3. On Organ Pathology

3. On Organ Pathology

In this regard, Tang offers insights based on his own clinical experience. For example, regarding the heart: “The heart is the organ of fire, illuminating all things; therefore, it governs the spirit. The spirit is intangible yet real—it is the fire-qi within the heart.” This links the traditional concept of the heart governing the spirit with the notion of “heart-fire-qi,” while also suggesting that this “fire-qi,” being “intangible yet real,” to some extent refutes idealistic interpretations of the “spirit.” Concerning the liver, Tang connects its function of regulating the flow of qi throughout the body with the phenomenon of qi stagnation leading to fire and blood heat running rampant. This further clarifies the relationship between the liver and blood-related syndromes, providing an effective pathway for syndrome differentiation and treatment of blood disorders. When discussing the spleen and stomach, he states: “The stomach earth absorbs dry substances, while the spleen earth transforms dampness into qi. If the spleen qi does not disperse, the stomach becomes dry and unable to eat, leading to reduced food intake and impaired digestion.” The digestion of grains and liquids is accomplished jointly by stomach yang and spleen yin—much like cooking: “Without fire in the pot, the food cannot cook; without water in the pot, the food cannot cook either.” By appropriately describing the interplay between the spleen and stomach, as well as the relationship between stomach yang and spleen yin, Tang makes the clinical significance of nourishing spleen yin clearer.

Part One: Academic Thought

Pei Zhengxue’s TCM Studies—Discussions on TCM Theory and Clinical Case Records

Published by Taiwan Book Publishing House

Once blood leaves the circulation, it can no longer re-enter, “If old blood does not flow, new blood will certainly not form.” Therefore, it is imperative to promptly remove stasis so that new blood can regenerate quickly. Moreover, blood stasis can obstruct the flow of qi, causing pain, and over time may lead to a series of symptoms such as tidal fever and bone-steaming. Thus, promoting blood circulation and removing stasis is an important therapeutic method for blood disorders, following hemostasis. For upper-jiao stasis, use Xuefu Zhuyu Tang; for middle-jiao stasis, use Jiaji Huatu Tang; for lower-jiao stasis, use Guixiong Shixiao San. Huirui Shi San can be widely applied to various types of blood stasis, helping to eliminate stasis through urination.

(3) Methods to Calm Blood

Qi reversal and blood disorder are among the root causes of bleeding. Although most cases can be controlled after hemostasis and stasis removal, recurrence often occurs within a few days, directly related to qi reversal disrupting the stability of the blood pool. For this reason, to achieve the goal of calming blood, it is essential to ensure that Chong Qi remains stable—this is a crucial factor in preventing recurrent bleeding. While Mai Men Dong Tang and Gui Ling Gan Cao Wu Wei Tang both have the effect of lowering qi and stabilizing it, their warming and drying nature can be detrimental to blood disorders. Tang Rongchuan proposes that Si Mo Tang possesses the dual benefits of lowering qi and stabilizing it without harming yin or stirring up blood, making it particularly effective for treating gastrointestinal bleeding and consistently achieving the goal of calming blood. In addition, Xiang Su Yin, Xi Jiao Di Huang Tang, Qing Zao Jiu Fei Tang, Xiao Chai Hu Tang, and Long Dan Xie Gan Tang all demonstrate certain calming effects on blood when used appropriately in clinical settings.

(4) Methods to Tonify Deficiency

Although the previous three methods can stop bleeding, if the resulting deficiency due to blood loss is not addressed promptly, it can lead to a series of complications and even trigger another episode of bleeding. Therefore, it is also necessary to treat blood disorders by tonifying deficiency. The lungs act as a canopy, regulating the functions of the five zang organs and six fu organs: “When the lungs are deficient, body fluids dry up, leading to symptoms such as asthma, cough, and wasting; because the lungs cannot regulate downward flow, qi rises and blood follows, so there is always a risk of bleeding unless the lung qi is protected.” Xin Zi Run Fei Gao, Huang Qi Nuo Mi Tang, and Sheng Mai San are used to tonify lung yin; Bao Yuan Tang is used to tonify lung yang. Blood disorders are often characterized by yin deficiency, so tonifying yin is the primary treatment; if yang is to be supplemented, care must be taken to avoid overheating and damaging yin. The kidneys govern bones, store essence, and share the same origin as marrow blood; when blood is depleted and marrow is exhausted, it is essential to tonify the kidneys, typically using Liu Wei Di Huang Tang with adjustments according to individual conditions. Although tonifying the lungs and kidneys is crucial in the later stages of blood disorders, treatment must still be tailored to individual clinical presentations. Sometimes, deficiencies in the heart, spleen, or liver may also be present, in which case Xin Dan, Gui Pi Tang, or Hua Shi Bu Gan San can be added or adjusted accordingly.