Which symptom set best reflects Spleen failing to control blood?

Question

BlackTom AI · Accepted Answer

Spleen in TCM governs blood and holds it within the vessels; when Spleen qi is deficient and fails to control blood, signs are bleeding and bruising. This is the core concept linking the symptom pattern to the Spleen’s failure to contain blood.

1) Relevant knowledge points and concepts
- Spleen governs blood and keeps it in the vessels (Spleen qi “holds the blood”).
- Spleen generates blood via transformation of food qi; Spleen qi deficiency leads to both poor blood production and inability to contain blood.
- Typical clinical manifestations of Spleen failing to control blood: easy bruising, spontaneous bleeding (e.g., prolonged or heavy menstrual bleeding, epistaxis, blood in stool or urine), pale complexion from blood loss or poor blood production.

2) Step‑by‑step reasoning
- Examine each option and match to the Spleen’s failure-to-hold-blood pattern.
- Option b lists easy bruising and prolonged menstrual bleeding directly indicating leaking of blood from vessels, plus pale complexion consistent with blood loss or poor blood production — all classical for Spleen failing to control blood.
- The other options lack the hallmark bleeding/leakage signs or point to other organ patterns (Heart or Liver blood deficiency, Spleen yang deficiency with diarrhea, etc.).

3) Calculations
- None required.

4) Why the correct answer is correct
- Option b contains the cardinal features: easy bruising (extravasation of blood), prolonged menstrual bleeding (uterine bleeding due to failure to hold blood), and pale complexion (consequence of blood deficiency/bleeding). These directly reflect a Spleen qi failing-to-hold-blood pattern.

5) Why other options are incorrect
- Option a (palpitations, poor memory, dream‑disturbed sleep): suggests Heart blood or Shen disturbance, not Spleen failing to control blood.
- Option c (fatigue, insomnia, weak pulse, diarrhea): diarrhea and fatigue point to Spleen qi deficiency affecting transport, but insomnia is not typical for the Spleen-holds-blood failure; no bleeding signs are present.
- Option d (dizziness, scanty menstruation, weak pulse, pale tongue): this pattern indicates blood deficiency (often Liver/Heart blood deficiency) with scanty menses, the opposite of bleeding/leakage expected when the Spleen fails to hold blood.

6) Conclusion
The best choice is b. Easy bruising, prolonged menstrual bleeding, and pale complexion are classic signs of the Spleen failing to control blood — confirming the provided answer (b).

Which symptom set best reflects Spleen failing to control blood?Single choice

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