The spleen has yin qi and yang qi. The yang qi of the spleen is spleen qi and spleen yang; while the yin qi of the spleen refers to spleen blood and the body fluids of the spleen. The pattern of spleen yin deficiency is a condition where the spleen's yin blood and body fluids are insufficient, leading to a deficiency of spleen yin qi. Clinically, the pattern of spleen yin deficiency sometimes refers to a deficiency of the spleen's body fluids, and other times to a deficiency of spleen blood. According to "Mai Yin Zheng Zhi": "Spleen deficiency can be divided into yin and yang. In cases of spleen yin deficiency, spleen blood is depleted, spleen fire flares up, and although the spleen is deficient, it still exhibits heat. If warming and tonifying methods are used, the fire will intensify and the yin will further deplete. Only by enriching and tonifying spleen yin can the yang recede and balance be restored." Therefore, the pattern of spleen yin deficiency is essentially a condition of "yin deficiency with yang hyperactivity" in the spleen, often caused by overstrain and internal damage. The clinical manifestations of spleen yin deficiency pattern mainly include: poor appetite, indigestion, retching hiccup, epigastric upset stomachache, dry mouth and thirst, dry stools, and muscle wasting. The tongue is red with little moisture, and the coating is yellow or absent. The pulse is thin and rapid.

The pattern of spleen yin deficiency is commonly seen in conditions such as "stomachache," "constipation," "vomiting blood," and "bloody stool."

The pattern of spleen yin deficiency should be differentiated from "stomach yin deficiency pattern," "pattern of fluid depletion in the large intestine," and "pattern of blood deficiency in the heart and spleen."

Spleen diseases are often discussed in terms of spleen qi deficiency pattern and spleen yang deficiency pattern. Xiezheng Lun·The Theory of Differences and Similarities between Men and Women states: "Starting with tonifying spleen yin, ancient times had few discoveries," yet the spleen's "one yin and one yang should not be neglected." Therefore, symptoms and signs caused by spleen yin deficiency should be carefully differentiated.

1. If stomachache presents with the pattern of spleen yin deficiency, there will be epigastric upset and pain, accompanied by poor appetite and digestion, dry throat, thirst, irritability, or retching hiccup, dry stools, red tongue with yellow coating, and a thin, rapid pulse. Xiezheng Lun·The Theory of Differences and Similarities between Men and Women also states: "Regulating the spleen and stomach requires distinguishing yin and yang. After Li Dong-yuan, those who emphasize the spleen and stomach only know to tonify spleen yang, but do not know to enrich and tonify spleen yin. If spleen yang is insufficient, water and grains will not be transformed; if spleen yin is insufficient, water and grains will still not be transformed." Therefore, "tonifying spleen yin to stimulate appetite and promote digestion" becomes one of the effective methods for treating stomachache. The formulas used are Coastal Glehnia Root Ophiopogon Decoction(Wenbing Tiaobian) and Ophiopogon Decoction(Jingui Yaolue).
2. If blood pattern present with spleen yin deficiency, such as spitting blood or hemoptysis, it is necessary to differentiate whether the main manifestation is spleen yin deficiency or yin deficiency with effulgent fire, and treat accordingly. Xiezheng Lun·Spitting Blood states: "If the spleen can control blood, then blood will naturally follow its path and not move recklessly. Now, the blood leaks into the stomach and is spit out, indicating that the spleen's yin aspect is diseased and has lost its normal function of controlling blood." It also states: "For spleen meridian yin deficiency, with a thin, rapid pulse, dry body fluids, and restless blood, use Ophiopogon Tuber Nourishing Decoction with Typha and Donkey-hide Gelatin." "For spleen meridian fire excess, with dry lips, severe constipation, and a slippery, full pulse, use Heart-Draining Decoction with Chinese Angelica, Unprocessed Rehmannia Root, Peony Root, Mongolian Snakegourd Root, Cun Dong, Submature Bitter Orange, Typha, and Liquorice Root."
3. If spleen yin deficiency fails to control blood, then "often due to overthinking damaging spleen yin, resulting in restless sleep, severe palpitation and overstrain, and poor appetite, use Returning to Spleen Decoction." (Jisheng Fang) If constipation presents with the pattern of spleen yin deficiency, it is the so-called "splenic constipation" syndrome mentioned in the Treatise on Cold Damage Diseases. The Annotation on the Treatise on Cold Damage Diseases·Differentiation of Yangming Disease Pulse Signs and Treatment Methods states: "If the stomach is strong and the spleen is weak, body fluids are constrained and cannot be distributed, only transported to the bladder, leading to frequent urination and difficult bowel movements. Use splenic constipation pill to unblock the intestines and moisten dryness." splenic constipation pill is Hemp Seed Pill. Alternatively, use Five-Kernel Pill(Shiyi Dexiao Fang).

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bubble_chart Differentiation of Similar Patterns

1. Stomach yin deficiency pattern and pattern of spleen yin deficiency: The spleen and stomach are one organ and one viscus, both being the foundation of the postnatal. The spleen prefers dryness and dislikes dampness, while the stomach prefers moisture and dislikes dryness. However, the stomach cannot lack yang qi, and the spleen cannot lack yin fluids. When the yin-yang drying dampness is appropriate, the functions of stomach reception and spleen transportation can be normal. If it loses its appropriateness, there will be the disadvantages of partial excess and partial deficiency. The stomach has differences of qi (yang) deficiency and yin deficiency, and the spleen also has differences of qi (yang) deficiency and yin deficiency. Moreover, because both reside in the middle energizer, the diseases are often similar and need to be carefully distinguished. Stomach yin deficiency and pattern of spleen yin deficiency, although both have symptoms such as reduced appetite, epigastric upset, vomiting and belching, constipation, red tongue with little fluid, and rapid pulse, their disease causes and mechanisms of disease are not entirely the same. Stomach yin deficiency is mostly caused by external-contraction febrile disease, where heat prevails and fluids are injured. Spleen yin deficiency is mostly caused by the hidden consumption of yin blood, where fluids are deficient and fire is vigorous. Stomach yin deficiency is acute, either from high fever, or from severe vomiting, diarrhea, profuse sweating, or major surgical operations that damage blood and consume yin. Spleen yin deficiency progresses more slowly. Stomach yin deficiency can be quickly relieved by increasing fluids and nourishing yin, while spleen yin deficiency requires enriching and tonifying spleen yin for gradual improvement.
2. Pattern of fluid depletion in the large intestine and pattern of spleen yin deficiency: The main clinical manifestation of pattern of fluid depletion in the large intestine is constipation, mostly seen in the elderly with weak constitution and fluid deficiency, or women postpartum with excessive loss of blood, and can also be seen in Rebing late stage [third stage]. Besides constipation and difficulty in defecation, symptoms such as red tongue with little fluid and yellow coating can be seen, but symptoms of spleen yin deficiency such as reduced appetite, epigastric upset, vomiting and belching rarely occur, and there are no signs of yin deficiency with effulgent fire such as muscle wasting, dry mouth and throat, and rapid pulse. The treatment usually involves moistening intestines to relieve constipation and "replenishing humor to promote defecation".
3. Pattern of blood deficiency in the heart and spleen and pattern of spleen yin deficiency: Pattern of spleen yin deficiency includes two aspects: spleen blood deficiency and deficiency of spleen body fluids. Clinically, it mostly refers to the deficiency of spleen body fluids as spleen yin deficiency. If the spleen is injured by overthinking and blood is reduced, the heart loses its nourishment, and symptoms such as palpitation, severe palpitation, insomnia, and forgetfulness can be seen. Pattern of blood deficiency in the heart and spleen is caused by overstrain and overthinking, leading to deficiency of heart blood and spleen blood, and the heart loses its nourishment. It also has symptoms such as palpitation, insomnia, and forgetfulness, but it is accompanied by manifestations of spleen qi deficiency, such as reduced appetite, abdominal distension, loose stool, fatigue, yellow complexion, shortness of breath, and emaciation. Pattern of spleen yin deficiency mostly presents with symptoms such as dry mouth, hiccup, epigastric upset, stomachache, dry stool, red tongue, and rapid pulse.

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bubble_chart Documentation

1. "Shenzhai's Posthumous Writings: Internal Damage": "Fatigue and discomfort in the body, nausea after eating, these symptoms are entirely due to the insufficiency of spleen yin. Insufficiency of spleen yin leads to the failure of stomach yang to rise, and liver depression encroaches, liver fire ascends, and the true yang in the stomach cannot generate, thus completely losing its nourishment, and water also weakens, the triple energizer becomes all yin fire."