5. The Spleen and Leukemia

5. The Spleen and Leukemia

(1) The Spleen Governs Transportation and Transformation

Traditional Chinese medicine attributes the digestive functions of the gastrointestinal tract to the spleen. After digestion, the refined substances produced are transported throughout the body, with a portion being transformed into red blood cells by the spleen. The "Spiritual Pivot · On the Chapter of Decisive Qi" states: "The middle jiao receives qi and extracts juice, which then transforms into red blood—this is what blood is." Since the spleen participates in blood production, the treatment of leukemia is inevitably related to the spleen.

(2) The Spleen Governs Blood Containment

The "Difficult Classic" states: "The spleen contains blood and warms the five zang organs." This indicates that the spleen plays a role in maintaining blood circulation and nourishing the five zang organs. The bleeding, exhaustion, and anemia symptoms seen in leukemia can all be treated by addressing the spleen.

II. The Relationship Between Leukemia and Pathogenic vs. Defensive Qi

The "Inner Canon" states: "Where pathogenic factors gather, qi must be deficient," and "When defensive qi is present, pathogenic factors cannot invade." These are the fundamental principles of traditional Chinese medicine regarding the relationship between defensive and pathogenic qi. The ebb and flow of these two forces typically correspond to the progression of disease. As the ancients said: "When pathogenic qi is strong, the condition is real; when defensive qi is depleted, the condition is虚." This shows that whether a disease is real or虚 depends entirely on the balance between defensive and pathogenic qi. Although the exact cause of leukemia remains unclear, based on the widely accepted viral theory and the apoptosis theory, the former leans more toward the concept of "pathogenic factors" in traditional Chinese medicine, while the latter incorporates elements of "defensive qi." Therefore, the understanding of leukemia in traditional Chinese medicine is neither purely real nor purely虚; rather, it is fundamentally虚, with real manifestations as the outward appearance. The progression of the disease is determined by the interplay between defensive and pathogenic qi. In terms of treatment, the effective way to resolve this contradiction is not simply "dispelling pathogenic factors" or solely "strengthening defensive qi," but rather a combination of both, where strengthening defensive qi and dispelling pathogenic factors complement each other. Traditional Chinese medicine has the saying: "When pathogenic factors are eliminated, defensive qi will naturally stabilize," as well as: "When defensive qi is sufficient, pathogenic factors will naturally disappear," indicating that the two are causally related. The former emphasizes the importance of eliminating pathogenic factors, while the latter highlights the significance of strengthening defensive qi. We believe that in the treatment of leukemia, both strengthening defensive qi and dispelling pathogenic factors should be given equal attention. Strengthening defensive qi is like preserving oneself, while dispelling pathogenic factors is like attacking the enemy. Only by preserving oneself can one effectively attack the enemy, and only by attacking the enemy can one effectively preserve oneself. Therefore, in treating leukemia, both approaches should be employed simultaneously, combining attack and reinforcement. However, this combination should not be a 50/50 split, but rather tailored to the specific clinical situation, taking into account the patient's level of defensive qi, the severity of pathogenic factors, the strength of the zang organs, and the duration of the illness, applying the principles of syndrome differentiation and individualized treatment. When pathogenic factors are dominant, treatment should focus on dispelling them while supporting defensive qi; conversely, when defensive qi is dominant, treatment should emphasize strengthening it while also dispelling pathogenic factors, striving to attack without harming defensive qi and reinforce without aiding pathogenic factors, ensuring that both methods find their proper place. For example, Guiyang Medical College reported that conventional methods of heavily tonifying qi and blood failed in 1955, but switching to an aggressive approach in 1958 proved effective. On the other hand, Lanzhou Dasha Ping Hospital used a combination of tonification and aggression in 1976, treating three cases with a tonifying approach and two with an aggressive one, and all patients remain in remission to this day^⑥^. Even when Guiyang Medical College shifted to an aggressive approach, prioritizing the elimination of pathogenic factors, they did not completely abandon strengthening defensive qi. Among the large number of heat-clearing and detoxifying herbs, they still included astragalus and angelica to support qi and blood, ultimately achieving complete remission in five cases. This demonstrates that only by employing a combined approach of tonification and aggression based on syndrome differentiation can ideal clinical outcomes be achieved. Both traditional Chinese medicine and Western medicine have their own methods for either strengthening defensive qi or dispelling pathogenic factors. Generally speaking, traditional Chinese medicine emphasizes strengthening defensive qi, while Western medicine focuses on eliminating pathogenic factors. In the treatment of leukemia, both traditions exhibit this characteristic as well. Western chemotherapy drugs have a powerful effect in eliminating pathogenic factors, but they also carry significant side effects. When treating acute leukemia with Western chemotherapy, if traditional Chinese medicine tonics are added to support defensive qi, the therapeutic effect is often remarkably satisfactory. Dr. Pei once used this method to achieve rapid and complete remission in many cases of acute leukemia, with one patient remaining in complete remission for 12 years and continuing to work healthily^⑦^. As for chronic leukemia, using traditional Chinese medicine alone to combine strengthening defensive qi with dispelling pathogenic factors can also lead to complete remission, with fewer side effects and better long-term results compared to Western drugs such as molybdenum and chlorambucil.

III. Syndrome Differentiation and Treatment of Leukemia

Leukemia is closely related to the five zang organs, and throughout the course of the disease, there are fluctuations between defensive and pathogenic qi. Therefore, in treatment, one can strengthen defensive qi based on the deficiency patterns of the zang organs, or eliminate pathogenic factors according to the degree of their dominance. Based on the principles of "where pathogenic factors gather, qi must be deficient" and "when defensive qi is present, pathogenic factors cannot invade," we believe that the pathogenesis of leukemia should be fundamentally虚, with real manifestations as the outward appearance. Strengthening defensive qi addresses the虚, while eliminating pathogenic factors targets the real. When the condition is stable, focus on strengthening defensive qi; when it is urgent, prioritize eliminating pathogenic factors. The methods for strengthening defensive qi mainly involve tonifying qi and blood and harmonizing yin and yang, while the methods for eliminating pathogenic factors are limited to clearing heat and detoxifying, as well as resolving blood stasis.