Spleen deficiency

Anticoagulants are used to prevent cardiovascular and cerebrovascular accidents. Most patients who are on anticoagulants are elderly people with chronic heart and vascular diseases. From a TCM perspective, the blood becomes thicker and tends to coagulate when heat (often generated by stress and emotional disturbance) consumes the blood, or when phlegm accumulates as a result of Spleen deficiency. Kidney deficiency is a potential cause of this as the Kidney-Qi weakens with age and is unable to maintain the proper functioning of the Spleen and Liver. 

In this formula, as in the formula Zuo Gui Wan, there is no herb to regulate the Qi and reduce the cloying nature of the tonifying herbs. This is a specific feature of formulas composed by Zhang Jing Yue - to focus on the main syndrome and treat it intensively. In clinical practice, it is better to include some of the herbs that regulate the Qi, particularly in conditions of Spleen deficiency. 

When damp-heat in the Upper-Jiao is not eliminated in time, it can invade the Middle-Jiao, obstruct the Qi and disturb the functions of the Spleen, Stomach, Large Intestine, Liver and Gall Bladder. It causes digestive disorders, skin diseases, tiredness, and swelling, pain and heaviness of the muscles and joints. The lingering dampness holds the heat, which can remain in the body for a very long period of time. When the function of the Spleen is injured by damp-heat, the excess condition of damp-heat can be complicated by Spleen deficiency. 

Huang Qi is sweet and warm, and enters the Lung and Spleen meridians. It can tonify the Spleen-Qi and Lung-Qi, and has an ascending tendency. It is often used in a chronic bleeding condition due to Spleen deficiency that fails to control the blood. 

Ren Shen and Bai Zhu are sweet and warm, and Fu Ling is sweet, neutral and bland. They all enter the Spleen meridian. They can directly tonify the Spleen and are selected as chief in the formula when the disharmony is caused directly by chronic Spleen deficiency. Moreover, they can also be used as deputies as they generate the Qi and blood, and can maintain the proper function of the Liver. In addition, they strengthen the Spleen in order to stimulate its resistance at the same time that the Liver-Qi is attacking the Spleen. 

Bacterial translocation is defined as the passage of viable indigenous bacteria from the GI tract to extraintesti-nal sites, such as the mesenteric lymph node complex, liver, spleen and bloodstream [183], Three major mechanisms promote bacterial translocation intestinal bacterial overgrowth, deficiencies in host immune defenses and increased permeability or damage to the intestinal mucosal barrier [184], These mechanisms can act in concert to promote synergistically the systemic spread of indigenous translocating bacteria to cause lethal sepsis. 

An endemic zinc deficiency syndrome among young men has been reported from Iran and Egypt, and is characterized by retarded growth, infantile testes, delayed sexual maturation, mental lethargy, anemia, reduced concentration of zinc in plasma and red cells, enlarged liver and spleen, and hyperpigmentation oral supplementation of 30 mg Zn daily had a prompt beneficial effect (Prasad 1979 Elinder 1986). 

Hemolytic anemia results from decreased RBC survival time due to destruction in the spleen or circulation. The most common etiologies are RBC membrane defects (e.g., hereditary spherocytosis), altered Hb solubility or stability (e.g., sickle cell anemia [see Chap. 34] and thalassemias), and changes in intracellular metabolism (e.g., glucose-6-phosphate dehydrogenase deficiency). Some drugs cause direct oxidative damage to RBCs (see Appendix 3). 

Despite the obvious expression of GABAb receptors in many peripheral organs, such as heart, spleen, lung, liver, intestine, stomach, and urinary bladder, no overt peripheral phenotype has been described for GABAB(1)-deficient mice. However, as in the central nervous system (CNS), knockout studies demonstrate that the GABAB(i) subunit is an essential requirement for GABAb receptor function in the enteric and peripheral nervous system (PNS) (66). 

In a biopsy of an AIDS patient s enlarged thymus (P4), the adipose involuted thymus, with persistence of many Hassall s corpuscles, was judged to be a large lymphoid follicular hyperplasia. This follicular hyperplasia was similar to that described for lymph nodes, spleen, and other lymphoid tissues at earlier stages of human immunodeficiency virus infection, before the development of acquired immune deficiency syndrome. Human immunodeficiency virus RNA and p 24 were detected in the hyperplastic germinal centers (lymphocytes and follicular dendritic infected cells) and also in many cells that may have been either lymphocytes or epithelial cells in the interfollicular areas. 

The red blood cell has no mitochondria and is totally dependent on anaerobic glycolysis for ATP. In pyruvate kinase deficiency, the decrease in ATP causes the erythrocyte to lose its characteristic biconcave shape and signals its destruction in the spleen. In addition, decreased ion pumping by Na /K -ATPase results in loss of ion balance and causes osmotic fragility, leading to swelling and lysis. 

Indications Prostration syndrome due to deficiency of qi deficiency svndrorne of the spleen syndrome of deficiency of the lunq-ai thirst and diabetes due to impairment of body fluid irritability, insomnia, dreaminess, palpitation induced bv frioht. forgetfulness, listlessness, lassitude and others due to deficiency of both the heart and spleen syndromes of deficiency of the blood or both the ai and blood. 

---