Spleen deficiency syndromes

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). 

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 main substances of the body are the Qi and essence that further generate blood, body fluids, Yin and Yang. In pathological conditions, the deficiency often shows four aspects, namely deficiency of the Qi, deficiency of the blood, deficiency of the Yin and deficiency of the Yang. The deficiency can be found in specific organs, such as Kidney-Yin deficiency, Spleen-Qi deficiency or Heart-blood deficiency. A deficiency syndrome also exists in patients with a weak constitution or those in the recovery period of disease, in elderly people or in children. In those situations, it is difficult to determine which organ is weak and which part should be tonified, as the general condition of the patient is weak. 

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. 

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. 

This book mainly considers individual syndromes, such as the syndrome of Spleen-Qi deficiency, and it discusses the composition of individualized formulas, such as a formula to tonify the Spleen-Qi. In practice, a syndrome can be much more complicated. The sections on Common accompanying symptoms and treatment offer more possibilities for herb selection in complicated situations. To treat a syndrome with different kinds of secondary syndromes, such as Spleen-Qi deficiency with dampness accumulation or food accumulation, a practitioner should consult different chapters to compose an effective formula. 

A secondary syndrome might be a coexisting syndrome that is less important at the time of treatment. For example, in an acute condition of Liver-Yang ascending and generating Liver-wind, the patient may also have a syndrome of Spleen-Qi deficiency but this is less important for treatment in this acute condition. 

When patients suffer from chronic liver or kidney disease, the selection of the herbs and their dosages should be determined carefully to avoid placing an unnecessary workload on these weakened organs. At the same time, herbs that protect these organs and promote their function should also be included. For instance, acute or chronic liver diseases are mainly differentiated into a syndrome consisting of Spleen-Qi deficiency, damp-heat and heat-toxin accumulation, and herbs that treat this syndrome can be used. Chronic kidney diseases are mainly differentiated as Kidney-Yang and Spleen-Yang deficiency, dampness accumulation and heat-toxin in the blood. Herbs that treat this syndrome should be used in appropriate doses to help restore kidney function. 

In TCM, hypothyroidism is considered a syndrome of Spleen-Qi deficiency and accumulation of dampness or damp-phlegm in the body. Although western drugs may help to keep thyroid hormone levels normal, symptoms such as tiredness, coldness, weight gain and constipation may still exist. In the differentiation of the syndrome, many patients still show signs of Spleen-Qi deficiency and accumulation of dampness in the body, therefore treatment should be given to tonify the Spleen-Qi, activate Qi movement and leach out dampness. 

This syndrome is caused by accumulation of internal cold together with undigested food. It occurs after indulgence in cold food and drinks, which obstruct the Qi of the Stomach and Spleen. It may exist when the Spleen-Yang is deficient internal cold is thus generated and disturbs the function of the intestines. 

This formula primarily treats Spleen-Qi and Yang deficiency. In fact, it treats a chronic syndrome of deficiency of the Middle-Jiao, where not only Qi and Yang, but also Yin and blood are deficient, due to long-term Yang and Qi deficiency. 

Si Jun Zi Tang is a principal formula to tonify the Spleen-Qi and treat the syndrome of Spleen-Qi deficiency. Although there are only four herbs in this... 

This formula tonifies the Spleen-Qi and transforms dampness from the Middle-Jiao. It treats the syndrome of Spleen-Qi deficiency with obvious accumulation of dampness in the Middle-Jiao, and at the same time treats deficiency of Lung-Qi due to Spleen-Qi deficiency. The symptoms are chronic diarrhea, weakness of limbs, weight loss, a low and soft voice and shortness of breath. A pale tongue with a moist white coating and a soft and slow pulse indicate the presence of dampness with Qi deficiency. 

In this section, the strategies of composing the formulas that tonify the Heart-blood and Liver-blood are discussed because they are common syndromes. The related Spleen disorder is discussed in Section 1, Syndrome of Spleen-Qi deficiency, the related Lung disorders are discussed in Section 2, Syndrome of Lung-Qi deficiency and Section 6, Syndrome of Lung-Yin deficiency, and the related Kidney disorder is introduced in Sections 10 and 11, Syndrome of Kidney-Yin deficiency and Syndrome of Kidney-Yang deficiency, respectively. 

Bai Shao Yao is bitter, sour and slightly cold, and enters the Liver and Spleen meridians. It particularly tonifies the substantial part of the blood and increases the Yin. It is often used in the syndrome of blood and Yin deficiency that manifests as palpitations, restlessness, stiffness and cramping pain of the limbs, dry eyes, blurred vision and scanty menstruation due to deficiency of the blood and Yin of the Heart and Liver. 

This is a well-organized formula for treating a chronic deficiency condition. It concerns the relationship of the physiological and pathological aspects between the Spleen, Heart and Kidney, as well as the Qi and blood of the Heart and Spleen. It balances the composition and dosage to achieve the optimal result of tonifying the Heart-Qi and blood in order to improve all the symptoms in this syndrome. 

Shan Yao is sweet and neutral, and enters the Lung, Spleen and Kidney meridians. It can either tonify the Qi or nourish the Yin. Its astringent property enhances its tonifying and stabilizing function. This herb is particularly useful in chronic conditions of Qi and Yin deficiency, such as in Thirst and West syndrome (diabetes) to moisten the internal organs and stabilize the body essence. 

This formula primarily treats Spleen-Qi and Yang deficiency. In fact, it treats a chronic syndrome of deficiency of the Middle-Jiao, where the Yin and blood are also deficient due to long-term Yang and Qi deficiency. The Yang and Qi deficiency are manifested as intermittent, spasmodic abdominal pain that responds favorably to local application of warmth and pressure, reduced appetite, and cold and sore extremities. The Qi and blood deficiency are manifested as a lusterless complexion, palpitations, a pale tongue and a thready pulse. The Yin deficiency shows in low-grade fever, dry mouth, dry throat and irritability. 

Two common syndromes that are referred to as the cold water affects the Heart and the cold water attacks the Lung mainly cause the secondary symptoms. These may occur if there is Heart-Yang and Kidney-Yang deficiency, or Heart-Yang and Spleen-Yang deficiency. 

This is a formula that treats both the cause and the manifestations of bleeding syndrome due to Spleen-Qi deficiency. 

Bai Zhu is bitter and warm, and enters the Spleen meridian. As it not only tonifies the Spleen-Qi, but also dries dampness, it is a perfect herb for a syndrome of dampness accumulation due to Spleen-Qi deficiency. 

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