Discussion

Leukemia is a malignant disorder of bone marrow hematopoietic function; traditional Chinese medicine does not yet have a specific term for this disease. However, in this case, the patient was cured through an integrated approach combining traditional Chinese medicine and Western medicine. The author has gained the following insights into the role of traditional Chinese medicine and herbal remedies in treating this condition.

From the beginning to the end of the patient's illness, obvious symptoms of qi deficiency were present, such as pale complexion, spontaneous sweating, fatigue, shortness of breath, dizziness, and blurred vision. "Qi governs blood," and "blood is the mother of qi." Qi deficiency inevitably leads to blood deficiency. Therefore, during the middle stage of the disease, symptoms like palpitations, shortness of breath, and restless sleep—characteristic of blood deficiency—began to appear. According to the Inner Canon, "Qi is yang, while blood is yin," and "a solitary yin cannot generate life, nor can a solitary yang endure long." Qi deficiency and blood deficiency reinforce each other, causing the disease to progress rapidly, eventually leading to yin deficiency with internal heat, blood heat manifesting externally, and qi deficiency resulting in yang depletion, where qi cannot properly control blood. In the formation of these pathological mechanisms, qi deficiency, which appeared earliest, played an extremely important role. To treat this disease, it is essential to focus on tonifying qi in order to achieve the goal of treating the root cause. The author proposed five different formulas, all centered around qi tonification, using high doses of ginseng root, codonopsis pilosula,太子参, astragalus, and other qi-tonifying herbs. What exactly is qi? From a modern medical perspective, qi may be regarded as the overarching concept that encompasses all normal physiological functions and defensive forces within the body. As the Inner Canon states, "When evil enters, qi must be deficient," and "When righteous qi resides within, evil cannot take hold." By fully tonifying qi, the body’s own disease-fighting capabilities can be fully mobilized; the physiological functions of the hematopoietic system can be further enhanced, which is a key factor in curing this disease. While tonifying qi, it is also necessary to nourish yin. Nourishing yin in traditional Chinese medicine involves increasing blood volume, fluid levels, and nutrient intake—substances that are essential prerequisites for maintaining normal bodily functions. When qi and yin are combined, they complement each other and produce remarkable therapeutic effects. All five formulas included ingredients similar to Liu Wei Di Huang Tang; Liu Wei Di Huang Tang was specially developed by Qian Yi of the Five Dynasties to tonify yin, with the notable efficacy of "strengthening water to control yang." The term "strenghening water" refers to tonifying kidney yin, while "kidney governs bones" and "bones store marrow." Since Liu Wei Di Huang Tang tonifies kidney yin, whether it can also benefit bone marrow hematopoiesis remains a question worthy of further research. In addition to ginseng-based qi tonification, the formula also includes yin-nourishing herbs such as Mai Dong and Wu Wei Zi. These two herbs, when combined with ginseng, form the Sheng Mai San—a renowned formula developed by Sun Simiao of the Tang Dynasty, used to tonify qi and nourish yin. For this condition, the combination of ginseng and yin-nourishing herbs helps ginseng to tonify qi and supports the yin-nourishing properties of the formula, enhancing the effectiveness of qi tonification and yin nourishment. In Formula I, "White Tiger" is added to clear heat, while Rhinoceros Horn is used to cool blood. Formula II incorporates Artemisia and Turtle Shell to remove residual heat and alleviate bone marrow fever. Formula V uses Ma Gui to resolve exterior cold and disperse cold, all of which are appropriate adjustments based on the patient's condition.

Appendix:

① Formula I: 30g Gypsum, 12g Motherwort, 9g Rice, 15g Ginseng Root, 15g Charcoal, 30g North Codonopsis, 30g South Codonopsis, 9g Rhinoceros Horn, 15g Yuan Shen, 30g Rehmannia Root, 9g Paeonia Bark, 15g Dioscorea, 30g Cornus Fruit, 15g Dragon Bone, 15g Oyster, 3g Wu Wei Zi, 30g Floating Wheat.

② Formula II: 15g Artemisia, 15g Turtle Shell, 15g Motherwort, 15g Stir-fried Bitter Melon, 15g Ginseng Root, 15g Charcoal, 30g North Codonopsis, 30g South Codonopsis, 9g Rhinoceros Horn, 30g Rehmannia Root, 30g White Peony, 9g Paeonia Bark, 15g Dioscorea, 30g Cornus Fruit, 15g Dragon Bone, 15g Oyster, 3g Wu Wei Zi, 30g Floating Wheat.

③ Formula III: 15g Ginseng Root, 20g North Codonopsis, 30g South Codonopsis, 15g Dioscorea, 15g White Peony, 9g Grass, 9g Mai Dong, 30g Rehmannia Root, 9g Dragon Bone, 30g Oyster, 3g Wu Wei Zi, 9g Hawthorn, 30g Cornus Fruit, 30g Floating Wheat, 10 Dates.

④ Formula IV: 90g Northern Codonopsis, 90g Prince Codonopsis, 90g North Codonopsis, 90g Yuan Shen, 15g Rehmannia Root, 15g Mature Rehmannia Root, 90g Winter Bamboo, 90g White Peony, 90g Goji Berries, 90g Polygonum Cuspidatum, 90g Dioscorea, 90g Cornus Fruit, 90g Lily, 90g Angelica Sinensis, 120g Heart-Removed White Lotus Seeds, 45g White Wisteria, 90g Atractylodes Macrocephala, 90g Licorice Root, 90g Oyster, 90g Hawthorn, 90g Perilla Seed, 250g Red Date, 15g Wu Wei Zi, 45g Stir-fried Paeonia Bark, 150g Roasted Yellow Ginger, all herbs are decocted four times to create a concentrated extract, then 15g of E Jiao, 15g Turtle Shell Gelatin, and 2kg of brown sugar are dissolved into the extract and taken on an empty stomach with hot water, 15g per dose.

⑤ Formula V: 15g Ephedra, 15g Cinnamon Twig, 15g Apricot Kernel, 15g Licorice, 9g Scutellaria Root, 9g Cortex Phellodendri, 9g Mulberry Bark, 15g Ginseng Root, 15g North Codonopsis, 15g South Codonopsis, 15g Dioscorea, 15g White Peony, 9g Licorice Root, 15g Mai Dong, 3g Wu Wei Zi, 30g Rehmannia Root, 30g Cornus Fruit, 9g Rhinoceros Horn, 15g Paeonia Bark.

Note: This patient was followed up in March 2002 and remains healthy, now over sixty years old, with many descendants.

Two Cases of Leukemia

Case One: Wei ××, male, 14 years old, student, member of a family working at the Gansu Provincial Academy of Sciences. On May 23, 1975, he first visited the clinic, accompanied by his parents. They reported that three months earlier, Mr. Wei had experienced fatigue, weakness, dizziness, loss of appetite, discomfort in both flanks, and soreness in his lower back and legs. A test conducted at the ×× Hospital in Lanzhou revealed a white blood cell count of approximately 165,000/㎜³, along with a bone marrow examination showing extreme bone marrow hyperplasia—both primitive and early myeloid cells accounted for over 22%. His liver and spleen were slightly enlarged, and he was diagnosed with chronic granulocytic leukemia. After diagnosis, Mr. Wei experienced bitter taste in his mouth, hearing loss, irritability, redness on his face, thirst and insomnia, and subtle pain in his chest. His condition was attributed to disharmony of the internal organs, with the theory that excess fire resided in the liver. He was treated with Jiawei Danggui Luhua Decoction, adding 0.6g of Bull's Eye (taken in two divided doses) to enhance the efficacy of eliminating pathogenic factors. He visited the clinic multiple times afterward, continuing to use this formula. On October 4 of the same year, during his seventh visit, his complexion returned to normal, his appetite improved, his spirits lifted, and his white blood cell count dropped to 21,000/㎜³. He switched to Danggui Luhua Pills, taking 6 pills twice daily. Three months after starting treatment, he was able to participate in light physical labor, his liver heat symptoms significantly lessened, and he continued to follow up with therapies such as Xiaoyao and Guipi. On November 18, 1977, his white blood cell count had fallen to 18,300/㎜³, his symptoms had disappeared, his physical strength had increased, and his appetite was good. He continued to work at the × Factory of the Academy of Sciences, alternating between Shengmai Dihuang Pills and Danggui Luhua Pills to consolidate his treatment results. Since the onset of the disease, Mr. Wei had been undergoing traditional Chinese medicine treatment for three years and continues to receive ongoing care and observation.

Case Two: Wei ××, male, 11 years old, student, native of Lanzhou City. In April 1974, he was hospitalized at the Gansu Provincial People’s Hospital due to fever, fatigue, loss of appetite, and mild pain in his chest. He was diagnosed with acute lymphoblastic leukemia. He underwent combined chemotherapy but was unable to control the progression of his condition. Given the persistent decline in his white blood cell count, he sought consultation from a traditional Chinese medicine practitioner on June 12 of the same year. His complexion was pale, his body was thin, he experienced fever with spontaneous sweating, chest pain upon pressure, a floating pulse that was weak, and weaker pulses in the lower two fingers. His blood test showed hemoglobin levels of 9.2g, red blood cells at 2.32 million/㎜³, white blood cells at 1,550/㎜³, lymphocytes accounting for 10%, and platelet counts of 33,000/㎜³. His condition was characterized by deficiency in both lung and kidney qi. He was treated with a formula to tonify qi and nourish yin. During his second consultation on June 26, after taking the above formula for 12 doses, his fever subsided, his symptoms improved, and his blood test showed hemoglobin levels of 11g, red blood cells at 4.12 million/㎜³, white blood cells at 5.100/㎜³, neutrophils at 76%, lymphocytes at 23%, and immature cells (monocytes) at 1%. His platelet count was 120,000/㎜³. He continued to take the original formula as usual. On July 1, he suddenly developed a high fever, accompanied by vomiting and diarrhea. On July 7, during his third consultation, his temperature remained at 39°C, his stools were loose and black, he felt fatigued, had abdominal fullness and no desire to eat, his mouth was dry and he did not feel inclined to drink, his pulse was deep and rapid, his tongue was red with a thin white coating. His condition was characterized by blood deficiency, with yin deficiency and internal heat intertwined with warm pathogens. Following the principles of Xie Xin Tang and Qing Gu San, he prescribed: 9g North Codonopsis, 9g White Kidney Beans, 9g Poria, 9g Polyscias. Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Ren 15g, Bai Kou Ren 1.5g, Huang Lian 2.4g, Gan Jiang 2.4g, Yin Chai Hu 9g, Qing Hao 9g, Bi Jia 9g, Jiao

Zha 9g, Dan Pi Shi, Bai Wei 6g, Lai Fu Zi 6g, Zhi Gan Cao 3g, decocted in water and taken orally. Fourth time on July 12th.

Consultation: After taking the above formula for 3 doses, the body temperature dropped to 36.4°C, loose stools had stopped, the patient was able to eat somewhat, and the pulse was deep and weak.

The tongue was red, with a white coating gradually fading away; however, there was still a small patch about the size of a fingernail that appeared slightly greasy. The patient felt tired in the morning but more energetic in the afternoon, with occasional spontaneous sweating. The treatment was adjusted to include Buzhong Yiqi Tang and Yiqi Yangqi Tang combined. After more than a month of treatment, the condition and blood count returned to the complete remission state seen on July 1st. Since then, regarding traditional Chinese medicine, one dose of the formula was divided into two doses per day, once each, alternating between Yiqi Yangqi Tang and Yiqi Nourishing Yin Tang. As for Western medicine, aside from using combination chemotherapy at the onset of the illness, the patient has only relied on traditional Chinese medicine for treatment over the past year and a half. Now, after two full years, the patient remains in complete remission.

Three Cases of Misdiagnosis and Corrective Treatment of Malignant Lymphoma

Case 1: Chen ××, female, 48 years old, medical record number: 6380.

The patient was admitted to our department in September 1992 due to “abdominal distension and ascites for more than two years, with worsening symptoms for the past six months.” She reported feeling fatigued and experiencing night sweats two years ago, along with gradual abdominal distension and swelling. She had been diagnosed with “tuberculous peritonitis” by another hospital and had received systematic treatment with anti-hemorrhoidal medications. Over ten abdominal paracenteses were performed, during which more than 20,000 ml of ascitic fluid was drained. The treatment lasted for six months, but her condition progressively worsened, with rapid increases in ascitic fluid volume and extremely poor overall health, leading to admission to our department. Physical examination revealed: T 36.2°C, P 120 beats per minute, BP 13/8 kPa. The patient was severely emaciated, in a state of extreme exhaustion and cachexia. Aside from a bean-sized lymph node palpable in the right neck, no other superficial lymph nodes were detected. Cardiac and pulmonary examinations were negative. Abdominal distension was severe, with an abdominal circumference of 90 cm, and percussion revealed large amounts of ascitic fluid. Blood tests showed: Hb 100 g/L, WBC 12.9 × 10^9/L, N 82%, L 18%; PLT 60 × 10^9/L. Urine analysis indicated: BIL: SmalL, KET: 0.5 mmol/L, PRO: 0.3 g/L, URO: 33 mmol/L, NIT: POS, WBC: 12 u/L, ESR: 55 mm/h. Ascitic fluid cytology revealed: clumps of degenerated cells (malignant tumor not excluded), and CT scan suggested a suspected malignant tumor in the retroperitoneal space. This massive ascitic fluid could be caused by malignant lymphoma; therefore, a biopsy of the cervical lymph nodes was performed concurrently with chemotherapy. To reduce chemotherapy side effects and enhance the efficacy of chemotherapy drugs, traditional Chinese medicine—“Lanzhou Formula” (main ingredients: Rehmannia, Cornus officinalis, Ginseng root, etc.)—was used, with one dose of the formula decocted in water and taken orally daily, alongside the chemotherapy regimen COPP: 600 mg of CTX intravenously weekly, 2 mg of VCR intravenously weekly, 50 mg of PCZ per day, three times a week, followed by a one-week rest period before continuing. A total of three cycles were administered. The patient’s ascitic fluid decreased daily, and by the end of chemotherapy, the ascitic fluid had completely disappeared. Her physical condition improved, and she was able to walk around. Blood tests showed: Hb 30 g/L, WBC 6.8 × 10^9/L, N 76%, L 24%; ESR was 6 mm/h. All other tests were normal, and the pathology biopsy report indicated malignant lymphoma (NHL).

Case 2: Dong ××, male, 43 years old, medical record number: 6251.

The patient was admitted to our department in August 1992 due to “abdominal distension and ascites for six months.” She reported abdominal distension and subsequent ascitic fluid six months earlier, triggered by fatigue and exposure to cold. She had been diagnosed with “liver cirrhosis with ascites” by another hospital, but despite five months of systemic treatment aimed at protecting the liver and promoting diuresis, the condition did not improve, and her condition significantly worsened, leading her to our department. Physical examination revealed: T 36.1°C, P 87 beats per minute, BP 13/9 kPa. The patient was in poor spirits, with a chronic wasting appearance, and no superficial lymph nodes were palpated. Cardiac and pulmonary examinations were negative. Abdominal distension was present, with visible abdominal veins, though not varicosae; the liver and spleen were not palpable below the ribs. The ascitic fluid was abundant, with an abdominal circumference of 98 cm. Bowel sounds were not increased, and there was no edema in both lower limbs. Blood tests showed: Hb 38 g/L, WBC 8.2 × 10^9/L, N 86%, L 14%; ESR was 5 mm/L. Urine analysis indicated: SG > 1.030, NIT: POS, liver function tests, protein electrophoresis, and three-system tests were all normal. Isotope studies showed: SA 777 µg/ml, B2-M: 3.08 µg/L, others were negative. Ultrasound imaging revealed: liver cirrhosis with suspected ascites, with enlargement of the left liver. First, the ascitic fluid was analyzed and chemotherapy was initiated, following the same protocol as in the previous case. A total of five cycles were administered, with intervals of three weeks, accompanied by the use of “Lanzhou Formula” in conjunction with traditional Chinese medicine. The ascitic fluid completely disappeared, and ultrasound imaging showed no abnormalities. Laboratory tests were all normal, and the patient made a clinical recovery and was discharged. Ascitic fluid analysis revealed a large number of lymphocytes; pathology indicated malignant lymphoma (NHL).

Case 3: Huang ××, female, 59 years old, medical record number: 5815.

The patient was admitted to our department in June 1992 due to “left cervical lymphadenopathy for four months, accompanied by redness, swelling, heat, and pain for one month.” Four months prior to admission, a pea-sized lymph node had appeared in the left neck without any obvious triggering factors; the patient had no other symptoms. She had been diagnosed with “cervical lymph node tuberculosis” by another hospital and had undergone anti-tuberculosis treatment for more than three months. However, the lymph nodes continued to enlarge, accompanied by redness, swelling, heat, and pain, leading her to our department. Physical examination revealed: T 36.3°C, P 74 beats per minute, BP 12/8 kPa. The patient was malnourished, with a chronic disease appearance and poor spirits. A 2.3 cm × 2.4 cm enlarged lymph node was palpated in the left neck, lobulated with a smooth surface, firm in texture, and poorly mobile, accompanied by redness, swelling, heat, and tenderness. There was also a sensation of throbbing pain. Cardiac and pulmonary examinations were negative; the abdomen was soft, with no signs of ascites; ultrasound and chest X-ray were both normal, and the electrocardiogram was also normal. Blood tests showed: Hb 30 g/L, WBC 8.8 × 10^9/L, N 84%, L 16%; PLT 60 × 10^9/L. Urine analysis indicated: HIT: POS, microscopic white blood cells: 1–7/HP, ESR: 75 mm/h. Isotope studies showed: DNA-P (+), others (-). Lymph node biopsy revealed malignant lymphoma (HD). Chemotherapy was then initiated using the COPP protocol, with the same drug dosages as in the previous case, combined with “Lanzhou Formula” in conjunction. After four cycles, the patient’s neck mass had completely disappeared, the ESR was 5 mm/h, and all other laboratory tests were normal. The patient made a clinical recovery and was discharged. To date, there have been no recurrences.

Two Cases of Purpuric Lesions

Case 1: Sun ××, female, 11 years old. First visit on February 3, 1997.

After an external infection, purpuric lesions appeared on both lower limbs, accompanied by pain in both knee joints, abdominal pain, and dry throat. Local hospitals provided hormone therapy without significant improvement, so she came to our hospital seeking treatment. Cardiac and pulmonary examinations were normal, the liver and spleen were not palpable, and clustered or scattered hemorrhagic spots were observed on both lower limbs, most prominently on the medial ankle joint, with colors ranging from bright red to dark purple. When pressed, the color did not return. The tongue was red with a thin yellow coating, and the pulse was floating and rapid. Laboratory tests showed a platelet count of 228 × 10^9/L. Western medical diagnosis: allergic purpura. This condition was attributed to wind-heat invading the interior and causing blood heat to run rampant. The treatment should focus on clearing heat and detoxifying while cooling the blood and dispelling wind. The prescription included: Shuanghua 15 g, Lianqiao 15 g, Chaoxu 15 g, Shengdi 12 g, Difuzi 10 g, Bai Ai Li 20 g, Bai Xian Pi 20 g, Chi Shu 10 g, Danpi 10 g, Fangfeng 12 g, Tu Fuling 12 g, Mu Xiang 6 g, Huang Lian 6 g, decocted in water and taken orally, one dose per day. Ten days later, the purpuric lesions on both lower limbs had reduced, abdominal pain had disappeared, but the patient still experienced pain in both knee joints. The tongue was red with a thin yellow coating, and the pulse was wiry. The above formula was modified by removing Mu Xiang and Huang Lian, adding 6 g of Fuzi and 10 g of Chai Hu. After taking more than 20 doses, the symptoms had subsided.

According to the principle: “When wind and fire are stirred externally, convulsions may occur; when wind and fire are stirred internally, blood may run rampant.” Allergic purpura is considered to be caused by wind and fire stirring internally; therefore, treatment must emphasize both “clearing fire” and “dispelling wind,” ensuring that the medication addresses the root cause of the disease. Clearing fire involves using herbs like Shuanghua and Lianqiao in high doses; dispelling wind requires using herbs like Shengdi and Chai Hu in high doses.

Case 2: Wang ××, female, 24 years old. She had intermittent purpuric lesions all over her body for two years, accompanied by nasal congestion, poor appetite, fatigue, and heavy menstrual bleeding. She visited our hospital in April 1995. Her complexion was pale, and her spleen was palpable below the ribs. The tongue was pale with a thin white coating, the pulse was slippery and rapid, and subcutaneous hemorrhagic spots of varying sizes were present throughout her body, particularly on both lower limbs. Laboratory tests showed a platelet count of 40 × 10^9/L. Western medical diagnosis: thrombocytopenic purpura. This condition was caused by spleen dysfunction and blood deficiency, with excess fire rising up from the blood. Treatment focused on tonifying the spleen and clearing excess fire. The prescription included: Huangqi 15 g, Danggui 10 g, Baizhu 10 g, Huanglian 3 g, Huangbai 10 g, Bai Ai Li 20 g, Tu Da Huang 15 g, Zhi Lu Xiang 3 g, Mo Xiang 3 g, Danpi Tan 10 g, Xue Yu Tan 10 g, Gan Cao 6 g, decocted in water and taken orally, one dose per day. After taking the formula for more than 20 doses, the purpuric lesions had reduced, but she still felt fatigued and had poor appetite. The tongue was pale with a thin coating, and the pulse was fine and rapid. The above formula was modified by removing Danpi Tan and Xue Yu Tan, adding 12 g of Shan Yao and 10 g of Shihu, and after taking more than 20 doses, all symptoms had resolved. Laboratory tests showed a platelet count of 80 × 10^9/L.

According to the principle: “When qi deficiency prevents blood from being properly regulated, blood can overflow or become stagnant; prolonged stagnation of blood can lead to fire, which in turn causes blood to run rampant.” This is the underlying mechanism of primary thrombocytopenic purpura. Treatment should emphasize both “strengthening the body’s vital energy” and “clearing fire,” while also addressing blood stasis and stopping bleeding. For strengthening the body’s vital energy, use Danggui, Baizhu, and Huangqi; for clearing fire, use Huanglian, Huangqin, and Huangbai, supplemented by Zhi Lu Xiang and Mo Xiang to resolve blood stasis, and Danpi Tan and Xue Yu Tan to stop bleeding. From these two cases, we can see that although both allergic purpura and thrombocytopenic purpura share purpuric lesions as their clinical manifestation, their underlying mechanisms are quite different: the former is a condition of wind-heat, characterized by blood heat running rampant; the latter is a condition of qi deficiency, where blood is not properly regulated. The former should be treated with clearings, while the latter should be treated with tonics—only through combined approaches can effective results be achieved.

Two Cases of Aplastic Anemia

Case 1: Patient Ma Rong, male, 54 years old, was admitted in May 1992. He reported dizziness, fatigue, loss of appetite, diarrhea, chills, and soreness in his lower back and knees. Physical examination revealed a thin body frame, with no obvious abnormalities found in the heart or lungs. The abdomen was flat and soft, with the spleen palpable below the ribs. The tongue was pale with a thin coating, and the pulse was deep and fine. Laboratory tests showed: red blood cells 2.1 × 10^12/L, hemoglobin 63 g/L, platelets 50 × 10^9/L, white blood cells 2.0 × 10^9/L, and reticulocytes 1.2%. Western medical diagnosis based on bone marrow aspiration: aplastic anemia. Treatment focused on tonifying qi and strengthening the spleen, using Guipi Tang with modifications. The prescription included: Huangqi 30 g, Danggui 10 g, Dangshen 10 g, Baizhu 10 g, Fuling 12 g, Gan Cao 6 g, Mu Xiang 3 g, Yuan Rou 20 g, Fuzi 6 g, Rou Gui 3 g, Jixue Teng 15 g, Po Guo Zhi 15 g, decocted in water and taken orally, one dose per day. After taking the formula for more than 20 doses, his mental state and appetite improved, and his stools became formed. However, he still felt cold, had lower back discomfort, tinnitus, and nocturnal emission. The tongue and pulse remained unchanged, and laboratory tests showed: hemoglobin 84 g/L, platelets 60 × 10^9/L, red blood cells 2.8 × 10^12/L, white blood cells 2.4 × 10^9/L. Therefore, the treatment was changed to You Gui Wan with additions: Shan Yao 15 g, Lu Jiao Gao 15 g, Gou Qi Zi 15 g, Du Zhong 10 g, Shan Yu Rou 30 g, Danggui 10 g, Tu Si Zi 15 g, Fuzi 6 g, Rou Gui 3 g, Sheng Di 15 g, Dan Shen 10 g, Mu Xiang 3 g, Cao Kou 13 g, decocted in water and taken orally, one dose per day. After taking the formula for more than 20 doses, his cold and lower back discomfort had significantly improved. Repeat blood tests showed: hemoglobin 100 g/L, platelets 64 × 10^9/L, white blood cells 3.4 × 10^9/L, red blood cells 3.4 × 10^9/L—close to normal levels.

Case 2: Patient Zhang ××, female, 44 years old, had a history of aplastic anemia for more than ten years. She was admitted in April 1995. She experienced dizziness, fatigue, lightheadedness, tinnitus, nasal congestion, dry throat, and heavy menstrual bleeding. Physical examination revealed a pale complexion, with scattered bruising spots under both upper limbs. Cardiac and pulmonary examinations were normal, the abdomen was flat and soft, and the spleen was palpable below the ribs. The tongue was pale with a thin coating, and the pulse was fine and tight. Laboratory tests showed: red blood cells 1.90 × 10^12/L, hemoglobin 60 g/L, platelets 50 × 10^9/L, white blood cells 2.4 × 10^9/L, and reticulocytes at 1%. Western medical diagnosis based on bone marrow aspiration: aplastic anemia. Traditional Chinese medicine diagnosis: kidney yin deficiency, blood stasis within the vessels. Treatment should focus on nourishing yin, tonifying the kidneys, and activating blood circulation to resolve stasis. The prescription included: Danggui 10 g, Chuan Xiong 6 g, Sheng Di 12 g, Xian He Cao 15 g, He Shou Wu 15 g, Tu Da Huang 15 g, Jixue Teng 15 g, Dan Shen 15 g, Hong Hua 6 g, Black Soybeans 30 g, Shan Yu Rou 20 g, Longan Flesh 15 g, Nu Zhen Zi 15 g, Gou Qi Zi 15 g, Da Yun 10 g. After taking the formula for more than 20 doses, her dizziness and lightheadedness eased, but she still experienced nasal congestion and dry throat. Her red blood cell count was 2.4 × 10^12/L, hemoglobin 68 g/L, platelets 60 × 10^9/L, white blood cells 2.8 × 10^9/L. Therefore, the formula was modified by removing Po Guo Zhi and adding 3 g of Huang Lian and 10 g of Huang Qin. After taking additional doses for more than 40, repeat blood tests showed: red blood cells 3.5 × 10^12/L, hemoglobin 85 g/L, platelets 60 × 10^9/L, white blood cells 3.0 × 10^9/L. All symptoms had disappeared.

Treatment for aplastic anemia should, on the one hand, inherit the ancient principles of tonifying qi and blood and regulating the spleen and stomach; on the other hand, it is advisable to integrate these practices with various modern medical findings. Patients with low white blood cell counts often exhibit symptoms such as fatigue, lack of energy, and reluctance to speak, while those with low red blood cell counts often experience dizziness, lightheadedness, and pale complexions. The former often indicate qi deficiency, and treatments like Huangqi, Fuzi, and Rou Gui are commonly used to replenish qi, as seen in Case 1. The latter often indicate blood deficiency, and remedies like Sheng Di, He Shou Wu, and Nu Zhen Zi are used to nourish blood, as seen in Case 2. However, “physical blood cannot be rapidly restored; yet, spiritual qi must be replenished urgently.” Therefore, treating aplastic anemia to increase white blood cell counts yields quick results, whereas increasing red blood cell counts requires consistent medication—do not stop treatment just because symptoms improve slightly, as you may lose all previous efforts. While strengthening the spleen and nourishing the kidneys and tonifying qi and blood, consider incorporating herbs that promote blood circulation and resolve stasis. Modern medicine has confirmed that promoting blood circulation and resolving stasis can greatly improve microcirculation in the bone marrow. Clinically, most patients benefit from adding a few blood-activating herbs to their treatment regimen for spleen and kidney tonification—this approach can truly “add the finishing touch.”

Four Cases of Arrhythmias