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ZANG FU - SPLEEN

Chapter 3: Spleen Disease Patterns

Physiological Characteristics and Functions of the Spleen

  • Location: Spleen is a sickle-shaped organ located in the middle burner under the left side of the diaphragm.

  • Channel: Begins at medial tip of the big toe, ascends leg, reaches abdomen, diaphragm, chest, up to the esophagus, terminating under the tongue.

  • Connections: Interior-exterior connection with the Stomach; both are essential digestive organs generating qi and blood.

  • Functions:

    • Governs Transformation and Transportation: Transforms food into essence; assimilates and distributes nutrients.

    • Controls Blood: Maintains blood circulation within vessels.

    • Ascend Function: Sends clear essence to the Lung; stabilizes internal organs.

  • Characteristics: Granary organ, controls muscles, manifests on lips, opens to the mouth, prefers dryness, and dislikes dampness.

  • Associated Properties:

    • Fluid: Saliva

    • Season: Late summer

    • Emotion: Worry and pensiveness

Functions of the Spleen

  1. Transformation and Transportation:

    • Transforms food and drink into essence and distributes throughout the body.

    • Involves both food/drink and water-dampness transformation.

  2. Blood Control:

    • Regulates and circulates blood effectively within vessels.

  3. Supportive Role:

    • Directs vital substances upwards to the Lung; secures internal organs in position.

Summary of Spleen Functions (Chart 3.1)

  • Governs transformation, controls blood, oversees muscular function, opens to mouth.

Common Etiological Factors in Spleen Disorders

  • Primary Causes:

    • Exopathogenic cold or dampness invasion.

    • Improper diet (overconsumption of raw/cold foods).

    • Emotional stress leading to excessive worry.

    • Chronic illness or aging.

Clinical Manifestations of Spleen Disorders

  1. Poor Appetite:

    • Definition: Loss of desire to eat; aversion to food.

    • Characteristics: Due to chronic illness and bloating.

    • Etiological Mechanisms: Slowed stomach decomposition; Spleen's ascending function compromised.

  2. Loose Stools:

    • Definition: Increased frequency of defecation with dilute or watery stools.

    • Characteristics: Often contains undigested food; stool may be muddy/watery.

    • Etiology: Excess fluid/dampness accumulation, increased intestinal peristalsis.

  3. Bloating and Distention:

    • Definition: Sensation of fullness in the abdomen.

    • Characteristics: Commonly worsens after greasy or cold food consumption.

    • Etiological Mechanism: Factors causing qi stagnation in abdominal region.

  4. Bleeding:

    • Definition: Loss of blood from body; chronic and subcutaneous bleeding.

    • Etiology: Spleen's failure to control blood, caused by qi deficiency.

Summary of Symptoms (Chart 3.2 - 3.5)

  • Abdominal pain, emaciation, fatigue, phlegm, edema, and abnormal tastes are associated signs related to Spleen disorders.

Common Patterns in Spleen Disease

  • Seven commonly seen patterns: Spleen Qi Deficiency, Spleen Qi Sinking, Spleen Yang Deficiency, Spleen Not Controlling Blood, Cold-Dampness, Damp-Heat.

  • Classification:

    • Deficiency Patterns: Spleen Qi Deficiency, Qi Sinking, Yang Deficiency.

    • Excess Patterns: Cold-Damp, Damp-Heat.

Detailed Common Pattern Descriptions

  1. Spleen Qi Deficiency:

    • Symptoms: Sallow complexion, tiredness, weak limbs, poor appetite, abdominal bloating, shortness of breath, pale tongue.

    • Etiology: Constitutional deficiency, emotional stress, aging.

  2. Spleen Qi Sinking:

    • Symptoms: Prolapse of organs; chronic loose stools; listlessness.

    • Etiology: Severe qi deficiency leads to failure of supportive function.

  3. Spleen Not Controlling Blood:

    • Symptoms: Various bleeding types and signs of qi deficiency.

    • Etiology: Spleen qi deficiency leading to inability to contain blood.

  4. Spleen Yang Deficiency:

    • Symptoms: Cold extremities, dull abdominal pain relieved by warmth, poor appetite.

    • Etiology: Chronic illness, overconsumption of cold foods/herbs.

  5. Spleen Yin Deficiency:

    • Symptoms: Hunger with no food desire, dry mouth, yellow urine.

    • Etiology: Long-term overstrain, malnutrition.

  6. Cold-Dampness Encumbering the Spleen:

    • Symptoms: Abdominal bloating, nausea, vomiting, preference for warmth.

    • Etiology: Cold dampness invasion, improper diet.

  7. Damp-Heat Encumbering the Spleen:

    • Symptoms: Presence of damp-heat signs, sticky foul-smelling stool, jaundice.

    • Etiology: Exogenous damp-heat invasion or internal generation due to poor diet.

Summary of Clinical Manifestations and Treatment Context

  • Key manifestations include poor appetite, abdominal bloating, bleeding, emaciation, edema, etc.

  • Clinical differentiation is vital for treatment strategies, which can include nourishing qi, regulating blood, tonifying yang, or clearing damp-heat depending on the pattern identified.

Treatment Strategies and Herbal Formulas (Chart 3.xx)

  • Spleen Qi Deficiency: Si Jun Zi Tang

  • Spleen Qi Sinking: Bu Zhong Yi Qi Tang

  • Spleen Not Controlling Blood: Gui Pi Tang

  • Spleen Yang Deficiency: Li Zhong Wan

  • Cold-Dampness: Huo Xiang Zheng Qi San

  • Damp-Heat: Lian Pu Yin

Conclusion: Understanding the Spleen's functions, imbalances, and related clinical manifestations forms the foundation for diagnosis and treatment within Traditional Chinese Medicine (TCM).