I. Physiological Functions and Pathological Core of the Spleen
1. Physiological Characteristics of the Spleen
- Foundation of Postnatal Life: Governs the transformation and transportation of nutrients, raising the clear and lowering the turbid, controlling blood (Su Wen · Ling Lan Mi Dian Lun: “The spleen and stomach are the officials of the granary, from which the five flavors come forth”).
- Source of Qi and Blood Generation: Spleen deficiency leads to the birth of various diseases, and insufficient qi and blood result in malnourishment of the organs and internal generation of water, dampness, and phlegm.
2. Core Pathogenesis of Spleen Diseases
- Disorder of Qi Movement: Spleen qi deficiency and sinking (prolapse of organs), spleen failing to control blood (bleeding).
- Stagnation of Water and Dampness: Insufficient spleen yang (edema), dampness obstructing the spleen (abdominal distension and poor appetite).
II. Differential Diagnosis and Treatment Plans for Spleen-Related Diseases
General Formula for Spleen Deficiency: Moxibustion + Manual Techniques + Gua Sha.
Moxibustion: Shenque, Yinlingquan, Neiguan, Baliao;
Manual Techniques: Axillary tendon, Golden Line, Clearing Stomach Fire, Dai Mai;
Acupressure: Neiting, Tushui, Yinbao, Gongsun;
Gua Sha: Lateral side of the tibia (stomach meridian on the lower leg).
① Spleen Qi Sinking: Pathological manifestations in digestion and water metabolism due to poor spleen function.
Symptoms: Loss of appetite, eating less, poor digestion, abdominal distension, stools that are first dry then loose (spleen not functioning well, water and dampness stagnating in the large intestine);
Fatigue, weak voice (nutrients not being transported to the upper jiao to form Zong Qi, which is related to speech);
Eating less, white urine (essential substances not being transported upward to form qi and blood, but instead going downward into the bladder, causing urine to be white like rice soup), fever (sinking leading to damp-heat descending, causing fever in the lower jiao later on);
Tongue Appearance: Thick white coating in the middle jiao, slightly yellow in the lower jiao;
Symptoms: Chronic indigestion, gastric ulcer, chronic enteritis, hepatitis, liver disease edema, malnutrition;
Manual Techniques: Golden Line;
Moxibustion: Simple Moxibustion;
Chinese Medicine: Bu Zhong Yi Qi Tang;
Dietary Therapy: Yam rice soup, millet soup.
Yam: Yellow skin enters the spleen, strengthens the spleen and stops diarrhea (astringent – strengthens the spleen and stops diarrhea), nourishes both qi and yin, not suitable for those with food stagnation or damp-heat in the lower jiao, not suitable for those with blood sugar levels above 6 before meals;
Red Dates: Red skin and yellow flesh, sweet taste, enters the spleen, sweet and warm to nourish qi;
Tangerine Peel: Yellow color, pungent taste (pungent can move qi), treats stomach and abdominal distension and pain caused by qi stagnation in the spleen and stomach.
② Spleen Yang Deficiency: Qi sinking, spleen deficiency and sinking
Diagnosis: Insufficient qi and blood, organ prolapse (gastric prolapse, uterine prolapse, kidney prolapse, hemorrhoids, rectal prolapse, etc., because the spleen governs the raising of the clear, bringing nutrients to the whole body, spleen yang deficiency leads to qi sinking, unable to support and thus causing prolapse)
1. Insufficient Qi and Blood
Due to the inability of clear qi to rise, turbid substances remain in the upper part, causing fullness, and diarrhea due to the inability of spleen qi to rise.
Symptoms: Dizziness, abdominal distension
2. Organ Prolapse (Unable to Lift): Gastric prolapse, kidney prolapse, etc., including hernia
Symptoms: Diarrhea, white urine
3. Internal Injury Fever, Damp-Heat Descending
Adjustment Methods: Golden Line + Pinching the Spine, Tapping Baihui
Dietary Therapy: Bu Zhong Yi Qi Tang, Ge Gen Soup.
③ Spleen Not Controlling Blood
Logic: Fire generates earth, the child can strengthen the mother, the blood produced by the spleen must be supplied to the heart, it has the function of transportation, when the spleen qi is weak, blood cannot circulate normally, leading to blood overflowing outside the vessels, causing gastrointestinal bleeding (bloody stools), bladder bleeding (hematuria), subcutaneous bleeding (skin purpura), gum bleeding, menorrhagia, etc.
Acute Treatment: Needling,
Medication: Dang Shen, Huang Qi, Ren Shen
Treatment for Spleen Qi Deficiency: Moxibustion + Yinbao (to invigorate spleen qi)
④ Spleen Deficiency Edema
Cause: The spleen governs the transformation of water, insufficient spleen yang cannot transform water, water and dampness accumulate internally, water cannot enter the bladder normally, and during the process of staying in the body, it cannot be metabolized, and the form of yin accumulates, with yin water accumulating in the limbs and other parts.
Symptoms: Loose stools, abdominal distension
Treatment: Warming and supplementing spleen yang, promoting diuresis and reducing swelling
Dietary Therapy: Fu Ling (strengthens the spleen and promotes diuresis), winter melon
General Formula: Clearing Stomach Fire + Golden Line (Yinlingquan + Gongsun)
⑤ Dampness Obstructing the Spleen
Symptoms: Easy to feel sleepy, heavy head and body, weakness in the limbs, abdominal fullness and distension, stomach acid reflux
General Formula: Golden Line + Dai Mai
| Syndrome | Core Pathogenesis | Typical Symptoms | Treatment Principles | Representative Formulas/Techniques |
|---|---|---|---|---|
| Spleen Qi Sinking Syndrome | Insufficient central qi, inability to lift | Organ prolapse, loose stools, cloudy urine | Supplementing central qi, raising yang and lifting sinking | Bu Zhong Yi Qi Tang + Golden Line Lifting |
| Spleen Yang Deficiency Syndrome | Yang deficiency causing cold, water and dampness not being transported | Abdominal cold pain, edema, clear and thin leukorrhea | Warming yang and dispelling cold, strengthening the spleen and promoting diuresis | Li Zhong Wan + Moxibustion at Shenque Point |
| Spleen Not Controlling Blood Syndrome | Qi not controlling blood, blood overflowing outside the vessels | Bloody stools, menorrhagia, subcutaneous purpura | Supplementing qi and controlling blood, consolidating Chong and Ren meridians | Gui Pi Tang + Pressing Yinbao Point |
| Spleen Deficiency Edema Syndrome | Spleen deficiency causing water overflow, accumulation of yin water | Edema in the limbs, abdominal distension like a drum | Warming yang and promoting diuresis, strengthening the spleen and resolving dampness | Shi Pi Yin + Golden Line Gua Sha |
| Dampness Obstructing the Spleen Syndrome | Internal obstruction by damp turbidity, spleen not functioning well | Heavy head and body, poor appetite and acid reflux | Drying dampness and strengthening the spleen, regulating qi and harmonizing the middle | Ping Wei San + Dai Mai Relaxation |
III. Special Therapies and Practical Guidelines
1. Manual Techniques and Acupoint Adjustment
- Spleen Qi Sinking:
- Golden Line Lifting: Lift the Ren meridian from Tiantu to Jiuwei to enhance the spleen’s ability to raise the clear.
- Pressing Gongsun Point: Strongly stimulate the Gongsun point (base of the first metatarsal bone) to regulate the qi of the spleen and stomach.
- Spleen Yang Deficiency:
- Moxibustion at Shenque and Mingmen: 15 minutes daily to warm and supplement the spleen and kidney yang (Zhen Jiu Da Cheng).
- Pinching the Spine Technique: Pinch and lift along both sides of the spine from the sacrum to the neck to stimulate the spleen meridian qi.
2. Analysis of Classic Formulas
- Bu Zhong Yi Qi Tang: Huang Qi supplements qi, Chai Hu raises yang, Bai Zhu strengthens the spleen, these three herbs combined to lift the central qi (Pi Wei Lun).
- Shi Pi Yin: Hou Po and Mu Xiang move qi, Fu Ling and Bai Zhu strengthen the spleen, Fu Zi warms yang, treats edema caused by yin water.
IV. Dietary Therapy and Daily Care
1. Food and Medicine Homologous Schemes
- Spleen Qi Sinking:
- Yam Rice Soup: 100g of yam + japonica rice cooked into porridge, strengthens the spleen and stops diarrhea (nourishes both qi and yin, use with caution in cases of food stagnation). (Yam: Supplements spleen yin, can stop diarrhea, nourishes both qi and yin, if there is food stagnation or damp-heat in the lower jiao, yam will not be effective.)
- Huang Qi Red Date Tea: 10g of Huang Qi + 5 red dates boiled into a decoction, supplements qi and raises yang.
- Porridge: Yam and lotus seed porridge, red date and lotus seed millet porridge, coix seed porridge, longan porridge, pumpkin porridge, lotus root, corn, etc.
- Soups, rice soup, millet soup
- Spleen Yang Deficiency:
- Ginger and Pig Stomach Soup: 15g of ginger + pig stomach stewed, warms the middle and dispels cold.
- Fu Ling and Red Bean Porridge: 30g of Fu Ling + 20g of red beans + japonica rice cooked into porridge, promotes diuresis and reduces swelling.
2. Taboos and Health Preservation
- Chew slowly and thoroughly, eat at regular times and in regular amounts
- Dietary Taboos: Avoid raw and cold foods (iced drinks, sashimi) for spleen deficiency, avoid sweet and greasy foods (cakes, chocolate) for excessive dampness.
- Schedule Recommendations: The spleen meridian is active during the Si hour (9-11 AM), rub the abdomen 100 times in the morning to promote spleen and stomach function.
V. Modern Research and Classic Origins
- Huang Di Nei Jing: “When the spleen is diseased, the limbs cannot be used” – spleen deficiency leads to insufficient qi and blood, causing limb malnutrition.
- Modern Research: Moxibustion at the Pishu point can increase pepsin activity in patients with chronic gastritis (Chinese Acupuncture, 2023).
- Tongue Appearance Correlation: Differentiating between a pale and swollen tongue with teeth marks (spleen deficiency and dampness) and a red tongue with little coating (stomach yin deficiency).
- Comparing my own condition, the symptoms of spleen qi sinking are very obvious, indicating poor digestive function and inability to absorb nutrients. I will start doing the Golden Line seriously and drink a bowl of rice soup in the morning as water.
Note: The therapies described in this article require guidance from a TCM practitioner. Organic diseases (such as liver cirrhosis, splenomegaly) require combined treatment with Western medicine. The dosages of the formulas are for adult regular use, and clinical application needs to be adjusted individually.
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