All lessons Module 4: Organ by organ Lesson 4
Spleen
Teeth marks, a Pale, wet, Swollen tongue, a pulse that falls away when you press: which pattern of the Spleen do you read, and what tells the neighbours apart?
After this lesson you know where to read the Spleen (the centre of the tongue, the edges of the middle section and right guan), you know the tongue and pulse of every Spleen pattern, you separate the soft pulses (empty, weak, soggy, slippery), you read from the coating whether the Dampness was made inside or has invaded, you know which tongues go to a doctor first, and you read tiredness after eating from finding to principle.
Know by heart
- Where you read the Spleen. On the tongue, the centre (Spleen and Stomach) and the edges of the middle section; at the wrist, right guan. Teeth marks: the Spleen does not hold the shape; mnemonic: the Spleen sits in the middle and shows its teeth.
- Qi and Yang. Spleen-Qi deficiency: Pale, teeth marks; empty, right guan the weakest. Spleen-Yang deficiency: Pale, wet, Swollen; deep, weak, slow; mnemonic: wet and slow is the Yang.
- Sinks, leaks, lacks. Spleen-Qi sinking: Pale; empty, without strength. Spleen not controlling Blood: Pale; thin, without strength. Spleen-Blood deficiency: Pale, Thin, slightly dry; thin or choppy; mnemonic: three times a Pale tongue; the complaint says which.
- Yin. Spleen-Yin deficiency: normal or slightly red, dry, little coating in the centre; short transverse cracks on the edges of the middle section (textbook); thin.
- Three kinds of Dampness. Spleen deficiency with Dampness: Swollen, teeth marks, sticky white; slippery or soggy. Cold-Damp invading: thick sticky white; slippery and slow, with strength. Damp-Heat: Red, sticky yellow; slippery-rapid; mnemonic: soft and white is made inside, strong and white has invaded, yellow is hot.
- The soft pulses. Empty: big and soft, gives way (Qi). Weak: deep, thin and soft (Qi and Yang). Soggy: thin and soft on top, gone under pressure (Dampness on deficiency). Slippery: smooth and rolling (Dampness with strength); mnemonic: soggy is soft on top, weak is soft below, slippery rolls.
- Red flags. A large tongue with teeth marks in someone who has become slow, sensitive to cold and heavier: thyroid. Snoring with pauses in breathing: sleep apnoea. Pale with weight loss, blood in the stools or diarrhoea at night: a GP or primary care doctor. Black stools or vomiting blood: urgent.
The rest of this lesson is reference.
Three practice questions from this lesson
Where do you read the Spleen on the tongue and at the wrist?
- The sides of the tongue and left guan
- The centre of the tongue and right guan
- The root of the tongue and right chi
Answer: The centre of the tongue and right guan. The centre is the zone of the Spleen and Stomach; teeth marks, swelling and transverse cracks show on the edges of the middle section. Right guan is the position of the Spleen. The sides and left guan belong to the Liver, the root and chi to the Kidneys.
What do teeth marks mean, and why do they not belong only to Spleen-Qi deficiency?
- The build of the jaw, not a sign of an organ
- A sign of the Spleen; Swollen and wet points to Yang deficiency or Dampness
- A sign of Heat that makes the edges swell, as with the Liver
Answer: A sign of the Spleen; Swollen and wet points to Yang deficiency or Dampness. Teeth marks are a sign of the Spleen: it does not hold the shape. The size and the colour say which pattern: only Pale is Qi deficiency, Swollen and wet is Yang deficiency or Dampness. Fine marks on a tongue that is not swollen sometimes come from tension in the jaw.
Case. Woman, 34: tired, especially after eating, poor appetite, bloated after meals, loose stools. Not sensitive to cold, no feeling of heaviness. Tongue Pale with teeth marks, thin white coating. Pulse big and soft, right guan the weakest.
- Spleen deficiency with Dampness
- Spleen-Yang deficiency
- Spleen-Qi deficiency
Answer: Spleen-Qi deficiency. Pale with teeth marks and an empty pulse at right guan, without cold and without sticky coating: Spleen-Qi deficiency. With tiredness, Hb, ferritin and TSH first.
The rest of this lesson
In the course you get the step-by-step explanation with illustrated tongues and animated pulse models, 16 case-based practice questions, 16 spaced-repetition flashcards, the pitfalls, the bridge to physiology and the visual trainer. This lesson belongs to module 4: Organ by organ.