In a case of chronic menorrhagia with pale complexion and weak pulse after treatments for deficient Qi, what is the underlying root cause?

In the context of chronic menorrhagia, particularly when accompanied by a pale complexion and weak pulse after initial treatments for deficient Qi, the underlying root cause is most closely associated with deficient blood. In Traditional Chinese Medicine (TCM), chronic menorrhagia can lead to blood loss, resulting in a deficiency that manifests in symptoms such as pallor and weakness.

When Qi is deficient, it can be insufficient to adequately support the blood production processes, causing a cascade that leads to blood deficiency. In this scenario, treating for deficient Qi may provide temporary relief, but if the blood remains deficient, symptoms such as pale complexion and weak pulse persist.

The conditions of "heat" or "hot blood" typically involve excess conditions within the body, such as inflammation or lively blood flow, which does not align with the symptoms presented—namely, the pale complexion and weak pulse indicating insufficiency rather than excess. Hence, recognizing that the root cause of the challenges depicted lies primarily in blood deficiency allows for a more targeted and effective approach to treatment, focusing on nourishing blood to resolve the chronic menorrhagia and its symptomatic expressions.