blood, sorting them into nutrients and waste. The small intestine is known as the 'official that separates the pure from the turbid,' absorbing the nutrients that become the source of blood (pure) from digested food and drink, and passing them to the spleen.
If the function of the small intestine slows down, no matter how much you eat, the materials for blood cannot be extracted effectively, and the quality and quantity of blood produced by the spleen will diminish—understanding this connection makes the logic of self-care easier to grasp.
Typical Blood Pathologies — Four Patterns
Disorders of the blood can be broadly organized into four patterns.
Blood Deficiency (Xue Xu) — Insufficient Blood
This is the most common pathology in modern people. It occurs due to insufficient production by the spleen, or through exhaustion, blood loss, or overwork.
Pale complexion, pale lips or nails
Dry hair, hair loss, increase in gray hair
Blurred vision, shallow sleep, tendency toward anxiety
Brittle nails, numbness in hands and feet
Scanty or delayed menstrual flow
This blood deficiency is very often behind feelings of 'not quite having energy' or 'lack of skin luster'.
Blood Stasis (Xue Yu) — Stagnant Blood
A state where there is enough blood, but the flow is stagnant. There is a relationship where prolonged Qi stagnation leads to blood stasis, and it is caused by stress, cold, bruising, or long periods of sitting.
Stabbing, localized pain (headaches, stiff shoulders, menstrual pain)
Dark complexion, dullness, dark spots
Veins under the tongue are prominent and dark
Menstrual blood contains clots
This is a pathology that overlaps significantly with what modern medicine calls 'poor blood circulation'.
Blood Heat — Heat trapped in the blood
A condition where heat enters the blood, causing inflammatory symptoms in various places.
Nosebleeds/abnormal bleeding (bright red and relatively heavy)
Facial redness, acne, and eczema
Feeling flushed and irritability
This is a condition that tends to be aggravated by spicy food, alcohol, and stress.
Bleeding — Failure of containment
A state where the Spleen's ability to contain blood weakens, causing blood to leak outside the vessels. As an extension of chronic fatigue and Spleen deficiency, a tendency toward bleeding gradually appears.
▶ Click here for all articles in the Oriental Medicine series → Summary Magazine
Modern people and blood depletion
Modern life is full of conditions that make it easy for blood to decrease.
Menstruation and postpartum: A life cycle where women are physiologically prone to blood depletion
Staying up late and irregular sleep: Night is the time for blood to return to the Liver. If you cannot sleep, the storage of blood does not function
Excessive use of smartphones and eyes: 'The Liver opens into the eyes' = Overusing the eyes depletes Liver blood
Excessive dieting: Materials do not reach the Spleen, and the production of blood itself thins out
Chronic stress: The Liver's dredging function is disrupted, and the balance of blood storage is also lost
It is not rare for people who come to me to be dealing with all five of these. In fact, from the perspective of Oriental medicine, 'anxiety, insomnia, and menstrual irregularities occurring together' can often be explained as a consistent state where 'blood deficiency is at the base'.
Three small health practices to nourish blood
① Go to bed early
The time for blood to return is at night. In particular, 11 PM to 3 AM is considered the time of the Liver and Gallbladder, and whether you are asleep during this window changes the amount of Liver blood recovery. Just lying down before midnight can make a difference in the next morning's eye fatigue and complexion.
2. Be mindful of black and red foods
Representative foods that replenish blood are black (black beans, black sesame, black wood ear mushrooms, nori, seaweed) and red (jujube, goji berries, liver, red meat, carrots).
I sometimes recommend tea with jujube or brown sugar to my patients as a snack at home after their treatment. The gentle sweetness and the feeling of the body warming up are why it's easy to recommend.
3. Rest your eyes
Consciously limit the time you spend looking at your smartphone. Just doing this will significantly reduce the consumption of liver blood. Look into the distance, close your eyes and warm them, or stay away from screens for an hour before bed—it's difficult, but it's a health practice that gradually becomes effective.
How acupuncture and moxibustion view it
For blood imbalances, we make the following assessments while checking the pulse, tongue, and condition of the abdomen.
Blood deficiency → Acupoints to replenish blood (Sanyinjiao, Xuehai, Zusanli, etc.)
Blood stasis → Acupoints to circulate blood (Geshu, Xuehai, Taichong, etc.)
Blood heat → Acupoints to cool heat (Quchi, Hegu, etc.)
Bleeding → Support blood containment (Pishu, Zusanli, etc.)
Sanyinjiao is a place where the Spleen, Liver, and Kidney meridians intersect, which I also introduced in the article on meridian acupoints. Since it is an acupoint related to all three organs closely tied to blood, I use it for almost all women's health issues.
The topic of blood is about the 'internal nourishment' that sustains the body, and it is also about the 'foundation' of mental stability. Seeing patients, I realize that when this foundation thins, even their mental state becomes unstable.
Summary
Blood is a collaboration of three organs: created by the Spleen, circulated throughout the body by the Heart, and stored in the Liver
The small intestine is the entrance that sorts out the materials for blood
There are 4 patterns of blood imbalance: blood deficiency, blood stasis, blood heat, and bleeding
Modern people are prone to blood deficiency as a base (menstruation, staying up late, smartphones, dieting, stress)
The entrance to health practices is the three things: 'sleeping early, black and red foods, and resting your eyes'
The topic of blood was about 'quantity,' 'circulation,' and 'how to store it.' Next time, we will finally have the final installment of the Qi, Blood, and Body Fluid series, covering Body Fluids (Jin-ye). This is a discussion of all the moisture in the body, including sweat, tears, and joint fluid. We will organize how to interpret imbalances in water, such as 'the face is puffy but the mouth is dry' or 'the skin is dry but the legs feel heavy'.