Kai Chen Ph.D. in Chinese Medicine

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Chinese Medicine Spleen Disorders

In Chinese Medicine, spleen function mainly is controlling digestion system; the related organs are stomach, small intestine and large intestine.  The disorders often are digestive symptoms and signs, such as epigastria pain, vomiting, constipation, etc.     

1. Epigastria Pain

The frequent pain is over the epigastria region.

1.1 Etiologies and Pathogenesis 

Attack of the stomach by pathogenic factors

Invasion of the stomach by liver qi

Spleen and stomach deficiency

Diet disorder 

1.2 Differentiations and treatment

1.2.1 Liver qi attacking the stomach

Clinical manifestation: Epigastria fullness, distension and wandering pain or radiating hypochondriac region, the pain is worse after emotion, white fur, wiry pulse

Treatment principle:  Soothing the liver qi and pacifying the stomach to stop pain

Herb formula: Chahu Shu Gan San

1.2.2 Food Retention 

Clinic manifestation: Epigastria distension pain after overeating, thick greasy tongue fur and slippery pulse

Treatment principle:  Relieve food retention and pacifying the stomach to stop pain

Herb formula: Bao He Wan

1.2.3. Cold in the spleen and stomach

Clinic manifestation: Epigastria cold and dull pain aggravated by cold and alleviated by warm, or accompanied with yang deficiency symptoms 

Treatment principle: Warming up the middle-jiao, strengthening the spleen to eliminate cold and stop pain 

Herb formula: For yang qi deficiency: Huangqi Jian Zhong Tang

For excessive cold syndrome: Liang Fu Wan

1.2.4. Retention of heat in the stomach and liver

Clinic manifestation: Epigastria burning pain, irritability, dry mouth, bitter taste,  red tongue with yellow fur

Treatment principle: Clearing away the heat in the stomach and liver to stop pain 

Herb formula: Hua Gan Jian

1.2.5.  Blood stasis 

Clinic manifestation: Epigastria sharp and fixed pain, purple tongue

Treatment principle: Promoting blood and qi circulation to remover blood stasis for stopping pain 

Herb formula: Dan Shen Yin

1.2.6. Stomach yin deficiency

Clinic manifestation: Chronic epigastria dull and burning pain, red dry tongue, thin and rapid pulse  

Treatment principle: Nourishing stomach yin for stopping pain 

Herb formula: Yi Guan Jian

2. Dysphagia (Yege syndrome)

Ye is to swallow difficultly, often difficult to dry food; Ge is a more severe condition even unable to drink liquid.

2.1 Etiologies and Pathogenesis

Pathogenic factors of cold and heat invading

Emotional changes

Diet

Constitution deficiency

2.2 Differentiations and treatment

2.2.1. Blockage by phlegm and stagnant qi 

Clinical manifestation:  Difficulty in swallowing to dry food, full or dull pain in the chest and diaphragm, red tongue with greasy fur, taut and smooth pulse 

Treatment principle: Relieving stagnation, moisten dryness and resolving phlegm

Herb formula: Jie Ge San

2.2.2. Blockage by heat 

Clinical manifestation:  Difficulty and pain in swallowing, pain in the chest and diaphragm, emaciation, red tongue with yellow fur, rapid pulse 

Treatment principle: Nourishing yin and clearing heat 

Herb formula: Wu Zhi An Zhong Yin

2.2.3. Blockage by blood stasis 

Clinical manifestation:  Difficulty in swallowing, even water, more emaciation, purple tongue, deep and weak pulse 

Treatment principle: Tonifying qi and blood, removing blood stasis

Herb formula: Tong You Tang

2.2.4.  Qi and yang deficiency 

Clinical manifestation: Very difficulty in swallowing anything longtime , extremely emaciation, pale tongue, very deep and thin pulse 

Treatment principle: Tonifying qi and yang

Herb formula:  Du Shen Tang

3. Vomiting

3.1 Etiologies and Pathogenesis

Attack of the stomach by pathogenic factors

Improper diet

Emotional upsets

Spleen and stomach deficiency

3.2 Differentiations and Treatment

3.2.1. Exogenous pathogenic invasion into the stomach

Clinic manifestation: sudden vomiting, accompanied with exterior syndrome

Treatment principle:  Relieving exterior syndrome, regulating qi to stop vomiting

Herb formula:  Huo Xiang Zheng Qi San

3.2.2 Food Retention 

Clinic manifestation: Vomiting sour fluid or food, epigastria pain after overeating, thick greasy tongue fur 

Treatment principle:  Relieve food retention and pacifying the stomach to stop vomiting

Herb formula: Bao He Wan

3.2.3. Liver qi attacking the stomach

Clinic manifestation: Vomiting, epigastria fullness, distension and wandering pain or hypochondriac pain

Treatment principle:  Soothing the liver qi and pacifying the stomach to stop vomiting

Herb formula:  Ban Xia Hou Po Tang added Zuo Jin Wan

3.2.4. Deficiency in the spleen and stomach

Clinic manifestation: Nausea and vomiting after eating   accompanied with yang deficiency symptoms 

Treatment principle: Warming up the middle-jiao, strengthening the spleen to eliminate cold and stop vomiting 

Herb formula:  Li Zhong Wan

3.2.5.  Yin deficiency in the stomach

Clinic manifestation: repeat vomiting, irritability, dry mouth, bitter taste,  red  tongue with yellow thin fur or without fur

Treatment principle principle: Tonifying yin and clearing away  heat  to stop vomiting 

Herb formula: Mai Men Dong Tang

4. Hiccup (E-Ni)

Hiccup is caused by the adverse of stomach qi marked by  an involuntary short, quick sound in the throat.

4.1 Etiologies and Pathogenesis

Improper diet

Emotional upsets

Deficiency of spleen and kidney yang

Deficiency of stomach yin

4.2 Differentiations and Treatment

4.2.1. Excess

4.2.1.1 Retention of cold in the stomach

Clinical manifestation: Hiccup with deep and slow sounds, alleviated by warmth and aggravated by cold, white tongue fur and slow pulse

Treatment principle: Warming the middle-jiao, eliminating cold to check hiccup

Herb formula: Ding Xiang San

4.2.1.2 Heat in the stomach

Clinical manifestation: Hiccup with loud and strong sounds, thirst, foul breath, red tongue yellow fur and rapid pulse

Treatment principle: Clearing heat to check hiccup

Herb formula: Zhu Ye Shi Gao Tang

4.2.1.3 Qi Stagnation

Clinical manifestation: Hiccup alleviated or aggravated by emotion changes, white tongue fur and taut pulse

Treatment principle: Regulating qi 

Herb formula: Wu Mo Yin Zi

4.2.2. Deficiency

4.2.2.1 Spleen and stomach yang deficiency

Clinical manifestation: Hiccup with weak sounds, alleviated by warmth and aggravated by cold, pale complexion, pale tongue with white fur and deep and weak pulse

Treatment principle: Warming the middle-jiao, tonifying spleen and stomach to check hiccup

Herb formula: Li Zhong Wan

4.2.2.2 Yin deficiency of the stomach

Clinical manifestation: Hiccup with weak sounds, and yin- symptoms, red thin tongue with thin yellow fur and thin rapid pulse

Treatment principle: Nourishing stomach yin to check hiccup

Herb formula: Yi Wei San

5. Diarrhea

Diarrhea is marked frequent and watery bowel movement

5.1 Etiologies and Pathogenesis

Pathogenic factors invading

Emotional changes

Diet

Spleen and stomach deficiency

Kidney Yang-deficiency

5.2 Differentiations and treatment

5.2.1. Acute diarrhea 

5.2.1.1 Cold-dampness or wind-cold

Clinical manifestation: Diarrhea with clear and diluted stool or watery stool in severe cases, abdominal pain, borborygums, white tongue fur and weak pulse

Treatment principle: Dispersing cold and resolving the turbid qi to stop diarrhea

Herb formula: Huo Xiang Zhan Qi San

5.2.1.2 Summer-heat

Clinical manifestation: Rapid or intermittent diarrhea with foul stool, abdominal pain, borborygums, yellow greasy tongue fur and rapid pulse

Treatment principle: Dispersing heat-damp and resolving the turbid qi to stop diarrhea

Herb formula: Ge Geng Qin Lian Tang

5.2.1.3 Retention of food

Clinical manifestation: Diarrhea after overeating, very foul and dirty stool, abdominal pain and relieved by diarrhea, borborygums, yellow and thick tongue fur and rapid pulse

Treatment principle: Dispersing retention of food and resolving the turbid qi to stop diarrhea

Herb formula: Bao He Wan

5.2.2. Chronic diarrhea

5.2.2.1 Invasion of the spleen by liver qi

Clinical manifestation: Diarrhea with emotion change, before diarrhea very abdominal pain, borborygums, white tongue fur and weak and taut pulse

Treatment principle: soothing liver qi and tonifying spleen qi to stop diarrhea

Herb formula: Tong Xie Yao Fang

5.2.2.2 Spleen and stomach deficiency

Clinical manifestation: Chronic diarrhea, abdominal pain, borborygums, white tongue fur and weak pulse with spleen qi- 

Treatment principle: tonifying spleen qi to stop diarrhea

Herb formula: Shen Ling Bai Zhu San

5.2.2.3 Kidney yang deficiency

Clinical manifestation: Chronic diarrhea in the early morning with abdominal pain, borborygums, and white tongue fur and weak and deep pulse

Treatment principle: Tonifying kidney yang to stop diarrhea

Herb formula: Si Sen Wan

6. Abdominal Pain

The frequent pain is over the abdominal region.

6.1 Etiologies and Pathogenesis

Attacked by pathogenic factors

Emotion

Diet disorder 

Yang deficiency

6.2 Differentiations and treatment

6.2.1. Cold attacking 

Clinic manifestation: Abdominal cold and dull pain aggravated by cold and alleviated by warm, white fur and tense pulse 

Treatment principle: Warming up the middle-jiao  

Herb formula: Liang Fu Wan added Zheng Qi Tian Xiang San

6.2.2. Retention of heat-damp

Clinic manifestation: Hot pain, irritability, dry mouth, bitter taste, red tongue with yellow greasy fur

Treatment principle: Clearing away the heat o stop pain 

Herb formula: Da Cheng Qi Tang

6.2.3. Yang deficiency

Clinic manifestation: Cold pain with yang- symptoms, pale complexion, pale tongue and deep thin pulse

Treatment principle: Tonifying yang  

Herb formula: Xiao Jian Zhong Tang

6.2.4. Food Retention 

Clinic manifestation:  Pain after overeating, thick greasy tongue fur 

Treatment principle:  Relieve food retention and pacifying the stomach to stop pain

Herb formula: Bao He Wan or Zhishi Dou Zhi Wan

6.2.5.  Blood stasis and qi deficiency 

Clinic manifestation: Blood stasis: sharp and fixed pain, purple tongue

Qi stagnation: Distension and wandering pain 

Treatment principle: Promoting qi and blood circulation to remover blood stasis for stopping pain 

Herb formula: Xiao Yao San or Shao Fu Zhu Yu Tang

7. Constipation

It is difficult to pass stools.

7.1 Etiologies and Pathogenesis

Diet and strong constitution

Emotional changes

Qi-blood deficiency

Yang deficiency

7.2. Differentiations and treatment

7.2.1. Excess heat 

Clinical manifestation: Constipation and excessive constitution, red tongue with yellow dry fur, smooth and rapid pulse

Treatment principle: Clearing away heat and moistening intestine

Herb formula: Ma Zi Ren Wan

7.2.2. Qi stagnation

Clinical manifestation: Constipation and fullness in the abdomen, white fur, and taut pulse

Treatment principle: Promoting qi circulation and moistening intestine

Herb formula: Liu Mo Zi Tang

7.2.3. Deficiency 

7.2.3.1 Qi deficiency

Clinical manifestation: Chronic constipation with qi- constitution, pale tongue with white fur, weak pulse

Treatment principle: Tonifying qi and moistening intestine

Herb formula: Huang Qi Tang

7.2.3.2 Blood deficiency

Clinical manifestation: Chronic constipation and blood- constitution, pale tongue with white fur, thin and deep pulse

Treatment principle: Nourishing blood and moistening intestine

Herb formula: Run Chang Wan

7.2.4. Cold type

Clinical manifestation: Constipation and yang- constitution, pale tongue with white fur, deep, weak and slow pulse

Treatment principle: Warming yang to promote stools

Herb formula: Ji Chuan Jian

Copyright by Kai Chen Ph.D. in Chinese Medicine