Spleen Pattern Differentiation in Chinese Medicine
- Spleen Qi Deficiency
- Spleen Yang Deficiency
- Spleen Qi Sinking
- Spleen Unable Control Blood
- Damp Cold Invading the Spleen
- Damp-Heat Invading the Spleen
Etiology of Spleen Patterns
- Mental factors
Excessive thinking, studying, concentrating, brooding, obsessing, etc. weakens Spleen.
Very important. Spleen likes foods that are warm (in energy & temperature) e.g. meat, pepper, ginger, orange peel, kumquat, and dry foods.
Excessive consumption of Cold foods (in temperature & energy) will impair Spleen function of transformation/transportation and cause interior Dampness & digestive problems.
In addition, eating in a hurry, when stressed or upset, skipping meals and eating poor quality food all significantly weaken Spleen Qi.
NOTE: further reading on the energy of foods according to TCM:
The Tao of Healthy Eating - Bob Flaws
- Exogenous Pathogens
Spleen hates Dampness: can be invaded by Exogenous Dampness. Dampness can invade when people live in damp places, remain in wet clothes after running or swimming, wade in water or work in watery areas.
Women are very prone to invasion of exogenous Dampness during menstruation and after childbirth.
Exterior Dampness can combine with Heat or Cold.
Spleen Qi Deficiency
|NO Appetite||Spleen Qi weak|
|Abdominal distention after eating||Impairment of Spleen's transformation & transportation function|
|FATIGUE, lassitude, weakness of limbs||Spleen transports food essences to the four limbs|
|LOOSE STOOLS||Impaired transformation/transportation function|
|If Deficient Spleen Qi leads to Internal Dampness:|
|Nausea||Dampness obstructs epigastrium & prevents Stomach Qi from descending|
|Stuffiness of chest & epigastrium||Dampness obstructs chest area|
|Feeling of heaviness in head and limbs (head in a bag)||Dampness interferes with the clear Yang in the head, obstructs muscles|
|Tongue: Pale or normal
Chronic: swollen sides in the MIDDLE SECTION only of the Tongue. Very severe cases have swollen sides with transverse cracks)
|Spleen area of Tongue|
|Coating: thin, white sticky, greasy||Deficient Spleen Qi
Excessive Cold and raw foods deplete the Spleen Qi.
Eating too little in general or not enough protein.
- Mental Strain
Excessive thinking over long time (common in students & business people).
Especially bad if discuss work over lunch or hurry lunch and rush back to work.
Prolonged exposure to damp weather or damp house weakens Spleen
- Chronic Disease
Tends to weaken Spleen (which is the root of Postnatal Jing and is hence overworked trying to restore health).
This pattern forms the basis for all other Spleen disharmonies. It is a very common pattern in our culture because of excessive thinking and irregular eating habits.
- Tonify Spleen Qi
|REN-12 (Zhong wan)||Tonifies Spleen Qi|
|ST-36 (Zu san li)||Tonifies Spleen Qi|
|SP-3 (Tai bai)||Source point: tonifies Spleen Qi|
|SP-6 (San Yin jiao)||Tonifies Spleen Qi|
|BL-20 (Pi shu), BL-21 (Wei shu)||Tonifies Spleen Qi (esp. important combo Tonifies Spleen and Stomach Qi) where the Spleen and Stomach are both chronically Deficient.|
|Method:||Tonification. Moxa is applicable.|
Spleen Yang Deficiency
|Lack of Appetite|
|Abdominal distention after eating|
|Bright white or sallow complexion||Deficiency|
|Weakness of the four limbs||Deficient Spleen not sending food essences to limbs|
|LOOSE STOOLS (often with undigested food)||Deficient Spleen Yang fails to transform digestate|
|CHILLINESS - Cold LIMBS||Signs of Cold|
|Edema||Impaired Spleen function of transforming/transporting fluids|
|Tongue: Pale, swollen, wet||Deficient Yang causes accumulation of untransformed fluids on Tongue.|
|Pulse: Weak, slow, deep||Deficient Yang|
As for Spleen Qi Deficiency, or from overeating of Cold and raw foods, or exposure to Cold and Damp environment.
Similar pattern to Spleen Qi Deficiency but has symptoms of Cold because Spleen Yang fails to warm the body.
- Tonify and warm Spleen Yang
NOTE: If edema or Dampness is present, the following Points are SEDATED:
|SP-9 (Yin ling quan), REN-9 (Shui fen)||Resolve Dampness in lower burner|
|ST-28 (Shui dao), BL-22 (San jiao shu)||Enable Spleen to transform/transport fluids|
|Method:||Tonification and Moxa|
Spleen Qi Sinking
Signs of Spleen Qi Deficiency, plus:
PROLAPSE: of uterus, anus, stomach, vagina, heavy sensation in abdomen, e.g. of bearing down,
Hemorrhoids, varicose veins
As for Spleen Qi Deficiency but even more likely in those who have Spleen Qi Deficiency and who also stand for a long time every day (i.e. - at work).
- Tonify Spleen Qi and Raise Qi
As for Spleen Qi Deficiency plus
|Du 20 (Bai hui)||Raises Qi (apply cones of moxa). Esp. good for prolapse of uterus|
|Ren 6 (Qi hai)||Tonifies Qi, raises Qi: use for any prolapse|
|ST 21 (Liang men)||Tonifies Stomach: use for prolapse of Stomach|
|Du 1 (Cheng Qiang)||Use for prolapse of anus|
|Method:||Tonification. Moxa applicable|
Spleen Unable Control Blood
Signs of Spleen Qi Deficiency plus Signs of Bleeding
Examples: Petechiae, ecchymoses (bleeding into the skin), Blood in stool or urine, menorrhagia, Spleen fails to govern Blood, Metorrhagia, sallow complexion, shortness of breath
|Pulse: FINE||Deficient Blood|
Spleen function of keeping Blood in the vessels is impaired: therefore bleeding occurs. Bleeding is of Deficiency kind rather than the Excess type of bleeding that occurs when there is Heat in the Blood.
Same as for Spleen Qi Deficiency
- Tonify Spleen Qi
Same as for Spleen Qi Deficiency plus:
|SP-10 (Xue hai)||strengthens Spleen function of controlling Blood & returns Blood to Vessels|
|BL-17 (Ge shu)||tonifies Blood & stops bleeding, when needled (not with moxa)|
|SP-1 (Yin bai)||with moxa cones to strengthen Spleen function of controlling Blood; stops uterine bleeding. Use moxa on this point to stop bleeding only of a Deficient nature (esp. uterine)|
|Method:||Tonification. Moxa is applicable|
Damp Cold Invading the Spleen
|STUFFY CHEST & EPIGASTRIUM,||Dampness obstructs chest and epigastrium, preventing normal movement of Qi|
|Cold feeling in epigastrium improved by warmth|
|HEAVY FEELING in head,||Damp prevents the clear Yang ascending to head|
|Heavy limbs, lethargy,
No taste or sweetish taste in mouth,
|Patient already excessively Damp|
Turbid secretions/excretions: white vaginal discharge, diarrhea
|Dampness tends to sink diarrhea downwards to the lower burner|
|stickiness of eyes and fluid filled skin eruptions.
May be retention or dribbling urine & edema
|Dampness impairs fluid of metabolism|
|Tongue: Pale with THICK STICKY WHITE COATING||Dampness|
|Pulse: SLIPPERY, slow||Dampness and Cold|
Pathology: Cold or Damp will predominate
- If Cold predominates, this pattern is commonly associated with the pattern of retention of fluid in Stomach due to Cold and with Deficient Spleen Yang.
- If Dampness predominates, it can be Internal or External.
External Dampness is usually acute and of more sudden onset. It can be caused by too much Cold or raw food & drink as well as by damp climatological factors. Internal Dampness gradually accumulates from Deficiency of Spleen Qi and Spleen Yang being unable to transform/transport Fluids.
(This is a Deficiency pattern turning into Excess).
Exposure to external Dampness (Cold/raw food/drink or climate, etc.) or from Deficient Spleen Qi or Deficient Spleen Yang.
- Resolve Dampness
|SP-9||Yin ling quan||Resolves Dampness from Lower Burner|
|SP-6||San Yin jiao||Resolves Dampness|
|REN-12||Zhong wan||Tonifies Spleen to resolve Dampness|
|SP-3||Tai bai||Resolves Dampness|
|ST-8||Tou wei||Resolves Dampness from head; particularly good for HA or heavy head from Dampness|
|Method:||Sedation or neutral (even) method|
Damp-Heat Invading the Spleen
Overlaps with the pattern Damp-Heat in Large Intestine or if bile flow is Obstructed, as Damp-Heat in Liver and Gallbladder.
- No Appetite
- Feeling of heaviness
- Stuffiness/distention of epigastrium & lower abdomen
- Thirst without desire to drink or desire to drink small sips
- Nausea, vomiting
- Abdominal pain
- Loose stool with offensive odor
- Burning sensation of anus
- Scanty, dark yellow urine
- Low grade fever
|Tongue: STICKY YELLOW COATING, maybe slightly red body|
|Pulse: SLIPPERY, RAPID|
- Subdivided into predominance of Damp or of Heat
- Damp predominating: no thirst or thirst without desire to drink not particularly rapid Pulse, not very red Tongue body.
- Heat predominating: thirst, rapid Pulse, red Tongue body.
- Subdivided into External Damp-Heat or Internal Damp-Heat
- External Damp-Heat; usually acute & of sudden onset: arises from exposure to hot, humid climate or from contaminated food.
- Internal Damp-Heat usual chronic, gradual onset; arises from excess consumption of greasy foods & alcohol etc. over long time.
- Subdivided into whether bile flow Obstructed or not
- Bile flow Obstructed: Signs are similar to Damp-Heat in Liv & GB i.e. jaundice, bitter taste in mouth. Tx as for the latter. (Common disease patterns would include hepatitis, cholecystitis & cirrhosis)
in general, Signs are of Dampness accumulating and obstructing the flow of Qi, e.g. Signs of heaviness, distention & scanty urination. Damp depresses Spleen function producing lack of Appetite & lethargy.
Heat Signs include low fever, thirst, (but without desire to drink much, because of presence of Dampness).
- Resolve Dampness, clear Heat
|Resolve Dampness and Damp-Heat from lower burner|
|LI-11||Quchi||Clears Heat, resolves Dampness|
|Method:||sedation, no moxa|