12. Syndrome of Spleen-Yang deficiency
Manifestations
Main symptoms
Cramping pain in the epigastria or abdomen, which is often worse after taking cold food and drinks, poor appetite, abdominal distension.
Secondary symptoms
Diarrhea, poor appetite and feeling full easily, cold limbs, heaviness of the body, tired and reluctant to move.
Tongue
Pale, dull in color with a white and moist coating.
Pulse
Deep, slow and weak, especially in the second position on the right side.
Associated disorders in western medicine
Chronic digestive diseases, anemia, edema, nephritis, hypotension, hypothyroidism, hypoadrenalism, poor nutrition or consuming a low calorie diet.
Analysis of the syndrome
Spleen-Yang is very important in promoting digestion and water metabolism. It is considered as the key control in the body as the ascending of the Spleen-Qi and descending of the Stomach-Qi directly influence how the Qi, water and food essence move and change in the body. Spleen-Yang warms and stimulates the Qi movement and water metabolism, and promotes the process of Qi and blood generation in the body, which provides a foundation for life after birth of each individual.
Spleen-Yang can be weakened by improper food, eating habits and medicines, or by chronic diseases. In addition, Kidney-Yang deficiency may directly cause Spleen-Yang deficiency.
• When Spleen-Yang is too weak, it may generate internal cold and make the Qi and blood circulation slow down; thus cramping pain in the abdomen and cold limbs may present.
• When the Spleen-Yang is weak and is not able to transform and transport food and drink, diarrhea may occur.
• If the Yang is too weak to transform water into body fluids, water and dampness may accumulate in the Middle-Jiao and in muscles. Patients may feel tired, heavy of body and reluctant to move.
• If the Yang fails to stimulate the Stomach-Qi, patients will lose appetite and develop distension in the stomach and abdomen.
• Spleen-Yang deficiency is manifested as a pale and dull color of the tongue with a white, moist coating and a slow, deep and weak pulse, particularly in the second position on the right side.
Treatment principle: Tonify the Spleen-Yang and warm the Middle-Jiao
Herb selection principles and formula composition strategies
• First, sweet and warm herbs that enter the Spleen meridian, are able to warm the Spleen-Yang and tonify the Spleen-Qi are selected.
• Second, pungent and warm herbs that can scatter the cold in the Middle-Jiao, thereby spreading the warmth in the body and accelerating the water metabolism, are often used.
• Third, warm and pungent or warm and bitter herbs are selected to promote Qi movement and spread fluid.
CAUTIONS
1. Protect the Stomach:
Herbs that cause irritation of the Stomach should be avoided. In conditions where the herbs are really necessary, they should be taken after meals.
2. Protect the Spleen:
Cloying and heavy herbs can place an extra burden on the Spleen and should be used with caution. They should be used with herbs that regulate the Qi in the Middle-Jiao or herbs that promote digestion.
Structure of the formula and selection of herbs
Chief: Tonify the Spleen-Yang
Ren Shen ( Ginseng radix) and Huang Qi ( Astragali radix)
Ren Shen and Huang Qi are two strong herbs that tonify the Qi. Both are sweet and slightly warm, and enter the Spleen and Lung meridians. They may effectively tonify the Qi and gently strengthen the Yang and the Middle-Jiao. They are often selected as chief in formulas. Together with herbs that are pungent and warm, which stimulate the Yang of the Spleen and disperse the cold, they can generate the Yang of the Spleen and treat the symptoms that are caused by cold and weakness of the Spleen.
Moreover, Huang Qi, and especially raw Huang Qi, can ascend the Qi in the Middle-Jiao, strengthen the muscles and treat tiredness. As it enters the Lung meridian, it can strengthen the Lung-Qi so as to accelerate the water metabolism, and therefore can treat water accumulation in the body, such as edema.
Zhi Gan Cao ( Glycyrrhizae radix preparata) and Yi Tang ( Maltose)
Zhi Gan Cao and Yi Tang are able to tonify the Spleen-Qi. Compared with tonifying herbs such as Huang Qi and Ren Shen, their tonifying strength is mild. However, they have special usage in tonifying the Spleen.
Zhi Gan Cao and Yi Tang are sweet and neutral in nature, and enter the Spleen meridian. According to the concept that the combination of sweetness, warmth and pungency develops the ability to tonify the Yang, they are often used in combination with pungent-warm herbs in order to tonify the Yang in a gentle and steady way.
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