After briefly covering the five stagnations in January (Parts 1 and 2) and Qi stagnation in February (Parts 1 and 2), it makes sense to cover Blood stasis next. Qi and Blood are intricately connected in many ways, which means that tonifying or moving one, tonifies or moves the other. So now that we’ve gotten your Qi moving, your Blood is probably flowing better, too. However, Blood stasis can appear by itself and eventually cause Qi to stagnate. And you definitely don’t want your blood to stagnate – it can be MOST uncomfortable!

Blood Stasis

When Blood doesn’t circulate freely, it stagnates. This can occur as sluggish circulation, localized coagulations or fixed masses. Blood stasis tends to be more severe than Qi stagnation partly because it is a substantial fluid in the body. When Qi stagnates, pain is like rush-hour traffic – it comes and goes and changes location and severity – but when Blood congests, pain is like a major traffic accident with trauma, injuries and stabbing sensations.

Signs of Blood Stasis

Generally, three or more signs need be present to identify Blood stasis, but any of the following indicate its presence. While severe pain that is fixed and stabbing is a major sign, it’s possible to have Blood stasis without any pain at all.

• Severe pain that is stabbing or boring in nature and fixed in location
• Purple lips, nails, or tongue
• Masses that are fixed and don’t move
• Bleeding with dark blood and dark clots; larger clots
• Dark to dusky complexion and bluish/purplish skin discolorations (such as bruises; varicose veins; spider veins; dark vasculature; areas of trauma and spots on the skin or mucous membranes such as liver spots); rough scaly dry skin; dry hair
• On palpation, any hard masses; may be painful to the touch

Pulse and Tongue:

• Pulse: rough and “difficult” (like scraping bamboo with a knife), choppy (thready, slow, short and irregular), knotted (slower than 60 BPM with occasional irregular pauses), or accelerated (faster than 80 BPM with irregular pauses)
• Tongue: purple, blue-purple, purple spots; sub-lingual veins (under the tongue) tend to be engorged and purple

Blood Stasis in the Upper Warmer

Purple or blue discolorations, stabbing pains in the head or chest, immobile lumps, masses, tumors, or clots

Blood Stasis in the Heart Stabbing or pricking pain in the chest, stuffiness of the chest, purple tip or sides of tongue front, distended sub-lingual veins toward front of tongue

Blood Stasis in the Lungs Stuffiness of the chest, immobile masses, purple tip or sides of tongue front, distended sub-lingual veins toward front of tongue

Blood Stasis in the Middle Warmer

Immobile lumps, masses, tumors, or clots in the middle abdomen

Blood Stasis in the Stomach Vomiting of dark blood, dark blood in stools, epigastric pain, purple tongue especially in the center and distended sub-lingual veins in the center

Blood Stasis in the Lower Warmer

Severe menstrual pain, dark menstrual blood possibly with larger clots, immobile lumps, masses, tumors, or clots in the lower abdomen

Blood Stasis in the Liver Purple nails, painful periods with dark menstrual blood possibly with dark, larger clots, PMS pain, purple tongue especially on the sides, and distended sub-lingual veins near the rear

Blood Stasis in the Intestines Dark blood in the stools, severe abdominal pain, purple tongue at the rear and distended sub-lingual veins at the rear

Blood Stasis in the Uterus Menstrual pain, pre-menstrual pain, dark menstrual blood with dark and larger clots, abdominal masses, purple tongue and distended sub-lingual veins at the root

Causes for Blood Stasis

Several factors can lead to Blood stasis:

Qi Stagnation: This is the most common cause. Qi moves Blood; if Qi stagnates, then Blood congeals.

Deficient Qi: A deficiency of Qi over time makes it too weak to move Blood.

Heat in the Blood: Heat in the Blood can cause it to coagulate and stagnate.

Deficient Blood: A deficiency of Blood over time causes a deficiency of Qi, which then can’t move Blood so it stagnates.

Internal Cold: Coldness slows the circulation of Blood, which then can congeal. In fact, many people who feel “cold” are actually experiencing poor blood circulation. This especially happens with the elderly or infirm. Pathogenic Influences: If External Wind invades and pushes deeper into the body, it can cause Internal Cold. As well, External Wind-Cold or Wind-Damp or the congealing actions of warm pathogen diseases can cause Blood to congest.

Dampness and Phlegm: Dampness and/or Phlegm can slow or even obstruct circulation, leading to Blood stasis.

Trauma: Injuries, accidents and other traumas cause Blood stasis, either locally or internally.

Emotions: Any long-term suppressed or unexpressed emotion stagnates the Qi, which in turn can congeal the Blood. As well, restlessness, or irritability and the need to “break out” may be signs of Blood stasis. Some esoteric traditions teach that the personality and karma are carried in the blood. Perhaps this could account for the reason why people with heart transplants often have a personality change for the first two months! Also, keep in mind that emotions cause chemicals to be released, which then dock on receptor sites of cells to create changes in the body. According to Candace Pert (Molecules of Emotions: The Science Behind Mind-Body Medicine, Simon and Schuster, NY, 1999), these chemicals of emotion don’t just occur in the brain but exist everywhere in the body. These are produced directly at a cellular level when the neuropeptides bind with receptors, and your heart holds every single neuropeptide receptor. This means it’s very possible that emotions are carried through our blood stream, affecting its volume, flow and quality.

Diet: A diet rich in raw foods, salads and/or fruit, foods eaten directly out of the refrigerator or freezer (like milk, yogurt, ice cream, popsicles, or frozen yogurt), cold drinks (such as iced water or iced tea and juices) and cold-energied foods (such as soy milk, tofu, watermelon, bananas, crabmeat, shellfish) cause Coldness, which congests the blood. Hot, spicy foods, caffeine, and alcohol cause Heat in the Blood. If there’s also Qi stagnation avoid Qi-stagnating foods (listed here). If there is deficient Blood, then inadequate intake of food in general and protein in particular can lead to deficient Blood, which eventually causes Blood stasis.

Lifestyle Habits: External injuries, traumas, and accidents directly cause Blood stasis. Other causes include: insufficient dressing for the weather, such as including bare neck, back and midriff causes Cold to penetrate and lodge in the Interior; insufficient activity/movement causes Qi to stagnate, which in turn causes Blood stasis; and overuse of hot tubs and saunas thins the blood, possibly leading to deficient Blood and from there, Blood stasis, or disperses the Yang, causing Internal Coldness and then Blood stasis.

What is the Difference Between Qi Stagnation and Blood Stasis?

SYMPTOM/SIGN	QI STAGNATION	BOOD STASIS
Pain/Distension	More distension than pain	More pain than distension
Location	Moving pain, changes location	Fixed, immobile pain
Character	Distending pain that can come and go; feeling of fullness	Stabbing or boring pain that is immoblie
Masses	Appear and disappear	Fixed
Skin	Doesn’t appear on surface of skin; sub-cutaneous lumps that come and go and change location	Purple-bluish discolorations; sub-cutaneous lumps that are fixed
Face	May be unchanged	Purple-bluish
Tongue	Normal color with sides possibly curled up	Purple with possible purple spots
Pulse	Wiry	Rough, choppy, knotted, or accelerated

Blood Pathologies

 Blood stasis can be involved in such conditions as joint or muscle pain, tumors, gynecological disorders, cancer, fibroids, arthritis, intractable pain, angina, abdominal masses, heart disease, coronary artery disease, migraines, Reynaud’s, intercostal neuralgia, pain due to external injuries, Peyronie’s disease, emotional instability, insomnia, irritability, restlessness, vertigo, tinnitus, constipation, incontinence of urine, hard palpable masses, lumps and tumors, eczema, urticaria, dry, rough and itchy skin, abscesses and other skin diseases or sores, severe pain in the muscles, numbness or paralysis of the limbs, joints, muscles and nerves, angina pectoris, gastritis, ulcers, hepatitis, cholecystitis, pancreatitis, polycystic ovaries, infertility and more.

Hidden Pathology

 Blood stasis is often considered a “silent killer” because it can be the hidden pathology behind other issues. Any long-term condition that can’t be resolved generally has blood stasis involved. In Part II we will discuss treatments and therapies for Blood stasis. However, if you feel stagnant just by reading all of this, I suggest you immediately get up and MOVE, just as for Qi stagnation, as that’ll get your blood circulating, too!