2. Treatment Methods for Blood Disorders

2. Treatment Methods for Blood Disorders

Taking hematemesis as an example, Tang elaborated on four methods for treating blood disorders, presenting his reasoning clearly and distinguishing between primary and secondary considerations, thus systematizing the treatment approaches for blood disorders.

(1) Hemostasis

Tang said: "Blood flows when hot and coagulates when cold; it stops when it turns black and also stops when exposed to cold." This is the general rule for hemostasis. The "+Yao Shen Shu" formula +Hui San was formulated based on these principles, but it is only suitable for some mild cases and is not satisfactory for acute massive hemorrhage. Most severe cases of massive hemorrhage present as "a scene of utter chaos," often characterized by excess heat and real pathogenic factors, mostly caused by reversed qi and disordered blood flow. Therefore, using the method of removing the root cause to lower qi and stop the reversal is an effective way to achieve hemostasis. Xie Xin Tang and other formulas have this effect and are therefore frequently used in clinical practice. There is also a small portion of blood disorders accompanied by depleted vital energy, cold hands and feet, and weak pulses; in such cases, "Du Can Tang must be used to rescue the qi, ensuring that the qi does not escape, so that the blood will not gush out," in order to achieve hemostasis. From the perspective of modern medicine, this is hypovolemic shock, and using Du Can Tang to rescue shock is appropriate.

(2) Removing Stasis

After the bleeding has stopped, stasis still remains in the muscles, skin pores, and meridians. This stasis has already overflowed from the ice tubes and can no longer re-enter the bloodstream. "If the old blood cannot flow, the new blood will certainly not be produced. It is essential to remove the stasis promptly so that the new blood can grow rapidly. In addition, stasis can obstruct the flow of qi, causing pain, and over time may lead to symptoms such as tidal fever and bone-steaming. Therefore, activating blood circulation and removing stasis is an important method for treating blood disorders after hemostasis. For stasis in the upper jiao, use Xuefu Zhuyu Tang; for stasis in the middle jiao, use Jiaji Huatu Tang; for stasis in the lower jiao, use Guixiong Shixiao San; Huairui Shi San can be widely used for various stasis syndromes, helping the stasis to be eliminated through urination."

(3) Calming the Blood

Reversed qi and disordered blood flow are among the fundamental causes of bleeding. After hemostasis and removal of stasis, although most cases can achieve hemostasis, recurrence often occurs within a few days, directly related to the instability of the Blood Sea caused by reversed qi. For this reason, to achieve the goal of calming the blood, it is essential to ensure that the Chong qi is stable and harmonious, which is a factor that guarantees that bleeding will not recur. Mai Men Dong Tang and Gui Ling Gan Cao Wu Wei Tang both have the effect of lowering qi and calming reverse qi, but their nature is warm and drying, which is often detrimental to blood disorders. Tang proposed that Si Mo Tang has the effect of lowering qi and calming reverse qi without harming yin or stirring up blood, and when applied after gastrointestinal bleeding, it consistently achieves the effect of calming the blood. In addition, Xiang Su Ci/, Xijiao Di Huang Tang, Qing Zao Jiu Fei Tang, Xiao Chai Hu Tang, and Long Dan Xie Gan Tang all have a certain effect of calming the blood when used appropriately in clinical practice.

(4) Tonifying Deficiency

Although the previous three methods can stop the bleeding, if the deficiency caused by blood loss is not treated promptly, it can still lead to a series of complications, even causing another episode of bleeding. Therefore, treating blood disorders by tonifying deficiency is also very necessary. The lung is like a canopy, regulating the five zang organs and six fu organs. "When the lung is deficient, body fluids dry up, and symptoms such as asthma, coughing, and wasting appear. Because the lung cannot regulate downward, qi rises and blood also rises. No one has ever experienced hematemesis without damaging the lung qi." Xin Zi Run Fei Gao, Huangqi Nuomi Tang, and Shengmai San are used to tonify the yin of the lung; Baoyuan Tang is used to tonify the yang of the lung. Since blood disorders often involve yin deficiency, tonifying yin is the main treatment method. If tonifying yang is used, care must be taken to avoid overheating and damaging yin. The kidney governs the bones. The kidney stores essence, and marrow and blood share the same origin; when blood is deficient, marrow is exhausted. Therefore, it is necessary to tonify the kidney, usually with Liu Wei Di Huang Tang adjusted according to the specific condition. In the later stages of blood disorders, tonifying the lung and kidney is indeed urgent, but medication must still be administered based on clinical differentiation. Sometimes deficiencies in the heart, spleen, and liver may also be present, in which case Xin Dan, Gui Pi Tang, and Hua Shi Bu Gan San can be added or adjusted accordingly.