ZANG FU - SPLEEN

Spleen (TCM) - General Location

A pivotal Zang organ in Traditional Chinese Medicine (TCM), situated centrally in the middle burner, specifically located beneath the left side of the diaphragm.

Spleen (TCM) - Overall Importance

Considered foundational for overall health, it is indispensable for digestion, the assimilation of nutrients, and the intricate metabolism of fluids, profoundly influencing energy, vitality, and immunity.

Spleen's Primary Function

To 'govern transformation and transportation' (Yun hua) of ingested food and water into usable “post-natal” essences that are distributed throughout the body, to control the blood and maintain fluid balance in the Middle Burner.

Spleen's Transformation Role

It is responsible for digesting and transforming ingested food and water into 'pure essence' (Gu Qi and refined body fluids) so the body can utilize them.

Spleen (TCM) - "Middle Burner" Significance

The Spleen is the central component of the Middle Burner, governing the digestive process and acting as the pivotal mechanism for the ascent of clear Yang and descent of turbid Yin.

Spleen's Main Functions (Summary)

The Spleen's primary roles include governing transformation and transportation (Yun hua), controlling the blood, governing the muscles and the four limbs, and raising Qi.

Spleen's Function: Governing Transformation & Transportation (Yun Hua)

This is the Spleen's central function, involving the digestion and extraction of pure essences (Gu Qi and refined body fluids) from food and water, and their distribution throughout the body, while managing fluid metabolism.

Spleen's Transformation Role - Food

It is responsible for digesting and transforming ingested food into 'pure essence' (Gu Qi) so the body can utilize it for energy and substance.

Spleen's Transformation Role - Water

It transforms ingested fluids into refined body fluids, which are then distributed to moisten the body and help move out turbid fluids.

Gu Qi

Product of Spleen Transformation - Gu Qi (Grain Qi) is the pure essence derived from food and water by the Spleen, forming the basis for the production of Post-Heaven Qi and Blood.

Product of Spleen Transformation - Refined Body Fluids

These are the pure fluids produced by the Spleen's transformation, transported upwards to the Lungs and then distributed throughout the body to moisten and nourish.

Spleen's Transportation of Essences - Direction

The Spleen transports Gu Qi and refined body fluids upwards to the Lungs (for Qi) and Heart (for Blood), ensuring systemic nourishment.

Spleen's Transportation of Fluids - Role

The Spleen plays a crucial role in the metabolism of body fluids, ensuring proper distribution and preventing stagnation or accumulation of dampness.

Spleen's Transportation of Fluids - Dampness Prevention

By properly transforming and transporting fluids, the Spleen prevents the accumulation of dampness, phlegm, and edema within the body.

Spleen's Aid to Stomach - Digestion

While the Stomach 'rots and ripens' food, the Spleen extracts the nutrient essence and transports it, thus providing the driving force for digestion.

Spleen's Function: Controlling Blood

The Spleen's Qi has the vital function to keep blood circulating within the blood vessels, preventing extravasation, hemorrhage, and contributing to its production.

Spleen Controls Blood - Holding in Vessels

Spleen Qi acts as an upward, containing force that prevents blood from leaking out of the vessels and maintains its proper circulation. 

A strong Spleen Qi is essential to prevent various forms of bleeding, such as epistaxis, menorrhagia, or easy bruising.

Spleen Controls Blood - Production Role

The Spleen is the primary source of Post-Heaven Essence (Gu Qi), which is then harmonized with Kidney essence and Lung Qi to form Blood.

Spleen Controls Blood - Menstruation

A strong Spleen ensures proper blood containment during the menstrual cycle, preventing excessive, prolonged, or early bleeding.

Spleen's Function: Governing Muscles & Four Limbs

The Spleen is responsible for nourishing the muscles and producing Qi that energizes the four limbs, thereby influencing physical strength, tone, and vitality.

Spleen Governs Muscles & Four Limbs - Atrophy/Flaccidity

Spleen Qi deficiency leads to lack of nourishment, manifesting as muscle weakness, flaccidity, atrophy, and overall fatigue in the limbs.

Spleen's Function: Raising Qi (Upright Qi)

This function refers to the Spleen's ability to lift the internal organs in their proper positions and ensure the ascent of clear Yang Qi to the head, contributing to mental clarity and vitality.

Spleen Raises Qi - Preventing Organ Prolapse

Deficiency in the Spleen's raising Qi function can lead to prolapse of organs like the uterus, rectum, stomach, or bladder, and can also cause hemorrhoids.

Spleen Raises Qi - Clear Yang Ascent

Spleen Qi transports clear Yang upwards to the head, contributing to mental clarity, good eyesight, sharp hearing, and overall vitality.

Spleen's Basic Nature (Summary)

The Spleen inherently prefers dryness and dislikes dampness. It flourishes with warmth but is easily injured by cold. It governs the ascent of clear Yang and is highly susceptible to emotional imbalances (worry, pensiveness), improper diet, overwork, and external dampness.

Spleen - Opens to __?

The Spleen opens to the mouth, affecting taste perception, appetite, and the condition of the lips.

The mouth, specifically the sense of taste and the ability to chew and swallow, is associated with the Spleen's function.

Spleen - Manifests in __?

The Spleen's essence manifests in the lips, impacting their color, moisture, and plumpness, which are valuable indicators of Spleen health.

Healthy lips should be rosy and moist. Pale lips indicate Spleen Qi or Blood deficiency; dry, cracked lips may indicate Spleen Yin deficiency or heat.

A healthy Spleen will manifest in a vibrant, slightly yellowish-red or clear complexion. A deficient Spleen may show a pale, sallow, or dull yellow complexion.

Spleen's Associated Body Fluid

The Spleen is associated with saliva, specifically the thicker, clear saliva involved in the digestive process. Deficiency may cause excessive clear saliva; heat, dry mouth.

Spleen's Associated Tissue

The Spleen governs the muscles and flesh of the body, providing them with nourishment, tone, and firmness.

Spleen's External Manifestation - Edema

Impaired fluid transformation by the Spleen can lead to the accumulation of fluids, causing edema (swelling), particularly in the limbs or abdomen.

Spleen's External Manifestation - Abdominal Distension

Spleen dysfunction in transformation and transportation often leads to bloating and distension, especially after eating.

Spleen's Element

Earth. The Spleen embodies the qualities of stability, nourishment, growth, and transformation, rooting the body in its physical form.

Spleen's Season

Late Summer, encompassing the last 18 days of each seasonal transition. It represents the time of harvest, abundance, and preparing for the next season.

Spleen's Climate - dislikes __?

Dampness. The Spleen is highly susceptible to dampness, which can impair its functions. It 'dislikes dampness and likes dryness'.

Spleen's Direction

Center. This emphasizes its pivotal and central role in governing the middle burner and connecting all other organs.

Spleen's Color

Yellow, reflecting its Earth element association, a healthy complexion, and balanced digestive function.

Spleen's Sound

Singing or humming. An imbalance in the Spleen may manifest as excessive or inappropriate singing or sighing.

Spleen's Taste - Beneficial

Sweet. A small amount of natural sweet taste (e.g., from grains) strengthens the Spleen, aiding its transformation and transportation functions.

Spleen's Taste - Harmful (Excess)

Excessive consumption of sweet, greasy, or processed foods strongly compromises the Spleen, leading to dampness and impaired function.

Spleen's Paired Fu Organ

The Stomach. They form an interdependent pair, with the Stomach 'rotting and ripening' food, and the Spleen transforming and transporting the essences.

Spleen's Government Role

The Spleen is often referred to as the "Official of Granaries and Transport," underscoring its role in processing food and distributing nutrients throughout the body.

Common Etiologies of Spleen Diseases

1. Dietary Factors: Irregular eating; excessive cold, raw, greasy, sweet, or spicy foods; overeating; or insufficient food.

2. Emotional Factors: Chronic worry, pensiveness, overthinking, or anxiety.

3. Overwork or Lack of Rest: Mental or physical exhaustion depletes Spleen Qi.

4. External Dampness: Living in damp environments or prolonged exposure to damp weather.

5. Long-term Illness: Chronic diseases can eventually weaken Spleen function.

6. Constitutional Weakness: Inherited weakness of the Spleen.

Key Signs of Spleen Imbalance

1. Digestive Issues: Poor appetite, abdominal distension (especially after eating), loose stools, diarrhea, undigested food in stool.

2. Fatigue: Chronic tiredness, lack of energy, lethargy.

3. Dampness Symptoms: Edema, heavy sensation in limbs, feeling sluggish, clear vaginal discharge, phlegm.

4. Muscle Weakness: Flaccid muscles, muscle atrophy, weakness of the four limbs.

5. Complexion Changes: Pale, sallow, or dull yellowish complexion, pale lips.

6. Mental Symptoms: Foggy thinking, excessive worry or pensiveness, poor concentration.

Spleen-Heart Relationship - General

The Spleen's production of Gu Qi is vital for Blood formation, which the Heart depends on to circulate and house the Shen (Spirit).

Spleen-Heart Relationship - Blood Generation

The Spleen generates Gu Qi, a precursor to Blood. If Spleen Qi is deficient, Blood generation can be impaired, leading to Heart Blood deficiency and affecting the Shen.

Spleen-Heart Relationship - Nourishing Shen

Spleen's role in producing abundant Blood and Qi directly nourishes the Heart and ensures a calm and clear Shen (mind/spirit).

Spleen-Lung Relationship - General

The Spleen sends Gu Qi upwards to the Lungs, where it combines with air to form Zong Qi (Gathering Qi) and contribute to respiration and overall Qi.

Spleen-Lung Relationship - Qi Production

The Spleen's Post-Heaven Qi production is fundamental for the Lungs to form Zong Qi. Weak Spleen can lead to Lung Qi deficiency.

Spleen-Lung Relationship - Fluid Metabolism

The Spleen transforms and transports fluids, preventing dampness. The Lungs regulate water passages. Spleen dysfunction can lead to dampness accumulating in the Lungs (e.g., phlegm).

Spleen-Kidney Relationship - General

The Spleen and Kidneys are interdependent. Kidney Yang warms the Spleen to aid digestion, while the Spleen provides Post-Heaven Essence to nourish Kidney Essence.

Spleen-Kidney Relationship - Pre-natal & Post-natal Qi

The Kidneys store Pre-Heaven Essence, which relies on the Spleen's Post-Heaven Essence for nourishment and replenishment, ensuring continuous life force.

Spleen-Kidney Relationship - Yuan Qi Support

Spleen-generated Post-Heaven Qi supplements and fortifies the Yuan Qi (Original Qi) rooted in the Kidneys.

Spleen-Kidney Relationship - Yang Warming Digestion

Kidney Yang provides the essential warmth for the Spleen to effectively digest food and transform fluids. Kidney Yang deficiency often leads to Spleen Yang deficiency.

Spleen-Liver Relationship - General

The Liver stores Blood and regulates Qi flow, while the Spleen produces Blood and manages digestion. Their harmonious relationship is vital for Blood, Qi, and digestion.

Spleen-Liver Relationship - Qi Regulation

Smooth flow of Liver Qi is essential for the Spleen's smooth function. Liver Qi stagnation can impede Spleen's transformation and transportation, causing digestive issues.

Spleen-Liver Relationship - Dampness & Stagnation

Liver Qi stagnation can lead to dampness accumulation (as Liver's Qi affects Spleen's function) or Spleen attacking Liver (over-controlling Earth element).

Spleen's Spirit/Affect Mind and Emotions

1. Spirit (Yi): The Spleen houses the 'Yi' (Intellect), influencing our capacity for thought, intention, memory, study, and concentration.

2. Associated Emotions: Its primary associated emotions are worry, pensiveness, and overthinking. Excessive or prolonged indulgence in these emotions can directly impair Spleen function, leading to digestive issues and fatigue.

Spleen Qi Deficiency

1. Pathomechanism: Insufficient Spleen Qi to adequately transform and transport food, water, and essences, leading to impaired digestion and energy production.

2. Key Signs:

   • Fatigue, lethargy, especially after eating

   • Poor appetite or aversion to food

   • Abdominal distension after eating

   • Loose stools, possibly with undigested food

   • Weakness of the limbs

3. Other Possible Signs:

   • Pale complexion

   • Lightheadedness, mental fogginess

   • Mild edema

   • Breathlessness, weak voice

4. Tongue: Pale, swollen, with teeth marks, thin white coat

5. Pulse: Weak, thin (thready), or empty (deficient)

Spleen Yang Deficiency

1. Pathomechanism: Spleen Qi Deficiency compounded by a lack of warmth (Yang), leading to a cold, sluggish Spleen that cannot properly warm and activate transformation and transportation. Often involves Kidney Yang deficiency.

2. Key Signs:

   • Spleen Qi Deficiency signs (fatigue, poor appetite, abdominal distension)

   • Frank diarrhea with undigested food, constant loose stools

   • Cold limbs, especially the hands and feet

   • Abdominal pain relieved by warmth and pressure

   • Edema (pitting), especially in the legs

3. Other Possible Signs:

   • Cold sensation in the abdomen

   • Deep fatigue

   • Clear, profuse urine

   • Weight gain due to dampness

4. Tongue: Pale, very swollen, wet, with teeth marks, white slippery coat

5. Pulse: Deep, slow, weak

Spleen Not Controlling Blood

1. Pathomechanism: Spleen Qi is severely deficient and loses its ability to hold blood within the vessels, leading to various forms of hemorrhage.

2. Key Signs:

   • Chronic-type bleeding (e.g., menorrhagia, prolonged menstrual periods, heavy periods)

   • Epistaxis (nosebleeds) or gum bleeding

   • Subcutaneous spontaneous bruising

   • Hematochezia (blood in stool) or hematuria (blood in urine)

   • Accompanying Spleen Qi Deficiency signs (fatigue, pale complexion, poor appetite)

3. Other Possible Signs:

   • Dizziness

   • Palpitations

   • Insomnia (due to Blood deficiency consequent to hemorrhage)

4. Tongue: Pale, possibly swollen, with a thin white coat

5. Pulse: Weak, thin, slightly rapid (if blood loss is acute)

Spleen Qi Sinking

1. Pathomechanism: Severe Spleen Qi Deficiency leads to a loss of the Spleen's 'raising' function, causing organs to drop from their normal positions.

2. Key Signs:

   • Feeling of bearing down or heaviness in the abdomen

   • Prolapse of organs (e.g., uterus, rectum, stomach, bladder)

   • Hemorrhoids

   • Accompanying Spleen Qi Deficiency signs (fatigue, poor appetite, loose stools)

   • Chronic low back pain

3. Other Possible Signs:

   • Urinary incontinence

   • Frequent urination

   • Aggravation of symptoms upon standing or exertion

4. Tongue: Pale, swollen with teeth marks, often depressed in the center

5. Pulse: Weak, especially in the right guan (middle) position, often sunken or empty

Cold-Dampness Obstructing Spleen

1. Pathomechanism: Accumulation of cold and dampness (internally due to Spleen Yang deficiency or externally from exposure) obstructs the Spleen's transformation and transportation, leading to extreme sluggishness.

2. Key Signs:

   • Abdominal distension and fullness, worse after eating

   • Heavy sensation in the head and body

   • Loss of appetite, nausea, poor taste

   • Loose stools, watery diarrhea with mucus

3. Other Possible Signs:

   • Thirst but no desire to drink

   • Cold limbs, feeling of coldness in the body

   • Vaginal discharge (clear, copious)

   • Sticky phlegm

   • Feeling of oppression in the chest

4. Tongue: Pale, swollen, with a thick, white, greasy coat

5. Pulse: Slow, soggy (soft), or slippery

Damp-Heat Obstructing Spleen

1. Pathomechanism: Dampness accumulation combined with internal heat, often affecting both Spleen and Stomach, impairing their digestive functions and leading to a mixture of damp and heat symptoms.

2. Key Signs:

   • Abdominal distension and fullness

   • Nausea, vomiting, aversion to greasy food

   • Heavy sensation in the head and body

   • Yellowish complexion or yellowish urine/sclera (minor jaundice)

   • Fever (low grade or intermittent), sticky sweat

3. Other Possible Signs:

   • Diarrhea with foul-smelling stools, possibly burning anus

   • Thirst with little desire to drink or wanting cold drinks

   • Vaginal discharge (yellow, sticky, foul-smelling)

   • Dizziness, mental fogginess

4. Tongue: Red body, thick, yellow, greasy coat

5. Pulse: Slippery, rapid (could also be soft/soggy with rapid)

Spleen Yin Deficiency

1. Pathomechanism: Insufficient Spleen Yin (fluids and moisture) to nourish the Spleen, leading to an empty heat condition and impaired digestive function. Often occurs alongside Stomach Yin deficiency.

2. Key Signs:

   • Dry mouth, lips, and throat, but little desire to drink

   • Poor appetite, possibly with desire for small sips of fluid

   • Abdominal dryness, possible constipation or dry stools

   • Slight abdominal pain or discomfort

   • Low-grade fever in the afternoon or evening

3. Other Possible Signs:

   • Thirst, but aversion to large quantity of fluids

   • Emaciation (wasting), dry skin

   • Weakness of limbs

   • Night sweats

4. Tongue: Red, dry, no coat or very little coating