Syndrome Differentiation by Spleen and Stomach

Syndrome Differentiation by Spleen and Stomach


1. Spleen Qi Deficiency


Poor appetite, abdominal distention (worsening after eating), loose stools, fatigue, shortness of breath, bodyweight loss, pale complexion, obesity, body puffiness, pale tongue, white coating, and moderate and weak pulse.



1) Dysfunction in transformation and transportation

failure to transport “water and grain”

spleen qi stagnation after eating

food undigested, a mixture of the “clear” and the “turbid” draining into intestine

accumulated “water-dampness” spreading over to skin


2) Hypofunction

qi and blood can’t reach limbs and muscles

face area lacks nourishment

pectoral qi is deficient


2. Spleen Qi Deficiency and Qi Sinking


Abdominal distention, especially after eating, the sensation of frequent defecation and “sinking” anus, prolonged diarrhea, (even) prolapse of rectum or uterus, or cloudy urine (as water from washing rice). (Usually accompanied with) shortness of breath, tiredness, dizziness, blurred vision, pale complexion, poor appetite, loose stools, pale tongue with white coating, weak and moderate pulse.



reduce ascending force

internal organs losing holding

“clean qi” sinking and leaking into the urinary bladder

nutrient not rising to head

spleen qi weak and TnT weak


3. Spleen Yang Deficiency


Poor appetite, lingering abdominal pain (preferring warmth and massage), cold limbs, shortness of breath, tiredness, pale or puffy complexion, puffy body, scanty urine, or profuse thin leucorrhoea, pale, puffy tongue with white wet coating, deep, slow, weak pulse.



refrained TnT

“water damp” retained

cold (from yang deficiency) constricting qi movement

lack of warmth in the body


4. Spleen not Holding Blood (Spleen Deficiency Leading to Bleeding)


Sallow or pale complexion, poor appetite, loose stools, listlessness, shortness of breath, no energy to talk, bloody stools, bloody urine, skin bruise, nose bleeding, menorrhagia, uterine bleeding, pale tongue, thready weak pulse.



blood leaking from vessels: hypo TnT

impaired source of transformation


5. Cold Damp in Spleen


Abdominal fullness or pain, lack of taste and absence of appetite, nausea, heaviness of head and body, or puffy limbs, scanty urine, dark yellowish skin and sclera, leucorrhea, pale, flabby tongue, white sticky coating, moderate weak or deep thin pulse.



damp blocking spleen yang, hypo TnT:

spleen yang is not ascending, stomach qi is not descending but ascending

water-damp not being transformed:

spleen earth stagnated, leading liver wood stagnation:

dampness heavy, blocking “light” yang qi from ascending


6. Damp Heat in Spleen


Abdominal fullness, poor appetite, nausea, loose and sticky stools, heaviness of limbs, thirst (but drinking little), low fever which is not relieved by sweating, or jaundice with fresh yellow skin and sclera, or itching, red tongue with a yellow greasy coating, and soft and rapid pulse.



loss control of TnT disturbed ascending and descending

damp-heat pushing downwards, damp stagnating “qi ji”

steaming liver and gallbladder, bile evaporating to skin

damp affecting limbs

damp trapping heat


7. Cold in the Stomach


Sudden cold pain in epigastrium, intensified with cold and relieved with warmth, nausea, vomiting (which reduces the intensity of pain), no thirst, or increased thin saliva in mouth, pale or blue complexion, lack of warmth in limbs, white wet coating, wiry or deep tight pulse.



a. Interrupted descending

cold, contraction, qi stagnation: stomach qi adversely rising

warmth dispersing cold

cold intensifying contraction

relieving stagnated qi by vomiting


b. Cold compromising yang

water following stomach qi rising

cold blocking heat inside


8. Stomach Heat


Epigastric burning pain, worsening pressure, thirst with drinking cold water or eating a lot but hungry, foul breath, swelling and painful gums, bleeding gums, constipation, yellow scanty urine, red tongue with a yellow coating, slippery rapid pulse.



heat disturbing stomach

hyper processing food

stomach heat moving along the channel upwards

turbid stomach qi rising

lack of nourishment in the intestine

blood vessels damaged by heat


9. Stomach Yin Deficiency


Dull burning pain in the stomach, hunger but losing appetite, discomfort in the stomach, dry vomiting, hiccups, dry mouth and throat, constipation with dry stools, red tongue without moisture, and a rapid pulse.



lack of nourishment to the stomach

yin deficiency producing internal heat


10. Food Retention in the Stomach


Fullness, distention and possibly pain in the epigastrium, belching, acid regurgitation, vomiting, borborygmus with abdominal pain, diarrhea with stinky stools, or dry stool, thick greasy tongue-coating, slippery or deep forceful pulse.



blocked stomach qi descending:

undigested food retained in the intestine


11. Stomach Blood Stasis


Epigastric poking pain with fixed spot, worsening with pressure or after eating, poor appetite, loss of body weight, vomiting blood, or tar-like stool, purple tongue with purple spots, choppy pulse



blood stasis staying in the stomach collateral

blood stasis in the stomach, affecting the stomach processing of food

blood circulation is blocked by blood stasis

decreased nutrients to muscles and tissues


1) Common symptoms for the spleen and stomach are stomachache, epigastric distension, nausea, and vomiting. The most practical way to determine the root of each symptom is to perform its syndrome differentiation according to the functions of the spleen and stomach. There are excess and deficiency types according to eight principle methods, and cold, heat, food retention, and blood stasis according to etiology. Both Chinese herbal medicine and acupuncture are effective for most of these syndrome patterns.

2) TnT: refers to the spleen’s function, the transformation and transportation, similar to digestion and absorption in modern medicine.


Internal Links