4. Contraindications for Medication in Blood Disorders

4. Contraindications for Medication in Blood Disorders

Sweating and vomiting can exacerbate the upward rebellion of qi, worsening blood disorders, so they are generally contraindicated. As for purgation, the author considers it an important method for treating blood disorders. He says: "Eight to nine out of ten blood disorder cases involve excessive qi and fire; when they surge uncontrollably, it is precisely the time to descend and break their momentum." He further adds: "In Zhang Zhongjing's Yangming syndrome, there is an urgent method of descending to preserve yin... For blood disorders with excessive fire and qi, the greatest fear is losing yin; descending is actually saving yin, and purgation is no different from tonification." It is evident that purgation is beneficial for blood disorders, as it can both calm the surging qi and preserve the yin that is about to be depleted, making it a truly win-win approach. As for harmonization and tonification, they are also indispensable methods in treating blood disorders. Harmonization includes balancing exterior symptoms with lung qi, interior symptoms with liver qi, and regulating middle qi. In addition, there are various forms of harmonization, such as tonifying yin and yang, tonifying yang and yin, removing stasis and blood, and draining water and qi. Tonification, on the other hand, includes tonifying the lungs, spleen, and kidneys. In terms of yin and yang, tonifying yin is far more common in blood disorders, accounting for eight to nine tenths of cases, while tonifying yang is rare, only about one or two tenths. Before applying tonification, it is essential to eliminate pathogenic factors and remove stasis; otherwise, it may lead to the consequence of closing the door to chase away the thief.

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IV. The Integration of Traditional Chinese and Western Medicine in "On Blood Disorders"

Tang Zonghai was a leading figure in the modern integration of traditional Chinese and Western medicine, and his work "On Blood Disorders" naturally reflects this integrated perspective. The book states: "Recently, Western medical texts have been introduced into China, often conflicting with the principles of the 'Inner Canon.' In fact, the 'Inner Canon' emphasizes spiritual transformation, while Western medicine tends to focus on material phenomena. Viewed through the lens of the 'Inner Canon,' spiritual transformation can encompass material phenomena. However, Westerners meticulously study material aspects and occasionally discover elements that align with spiritual transformation." This passage demonstrates the author's attitude toward Western medicine, a new phenomenon just emerging in China. His stance is neither the rigid rejection advocated by the pro-classical school nor the uncritical worship of Western medicine promoted by comprador intellectuals. After studying and researching, he concludes that both traditional Chinese and Western medicine have their own strengths. Traditional Chinese medicine excels in "spiritual transformation," while Western medicine excels in "material phenomena." Western medicine, through its study of material aspects, can gradually achieve spiritual transformation as well. He warmly embraces this new development but does not neglect the traditional theories of Chinese medicine. Precisely because of this balance, he is able to leverage the strengths of Western medicine to compensate for the weaknesses of traditional Chinese medicine, becoming one of the earliest pioneers of integrating Chinese and Western medicine in China.

Many of the integrated perspectives presented in "On Blood Disorders" remain significant today. Regarding the regulation of the spleen and stomach, he argues that Li Dongyuan's "On the Spleen and Stomach" focuses solely on tonifying spleen yang while ignoring the importance of spleen yin. The digestion of food and water by the spleen is accomplished through the combined action of spleen yang and spleen yin, much like cooking: "Without fire in the pot, the food won't cook; without water in the pot, the food won't cook either." He says: "Western medicine, through its meticulous study of material aspects, has come to recognize that the transformation of food depends on juices." "Western medicine claims that when food enters the stomach, sweet pancreatic juice is secreted to aid digestion, while bitter bile is secreted in the small intestine to assist digestion, and these juices combine with gastric juice to transform food." These so-called "juices" are essentially spleen yin, including sweet pancreatic juice, bitter bile, and gastric juice—all of which belong to the category of spleen yin. By citing Western medical views to clarify the concept of spleen yin in traditional Chinese medicine, the author provides a material basis for the existence of spleen yin, thereby further clarifying its role in the digestion of food and water. As a result, the theory of spleen-stomach differentiation in traditional Chinese medicine becomes more complete. Based on this view, he widely adopts methods to tonify spleen yin in clinical practice, achieving remarkable therapeutic effects. He uses Gan Lu Yin, Qing Zao Yang Rong Tang, and Ye Shi Yang Wei Tang to nourish gastric juice, Ren Shen Gu Ben Tang and Zhi Gan Cao Tang to nourish bile, and Xiao Chai Hu Tang to generate fluids and stimulate pancreatic juice. All these formulations are grounded in clinical practice, making them highly significant for the development of traditional Chinese medicine.