My Spleen is What? The Earth Element in Chinese Medicine...

This the fourth edition in my general introduction to the meridian/organ systems in Chinese Medicine will focus on the Stomach and Spleen meridians. As we have discussed in previous articles on the Liver, Kidney, and Heart systems, Chinese Medicine uses meridians named after and related to our physical organs to treat disease and imbalances in the body. The organ names are there to help describe the function of the related meridian and also to describe the myriad of relationships that exist in our bodies and between us and our environment. When your acupuncturist tells you that you have "Spleen Qi Deficiency" you might just stare back at him or her blankly not understanding a word of how that explains the issues that you are seeking to resolve. This set of articles was prompted by that blank stare and serve to help us all understand each other better and benefit as much as possible from this amazing form of medicine.

As described previously, Chinese Medicine theory uses the names of the organs to help illustrate a pattern of related physical and psychological issues. When a practitioner says you have a "spleen" issue they are generally speaking of the "spleen system" from a Chinese Perspective. This system involves the physical spleen, the pancreas, the spleen acupuncture meridian, spleen related disharmonies (or patterns), western medicine spleen/pancrease related diseases such as diabetes and chronic fatigue, and a range of health issues that arise from the spleen related disharmonies from a TCM perspective.

As all of the organ systems in Chinese Medicine are discussed in yin and yang pairings or what is also known as the zang (solid, full) and fu (hollow) pairings - the spleen is no exception. As the liver is paired with the gall bladder, the heart with the small intestine, and the kidneys with the urinary bladder, the spleen is paired with the stomach. What is unique about the spleen pairing is that the system functionally comprises the spleen, the pancreas, and the stomach. As opposed to other systems in Chinese Medicine you will see the terms stomach and spleen used far more interchangeably due to the complex relationships between these organs. The "spleen" ultimately refers to the spleen/pancreas system so an understanding of both of these organs is important to grasp the range of health issues that may be contributed to by imbalances in these systems.

About The Spleen:

The spleen is a fist sized organ located in the upper-left portion of the abdomen between the stomach and the diaphragm. The principle functions of the spleen have nothing to do with digestion (whereas the pancreas has quite a bit to do with digestion) and revolve around our immune and cardiovascular systems. The spleen is responsible for the removal of old red blood cells and the production and storage of white blood cells (lymphocytes) which will cleanse bacteria from the blood in the spleen and provide important tissue healing and other immune responses throughout our body. The spleen is functionally equivalent to a large lymph node with a focus on cleansing our blood and aiding immunity.

About The Pancreas:

The pancreas is a roughly 6-10 inch gland organ located behind the stomach with a narrow tail that extends to the left abdomen next to the spleen. The pancreas produces various chemicals which allow for proper digestion of food. The chemicals help us to digest protein, break down carbohydrates and break down fats into fatty acids and cholesterol.

There is an endocrine portion of the pancreas which secretes insulin when blood sugar is elevated. Insulin moves sugar (glucose) from our blood into muscles and other tissues so it can be used for energy. On the opposite side, the pancreas also releases glucagon when blood sugar levels are low. Glucagon causes stored sugar to be broken down into glucose by the liver to return blood sugar levels to a normal balance. These functions are obviously critical in conditions such as diabetes.

The "Spleen" in Chinese Medicine performs the following functions:

"Governs" transportation and transformation:

This function involves the transformation of water and food into the qi and blood of the body. The spleen is the principle organ for the production of qi and blood in the body and serves a vital function in this capacity. When the spleen is functioning well a person has a good appetite, strong digestion, and vibrant energy. When this function is weak you will see issues such as bloating, reflux, fatigue, diarrhea, poor appetite and/or malnutrition.

Another transformative function of the spleen relates to the resolution of dampness in the body. Dampness is a topic we will discuss later in this article but it refers to an internal issue which can result in sluggish energy, poor digestive functions, may solidify into fibroids/cysts/tumors and can cause many other issues. Within this function the spleen helps remove this dampness from the meridians and all organs of the body. A weakness in this function may lead to conditions such as edema, diarrhea and other fluid retention issues.

"Controls" the blood:

The spleen serves an important role in keeping the blood circulating in the body and meridians. If a weakness occurs in the spleen (which also plays an important role in the production of blood) you will see many of the signs listed above along with bleeding issues such as blood in the stool, hemorrhage and uterine bleeding among other issues.

"Dominates" the muscles and the four limbs:

This function relates to the spleens role in providing nourishment to the body. If the body is nourished the muscles and limbs will be strong and able and a weakness in this function will lead to weakness, atrophy, and other issues.

"Opens" into the mouth and "manifests" in the lips:

Proper spleen function will lead to a good appetite and a good sense of taste. A weakness in this function will lead to a poor appetite, diminished (or loss) of taste. Generally the condition of the lips will in part indicate the relative level of functioning of the spleen. Dry and cracked lips indicate issues with fluid metabolism and pale lips indicate an overall weakness of spleen qi.

What Symptoms May Arise?

As you can see the functions of the "spleen" in Chinese Medicine are functionally related to the spleen and pancreas as we understand them in western medicine. Conditions that may arise from a spleen imbalance in TCM terms are wide and varied starting with a range of digestive issues (poor appetite, bloating, reflux, diarrhea) to systemic issues (fatigue, poor thinking, muscle weakness, loss of control of muscles, cysts) and more. As the spleen plays a foundational role in the production of our bodies energy and nourishment many conditions can arise from weaknesses in this system.

Spleen System Patterns and Their Meanings:

One of the most common patterns found in western people is something we call Spleen Qi Deficiency. This can arise from any number of reasons but a poor diet mixed with irregular eating patterns and stress is a common way to develop this pattern. Spleen qi deficiency involves symptoms such as poor appetite, bloating (particularly after eating), weakness of the arms and legs, fatigue and/or loose stools.

As spleen qi deficiency continues to progress a subsequent pattern may develop called Spleen Qi Sinking. This pattern is essentially the same as spleen qi deficiency but with prolapses of the stomach, uterus, anus and/or vagina along with frequency or urgency of urination. This pattern shows a more internal weakness where the body can no longer hold the organs in place.

Another progression of spleen qi deficiency is the Spleen Not Controlling The Blood. This pattern has signs of spleen qi deficiency along with blood related symptoms such as hemorrhages, vaginal bleeding and/or bleeding under the skin. Another term for this pattern is "reckless bleeding".

A final progression of spleen qi deficiency (not that you have to go through all of the stages) is Spleen Yang Deficiency. Yang deficiencies are much deeper than qi deficiencies and are often involved with people experiencing serious or chronic illnesses. Symptoms of spleen yang deficiency are similar to that of qi deficiency along with more signs of cold in the body, cold limbs, chilliness, edema, etc.

Two Acupuncture Point Examples:

The extent of conditions that can arise from these patterns is best illustrated by looking at two very widely used acupuncture points, Stomach 36 (ST 36) and Spleen 6 (SP 6).

Stomach 36 may be used with acupuncture, acupressure, moxibustion and through other methods. It is found by sliding your 4 fingers together up your shin towards the knee stopping when your finger hits the knee. The point will be one finger width from the tibia on the outside of the leg just in line with the bottom of your pinky finger, pressing where it is most tender.

The functions of this point include aiding in nearly all digestive and weakness issues, building the "wei-qi" which is the loose equivalent to our immunity to colds/flus and other infections, the strengthening of our blood (a strong part of our overall immunity), also problems with the breasts (distention, lactation), pain in the lower leg, aids the lungs in conditions such as asthma and wheezing, and serves to balance a range of psychological issues such as depression and anxiety as well as issues such as PMS.

Spleen 6 may also be used with acupuncture, acupressure, moxibustion or other methods of stimulation. It is found by sliding your finger along the inside of the tibia (inside of leg) up from the ankle about 4 fingers width and pressing where it most sore.

The functions of this point include all spleen related issues including your energy overall, digestive issues, prolapses of organs, along with a range of gynecological issues, sexual issues in men (impotence, etc.), promotion of labor, hot skin diseases (eczema, acne, rashes, etc.), as well as a range of psychological issues such as insomnia and anxiety.

You can see from these two points the range of spleen issues range from mild digestive issues to fatigue and muscle strength to the strength of thought and emotion.

What Is Dampness in Chinese Medicine?

One of the patterns left out from above is that of dampness in the body. This is a somewhat intricate but ultimately worthwhile pattern of disease to understand. As I mentioned earlier, one of the principle functions of the spleen is fluid metabolism. The fluids in the body comprise saliva, digestive enzymes, intestinal enzymes, the fluid in the joints, tears, mucus, sweat and urine. In Chinese Medicine theory fluids are divided into two basic categories, "Jin" (clear and thin) and "Ye" (thick and heavy) and the spleen is in charge of both of these. Together these fluids nourish all the tissues and organs of the body.

What happens, then, when these fluids are out of balance? One possibility is the lack of fluids which on a mild scale can lead to brittle joints, dry mouth, sensations of rising heat in the body, and ultimately while we can live without food without water our bodies will literally burn up, dry out, and we will extinguish.

But what of too much?

Dampness is the result of too many fluids, too weak of a spleen, and/or living in a damp environment. 

The difficulty of this for us westerners is that our ability to eat and drink in excess which one might perceive as beneficial to our health (as opposed to not having enough to eat) overloads and potentially weakens the spleen system leading to this issue of dampness.

  Within our body dampness can lead to many relatively mild issues all the way to serious health problems such as cancer, muscle control disorders such as ALS, and more.

Generally speaking a principle sign of dampness is heaviness (lethargy, fatigue, sinking, depression) which many of us mask with caffeine and other stimulants. One may feel a heavy sensation in the head particularly or the body as a whole. If the dampness is prolonged in the body it has a tendency to create stagnation (fixed masses), settle in joints (arthritis), or create heat which can rise up and/or towards the surface (eczema).

A clinical example of dampness is arthritis. Arthritis within Chinese Medicine is actually something called bi-syndrome, of which there are four kinds - wind, cold, damp and heat. Arthritis that results from dampness typically involves heaviness of the local area, numbness of the skin and/or muscles, a very fixed pain with swelling and pain that is aggravated in damp weather/conditions. Here the function of the spleen to drain fluids is comprised so the joints become swollen, potentially numb and painful.

So More May Not Be Better... Dampness, Obesity, and TCM:

Another all too common condition that often involves dampness is obesity. Obesity is a tremendous public health issue, perhaps the most important of our time. Many people come to acupuncture for help with weight loss and they say things like the following:

I don't understand, I drink a gallon of water daily, eat salads at lunch, and am working out and I still cannot lose weight...

From a Chinese Medicine perspective they may simply have a weak transformative function within their spleen system. This is actually contributed to if not outright caused by the intake of too many fluids and too many damp foods (raw foods, juicing, salads in particular, see diet article...) - they are literally drowning their "spleen". So what may look like it should be helpful is actually contributing to the underlying cause. This helps to explain why so many people who appear to be doing the "right" things do not lose weight.

All in all these patterns indicate our need for regulation. As all systems have relationships to the seasons, the spleen system relates to the earth. The earth element in Chinese Medicine provides us with our stability, groundedness and our root. Without a strong root nothing can grow. When you drown a plant with water it dies, when it is too hot it wilts and dies, if you overfeed your plant it dies and if you don't feed your plant it dies - we are no different except the process takes longer and goes through many different avenues.

How Do I Balance My Spleen?

The take away from all of this is that our body needs to be properly nourished to nourish us. Too much or too little, as with anything else, will cause problems. The spleen is a system that we need to keep functioning well by not overloading it and not overworking ourselves. A more moderate lifestyle and diet will lead to a more harmonious function internally which leaves us with vibrant energy, a strong body, and perhaps most importantly a calm and balanced mind with clear thinking, balanced emotions and a feeling of ease. Acupuncture, moxibustion, dietary counseling, exercises such as qigong and tai chi can all help balance this system. As you can see from how the degradation of the spleen system seems to progress, now is the time to start.