Blood Letting: Shiraku Flashcards
Bloodletting techniques are generally used for treating…
Blood stagnation
other uses: clearing heat
The Su Wen says bloodletting should be done before or after tonification and dispersion?
BEFORE
Both a cause and a result of pathology in the body…
Blood Stasis
T/F: Blood stasis always leads to pathology if left untreated
TRUE
Some long term effects of blood stasis are:
- Poor function of any/all systems of the body
- Emotional or psycho-spiritialy instability, distress
- Pain or lack of sensation in joints, organs, muscles
- Deficiency due to lack of nourishment (Blood and Qi)
Indurations and masses are called…
Kori’s
Kori’s are a sign of what?
Blood stasis or some other form of stasis
When Blood is thicker it flows more slowly, both excess ______ and too much ______ can thicken the blood.
Cold
Heat
The Speed of bleeding tells you about what?
Internal heat vs. cod
slower bleeding indicates…
A more serious problem with stagnation
T/F: Stasis can create a false impression of deficiency
TRUE- once the stasis, “rock” is removed the true flow can be evaluated
Bloodletting is called…
Shiraku and is very moving
Bloodletting is best used when…
you determine that there is a clear problem with chronic or significant stagnation and/or excess heat
Signs of poor blood flow (blood stasis) are…
- fixed, stabbing pain
- dark purple color (skin, face, tongue, nails)
- rough, dark, dull quality to the skin
- moles, birthmarks
- spider veins
- poor or slow response to treatment
- wiry pulse
- CHRONIC psychological and/or emotional upset or distress
- Dark blood when you bloodlet
Skiraku contraindications:
- Hemophilia
- Patients with TB
- end stages of malignant tumor/cancer
- extreme weakness
-pregnancy: no jingwells, no bloodletting with cups, no contraindicated points
MAY bleed small spider veins on legs in some cases
Shiraku precautions
EXTREME caution with HIV, Hepatitis
-patients on blood thinning meds
-cerbral embolism: jingwells only
peripheral neuropathy: torso only
myocardial infarction: jingwells only
Possible side effects of Shiraku
- dizziness, nausea, lightheadedness
- significant fatigue
- hematoma (use moxa after bloodletting)
- sudden elevated body temperature which lasts longer than a few minutes (ok if it quickly passes)
- sudden chilled hands/feet other areas lasting 5-10 minutes after bloodletting
*If patient has cold extremities wait until they are warm to bloodless
Always make sure to…
- monitor patient’s reaction before he/she stands up
- frequently monitor the pulse and temperature and watch for signs of poor reaction in the face
- Have patient sit or stand slowly at the end of treatment
Correcting over treatment..
Moxa on : Hara: CV12, CV6, or 4, ST25
- ST36, GV20, CV14
- Salt moxa, CV8, Belly Bowl
- GV14
2 primary shiraku techniques
- Sairaku
2. Hifu which includes: Ranshi Ho, and Mattan Shiraku
Sairaku Shiraku
Bloodletting of a small, superficial vascular spider vein, cups are often used
Hifu Shiraku: Ranshi Ho
Bloodletting from ares which show signs of blood stasis such as rough skin, changes in pigmentation, etc. , usually combined with cupping
Hifu Shiraku: Mattan Skiraku
Bloodletting drops of extremities- Jingwells, ears, nose, crown of head
Mattan Siraku Indications
EXTREMITIES
- stagnant Blood in the channel
- pathological heat in channel or organ system
- chronic pathology affecting channel or organ system
Japanese term for pathological Qi (evil Qi) is…
Jaki
Diangosing Jingwells
JW’s often reflect the presence of pathology in the channel. Look for:
- differences in JW color
- Texture irregularities of nails or cuticles
- Problems with joints of particular fingers or toes such as pain or stiffness
- JW pain with palpation
Signs of pathology in JW
fingertip is black or dark
- nails feel cold to the touch
- fingers look bloated or thick
- nail is: grey, dark, purple, blackish-red
- nail is growing abnormally,not smooth
- cuticle is abnormal, peeled, split
- nearby joints are stiff, painful
- pain (press with guide tube)
If after pressing a JW the color does not come back quickly this indicates…
There is a problem with poor flow
The most important indicator of how much blood to let is…
the COLOR of the blood, done when blood turns bright red… only exception is if you are clearing excess heat
Dosage Guidelines
Deficient: 1-2 JW ; 1-2 drops/point
Healthy/Average: 4-5 JW ; 10-15 drops/point
Excess: 7-10 JW ; 15-20 drops/point
*stop of blood becomes bright red
Proper Depth of Bloodletting insertion
1-2 mm
Proper “hands” for expressing blood from JW
Grasp JW with left hand and squeeze from sides and bottom, use right index finger to roll down firmly
Keep a dry cotton ball between fingers 4 and 5
Only use cotton balls soaked in alcohol if…
Bleeding slows/stops and blood is still dark, mixing alcohol with blood lightens and thins it out
How to know when you are done when clearing heat…
watch for bleeding to slow or stop on its own
