What the heck is a spleen? In biomedicine it is an uber-lymph node involved in the production of new and removal of old blood cells. If you have old Southern relatives like I do, you may have had no clue what a spleen was, but you knew your grandpa needed to vent his from time to time. (And if you didn’t have old Southern relatives, that means grandpa needed to express his displeasure about something.)
But what does it mean when you hear it in TCM? The Spleen is one of the five Yin organs defined in The Huang Di Neijing. It’s coupled with the Stomach Yang organ and is physically responsible for digestion, assimilation of nutrients, and distribution of Qi/nutrients. This seeming disparity between Eastern and Western thought about the Spleen really bothered me when I was in school until I learned to associate it like this:
The immune system
The enteric system contains a huge number of the total immune related cells in your body. Your gut keeps you healthy in all kinds of ways. Stomach acids eat a lot of bacteria and can destroy some viruses. If you eat bad food you get food poisoning symptoms like diarrhea and vomiting. While this isn’t a lot of fun, it does keep the badness from invading the rest of your body. In TCM you keep your Spleen and Stomach healthy and you are less likely to get sick from either pathogens or a crappy diet. Moral to this tale: Spleen = immunity in western and in eastern medicine.
The blood connection
TCM says the Spleen (along with the Heart – it’s a cooperative venture) produces blood and holds blood in the vessels. In biomedicine the Spleen is also involved in the production of blood.
Root of Post-Heaven Qi
The Spleen is also said to the postnatal center of Qi It’s also called the Root of Post-Heaven Qi. When your parents conceive you they give you a kind of starter packet that is referred to as Prenatal Essence. Both mom and dad give up some of their own essence to produce you. While you are forming in the womb you are basking in your mom’s Qi. That’s why it’s desirable for a mom to be in good health, in a good emotional state, and for her body to be strong enough to carry a baby. The future health of the baby depends on this.
After you are born, however, you are responsible for producing your own Qi and that is Post-Heaven Qi. You get this from the air your breathe, from the food you eat, and from the liquids you drink. Your Spleen take the food and drink, extracts the good stuff out of it, and discards the rest. This is why your Spleen is called the Root of Post-Heaven Qi. This is also why the pancreas is considered to be part of the Spleen organ system in TCM.
Spleen/Yin and Stomach/Yang
The Spleen is the Yin half of this dynamic duo while the Stomach is the Yang half. Remember those Yin and Yang Relationship principles?
Yin and Yang work in opposition to form a perfect balance. Translated into Spleen and Stomach, it’s a matter of direction of movement: Spleen energy goes up while Stomach energy descends.
Spleen has to be coupled with the Stomach. The Stomach receives the food and ‘cooks’ it so that the Spleen can extract the rich creamy goodness from what you eat and drink. Also, (and this is an oversimplification) the Stomach is responsible for the upper half of digestion (getting hungry, chewing, eating). The Spleen is responsible for the lower half of the GI tract which has spawned so much junior high boy humor: excreting discarded digestive solids and passing gas. (And I will admit that I really wanted to type “pooping and farting” but I decided to be an adult about this.)
- Mutual Consumption and Intertransformation
This is about the state of dynamic balance between Spleen and Stomach. Stomach is fiery, its’ energy moves downward, it likes cool and moist. Spleen is cooler, its’ energy moves upward, it likes warmth and dryness because it tends to be too soggy anyhow. Stomach’s downward energy moves the food and drink Qi down to the Spleen so it can use it. Spleen sends the energy back upward in the form of Qi to feed the organs and to support the organs against the drag of gravity.
The Spleen and Stomach are located in the middle jiao, the center of the body. All other organ systems revolve around and depend on the Spleen and Stomach to function.
Physiological Functions of the Spleen
The Spleen governs transformation and transportation
This is the main function of the Spleen.
Transformation. It is the Stomach that holds, ripens and rots food and drink, but is it the Spleen which transforms it into Food (Gu) Qi…..or goes “EW!! What the hell is that?!” and discards whatever empty calories (gummy bears, Whataburgers, PBRs…) were consumed.
There are 2 kinds of Qi derived from food:
- Ying Qi or Nutritive Qi
Ying Qi is the stuff that nourishes the whole body. It is transported to the Heart and transformed into Blood. When a person has a poor appetite and isn’t eating well, there is little or no Ying Qi is available for Heart blood, so that patient will often have palpitations and a poor memory as a result.
- Wei Qi or defensive Qi
Wei Qi is the form of Qi that protects the body. It forms a protective layer over the body to fight off badness. Wei Qi derived from food by the Spleen and is transported to the Lung to be dispersed to the skin. When you sleep at night, the Wei Qi also sleeps, going inward. This is why you tend to get colder at night and cover up to protect your internal organs.
Transportation. You’ve already seen in the stuff above about Ying Qi and Wei Qi that the Spleen moves resources around. It not only creates and moves Qi around, but also regulates the digestion and use of water. Using its’ own upward flowing energy, it pushes water upward to the Lungs then to the surface of the body as sweat.
When the Spleen is too weak to transport water and food Qi upward, it gets pretty swampy and develops either dampness (so much on that later) or food stagnation. The substance of the Spleen is the food Qi it generates, which is a kind of Yin function. The Spleen’s Yang function is it’s ability to raise.
When the Spleen is deficient the Blood will also become deficient because the building components that are needed for Blood are no longer available. The same is true for immunity: poor Spleen qi means poor nutrient absorption, and therefore an inability create Wei Qi.
The Spleen is called the middle source of water in the body. It doesn’t store water, but it does receive and redistribute it. Just so you know, the Lungs are the upper source of water and the Kidneys are the lower source of water. I think of it like a three-tiered fountain with the water source piped into the middle part of the fountain. The Spleen receives it and lifts it up to the Lung which is like that little bubbling and misting part at the top. The Kidney is the lower source of water, the biggest part of the reservoir at the bottom.
The Spleen controls the ascending of Qi
A primary function of the Spleen is to raise or lift. A part of this function is the Spleen’s job of holding the organs in place. Without this lifting function patients get all kinds of organ prolapses. A prolapse means the organ is no longer held in its’ proper place. This could be a uterine prolapse, anal prolapse, bladder prolapse, or even hemorrhoids. The Spleen also keep the stool from descending too quickly. You’d think you just want to get rid of the crap (pun intended), but a lot has to happen to it before your body is ready to expel it. When the Spleen cannot balance the descent of the stool with its’ ability to ascend qi, lower digestive dysfunction in the form of diarrhea and/or loose stool can occur as a result of this Spleen Qi deficiency.
The Spleen raises clear Yang upwards
Clear Yang is the same thing as Yang Qi. Clear Yang has no turbidity. Because Qi is very light it ascends upward to the head which is then nourished and supported by the Yang. The result is clear thinking.
The Spleen controls Blood
Wait. What? I thought the Heart had to do with the Blood? It does. Blood is a very big deal – just ask any vampire. TCM gets technical about exactly what organ does what to blood. The Spleen’s job is to control it. Here’s how:
- Spleen produces the Nutritive Qi which it then sends to the Heart so that Blood can be produced. The Spleen controls the supply and transports that supply up to the Heart kind of like Sysco Foods delivers produce and other foods to a restaurant.
- Spleen holds the Blood inside of the vessels.
That’s part of it’s “keep things in their proper place” function. Ok, let’s get a little biomedical here. Blood vessels are composed of cells with junctions between them which form tubes that hold the blood inside. When the integrity of those junctions is compromised either through trauma or poor health blood leaks out. In TCM this leakage can occur due to poor Spleen Qi. The result can be easy bruising, dysfunctional uterine bleeding, bleeding gums and so forth, all due to deficient Spleen Qi.
Controls the muscles and the four limbs
Remember your Five Element Chart? What body tissue is associated with Earth and therefore with Spleen/Stomach? Correct: Muscle. When Spleen Qi is strong, the muscles and limbs are strong. When Spleen Qi is deficient or weak the muscles will be weak or atrophy.
Spleen houses the intellect and thoughts
Thoughts and memory are part of the Spleen’s functional realm. It influences our capacity for thinking, studying, concentration, memorization for work and school. This is part of the Pure Yang raising function.
The Heart houses the Mind, your thinker and memorizer. If you want to memorize and think/concentrate easily, you need good Blood quality which is delivered and controlled by the Spleen.
The Heart is responsible for short term memory while the Kidney is responsible for long term memory. To boost thinking and memory functions overall you also need to nourish the brain by controlling and nourishing the Marrow, which you will soon learn is associated with the Kidney.
Spleen is the root of Post Heaven Qi.
We’ve kind of been here, done that, got the t-shirt. Post Heaven Qi is the Qi we derive from food/drink (Gu Qi) and from air (Big Qi or Da Qi) and includes any nutritive substance we consume after we emerge from the womb and inhale that first lung full of air.
Spleen is the origin of birth and development
Muscles are controlled by the Spleen. If the Spleen is weak it cannot control the muscles or muscular development.
Spleen dislikes Cold and has an aversion to Damp
Though water is required for the conversion of food/drink into Qi, too much water and humidity or extra Dampness is very bad for the Spleen and bogs down it’s functioning, making it a swamp rather than a good middle source of water in the body. This excess water/damp results in water retention and phlegm. Cold makes Dampness worse and congeals it into phlegm (making kind of a slushy). The Spleen needs warmth and dry in order to dry it’s tendency toward dampness.
What the heck is dampness? Glad you asked. Dampness in my mind is associated more with extreme humidity than it is with water. Do you ski? If so I’m betting you’d rather ski in light fluffy powder than heavy damp snow. Do you prefer more warm weather sports like hiking or running? Then you know it’s more comfortable to move around in drier weather than in humid weather.
There’s a reason people say, “Yeah, but it’s a dry heat” when talking about the desert. I’ve lived in Phoenix and I’ve lived in Atlanta. I’ll take 98 degrees in Phoenix at 12% humidity over 98 degrees in Atlanta at 98% humidity any day.
Since we are a product of this environment, we have a mini-version of it inside our bodies. We can also suffer from the conditions of dampness or internal humidity. Like going out on a humid day and feeling your shirt stick to you, dampness in the body makes everything very sticky and hard to resolve.
Stomach: General Information
The Stomach is related to and paired with the Spleen. Both are represented by the element of earth. The pair is the engine that supplies the body with fuel and more than one practitioner considers it the element to keep healthy if you want the body to continue to function optimally.
Functions of the Stomach
Stomach controls the receiving of food
Stomach Qi holds ingested food so that the Stomach organ can ripen or rot it. Doesn’t that sound pretty? Read the next function for more on that. The Stomach Qi then descends, passing prepared foods on to the Small Intestine, so that the food does not stagnate. A rebellion or failure of Stomach Qi results in nausea, vomiting, hiccups. Why? Because Stomach Qi is supposed to move downward. When it moves upward this is a rebellion. Nausea, vomiting, and hiccups are a form of Stomach Qi moving the wrong way – up instead of down.
Stomach rots and ripens the food
Yeah, that sounds gross, but it’s really just a form of processing the food you eat. This is the beginning of digestion (…ok, technically, it starts in the mouth with chewing and salivary enzymes…). The rotting and ripening refers to the breakdown of food. The Spleen actually does the digesting of food, extracting Food Qi from that which is rotted/ripened.
Stomach controls the transportation of food essence to the Spleen
Stomach controls descending of Qi
Rotted and ripened food descends to the Small Intestine for nutrient extraction. Waste products descend to the Large Intestine/colon, rectum, and anus. These are all downward moving energies. When the Qi cannot descend the waste, the result is nausea, vomiting, and hiccups – Stomach Qi moving in the wrong direction. Middle Jiao problems such as gas, bloating, diarrhea, nausea, vomiting and hiccups are widely seen in the clinic. You will learn more about this in later classes, but I’ll clue you in on this little nugget:
- Upper stuff such as nausea, vomiting and hiccups are the result of Stomach dysfunction.
- Lower stuff such as gas, bloating, and diarrhea/loose stool (you know – all that Jr. High boy humor stuff) are the result of Spleen dysfunction.
Stomach likes wetness and cold
The Stomach, because it is a Yang organ, has ready-made dry and heat and doesn’t want more! This is in direct oppositional balance to the Spleen’s preference for both dry and warm and is why diet and constitution must be balanced in order for the “wheel” of the Spleen/Stomach to spin correctly Take note: The yin and yang complimentary qualities of the Spleen and Stomach must remain in balance!
Eating late at night affects both sleep and digestion. One of the Stomach channel’s branches goes to the Heart. When Stomach Qi is disturbed by a late meal this disturbance can influence the Heart, leading to dream disturbed sleep. It is the fire of the digestion that then disturbs the Shen of the Heart.
Dreams can reflect the condition of the Stomach:
- When one dreams of large meals the Stomach is deficient
- When one dreams of hunger the Spleen is deficient
- When one dreams of seeing the sun or of heaviness and inability to move there is excess or damp heat in the body.
Relationship between Stomach and Spleen
The Yin/Yang opposing complementary properties of the SP/ST must remain in balance! The Liver can overact on the Spleen, attacking it and disturbing the original Qi causing the problems mentioned in the table above. When one doesn’t eat well for a very long time the Liver becomes too strong and the middle Jiao (Spleen/Stomach) becomes too weak.
When the Stomach has heat one can suffer from a toothache because the meridian of the Stomach goes to the gums and teeth. Look for inflammation and bleeding gums in the upper jaw primarily.
- Wu, Qianzhi. “Foundations of Chinese Medicine.” AOMA Graduate School of Integrative Medicine, Austin Texas. Fall 2007. Lecture Series.
- Maciocia, Giovanni. The Foundations of Chinese Medicine. London: Elsevier Ltd, 2006. Print.
- Yang, Shou-zhong. Li Dong-Yuan’s Treatise on the Spleen & Stomach. Boulder CO: Blue Poppy Press, 1993. Print.
- Larre, Claud. Spleen and Stomach: Chinese Medicine from the Classics. Taos NM: Redwing Book Co, 1996. Print.