Period Bleeding Won’t Stop?
The opening: the “pillar” herb that tonifies the spleen
Today’s story is about a single herb — Bai Zhu (atractylodes). When it comes to tonifying the spleen in Chinese medicine, Bai Zhu is one of the most important players there is.
💬 Note from Doctor Luo: The most basic qi-tonifying formula in Chinese medicine is Si Jun Zi Tang (Four Gentlemen Decoction) — four herbs: Ren Shen (ginseng), Bai Zhu (atractylodes), Fu Ling (poria), and Gan Cao (licorice). Ginseng tonifies the qi, Bai Zhu tonifies the spleen, Fu Ling drains dampness, and Gan Cao harmonizes the middle. What do we mean by a “master formula”? A formula from the ancestors — the countless formulas of later generations are all variations built on this one, but the four-herb foundation of ginseng, atractylodes, poria, and licorice is never removed, no matter how you adjust it. That tells you Bai Zhu’s standing in the world of spleen tonification.
And the case we’re looking at today is another illness cured by tonifying the spleen — and it’s one of the biggest troubles a woman can face: menstrual bleeding that won’t stop.
Who was the patient? The menstrual blood simply would not stop
What illness did this woman have? Menstrual bleeding that wouldn’t stop — the period lingered on and on, blood never quite finishing. In modern terms, we call this beng lou (uterine bleeding).
💬 Note from Doctor Luo: Actually, beng and lou are two different things. Beng is a flood — the blood pours out all at once in a great gush, impossible to control, like a mountain collapsing. Lou is a leak — the blood trickles on and on, never quite finishing even after the period should be over, a little blood every day, like water dripping through a leaking roof. Put together as “beng lou,” it means the picture includes both.
How severe had it become? The patient had already taken medicine for more than ten days, and the blood had not stopped at all. This was no longer “lou” — it was basically in the “beng” state: massive blood loss, genuinely life-threatening.
💬 Note from Doctor Luo: Everyone, pay attention to that sentence — it is crucial. Bleeding that won’t stop, ten-plus days of medicine with no effect — by this point this was an extremely dangerous condition. Heavy blood loss endangers life itself; this is no minor complaint.
Doctor Zhang Xichun took the pulse — and knew what he was dealing with
At the critical moment, Doctor Zhang Xichun was called in. He took the pulse: floating and soft, but vanishing the moment pressure was applied — the pulse floated up, as if at the surface, yet the moment you pressed down, it was gone.
💬 Note from Doctor Luo: This pulse says a great deal. Floating and soft, but gone on pressure — it has the flavor of the kou (hollow) pulse, like pressing on a scallion stalk: solid outside, hollow inside. What does that tell us? The vital qi has been badly damaged! When the blood has all flowed away, how can a person still have any foundation of strength?
After the pulse, he asked about food and digestion — and that question hit the mark: the food did not digest — whatever she ate sat undigested in a bloated belly; and the stools were loose and slippery — diarrhea, unformed stool, everything draining downward.
💬 Note from Doctor Luo: These two details are vitally important. Food not digesting means the spleen’s transport and transformation function has already declined and begun to fail — the food goes in but doesn’t break down; some people even pass out what they ate, the vegetable leaves still visible in the stool, undigested. That kind of picture is mostly spleen deficiency. Loose, slippery stools are also the signature of a spleen too weak to hold and secure.
What does the spleen do? It governs the two characters “hold and secure”
Why does spleen deficiency cause bleeding? Here we come to a core principle of Chinese medicine.
💬 Note from Doctor Luo: The spleen has a function called gu se (holding and securing) — when spleen qi is sufficient, it holds the body’s organs in their proper positions and keeps the qi mechanism (qi ji) running in its normal rhythm. The moment spleen qi loosens, the whole qi loosens, and everything sinks downward: loose stools, urine that won’t quite finish, and blood that runs out of control.
Under normal conditions, when qi is sufficient, it is qi that commands the blood — the blood stays in its proper channels and runs its proper course. Once qi becomes deficient — especially spleen qi — it loses the power to command the blood, the blood disperses and flows off through every channel, and bleeding results.
Chinese medicine puts it as “qi is the commander of blood, and blood is the mother of qi”: qi commands the blood, keeping it running in fixed channels and governing its holding and securing; blood is the carrier of qi — without blood, qi has nothing to cling to.
💬 Note from Doctor Luo: So look at this patient: food undigested, stools loose, blood unstoppable — one diagnosis of “spleen deficiency” threads the whole picture together. When the qi of the middle jiao cannot transport and govern, when it cannot command and secure the blood around it, the result is excessive bleeding — even the qi transformation of the lower jiao can no longer be preserved.
The prescription revealed: Bai Zhu by the ounce, with raw chicken gizzard lining to follow
How did Doctor Zhang Xichun treat it? He didn’t say much else — only that within the blood-stopping medicine — that is, the hemostatic herbs, usually the charcoal herbs like Zong Lü Tan (palm charcoal) and Xue Yu Tan (human hair charcoal), along with Bai Ji (hyacinth orchid tuber) and San Qi (notoginseng) — he added two crucial herbs:
First, Bai Zhu (atractylodes), added at one liang (about 30 g). That is a very large dose — for what? Powerful spleen tonification.
Second, sheng ji nei jin (raw chicken gizzard lining), one liang (about 30 g). For what? To move and transform the spleen and stomach — helping digestion — and at the same time it resolves stasis.
💬 Note from Doctor Luo: Why resolve stasis? Because sometimes, even when the blood is flowing out in excess, the real cause is bleeding caused by stasis — when stagnant blood is stuck there blocking the way, the blood actually leaks out around it. This is “bleeding from stasis.” Doctor Zhang Xichun added the raw chicken gizzard lining, which on one side moves the spleen and stomach and dissolves food stagnation, and on the other side breaks up the stagnant blood — and then the bleeding actually stops. Resolving stasis to stop bleeding: that is the brilliance of a master.
One dose, and the bleeding stopped
What was the result? One dose, and the blood stopped. Doctor Zhang Xichun had the patient take several more doses to settle the condition properly, and the illness was cured.
💬 Note from Doctor Luo: There it is again — one dose and the bleeding stopped! The most important thing in this case is the idea Doctor Zhang Xichun applied: “the spleen governs the blood.” The blood running through the body is governed by the spleen qi; when spleen qi becomes deficient, the blood escapes. So a great many women with heavy periods, long periods, bleeding that can’t be controlled, a pale face, and insufficient upright qi (zheng qi) are often suffering from spleen deficiency.
Women with heavy periods and pale faces should mostly tonify the spleen
When we meet this situation today, what do we commonly use? Gui Pi Wan (Restore the Spleen Pill).
💬 Note from Doctor Luo: What does Gui Pi Wan do? It increases the qi of the spleen and stomach so that it can hold and secure the blood — and Bai Zhu is right there among its ingredients. Bai Zhu is an extremely effective spleen tonic, and the dose can be large — look at Doctor Zhang Xichun’s severe case here: he used a full liang. So after hearing today’s case, remember one principle: qi — and especially spleen qi — is what commands the blood; when spleen qi weakens, the blood scatters and runs in all directions, and bleeding follows.
Bonus: one principle, applied far and wide
Learn this principle and you can apply it to many situations.
💬 Note from Doctor Luo: When you meet bleeding of this spleen-deficiency kind, you know to tonify the spleen — fill the spleen qi back up, and it can hold and secure the blood again, and the bleeding stops. By the same logic, certain bedwetting and urinary incontinence are related too — all of them come from spleen qi deficiency, the qi mechanism sinking, and the body failing to hold and secure. So once you understand the principle, you can apply it broadly — that is the purpose of our study today.
The illness was cured, and the principle was made clear: if menstrual bleeding lingers on and on, first ask whether the spleen is deficient; to tonify the spleen and secure the blood, Bai Zhu is a fine hand. Tomorrow, we’ll continue with how Doctor Zhang Xichun used Bai Zhu.
What to take away
- Beng lou (uterine bleeding) comes in two flavors: beng is a sudden flood of blood, lou is a lingering trickle — this patient was in the dangerous, flood-like state.
- The hollow pulse is the giveaway: a pulse that floats yet vanishes on pressure (kou, hollow pulse, like pressing a scallion stalk) means vital qi has been badly depleted by blood loss.
- Look at digestion and stools: food not digesting and loose stools point straight at spleen deficiency — the same deficiency that lets the blood escape.
- The spleen governs the blood — “qi is the commander of blood”; when spleen qi weakens, blood scatters and flows out.
- Doctor Zhang Xichun’s move: keep the hemostatic herbs (palm charcoal, hair charcoal, Bai Ji, San Qi) but add large doses of Bai Zhu (30 g) to tonify the spleen and sheng ji nei jin (30 g) to move digestion and resolve stasis — resolving stasis can itself stop bleeding.
- One dose stopped the bleeding, and a few more doses settled the case.
- Today’s equivalent: Gui Pi Wan (Restore the Spleen Pill) for women with heavy periods, pale faces, and low energy.
Compiled from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records, originally published in Records of Chinese Medicine with Western Reference (《医学衷中参西录》, issued serially 1918–1934).