Looking at Blood Through Western Eyes

By Rory Williams

If your body is an engine, then blood would be your fuel. Those little cells keep your motor running by carrying oxygen and nutrients to your organs, removing waste, and fighting infections. But how do you know if you′ running high–octane? Western science tells us healthy blood is a matter of numbers and size.

"Western medicine kind of tends to break it down into numbers and scientific ways of examining things under the microscope," says 10,000 Victories student Kedar Che Prasad.

Prasad, a board–certified pathologist, would know. He′s been a doctor at Marin General Hospital for the past seven years and earned his degree at University of California, San Francisco, where he also took up a residency in pathology. As a pathologist, Prasad spends a good deal of time looking down a microscope at tissue samples and blood smears. "Blood is a good indicator of what′s going on in your body," Prasad says. "Although sometimes you can′t get exactly what the diagnosis is, it really helps guide you in the right direction."

Understand Your Blood

A man who weighs about 150 pounds walks around with roughly a gallon and a half of blood circulating through his body via arteries, veins, and capillaries. It′s made up of three parts: red blood cells, white blood cells, and platelets which are suspended in plasma. (Plasma is mostly water, but it also carries proteins, vitamins, ions, hormones, and more.)

Red blood cells (or erythrocytes) contain the protein hemoglobin which in turn contains iron. The iron is what the oxygen binds to, allowing oxygen to travel in the bloodstream, fueling the rest of your body′s cells and organs. When the blood cells move through the lungs, they pick up oxygen–the oxidation of the iron is what gives blood its red color. Red blood cells also contain nutrients from the food that you eat and digest. As red blood cells continue their cruise through blood vessels, they pass off the oxygen and nutrients to organs while at the same time gather up carbon dioxide and other waste gas. The heart then pumps these cells back to the lungs so that the waste gas can be exhaled, and more oxygen can be picked up.

White blood cells (or leukocytes) fight invading bacteria, germs, and viruses. They create antibodies, and in roving gangs (lymphocytes, nuetrophils, and others) track down and kill foreign or cancerous cells and infections.

To help your blood vessels when they spring a leak, cell fragments called platelets (or thrombocytes), help to clot blood in broken areas. The oval–shaped platelets pile up on one another and create a plug. Ever have a scab form on a cut? Thank platelets. You would lose a lot of blood without them.

Don′t worry about running out of these blood cells and platelets; your bone marrow is constantly making more.

Numbers, Size and Shape Matter

When a patient arrives at Marin General complaining of this symptom or that, a doctor will run what′s called a complete blood count test through a highly specialized machine. Red and white blood cells and platelets are tabulated, and the results combined with the symptom report can be very telling.

In an extreme case, these numbers can mean the difference between a common cold and early signs of cancer. For example, too many white blood cells can be a sign of leukemia. Anemia can be discovered by a patient having too few red blood cells and complaining of being tried and out of breath (as there aren′t enough red blood cells to carry oxygen and remove carbon dioxide from the organs). On the other hand, too many red blood cells can make the blood move slower and allow blood clots to form. A dislodged blood clot could then travel to the heart and cause a heart attack, or to the brain and cause a stroke.

After a patient′s complete blood count test is finished, a blood smear is sent to Prasad for observation. What Prasad is looking for are odd–shaped blood cells that may signal just what the infection or inflammation means. "They call the pathologist the doctor′s doctor," Prasad says. "The doctors come to you to put together what′s going on."

Size can be an indicator. For example, large blood cells can mean a patient is lacking vitamins like B12 or folate, and small blood cells can point to an inadequate amount of iron in the hemoglobin. Shape is also another tell. For instance, Red blood cells are disc–shaped, but if they contain abnormal hemoglobin, they can turn into a sickle shape–a result of sickle cell disease. When these sickle cells latch on together they can block blood flow and prove painful and even fatal.

With the combination of tests results and symptom report, the doctors are much closer to a diagnosis.

The hope is that your body′s check–engine light never flashes, but when it does, you can be sure that Prasad and his team are ready to investigate.

10,000 Victories student Rory Williams is the associate editor of the classical music magazine Strings and a freelance reporter.

The TCM Take on Blood

By Adam Shapiro, L.Ac.

In traditional Chinese medicine (TCM) we say that Blood is a Yin substance relative to Qi, which is Yang. Blood is cooling, moistening, and nourishing, whereas Qi is warming, drying and energetic. Qi moves Blood and Blood is the mother of Qi. To help understand Blood in terms of TCM, let′s look at the three key internal organs and the three associated disharmonies.

Internal Organs

Spleen (Earth Element) –Transformation and transportation of food and drink, controls the blood, rules the muscles, manifests on lips and opens to the mouth. The spleen′s No. 1 job is to transform food and drink into pure Qi and Blood and then transport it up to the Heart for circulation throughout the body. The Spleen is also significant for Blood control, helping to keep Blood in the vessels. Bruising easily is a mild symptom, whereas the failure to control the Blood resulting in hemorrhaging is a serious symptom. Poor muscle tone and fatigue, along with pale or dry lips are signs of Spleen Blood disorders.

Liver (Wood Element)–Stores the Blood, regulates flow of Qi, rules tendons, manifests in the nails, opens to the eyes. Qi moves Blood, therefore the Liver plays an important role in normalizing the movement and volume of Blood. This is especially true for women in regulating their menstrual cycles and reproductive activities. Tightness in tendons, brittle nails, and eye weaknesses are all indicative of Liver Blood disorders.

Heart (Fire Element) –Dominates the Blood and vessels, houses the mind, manifests on the face, and opens to the tongue. The Heart Qi is the motive force for blood circulation throughout its network of vessels that nourish (arteries) and remove toxins (veins) from all the organs and tissues of the body. Coldness, weakness, or numbness especially of the hands and feet, along with a pale complexion and tongue are signs of Heart Blood related disorders, as are insomnia, anxiety, poor memory, and concentration.

Disharmonies

Blood Deficiency–Not enough Blood. Often originating in the Spleen′s failure to produce enough Blood (the Spleen rules digestion, which is the process of transforming food and drink into Qi and Blood) due to constitutional weakness in the Spleen Qi and/or poor quality food and drink (amongst other issues), but can come from a loss of Blood or external, pathogens as well. Symptoms include pale face, lips, and tongue, blurred vision or "floaters", dizziness and lightheadedness, insomnia, palpitations, poor memory and concentration, cold extremities, and a thin pulse.

Blood Stagnation–Blood not moving. Blood will stagnate because of an obstruction in the vessels, a deficiency failing to fill the vessels, and/or sticky blood. Blood stagnation is marked by pain that is sharp or stabbing, in a fixed location and tends to be worse at night when the Qi moves less. Signs include bruising or laceration in the event of an external trauma, as well as varicose or "spider" veins through the course of prolonged but mild Blood stagnation. The tongue may be purple and pulse choppy, and women may experience painful menstruation and clotting. Blood stagnation can also lead to more serious and deadly ailments such as thrombosis, stroke, and heart attack.

Blood Heat–Overheating. Too much heat in the Blood can come from internal sources such as extreme emotions (anger) as well as pathogens such as rheumatic fever. Symptoms include mental restlessness and even mania; raised, red skin rashes; nosebleeds; coughing up blood; blood in the urine; profuse menstrual flow in women; rapid pulse; and red tongue.

It is important to remember that our body is interconnected. Imbalances in one area will affect others and may grow larger over time. For example, prolonged or severe Blood Deficiency creates a weak flow, which then results in Blood stagnation. The pressure and friction of accumulated blood because of Blood Stagnation will produce Heat in the Blood. Also contributing to Blood Heat is a failure of the nutritive effects of Blood (Yin) to balance the warming and moving effects of Qi (Yang). Prolonged Blood Heat leads to stagnation as the body fluids are burned off because of the excess heat and the blood becomes more sticky.

So what can you do to take better care of your blood? In addition to following simple dietary and lifestyle guidelines, a licensed acupuncturist (who is also trained in Chinese herbs) can help to diagnose and treat blood related disorders with acupuncture, herbs, or a combination of the two.