1. The Relationship Between Organs and Blood Syndromes in Differential Diagnosis

1. The Relationship Between Organs and Blood Syndromes in Differential Diagnosis

The onset of blood disorders is closely linked to all systems of the body, with the heart, liver, and spleen being the key organs for differentiation and treatment. The "Plain Questions" in the "Classic of Internal Medicine," specifically the chapter on the generation of the five zang organs, states: "All blood-related conditions are attributed to the heart." This highlights the subordinate relationship between the heart and the body's blood supply. The author inherits this view, asserting that "the heart is the sovereign fire, which gives rise to blood... When the fire rises, the blood rises; when the fire descends, the blood descends. Knowing that blood is generated by fire and that fire is governed by the heart, we can conclude that draining the heart is equivalent to draining the fire, and draining the fire is equivalent to stopping the bleeding." This argument clearly underscores the vital importance of the heart in the pathogenesis of blood disorders, tightly linking the TCM concept of "blood heat causing erratic bleeding" with the functions of the heart. In terms of treatment, it establishes the principle that "draining the heart is equivalent to draining the fire, and draining the fire is equivalent to stopping the bleeding," thereby making the mechanism of Dahuang Huanglian Xie Xin Tang in treating blood disorders more precise. The liver is responsible for storing blood, another organ crucial for the diagnosis and treatment of blood disorders. The author states: "The circulation of blood throughout the body relies on the three channels—Chong, Ren, and Dai—for regulation, while the Blood Sea and the uterus serve as the destinations where blood is transported and stored. The liver governs the Blood Sea, and the Chong, Ren, and Dai channels are under the liver's control; therefore, when nourishing blood, the primary focus should always be on tonifying the liver." This indicates that the normal flow of blood originates from the Blood Sea and the uterus, is circulated throughout the body by the Chong, Ren, and Dai channels, and is regulated by the liver. Consequently, treating blood disorders requires mastering the important principle of regulating the liver. Formulas such as Si Wu Tang and Xiao Yao San have become essential prescriptions for treating blood disorders precisely because they are based on this principle. The spleen is the foundation of postnatal life, governing the transformation and transportation of water and grain essence. Drawing on the "Inner Canon's" view that the middle burner receives qi, extracts juice, and transforms it into red blood, the author believes that "the origin of blood production lies in the spleen and stomach." Therefore, he particularly emphasizes the significance of the spleen and stomach in treating blood disorders. He argues that formulas like Gui Pi Tang, Ren Shen Yang Rong Tang, Bu Zhong Yi Qi Tang, and Zhi Gan Cao Tang are widely used in treating blood disorders because they are all based on regulating the spleen and stomach. Among them, Zhi Gan Cao Tang is a powerful tonic for the spleen and stomach, both generating the source of blood and guiding its flow, making it truly the "first choice for nourishing blood." In addition to the aforementioned organs, the relationship between the kidneys and lungs and the diagnosis and treatment of blood disorders also deserves attention, especially for patients in the advanced stages of blood disorders who benefit from the principle of "metal and water generating each other, with water and blood sharing the same origin." Thus, tonifying the kidneys and lungs is highly necessary. In summary, the human body is a unified whole with close interconnections, and this important principle must never be overlooked in the diagnosis and treatment of any disease.