By now, the reader may have observed the treatment algorithm that has been used for every case. First, the diagnosis is based on patern discrimination combined with fve wheel diferentiation. Using this information, the doctor forms a treatment strategy, selects a formula that addresses the patern of disease and, fnally, modifes the formula so that it is specific to the disease and its location. Thus, every formula is dictated by the patient’s constitution, the cause of the disease, its nature and the location.

This chapter discusses a species of bleeding. Bleeding has four major causative factors: heat, qi defciency, blood stasis and trauma. For this case, the formula selection addresses the patient’s underlying constitutional patern with modifcations that stop bleeding and have an afnity for the eyes.

In the primary case, the bleeding is caused by heat. Further discrimination clarifes that the heat is caused by yin defciency with fre abundance, which incites the blood to move recklessly. One of the guiding formulas to treat this pattern is Zhī Băi DìHuáng Wán. While it treats the root pattern, it does not treat the branch symptom of bleeding in the eye. The modifications include a group of medicinals that stop bleeding by cooling the blood and one medicinal to eliminate blood stasis.

By the second visit, the bleeding is controlled. The symptoms of empty fre have abated. The symptoms of yin defciency and blood stasis remain. The doctor makes an astute diagnostic observation: the bleeding was resolved, but the pinprick macules were dark. Thus, the diagnosis moves from heat, to blood stasis. The second formula is a modifed Liù Wèi Dì Huáng Wán. The doctor adds hàn lián căo and nü˘ zhēn zĭ, which nourish the blood and control bleeding. Chōng wèi zĭ is an especially nice choice in this formula as its actions are to move the blood and clear the vision. Dān shēn and zhĭ qiào round things out, harmonizing the qi and blood.