Spleen Patterns

Question 1

What are the main functions of the Spleen?

Answer 1

Governs transformation and transportation
Control ascending of qi
Control blood
Control muscles and the four limbs
Opens to the mouth and lips
Fluid is saliva
Houses ideation (yi)
Affected by pensiveness and worry

Question 2

What is the general aetiology of Spleen patterns?

Answer 2

EPFs - the spleen is particularly vulnerable to damp
Emotional strain - pensiveness, worry
Diet - the spleen prefers warm foods

Question 3

What are common Spleen Channel Symptoms?

Answer 3

Stiffening of the base of tongue
Heaviness in the body (damp)
Vomiting
Abdominal distension
Epigastric pain
Loose stools
Urinary difficulty
Pain and swelling along inner aspect of thigh, knees, and lower leg, to the big toe.

Question 4

What is the pathway of the Spleen Divergent Channel?

What are some of the pathologies that occur here?

Answer 4

Separates at the thigh, enters the abdomen, connects with the Stomach, Spleen, Heart, and emerges at the tongue.

Pathology:
Heart involvement: palpitations, chest oppression (ties with “Spleen not controlling Blood” → affecting Heart Xue).
Tongue connection: difficulty in speech, stiff/swollen tongue, mouth ulcers.
Useful in explaining mental-emotional aspects of Spleen Qi/Xue Xu (poor memory, worry, obsessive thought).
Damp/Phlegm lodging in chest and Heart → mental confusion, heaviness.

Question 5

What is the pathway of the Spleen Sinew Channel?

What are some of the pathologies that occur here?

Answer 5

Originates at the big toe, ascends the medial leg and thigh, binds at the external genitalia, umbilicus, ribs, and spine.

Pathology:
Musculoskeletal: pain, contraction, or stiffness along medial thigh/leg, pulling at the groin, genitals, or ribs.
Cold-Damp invasion: heaviness, weakness of medial legs, difficulty standing.
Reproductive/gynaecological issues: because it binds at genitals → hernia, pain/swelling in genitals, menstrual pain.
Spinal/abdominal tension from binding at lumbar spine and ribs.

Question 6

What is the pathway of the Spleen Luo-connecting Channel?

What are some of the pathologies that occur here?

Answer 6

Starts at SP-4, connects with the Stomach channel and intestines.

Pathology/conditions:
Excess: colic abdominal pain, vomiting, diarrhoea.
Deficiency: abdominal distention.
Related to Spleen Qi Xu and Cold-Damp/Damp-Heat (digestive upset, bloating, diarrhoea).
Can manifest as stomach and chest fullness, poor digestion, or abdominal masses.

Question 7

What are the treatment principles for:
1.Spleen qi deficiency
2. Spleen yang deficiency
3. Spleen failing to control blood
4. Sunken spleen qi
5. Spleen deficiency with dampness encumbrance
6. Spleen deficiency with water flood
7. Cold-dampness encumbering the spleen
8. Dampness-heat in the spleen

Answer 7

1. Fortify the spleen and replenish qi
2. Fortify the spleen and support yang
3. Tonify spleen qi and yang, stop bleeding
4. Raise the middle jiao qi
5. Fortify the spleen and drain dampness
   6.Warm the spleen and induce diuresis
   7.Dissipate cold and dispel dampness
6. Clear heat and eliminate dampness

Question 8

What are the shared symptoms b/w Spleen qi deficiency & Spleen yang deficiency?

Answer 8

• Lassitude - state of weariness/lack of energy, weakness of limbs (because the spleen is responsible for transporting Gu Qi to the 4 limbs)
• desire to lie down
• pale complexion
• Poor appetite, Loose stools or diarrhoea, Abdominal distention (impairment of spleens T&T function)

Question 9

What are the differentiating S&S of Spleen Qi Xu?

Answer 9

Fatigue
obesity (long-term spleen Xu)
Indigestion
Tongue: Pale
Pulse: Empty, weak
- tiredness & loose stool is enough to diagnose

Question 10

What are the variations of Spleen Qi Xu?

Answer 10

further stage - spleen-yang Xu
- spleen-qi sinking
- spleen not holding blood
- spleen-blood Xu

Question 11

6 acupuncture points to tonify spleen qi?

Answer 11

CV12 - tonifies spleen-qi
ST36
SP3 - yuan source point
SP6 - when sued bilaterally with ST36 and moxa on needles is extremely effective tonification of spleen & gives pt more energy almost immediately
BL20 & BL21

Question 12

What are the differentiating S&S of Spleen Yang Xu from Spleen Qi Xu?

Answer 12

Cold limbs
Coldness and pain in abdomen
Emaciation
Oedema

Tongue: Pale, swollen and wet
Pulse: Deep, weak, slow
- tiredness & loose stool PLUS feeling cold is enough to diagnose
- exact same aetiology as spleen-qi Xu, only difference is exposure to cold/damp environment

Question 13

9 acupuncture points to tonify and warm spleen-yang?

Answer 13

Same as for spleen-qi Xu - CV12, ST36, SP3, SP6, BL20 & BL21
PLUS
SP9 - resolves dampness in lower burner
CV9, ST28, BL22 - all stimulate Spleen to T&T, and resolve oedema

Question 14

What is the shared symptoms b/w Spleen failing to control blood & Sunken spleen qi?

Answer 14

Lassitude
Shortness of breath
Reluctance to speak

Question 15

What are 8 differentiating S&S of Spleen failing to control blood?

think Xu spleen Qi being unable to hold blood in vessels & is Xu in nature

Answer 15

Various chronic bleeding e.g. purpura
Flooding and spotting in women
Sallow complexion
Anorexia
Loose bowels
blood spots under skin
blood in urine/stools
Lack of strength

Tongue: pale
Pulse: Weak/fine

• fine pulse, pale tongue and bleeding are enough to diagnose

Question 16

9 acupuncture points to tonify spleen-qi and stop bleeding?

Answer 16

Same as spleen-qi Xu - CV12, ST36, SP3, SP6, BL20 & BL21
PLUS
SP10 - strengthens spleen function of holding blood & returns blood to BV
BL17 - tonifies blood & stops bleeding
SP1 - with moxa -> strengthens spleen function of holding blood & stops uterine bleeding (only applicable when bleeding is from spleen-qi Xu)
SP4 - stops bleeding related to spleen

Question 17

What are the differentiating S&S of Sunken spleen qi?

Answer 17

Sensation of epigastric bearing down especially after meals
Urgency of defecation with sensation of bearing down of the anus
Rectal or uterine prolapse
tendency to obesity
frequent & urgency of urination
may cause excessive menstrual bleeding

Tongue: pale with white coat
Pulse: Relaxed and weak

• bearing-down sensation and weak pulse is enough to diagnose
• people who in addition to spleen qi xu aetiology, need to stand for long hours a day

Question 18

9 acupuncture points to tonify Spleen-qi and raise qi?

Answer 18

Same as Spleen qi Xu -CV12, ST36, SP3, SP6, BL20 & BL21
PLUS
GV20 - raises Qi -> good when using moxa
CV6 - tonifies and raises Qi -> used in all prolapses
ST21 - tonifies stomach
GV1 - prolapse of anus

Question 19

What is the shared symptoms b/w Spleen deficiency with dampness encumbrance & Spleen deficiency with water flood?

Answer 19

Lassitude
Abdominal distension
Loose stools or diarrhoea

Question 20

What are 4 differentiating S&S of Spleen deficiency with dampness encumbrance?

Answer 20

Poor appetite
Borborygmi
Nausea
Thirst with no desire to drink

Tongue: Dense and slippery coat
Pulse: Soggy or weak

Question 21

What are the differentiating S&S of Spleen deficiency with water flood?

Answer 21

Oedema of the face and limbs or with ascites
Associated with reduced food intake
Pale complexion
Tongue: Pale plump with white slippery coat
Pulse: Soggy or weak

Question 22

What are 5 shared symptoms b/w Cold-dampness encumbering the spleen & Dampness-heat in the spleen?

Answer 22

Abdominal distension - fullness of epigastrium and/or abdomen
poor appetite
feeling of heaviness
Nausea (due to damp preventing Stomach-Qi from descending)
loose stools

Question 23

What are the differentiating S&S of Cold-dampness encumbering the spleen?

Answer 23

Stickiness (sweetish taste) or tastelessness in mouth (because spleen opens into the mouth)
feeling of cold in epigastrium (improved with heat)
no thirst
oedema
dull-white complexion
excessive white vaginal discharge (because dampness is heavy & tends to infuse downwards)
Heavy sensation of Head as well as body (dampness prevents clear Yang from rising to head)

Tongue: Pale plump with white slimy coat
Pulse: Soggy relaxed

Question 24

What are 10 differentiating S&S of Dampness-heat in the spleen?

Answer 24

• epigastric and/or abdo pain
• thirst with no desire to drink
• feeling of heat
• scanty dark urine, stools have offensive odour, burning sensation of anus, bitter taste (due to heat)
• low-grade temp (constant during the day & due to steaming of Damp-heat)
• dull headache with feeling of heaviness
• yellow sclera of eyes
  -oily sweat
• itchy skin/skin eruptions
• Vomiting

Tongue: Red with yellow slimy coat
Pulse: Rapid soggy

Question 25

What are 7 symptoms and aetiology of spleen-blood Xu? - strictly speaking - no such thing as spleen-blood xu - rather it indicates Xu of spleen-qi leading to Xu of blood as spleen produces Gu qi

Answer 25

key symptoms - tiredness, slight abdo distension, scanty periods - poor appetite, dull-pale complexion, depression, insomnia Tongue: pale, thin and slightly dry pulse: choppy/fine Aetiology - same as spleen-qi Xu, however diet is particularly important when with inadequate consumption of blood-producing foods

Question 26

8 acupuncture points to tonify spleen-qi and nourish blood?

Answer 26

CV12, ST36, SP3, SP6, BL20, BL21 - tonify spleen CV4 - nourishes blood (especially uterus) BL17 - with direct moxa nourishes blood