spleen patterns Flashcards
the 7 sp xu patterns are
Deficiency
1. Spleen Qi Deficiency
2. Spleen Qi Sinking
3. Spleen Not Controlling the Blood
4. Spleen Yang Deficiency
5. Spleen Yin Deficiency
Excess
6. Cold Dampness encumbering (“invading”) the Spleen
7. Damp-Heat invading encumbering (“invading”) the Spleen
fx of spleen
The Spleen is a granary organ 食廪之官 shí lǐn zhī guā, responsible for food and in charge of the supply of nutrition to the body
functions of the Spleen:
1. Governing Transformation and Transportation of food and fluids (T&T)
2. Controls the muscles (M)
3. Controls Blood (B)
4. In charge of, “sending up” ^^^
T&T, M B SU
Longer list
● It controls the muscles and limbs
● Opens to the mouth, spreads over the tongue
● Favors dryness
● Dislikes dampness
● Its fluid is saliva
● Its season corresponds to late summer
● Its correlated emotions are pensiveness and worry
● Its associated climatic factor is dampness
● It controls the ascending and raising of Qi
● Its season is late summer
key symptoms of SP patterns
disruption of the Spleen’s function of Transformation and Transportation, or the Spleen’s inability to Control Blood.
four major clinical manifestations of Spleen fx disorder:
1. Poor appetite
2. Abdominal bloating and distention
3. Loose stools
4. Bleeding
ABBS
appetite, bloat, bleeding, loose stool
SP pattern causes
EXTERIOR
1. Invasion by exterior pathogenic cold or dampness
INTERIOR
2. Emotional strain: excessive thinking or worry (ruminating)
3. Improper diet or malnutrition, overconsumption of cold, raw or greasy foods; insufficient intake
4. Improper medical treatment: overuse of cold, heavy, greasy herbs; lack of proper treatment following severe illness
5. Chronic illness impairs Spleen functioning
6. Constitution, aging
Spleen Qi Deficiency
脾氣虛証
pí qì xū zhèng
Definition: failure of the Spleen’s transformation and transportation function
Clinical Manifestations: Sallow complexion, tiredness, lassitude, weak limbs, poor appetite, abdominal bloating and distention, loose stools, shortness of breath, aversion to speaking, low voice
Tongue: Pale tongue with teeth marks and a thin white coating
Pulse: Weak or soft
Etiology: constitutional deficiency, improper diet, physical overstrain, excessive emotional stress, including long-term worry or overthinking
🔑 Key Points: Poor appetite, abdominal bloating and distention, loose stools, combined with Qi deficiency signs and symptoms)
Spleen Qi Sinking Pattern
脾氣下陷
pí qì xià xiàng
Definition: prolapse of internal organs caused by severe Spleen Qi deficiency failing to support. This pattern is also called ‘middle qi sinking’ 中氣下陷 zhōng qì xià xiàn.
Clinical Manifestations: Poor appetite, abdominal bloating and distension with a sensation of
downbearing, chronic loose stools, possibly with a sagging sensation, listlessness, lassitude, low voice,
emaciation, sallow complexion, prolapse of internal organs such the uterus, stomach, kidney, or rectum.
Tongue: Pale
Pulse: Weak
Etiology: delayed/improper treatment worsening Spleen qi deficiency, Lung Qi Deficiency, Kidney Qi Deficiency
🔑 Key Points: Prolapsed organs or chronic diarrhea, loose stools, prolapse, plus qi deficiency signs and
symptoms.
Spleen not controlling Blood
脾不統血
pí bù tǒng xuè
Definition: bleeding due to Spleen Qi failing to control blood inside the vessels.
Clinical Manifestations:
All types of bleeding, incl. subcutaneous hemorrhage, gum
bleeding and hematochezia; preceded menstrual cycle, prolonged period, menorrhagia, and metrostaxis. Sallow or pale complexion, poor appetite, abdominal bloating and distention, loose stools
Tongue: Pale
Pulse: Thin weak
Etiology: Spleen Qi Deficiency:
● NOTE: Spleen not controlling the Blood is Deficient, vs Bleeding due to Excess– Heat in the Blood
🔑 Key Points:
Bleeding
plus
Spleen qi deficiency signs and symptoms
Spleen Yang Deficiency
脾阳虚証
pí yáng xū zhèng
Definition: failure of Spleen Yang to warm interior
Clinical Manifestations: Poor appetite, abdominal bloating and distention, loose stools (undigested food), dull and vague abdominal pain relieved by warmth and pressure, intolerance of cold, cold limbs, no desire to drink, edema, and scanty urine, copious clear vaginal discharge.
Tongue: Pale flabby tongue with teeth marks
Tongue coating: White and greasy
Pulse: Deep and slow
Precursors:
Spleen Qi deficiency often happens first, evolve from Lung Qi Deficiency
Spleen Yang Deficiency often lead to Phlegm and Damp more so than Spleen Qi Deficiency
🔑 Key Points: Poor appetite, loose stools, plus yang deficiency signs and symptoms
Tongue texture reflects …
the condition of the actual muscle and membranes of the tongue, which require nourishment from qi, blood and body fluids
ROUGH TONGUE TEXTURE arises when…
➢ arises when excessive pathogens invade the body and there is exuberant antipathogenic qi
➢ The battle between antipathogenic qi and pathogenic factors will be strong, causing the muscle fibers to bulge, which makes the striae rough and coarse
battle between pathogens and wei qi causes bulging
TENDER TONGUE means
TENDER TONGUE TEXTURE
➢ Mostly associated with deficiency
➢ If qi and blood are deficient, they are unable to fill up or nourish the tongue body, causing muscle fibers to become thin and atrophic; the surface of the tongue will appear tender
➢ If yang is deficient and unable to transform body fluids adequately, cold-damp can accumulate in the tongue, causing its tender appearance
damp, phlegm obstruct
blood, yin xu (tender and dry)
yang xu (tender and glossy)
Spleen Qi Deficiency vs.
Spleen Qi Sinking, Vs.
Spleen Not Controlling Blood vs. Spleen Yang Deficiency
common:
abdom. dist. worse after eat, poor app., loose stool, sallow complexion, weak limbs, dislike talk
sp qi xu:
emaciation, edema
sp qi sinking:
organ prolapse
sp yang xu:
vague abd pain relieved warmth and pressure, cold limbs, scanty urine, limb heaviness, edema, copious vag discharge
sp not controlling blood:
bleeding
Spleen Yin Deficiency
脾陰虛証
pí yīn xū zhèng
Definition: deficiency of Spleen Yin fluids causing deficiency fire to flare up
Clinical Manifestations: Emaciation and lack of strength, hunger but no desire to eat, abd. distension after eating, chapped lips and dry mouth, epigastric discomfort and pain, belching, reflux, five-center heat, night sweats, yellow urine, dry stools, constipation, hemorrhoids, may be abnormal bleeding ie hematochezia or hematemesis.
Tongue: Red tongue with a thin yellow or scanty coating
Pulse: Thin, rapid
Etiology
● long-term mental and physical overstrain w internal organ deficiency
● Malnutrition
● Febrile disease
🔑 Key Points: Poor appetite, abdominal bloating and distention after eating, chapped lips, plus yin
deficiency signs and symptoms
Cold Dampness Encumbering the Spleen
寒濕睏脾
hán shī kùn pí
Definition: cold-dampness accumulating in the MJ due to dysfunction of SP T&T function.
睏 kùn “encumbering” can also mean to besiege, assail or trap.
Clinical Manifestations: Epigastric and abdominal bloating and distention, poor appetite, bland but slimy taste in the mouth, diarrhea or loose stools, nausea, vomiting, heaviness of the entire body and head, jaundice with smoky yellow skin, copious clear vaginal discharge, edema with scanty urine.
Tongue: Pale flabby tongue with white greasy or white glossy coating
Pulse: Slow, moderate, or deep and thin pulse
Etiology: exterior dampness and improper diet
● once in the Spleen, it becomes an interior Dampness and an interior pattern
● NO simultaneous chills and fever
🔑 Key Points: Epigastric and abd bloating & distention, poor app, diarrhea, loose stools, nausea, vomiting, plus interior cold-dampness signs and symptoms
Cold Dampness Encumbering the Spleen
VS.
Spleen Yang Deficiency
common:
abd. cold pain, poor app., loose stool, copious vag discharge
Cold Dampness Encumbering the Spleen:
acute, short course
prefer warmth, dislike pressure
yin jaundice
t pale, flabby, white greasy tc
p deep, thready or slow
Spleen Yang Deficiency
gradual onset, long course
dull chronic abd pain
likes warmth AND pressure
t pale flabby, teeth marks, white glossy tc
p deep, slow, weak
