Pi-Wei System Related Diseases. Introduction

Transcription

1 1 A. Review of Pi-Wei System: I. Functions of Spleen Pi-Wei System Related Diseases Introduction By H. Shen The spleen is situated in the middle jiao and its meridian connects with the stomach with which it is closed related. The main functions of the spleen are as: 1. Governing transformation and transportation: Transformation implies digestion and absorption. Transportation implies transmission. The function of Spleen involves transformation and transportation of water and food on the one hand, and of dampness on the other. Spleen functions to perform the digestion, absorption and transmission of nutrient substance. Since water and food are the main source of the nutrient substance required by the body after birth, as well as being the main material base for the production of Qi and blood, Spleen is considered to be the main Zang organ for the manufacture of Qi and blood. When Spleen Qi is sufficient, digestion, absorption and transmission are normal. Deficiency of dysfunction of Spleen may lead to poor appetite, abdominal distension, loose stools or diarrhoea, lassitude, emaciation and malnutrition. Spleen also plays a role in the water metabolism, by transforming and transport dampness. It transports the excess fluid of the tissues, organs and all over the body and helps discharge it from the body. It ensures that various tissues of the body are both properly moistened and at the same time free from retention of dampness. Dysfunction of Spleen may lead to damp retention with such symptoms as oedema, phlegm and retained fluid. 2. Ascending Qi Movement: In the circulation of Qi and body fluids, the upwards movement is powered by Spleen. As there are no excretion organs in the upper part of the body, no turbid material or waste should be sent to there. All the upper part of the body needs is nutrient Qi (clear Qi), and Spleen sends the clear Qi transformed from food by Spleen itself upwards to Lung, where the clear Qi from food is combined together with the clear Qi (oxygen) inhaled from Lung to produce the primary Qi and blood. Spleen works together with Stomach, while Stomach descends the turbid Qi (waste from food after digestion) down to the intestines, Spleen ascends the clear Qi up to Lung. The Ascending function of Spleen also works to support the internal organs in their position against their own weight. The upwards movement of Qi is vital to keep the internal organs in their normal position, as supported by Spleen. Without such support from Spleen, the weight will pull the organs down by nature. 3. Confining blood in the vessels Spleen Qi has the function of keeping the blood circulating in the vessels and preventing blood overflowing outside the vessels. With the support from Spleen Qi, the blood vessels can confine the blood. If Spleen Qi is weak and fails to control blood, there may be various kinds of haemorrhage, such as bloody stool, uterine bleeding and purpura.

2 4. Dominating the muscles and four limbs Spleen supplies food essence and water to nourish the muscles and the four limbs. Adequate nourishment ensures well-developed muscles and proper function of the limbs. If Spleen fails to supply adequate nourishment, the muscles and/or four limbs will become weak, soft or even atrophic. 5. Opening into mouth and manifesting on the lips Spleen s function of transformation and transportation is closely related to food intake and the sense of taste. When Spleen functions normally, there will be good appetite and normal sense of taste; when there is dysfunction of Spleen, there will be poor appetite, impaired sense of taste with sticky, sweetish sensation in the mouth due to retention of pathogenic damp in Spleen. The lips reflect the condition of Spleen s function. With healthy Spleen, one will have sufficient Qi and blood to nourish and shine the lips, so lips will be red and lustrous. Deficiency of Spleen Qi may manifest as pale or sallow lips. II. Functions of Stomach, Small Intestine and Large intestine 1. Stomach Stomach is located in the epigastrium. ST Meridian communicates Spleen. Receiving and decomposing food, then transmitting food down to the small intestine. Relation with Spleen: performing part of transforming and transporting function of Spleen. Descending the turbid Qi down to small intestine while Spleen ascending Clear Qi up to Lung. 2. Small Intestine Small intestine is located in the middle abdomen. It connects the stomach and large intestine at its two ends. SI Meridian communicates with heart. Receiving and further digesting food from the stomach, absorbing food essence and part of the water from food, offering a place for Spleen to transform and transport food. Separating the clear from the turbid: small intestine extracts water from the half-digested food and transmits the water into bladder through kidney. The remaining water is transmitted with food residue to large intestine to moisten it. Relation with Heart: Heart-Fire can transmit to the Small Intestine causing thirst, bitter taste, tongue ulcers, and abnormal urination. 3. Large Intestine Large intestine is located in abdomen and its upper end connects small intestine and its lower end is the anus. LI Meridian communicates with Lung. Receiving food residue sent down from small intestine, to absorb its fluid content and form the remaining into faeces to be excreted. 2

3 The opening and closing of anus is controlled by large intestine and kidney together. Relation with Lung: Excess lung heat can lead to constipation. B. Pi-Wei Syndrome Patterns Spleen and Stomach are both located in Middle Jiao. They have their meridians to connect each other to form an exterior-interior relationship. Spleen transports and transforms food and fluids; Stomach receives and digests food and fluids. Spleen Qi is ought to ascend while Stomach Qi being ought to descend. Both work together to perform the function of food and fluids digestion, absorption and distribution, acting as the source for Qi and blood production. Therefore, Spleen and Stomach are called the source of post-heaven Qi. Spleen also has functions to confine blood and dominate muscles and limbs. The syndromes of Spleen and Stomach can be of cold or heat, excess or deficiency. Spleen syndromes are mainly due to dysfunction of T&T or blood confining, as well as damp retention or Yang Qi being too weak to ascend. Stomach syndromes are mainly caused by food stagnation or indigestion, Stomach Qi failing to descend but rebelling up. Spleen and Stomach (especially Spleen) work together to maintain the function of whole digestive system, so when they are caught in disorders, the clinical manifestations will include symptoms of small and large intestines, such as diarrhea, abdominal pain. In clinical manifestations, Spleen syndromes often cause abdominal distension and pain, loose stools or diarrhea, edema and haemorrhages. Stomach syndromes commonly cause epigasrtic pain, nausea/vomiting, belching and hiccup. 1. Spleen Qi Deficiency This refers to the weakness of Qi in Spleen causing dysfunction of transportation and transformation of Spleen, which is usually due to improper diet, congenital weakness, overwork, as well as other acute and chronic disorders over-consuming and damaging Spleen Qi. Clinical manifestations: Tiredness/fatigue in body and limbs, Low energy level and not willing to speak, poor appetite, abdominal distension especially after meals, loose stools or diarrhea, pale or sallow complexion, weak pulse. 2. Spleen Yang Deficiency Yang Qi of Spleen is too weak to warm the interior, leading to internal cold accumulation. It is usually a further development of Spleen Qi Deficiency, but can also be caused by congenital weakness, over-eating of cold food, or due to Kidney Yang deficiency with fire failing to generate earth. Clinical manifestations: Tiredness/fatigue in body and limbs, Low energy level and not willing to speak, poor appetite, abdominal distension, loose stools or watery diarrhea, dull abdominal pain which can be released by warmth and pressure, aversion to cold with cold limbs, or with heaviness in limbs, or edema in the body, pale and swollen tongue with white slippery coating, deep, slow and weak pulse. 3

4 3. Middle Jiao Qi Sinking Syndrome Spleen Qi is too weak to maintain its ascending movement, but suffers from sinking collapse. It is mostly caused by further development of Spleen Qi deficiency, usually seen in patients with long term chronic diarrhea or dysentery, or long term excessive overwork damaging Spleen Qi. Clinical manifestations: abdominal distension with heavy downward dragging sensation, especially after meals; or frequent feeling of wanting to defecate, with heavy dragging sensation in anus; or long term non-stop diarrhea or dysentery, or even rectal prolapsed; or uterine prolapsed; accompanied with fatigue and low energy level, weak and lazy limbs, not willing to speak with weak voice, dizziness with blurred vision. Pale tongue with white coating, weak pulse. 4. Spleen Failing to Confine Blood syndrome Spleen Qi is too weak to confine blood in the vessels causing various haemorrhages. Usually caused by congenital weakness of Spleen, or enduring illness consuming Spleen Qi, or overwork damaging Spleen. Clinical manifestations: Bleeding in the stool or in urine, purpura, nose or gum bleeding. In women menorrhagia or uterine bleeding. Accompanied with poor appetite, loose stools, fatigue with lethargic vitality, Not willing to speak with weak breathing, pale or sallow complexion, pale tongue white coating, thready and weak pulse. 5. Cold Damp Sieging Spleen Syndrome Cold and Damp accumulating in Middle Jiao, Spleen Yang is sieged by cold damp. Usually caused by improper diet such as over eating or raw cold food, wading in rain or ranking in water, as well as congenital factors with damp body constitution. Clinical Manifestations: Abdominal bloating and discomfort, poor appetite, loose stool, nausea and feeling sick, blank taste in mouth with no thirst, heavy and lethargic feeling in head and body, dull sallow complexion, or dull colour of jaundice in skin and eyes, or edema in limbs, scanty urine. Pale and swollen tongue with greasy white coating, soggy and slow pulse. 6. Damp Heat Reserving in Spleen Syndrome Damp and heat reserve in Middle Jiao and affecting the functions of Spleen. Usually caused by exterior damp heat pathogen invading into Middle Jiao, or over eating of hot, fatty and greasy, or sweet food, or over intake of alcohol causing damp heat being generated from interior. Clinical Manifestations: Abdominal distension and discomfort, poor appetite, nausea or even vomiting, loose stool or diarrhea, dark urine, heavy and lethargic limbs. Or jaundice in skin and eyes with bright colour like orange, or low body fever with tidal nature, perspiration that cannot release the fever. Red tongue with think yellow coating, soggy and rapid pulse. 7. Stomach Yin Deficiency Stomach Yin is too weak to nourish, the functions of stomach are impaired. Usually caused by enduring stomach illness over-consuming Stomach Yin, or in the late stage of febrile diseases with Yin and body fluids being impaired by heat, or overeating of spicy food generating heat in stomach, 4

5 or emotional factors leading to Qi stagnation which then transforms to heat, therefore heat impairs Stomach Yin. Clinical Manifestations: Dull pain in epigastric region, feeling hungry but not willing to eat, dry mouth and dry throat, constipation, discomfort in upper abdomen, or dry nausea and belching. Red tongue with little coating, thin and rapid pulse. 8. Food Stagnation in Stomach Syndrome Food is stagnated in Stomach and Stomach fails to digest and transport food down to intestines. Usually caused by Improper excessive diet, binge drinking and eating; or enduring Spleen and Stomach deficiency fails to transport and transform food. Clinical Manifestations: Pain, distension and discomfort in Stomach, belching with acid reflux, or vomiting foul odour food, relief of distension and pain after vomiting, or frequent farting with loose stool, stool being rancid foul and filth. Thick and greasy tongue coating, slippery pulse. 9. Stomach Cold Syndrome Yin cold condenses in Stomach causing Stomach dysfunction. Usually caused by catching cold in upper abdomen, overeating of raw cold food, or overwork impairing Stomach which is prone to cold invasion. Clinical Manifestations: Pain with cold sensation in Stomach region, either consistent pain or sharp colic severe pain, cold worsening the pain, warmth releasing the pain, blank taste in mouth with no thirst, excessive thin and clear saliva, or nausea and vomiting, or water glistening sound in stomach. White slippery tongue coating, wiry or slow pulse. 10. Stomach Heat Syndrome Heat or fire flaming in Stomach causes Stomach dysfunction. Usually caused by craving and overeating of spicy and greasy food, which transforms into heat/fire. Or emotional factors causes Qi stagnation which can also transform into heat/fire. Clinical Manifestations: Burning pain in Stomach, acid reflux, stomach upset, or vomiting immediately after eating food, or thirst with desire for cold drink, easy to get hungry and eat excessively, or toothache with swollen gum or gum bleeding, bad breath, constipation, scanty and dark urine. Red tongue with yellow coating, slippery and rapid pulse. 5