In Traditional Chinese Medicine Spleen Deficiency does not mean issues with the spleen as an anatomical organ. Spleen Deficiency suggests an issue with the pancreas or with digestive function. Spleen prefers a dry environment, it is prone to conditions of dampness from climate and dietary factors. It is especially sensitive to cold, damp weather and cold or raw foods, both of which are fertile ground for the pathogenic factor of dampness.
When the spleen functions properly, the body is strong and well nourished. Blood, fluids, and the organs are also in their proper places; thus there is no deficient-type bleeding (blood), edema (fluids), or prolapse (organs).
Spleen Qi Deficiency: When the qi of the spleen is deficient, the spleen is unable to perform its functions of digestion. In addition to the typical qi deficiency signs of fatigue and pale face and tongue, additional symptoms specific to the spleen include poor appetite, weight loss, fullness and sleepiness after eating, and loose stools. (Other conditions are associated with spleen qi deficiency, such as sagging organs and bleeding, but these are discussed as separate syndromes.) Some corresponding Western conditions are ulcers, gastritis, chronic fatigue, AIDS, chronic indigestion, and hepatitis. Treatment consists of tonifying spleen qi with herbs such as ginseng (ren shen). The classic formula to tonify spleen qi is Four Gentlemen decoction (Si Jun Zi Tang).
Spleen Yang Deficiency: This more severe version of spleen qi deficiency has the above-mentioned symptoms as well as cold signs such as cold hands and feet, edema, a desire for warm food and drinks, abdominal discomfort after eating cold food, and diarrhea with undigested food in the stools. Western diseases that fit this syndrome are chronic gastroenteritis, infection with Candida, food allergies, and chronic hepatitis. The treatment principle is to tonify spleen qi and yang and warm the interior with herbs such as ginseng (ren shen), Astragalus (huang qi), ginger (gan jiang), and black pepper (hu jiao).
Spleen Qi Collapse or Spleen Qi Sinking: Since spleen qi supports the organs with its uplifting energy, this aspect of deficient qi is associated with a prolapse (sagging) and a sensation of bearing down in the internal organs. Some organs affected are the stomach, transverse colon, uterus, and rectum. Hemorrhoids are also a condition of spleen qi collapse. In some cases, miscarriages can occur from lack of qi to "hold things up," or retain the fetus with "upward" force. Treatment is to "raise the middle qi" with classic formulas such as Bu Zhong Yi Qi Tang ("Decoction to Tonify the Middle Burner and Raise the Vital Energy"). This formula contains herbs such as ginseng (ren shen) and Astragalus (huang qi) to build the spleen qi, along with herbs that have an uplifting energy such as Bupleurum (chai hu) and Cimicifuga (sheng ma).
Spleen Not Controlling the Blood: Another function of spleen qi is to keep the blood flowing within the vessels. When this function is disturbed, standard symptoms of spleen qi deficiency occur along with bleeding under the skin (easy bruising), excessive menstrual bleeding, nosebleeds, and blood in the urine or stools. Since this bleeding is due to deficiency, the color of the blood is often lighter than might occur in excess bleeding disorders such as heat in the blood. Some of the Western disease patterns that could fall into this pattern are any chronic bleeding diseases, hemophilia, bleeding hemorrhoids, bruising from vitamin deficiency, and periodontal disease. The treatment is to tonify spleen qi and tonify blood. The classic formula for this purpose, Eight Treasure Decoction (Ba Zhen Tang), combines the standard formulas for qi and blood tonification.
Cold and Damp Surrounding the Spleen: This excess pattern arises when the dampness pernicious influence overwhelms the spleen. Symptoms include abdominal fullness and bloating, nausea, vomiting, watery stool, lack of thirst, sticky sensation and sweet taste in the mouth, dizziness, heavy feelings in the body, and a thick, greasy coat on the tongue. Some corresponding Western conditions are stomach "flu," chronic gastritis, chronic colitis, ulcers, and hepatitis. The treatment involves the use of fragrant herbs that "penetrate the dampness and wake up the spleen," such as patchouli (huo xiang).
Damp Heat in the Spleen: In this excess disharmony condition, the dampness symptoms combine with those of heat. They are: jaundice, yellow eyes, bitter taste in the mouth, nausea, vomiting, dislike of greasy food, burning urine and diarrhea, abdominal pain, bloating, and mouth sores. Some Western diagnoses are hepatitis, gallbladder disease, and acute gastroenteritis. The treatment principle is to clear damp heat with herbs such as Coptis (huang lian) and Artemisia (yin chen hao).
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