| There are three parts in this paper:an overview, origin and development of blood pattern in ancient times, and diagnostic characteristic study of blood pattern based on Tang Ronchuan’s Xue Zheng Lun (On Blood Pattern).The general term "blood" is used in the paper to mean "blood pattern".From history records, blood pattern was first mentioned in the book Wu Shi Er Bing Fan (Formulas for Fifty-two Diseases)written in the 5th-6th century before Christ, when charcoaled hair and cattail mat were used in the treatment of bleeding due to wound or hemorrhoid bleeding. Three centuries later, differentiation of blood pattern was discussed in detail in Nei Jing (Canon of Medicine), which had laid the foundation for differentiation of blood pattern for the later generations.In Shi Ji (Records of the Grand Historian), the case records about it at that time have been viewed as the originator of the modern medical records.With the perfection of "theory, method, prescription, and medicine", Shang Han Lun (Treatise on Cold Damage) enhanced the logic of differentiation and treatment for blood pattern, which included "empirical treatment", "focusing on pacification", and "sweat and blood relation". In gynecology the accompanied illness from water and blood should be noticed, and so should be the treatment for miscellaneous illness. It raised the principle of differentiation and treatment of blood pattern, which is still the essential guidance for today’s practice.In Zhong Zang Jing (The Treasured Classic), Mai Jing (The Pulse Classic) and Wang Shuhe’s Mai Jue (Verse on Pulse Diagnosis), pulse diagnosis was regarded most important, and disorders of the zang-fu organs was used to illustrate in the treatment of blood pattern.The cause, mechanism, disease site and diagnosis and treatment mentioned in Zhu Bing Yuan Hou Lun (Treatise on the Origins and Manifestations of Various Diseases) are the most complete records, which have been observed by physicians generation after generation.In the Northern and Southern Song dynasties, the three causes of blood pattern and mechanism were first mentioned in San Yin Ji Yi Bing Zheng Fang Lun (Treatise on Diseases, Patterns and Formulas Related to the Unification of the Three Etiologies). Along with Chen Ziming,the mechanism of "stagnation of cold blood" was metioned.The four schools of the Jin and Yuan dynasties laid stress on harmonious functioning among the zang-fu organs. They meant fire could be transformed from six kinds of qi, fire and heat induced disorders, it was important to nourish blood on bleeding, and all disorders were caused by damage to the spleen and stomach.In the Ming and Qing dynasties, Miao Xiyong puts forward " three key points of spitting blood" and "three essentials of treating bleeding ". Zhang Jingyue talked about the key role of blood played in the body, spirit and will. He pointed out that excessive fire and qi damage were the most important cause and mechanism of blood pattern.Yu Jiayan payed attention to the process of four diagnostic methods to find pathogenesis and hereby to prescribe medications. He proposed a guideline for treatments according to the ergency and severity of a disease.In ergent and severe cases,symptom relief should be in priority,and otherwise dealing with root causes. For female blood pattern Fu Qingzhu said "excessive fire is caused by lack of blood, so fire can be controlled by nourishing blood. In the treatment of blood pattern, the removal of dampness made fire downward.’To alleviate liver so as to strengthened spleen." was a new idea for female blood pattern. Ye Tianshi stressed that blood pattern from outside factors was determined by corresponding symptoms, and which from inside factors should be confirmed with internal evidence. Blood pattern from other factors should be evaluated by different zang-fu organs and meridians.Chen Xiuyuan paid attention to the qi transformation of six meridians, which laid the foundation for Tang RongChuan’s "Doctrine of yin yang, fire and water " and "Pathogenesis of Zang Fu diseases".Wang Qingren mentioned the anatomical locations and functional pathways of qi portal, main ducts of Wei and Rong, Qifu, Xue fu, Sui fu, Jin portal, and Jin duct, which disclosed the relation of circulation among qi, btood and fluid. The pathogenesis of hemostasis was focused on obstinate diseases and that had clinical meaning of guidance.According to "Correction of the Errors of Medical Works", Zhu Peiwen mentioned that carbon dioxide existed in blood circulation and the color purple appeared in hypoxemia. He concluded that qi, blood and body fluid all originated from water and grains, and various body fluid derived from blood.About Tang Rongchuan’s Xue Zheng Lun (On Blood Pattern).The features and the innovated studies of "Doctrine of Blood Pattern" lied in the philosophizing of the interdependence of yin and yang, and the correspondence between human and universe; with them the basic theory of yin-yang, water, fire, qi, and blood in "Doctrine of Blood Pattern" was reconstructed.Based on Yi-Jing, "the theory of yin-yang" was developed and was then innovated in the idea of reciprocity between water and fire, and their transformation to qi or blood. With the theory of "qi transformation" pathogenesis and etiology were elaborated on mutual restraint and reciprocity among water, fire, qi and blood.With the help of "the theory of qi transformation in six meridians", it was integrated in ’Doctrine ofyin yang, fire and water" and "Pathogenesis of Zang Fu diseases". These comprised the basic theory of blood patterns and became their characteristics in diagnosis and treatment based on syndrome differentiation. adopted the essence of previous studies from different practitioners and academic schools, in combination with the vast knowledge of western medicine, and integrated them into its theory and therapeutic guideline for blood pattern.Tang Rongchuan represented the school of merging western medicine with Chinese medicine in late Chin dynasty. The western medicine was familiar to him, so the knowledge of anatomy and physiology in west medicine had strong influence on his writings. There were notable features of diagnosis for blood patterns in Chinese medicine by Tang. Such were paying attention to disease location, integrating various approaches to syndrome differentiation, and using the "Ben-Biao-Zhong-Qi " of both "six-meridians-six-qi’s" and "zang-fu-meridians" to link syndrome differentiation related to them.To explore "Ben-Biao-Zhong-Qi of six-meridiarf qi" and’Ben-Biao-Zhong-Qi of zang-fu-meridians", he integrated the "Ben-Biao-Zhong-Qi of six-meridian-six-qi’s" and the "Ben-Biao-Zhong-Qi of zang-fu-meridians" by interlinking them with water, fire, qi and blood. This gave a new insight into the explanation of meridians’and miscellaneous diseases while reviewing the books of’Treatise on Febrile Diseases" and "Synopsis of Golden Chamber". Besides, there was also innovative knowledge and supplement added to the techniques of disease diagnosis.The water-fire-qi-blood related mechanism in physiological and pathological views had set up a foundation for microcosmic syndrome differentiation in the cases of blood patterns. This had profoundly advanced the diagnostic techniques for blood patterns in Chinese medicine. For example, in the chapter of "Sphygmology and Syndrome ofTaiyang Diseases ", Tang called both the small intestine meridian and the bladder meridian as’Taiyang meridian". Bladder was fu-organ of cold-water. Small intestine lead heart-fire to kidney system, and when the fire reached Qihai Xueshi, it would help transforming the bladder-water to qi.Summary:In terms of diagnosis for blood patterns, Tang Rongchuan reconstructed the mechanism of reciprocity and transformation among zng-fu organs, meridians, yinyang, water, fire, qi and blood. As for the blood-water related disease "Shui Yu" (blood stasis with fluid stagnation) mentioned by Tang Robgchuan had become a focused and challengeable topic in the syndrome differentiation for blood patterns in Chinese medicine. |
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