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TCM Book Club Issue 1609
One issue daily, accompanying the growth of TCM practitioners
IIntroduction:Anemia is a term exclusive to Western medicine and does not equate to the TCM concept of blood deficiency (xue xu). “The error in this case lies in the physician mistakenly equating the Western diagnosis of ‘anemia’ with the TCM pattern of blood deficiency, without following TCM diagnostic principles.” (Editor/Ju Ye)
Misdiagnosis of Anemia and Qi-Blood Deficiency
Compiled by/He Xueze
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Case of Misdiagnosis
Zhao, female, 40 years old, farmer, first diagnosed on October 8, 1991. The patient reported feeling heavy in the head and body, chest tightness, nausea, fatigue, poor appetite, constipation, dizziness, palpitations, and shortness of breath after being caught in the rain following sweating.
Diagnosis revealed a weak physique, pale complexion, red tongue with greasy, slightly yellow coating, and a fine, rapid pulse. Blood tests indicated ‘anemia’, and she was treated with Gui Pi Tang (Return the Spleen Decoction) to tonify Qi and blood.
After 4 doses, the patient experienced persistent chest tightness, discomfort, restlessness, insomnia, a red tongue with slightly yellow greasy coating, and a rapid, strong pulse. After further consideration, I concluded that this condition was misdiagnosed and mismanaged.
The treatment was then changed to Zhi Shi Zhi Zhi Tang (Bitter Orange and Gardenia Decoction) to clear heat, transform dampness, and relieve chest oppression. After 3 doses, symptoms slightly improved, and further pattern differentiation led to the prescription of Xue’s Five-Leaf Reed Decoction combined with Bamboo Leaf and Gypsum Decoction, resulting in improvement after 5 doses, and the anemia was resolved. [“Sichuan TCM”. 1996. 14(8)]
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Analysis of Misdiagnosis
The error in this case lies in the physician mistakenly equating the Western diagnosis of ‘anemia’ with the TCM pattern of blood deficiency, without following TCM diagnostic principles.
The patient reported feeling heavy in the head and body, chest tightness, nausea, fatigue, poor appetite, constipation, a slightly yellow greasy tongue, and a fine, rapid pulse, all indicative of damp-heat. The condition was caused by damp-heat obstructing the middle burner (zhong jiao) and spleen-stomach.
Although the patient exhibited symptoms of dizziness, palpitations, shortness of breath, and a pale complexion, which are signs of blood deficiency, these were not the primary concern. Moreover, supplementing blood in the presence of dampness would exacerbate the condition by obstructing the spleen and stomach, worsening the illness. Once the dampness is resolved, the spleen and stomach will strengthen, and the blood deficiency will self-correct.
Recommended Reading
Is anemia the same as blood deficiency?
Blood deficiency anemia can be treated with Astragalus (Huang Qi), Chicken Blood Vine (Ji Xue Teng), and brown sugar.
Three effective formulas for Qi and blood deficiency.
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