Spleen
The Spleen is a Yin (Zang) organ in TCM belonging to the Earth element. Known as the 'Root of Postnatal Qi' (后天之本), it is the primary organ responsible for transforming food and fluids into Qi and Blood, and distributing these nourishing substances throughout the body.
Five Element Correspondences
Season
Late Summer
Climate
Dampness
Emotion
Pensiveness, worry, overthinking
Color
Yellow
Taste
Sweet
Sound
Singing
Direction
Center
Sense Organ
Mouth (opens to the lips)
Body Tissue
Muscles and flesh
Body Fluid
Saliva (thin, watery - Xian 涎)
Peak Hours
09-11
Meridian
Spleen Meridian
Educational content · Consult qualified TCM practitioners for diagnosis and treatment
Overview
In Traditional Chinese Medicine, the Spleen (脾, Pí) holds a position of central importance as the body's primary digestive powerhouse. Unlike the Western anatomical spleen, which is an immune organ, the TCM Spleen encompasses a much broader functional system that includes aspects of the pancreas, digestive tract, and metabolic processes. It is honored with the title 'Root of Postnatal Qi' (后天之本), signifying its role as the foundation of all energy and nourishment acquired after birth.
The Spleen's essential function is transformation and transportation (运化, yùn huà)—converting food and drink into usable nutrients and energy, then distributing these throughout the body. This makes it the source of Qi and Blood production. The Spleen also plays a crucial role in water metabolism, preventing the accumulation of pathological Dampness, and in 'holding' the Blood within the vessels. Its ascending energy raises nutrients upward to the Heart and Lungs while also physically supporting internal organs against prolapse.
The Spleen is particularly vulnerable to Dampness and overthinking, and it prefers a warm, dry environment. Its health is reflected in the muscles, the mouth and lips, and one's overall vitality and digestive capacity.
Historical Context
The concept of the Spleen in Chinese medicine has evolved significantly over millennia. Early texts like the Huáng Dì Nèi Jīng (circa 200 BCE) established the Spleen's fundamental role in transformation and transportation of food essence. The Nán Jīng (Classic of Difficulties) described both the anatomical spleen and the 'scattered fat' (散膏, sàn gāo), which scholars now recognize as referring to the pancreas.
During the Ming and Qing dynasties, physicians like Lǐ Dōng-yuán (李东垣, 1180-1251) of the 'Earth School' (补土派) elevated the Spleen's importance, emphasizing that most chronic diseases stem from Spleen and Stomach weakness. His famous treatise Pí Wèi Lùn (脾胃论, Treatise on the Spleen and Stomach) established treatment principles still used today. When Western anatomy was introduced to China, the English term 'spleen' was translated using the character 脾, creating confusion because the Western organ has primarily immune functions while the TCM Spleen encompasses digestive-metabolic functions more aligned with the pancreas.
Physiological Functions
Governs Transformation and Transportation
主运化 (Zhǔ Yùn Huà)The Spleen's most important function is transforming food and drink into usable nutrients (Grain Qi/Gu Qi) and transporting these refined essences throughout the body. This includes breaking down food, absorbing nutrients, and distributing them to nourish all tissues and organs. When this function is impaired, symptoms like poor appetite, bloating, loose stools, and fatigue arise.
Transforms and Transports Fluids
运化水湿 (Yùn Huà Shuǐ Shī)The Spleen manages water metabolism by separating usable fluids from waste, sending pure fluids upward to the Lungs for distribution and turbid fluids downward for elimination. Dysfunction leads to accumulation of Dampness, Phlegm, or edema. This is why TCM states: 'All Dampness and swelling belong to the Spleen.'
Controls the Ascending of Qi
主升清 (Zhǔ Shēng Qīng)The Spleen Qi has a natural upward, lifting quality. It raises refined nutrients (clear Yang) to the Heart and Lungs to form Qi and Blood, sends clear Qi to the head for mental clarity, and holds internal organs in their proper position. When Spleen Qi sinks, prolapse of organs (stomach, uterus, rectum), chronic diarrhea, and mental fogginess occur.
Controls the Blood
统血 (Tǒng Xuè)The Spleen keeps Blood circulating within the vessels, preventing it from leaking out. This 'containing' function depends on adequate Spleen Qi. When the Spleen fails to control Blood, chronic bleeding occurs—typically in the lower body (bloody stools, urine, heavy menstruation, bruising)—with blood that is pale and thin, characteristic of deficiency-type bleeding.
Governs the Muscles and Four Limbs
主肌肉四肢 (Zhǔ Jī Ròu Sì Zhī)The Spleen transports nutrients to nourish the muscles and limbs. Strong Spleen function produces well-toned muscles and energetic limbs. Spleen deficiency leads to muscle weakness, wasting, heavy limbs, and overall fatigue—the characteristic feeling of 'no strength to lift one's arms.'
Relationships with Other Organs
Other
The Spleen and Stomach form a paired Yin-Yang unit and work together as the 'Middle Burner' digestive system. The Stomach receives and 'ripens' food, while the Spleen transforms it into nutrients. The Stomach Qi descends (sending food downward), while Spleen Qi ascends (raising nutrients upward). This complementary rising-descending relationship is essential for healthy digestion. The Spleen prefers dryness and dislikes Dampness; the Stomach prefers moisture and dislikes dryness.
Generating
The Heart (Fire) generates and supports the Spleen (Earth) in the Five Element generating cycle. The Spleen produces Blood from food essence, which the Heart then circulates. Together they share the function of keeping Blood in the vessels. Heart Blood Deficiency often develops from Spleen Qi Deficiency when Blood production is insufficient.
Generating
The Spleen (Earth) generates and supports the Lungs (Metal). The Spleen sends refined Food Qi upward to the Lungs, where it combines with air to form true Qi. If the Spleen is weak, insufficient Qi reaches the Lungs, causing shortness of breath, weak voice, and lowered immunity. Both organs work together in water metabolism—the Spleen raises fluids to the Lungs for distribution.
Controlling
The Liver (Wood) controls the Spleen (Earth) in the Five Element controlling cycle. The Liver's smooth flow of Qi assists Spleen transformation. However, when Liver Qi stagnates (often from emotional stress), it can 'invade' and overwhelm the Spleen, causing digestive symptoms—this is called 'Liver overacting on Spleen' (肝木克脾土). Symptoms include alternating constipation and diarrhea, bloating, and irritability affecting appetite.
Other
The Spleen is the 'Root of Postnatal Qi' while the Kidneys are the 'Root of Prenatal Qi.' These two organs support each other—the Kidneys warm the Spleen with Yang fire (Kidney Yang warms Spleen Yang for digestive 'fire'), while the Spleen replenishes Kidney essence through nourishment. Chronic Spleen deficiency can deplete Kidney Yang, and Kidney Yang deficiency can fail to warm the Spleen, creating a vicious cycle.
Common Pathological Patterns
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Tongue Manifestations
Spleen Qi Deficiency: Pale or normal colored tongue, possibly swollen with tooth marks (scalloped edges) on the sides indicating fluid accumulation, with a thin white coating. Transverse cracks may appear.
Spleen Yang Deficiency: Very pale tongue, wet and swollen, with a white slippery or watery coating.
Dampness Affecting the Spleen: Swollen tongue with a thick, sticky coating—white if Cold-Dampness, yellow if Damp-Heat.
Spleen Not Controlling Blood: Pale tongue reflecting underlying Qi deficiency.
Pulse Manifestations
Spleen Qi Deficiency: Empty (Xu) or Weak pulse, particularly in the right Guan (middle) position, which corresponds to the Spleen and Stomach.
Spleen Yang Deficiency: Deep, Slow, and Weak pulse—the depth and slowness reflecting internal Cold and Yang deficiency.
Dampness Patterns: Slippery pulse indicating fluid accumulation; if combined with Heat, also Rapid.
Spleen Qi Sinking: Weak pulse that may feel like it's 'falling away' or difficult to find with light pressure.
Clinical Relevance
The Spleen is central to TCM clinical practice, as most chronic conditions involve some degree of Spleen dysfunction. Digestive complaints (IBS, bloating, poor appetite), fatigue syndromes, prolapse conditions, and certain types of bleeding are commonly treated by strengthening Spleen Qi. The principle 'treat the Spleen to address Dampness' guides therapy for conditions ranging from edema to obesity to chronic sinusitis.
Modern research has explored connections between TCM Spleen deficiency patterns and gut microbiome imbalances, showing correlations with digestive disorders and metabolic conditions including diabetes. Clinically, practitioners assess the Spleen through tongue and pulse diagnosis, observing for pale color, tooth marks, and weak pulse quality. Treatment emphasizes warm, cooked foods, avoiding cold and raw foods, managing worry and overthinking, and using herbs and acupuncture to tonify Spleen Qi.
Classical Sources
Huáng Dì Nèi Jīng (黄帝内经)
Sù Wèn, Chapter 29 (素问·太阴阳明论)脾与胃以膜相连耳
The Spleen and Stomach are connected by a membrane.
Huáng Dì Nèi Jīng (黄帝内经)
Sù Wèn, Chapter 74 (素问·至真要大论)诸湿肿满，皆属于脾
All Dampness, swelling, and fullness belong to the Spleen.
Nán Jīng (难经)
Chapter 42脾重二斤三两，扁广三寸，长五寸，有散膏半斤
The Spleen weighs two jin and three liang, is flat and broad at three cun, five cun long, and has half a jin of 'scattered fat' [referring to the pancreas].
Yī Zōng Bì Dú (医宗必读)
Chapter on Spleen and Stomach后天之本在脾
The Root of the Postnatal [constitution] lies in the Spleen.
Modern References
The Foundations of Chinese Medicine
Comprehensive textbook with detailed chapters on Spleen physiology and pathology in TCM
Integrative metabolic and microbial profiling on patients with Spleen-yang-deficiency syndrome
Research correlating TCM Spleen deficiency patterns with gut microbiome changes
Diagnosis in Chinese Medicine: A Comprehensive Guide
Detailed diagnostic criteria for Spleen patterns including tongue and pulse signs
Analysis of spleen dominating transportation and transformation in TCM from the perspective of modern medicine
Beijing Journal of Traditional Chinese Medicine article examining Spleen function through modern lens