🌿 Folk Prescriptions

In my long-term clinical practice, I have accumulated some experience in treating spleen and stomach disorders. Here is a summary of my understanding and treatment experience:
One, The Physiological Characteristics of Spleen and Stomach Lie in Rising and Falling
The spleen and stomach are the foundation of postnatal life and the source of qi and blood. Their functional characteristics center on rising and falling. The spleen governs transportation and transformation, distributing refined substances upward (rising clear); the stomach receives and digests food, transforming it downward (falling turbid). A healthy spleen rises; a harmonious stomach falls. If the spleen fails to transport properly, clear Qi cannot rise; if the stomach fails to descend, turbid Qi cannot fall, instead reversing upward. The spleen is a yin organ, the stomach a yang organ, mutually related as interior and exterior, one rising, one falling, their rising and falling complement each other. Not only do they manage food digestion and distribution of refined substances, but they also govern the overall rise and fall of yin, yang, qi, blood, and fire-water in the body—making them the pivot of bodily movement. The rise and fall of the spleen and stomach are interdependent: if the stomach fails to descend, the spleen cannot rise; if the spleen fails to rise, the stomach cannot descend. As Yu Jia Yan said: "When the middle energizer is strong, the clear Qi from food and drink ascends to nourish the hundred meridians, while the turbid Qi descends into the large and small intestines via excretion." When the spleen’s clear Qi rises and the stomach’s turbid Qi descends, qi and blood generation has a source, and their entry and exit are orderly. Without proper transportation and rising, generation has no beginning; without descending, transmission has no way, leading to stagnation and disease.
Two, Spleen and Stomach Disorders Manifest Primarily as Dampness and Stagnation
Although spleen and stomach disorders vary widely, dampness and stagnation are common underlying mechanisms. The spleen and stomach are the "granary officials" and "sea of grains," receiving everything without rejection. Pathogens easily invade and settle here, disrupting the spleen and stomach’s normal rise and fall, obstructing qi flow, causing water to become dampness and food to become stagnation. Consequently, dampness, food accumulation, phlegm, qi stagnation, blood stasis, and fire stagnation arise together. Pathogen and righteousness intertwine, blocking the middle energizer, forming real stagnation. If the spleen and stomach are weak, their transformation and transportation fail, leading to imbalance in rise and fall, clear and turbid substances mixing, dampness and stagnation arising from deficiency—what is called "deficiency leading to excess, deficiency with stagnation." As *Suwen·Tiao Jing Lun* states: "Excessive fatigue weakens the body, reduces grain Qi, prevents upper energizer from functioning, and blocks lower energizer..." Because dampness and stagnation are key pathogenic factors, treatment of spleen and stomach disorders—whether warming, clearing, tonifying, or purging—must always aim to move stagnation, resolve dampness, and restore normal rise and fall.
Three, Treatment of Spleen and Stomach Disorders Prioritizes Regulation, with Additional Attention to Lung Qi Promotion
Spleen and stomach disorders are often marked by dampness and stagnation. Spleen disorders are often dampness-prone, easily overwhelmed by dampness; stomach disorders are often heat-prone, easily congested by heat. All stem from improper rise and fall of qi. Thus, spleen and stomach disorders should not be treated with excessive tonification or purgation but rather with regulation—seeking the root cause of qi imbalance, diagnosing the cause, and treating accordingly. Restore the normal rise and fall of the spleen and stomach, eliminate dampness and stagnation, and harmony will return—symptoms will vanish.
During regulation, also promote lung Qi. Since the spleen governs transformation of food and drink, like fermentation, and the lung distributes refined substances like mist, the spleen relies on the lung’s assistance to complete the distribution of food essence. As *Suwen·Jing Mai Bie Lun* states: "The spleen disperses essence upward to the lung, regulating water pathways and sending fluids downward to the bladder." The lung governs promotion and descent, the spleen and stomach govern rising clear and descending turbid. Both govern the rise and fall of qi. Thus, treating the spleen must consider the lung, and treating the lung must examine the spleen. In clinical prescriptions, add herbs to promote lung Qi and relieve depression—such as apricot kernel, trichosanthes, ephedra. Ye Tian Shi in *Linzheng Zhinan Yian* used apricot kernel to promote lung Qi and relieve depression, pioneering the method of promoting lung Qi, draining water, and strengthening the spleen.
Four, Clinical Experience
1. Spleen Dampness with Exogenous Infection: Wind is the leader of all diseases, often bringing other pathogens. Wind with dampness invading externally presents with fever and chills, epigastric fullness, nausea and vomiting, dizziness, head heaviness, neck and back stiffness. Use Pingwei San with apricot kernel, kudzu root, agastache, cinnamon twig, qianghuo, and saposhnikovia—herbs that dispel wind and harmonize the stomach. This treats both exterior wind and gastric dampness, suitable for gastroenteric flu.
2. Cold-Dampness Overcoming the Spleen: Cold and dampness are both yin evils, easily overcoming spleen yang and obstructing qi. Symptoms include back coldness, fear of cold, epigastric fullness, poor appetite, loose stools, nausea, and vomiting. Use Wu Ling San and Pingwei San with apricot kernel, ephedra, agastache, cardamom seed, and ginger—enhancing dampness removal and supporting spleen function. If cold predominates over dampness, replace cardamom seed with sand ginger and add cinnamon twig and high-quality ginger to warm the stomach and dispel cold. If dampness predominates over cold, add atractylodes.
3. Spleen and Stomach Dampness-Heat: Dampness-heat in the spleen and stomach manifests diversely—epigastric pain, burning sensation, dry mouth without desire to drink, hunger without appetite, yellow urine, constipation. Key diagnostic points: clear heat without hindering dampness, resolve dampness without promoting heat. Use Sanren Tang with modifications, often adding winter melon peel and patchouli to clear heat and resolve dampness, restoring spleen and stomach harmony. For dampness-heat dysentery, use Ge Gen Qin Lian Tang with modifications. If jaundice appears, use Yin Chen Wu Ling San with modifications.
4. Liver Qi Stagnation with Spleen Dampness: The rise and fall of the spleen and stomach are closely linked to liver Qi dispersion. If emotions are depressed, liver Qi stagnates and fails to disperse, invading the spleen and stomach, disrupting their rise and fall, generating internal dampness, obstructing the middle energizer—leading to epigastric fullness, bilateral rib pain, chest tightness, frequent belching, sighing, loose stools, poor appetite, limb heaviness, symptoms worsening with emotional stress. Treatment: soothe the liver, relieve depression, strengthen the spleen, dry dampness. For those with more stomach Qi stagnation, use Chaihu Shugan San with modifications. For those with more spleen deficiency, use Xiaoyao San combined with Pingwei San. For abdominal pain and diarrhea due to liver-spleen disharmony, use Tongxie Yaofang as the primary formula, adding patchouli, cyperus, green tangerine peel, agastache, cardamom seed to open depression and resolve dampness—so the liver disperses, spleen dampness moves, rise and fall harmonize, turbidity clears.
5. Spleen and Stomach Deficiency: Those with weak constitution, coupled with irregular diet, damaging the spleen and stomach, leading to impaired transformation and transportation—manifesting as shortness of breath, fatigue, pale complexion, poor appetite, loose stools. If accompanied by yang deficiency, symptoms include epigastric pain, preference for warmth and pressure, cold limbs, fatigue, poor appetite, worsened by cold, improved by warmth, clear diarrhea. Long-term spleen deficiency may lead to middle energizer sinking, causing prolonged diarrhea, rectal prolapse, menorrhagia. For qi deficiency, use Liu Junzi Tang to strengthen the spleen and tonify qi—where tangerine peel and pinellia prevent stagnation. For spleen-stomach deficiency with cold, warm and scatter cold—use Liang Fu Wan, Lǐzhōng Tāng, or Huángqí Jiànzhōng Tāng with modifications. For middle energizer sinking, tonify qi and lift yang—use Bùzhōng Yìqì Tāng with modifications.
6. Spleen Deficiency with Dampness: This condition is a mix of deficiency and excess—treat by reinforcing the root and removing the pathogen, balancing both. Commonly used formula includes codonopsis, atractylodes, poria, agastache, cardamom seed, magnolia bark, citri fructus, apricot kernel, ephedra. Codonopsis is neutral, sweet, entering spleen and lung meridians, with benefits of tonifying middle energizer and boosting qi. Atractylodes is sweet and slightly warm, targeting spleen and stomach meridians, strengthening spleen and stomach, drying dampness, and promoting urination—especially effective for strengthening spleen and boosting qi. Poria strengthens the spleen, resolves dampness, harmonizes the stomach, and calms the spirit—paired with atractylodes to enhance spleen-strengthening and dampness-resolving effects. Agastache is aromatic, slightly warm, with benefits of resolving dampness, regulating Qi, and harmonizing the center—used with cardamom seed to support both pathogen removal and reinforcement. Apricot kernel and ephedra are both bitter and warm, entering the lung meridian—opening the upper energizer's lung Qi, enabling lung Qi to circulate, thus resolving dampness obstruction. Magnolia bark and citri fructus regulate Qi and resolve phlegm, raising clear Qi and descending turbid Qi. Together, these herbs strengthen the spleen, dry dampness, promote lung Qi, and resolve phlegm—suitable for various spleen-dampness conditions such as edema, diarrhea, and cough. Applicable to all cases of spleen deficiency with dampness, regardless of cold or heat, adjustments can be made.
Five, Case Examples:
1. Gastric Pain Case: Mr. Zhang, male, 45 years old. Gastric distension and pain, chest and rib fullness, frequent sighing, frequent belching, poor appetite, heavy limbs, drowsiness, bowel movements not smooth, pale tongue with thick white greasy coating, deep wiry slippery pulse. Syndrome: liver stagnation with spleen dampness. Treatment: soothe the liver, harmonize the stomach, strengthen the spleen, resolve dampness. Formula: apricot kernel 10g, trichosanthes peel 12g, bupleurum 6g, cyperus 9g, poria 20g, agastache 12g, cardamom seed 9g, magnolia bark 9g, citri fructus 9g, white peony 12g, licorice 6g, pinellia 6g. After three doses, gastric distension and pain gradually decreased, bowel movements normalized, appetite improved, thick greasy coating faded. Continued for four more doses, fully recovered.
Gastric pain often results from emotional distress, fatigue, irregular eating, and exposure to cold, leading to impaired spleen-stomach Qi flow. Though causes vary, the mechanism is gastric Qi stagnation—obstruction leads to pain. Based on gastric distension and pain, often triggered by emotional distress, treatment often focuses on the liver. Thus, the formula uses bupleurum and cyperus to soothe the liver and regulate Qi; agastache and cardamom seed to resolve dampness and harmonize the stomach; poria to promote dampness elimination; apricot kernel and trichosanthes to promote lung Qi and relieve depression, enabling dampness obstruction to be resolved; white peony and licorice to relieve urgency and stop pain. Combined, these herbs achieve the effect of soothing the liver, harmonizing the stomach, strengthening the spleen, and resolving dampness.
2. Dampness-Heat Mouth Ulcer Case: Mr. Li, male, 50 years old. Recurrent mouth ulcers for over three years. Cold-clearing drugs cure ulcers but worsen loose stools. Switching to warm-tonifying drugs improves loose stools but aggravates ulcers, causing unbearable pain, inability to eat, and recurrence often linked to fatigue. Current symptoms include headache, dry mouth without desire to drink, loose stools, fatigue, pale tongue with yellow thick coating, slippery rapid pulse. Oral mucosa shows congestion, with two ulcers on the edges and tips, surrounded by redness. Syndrome: dampness-heat in spleen and stomach, fire toxin scorching. Treatment: clear heat, detoxify. Formula: apricot kernel 10g, coix seed 15g, cardamom seed 6g, poria 15g, dandelion 15g, saposhnikovia 9g, yam 20g, agastache 10g, bamboo leaf 6g, patchouli 10g, licorice 6g. After four doses, oral ulcers healed, pain disappeared, stools normalized. Continued with original formula for one week, then stopped. Follow-up for one year, no recurrence.
Mouth ulcers are usually due to stomach heat scorching or yin deficiency with fire. However, this case recurs and persists, accompanied by abdominal distension and loose stools, dry mouth without desire to drink—indicating spleen deficiency with dampness. Unable to supplement or purge effectively, a comprehensive analysis reveals dampness-heat in spleen and stomach, with stomach heat scorching the orifice. Due to fatigue and overwork, spleen and stomach are damaged, transformation and transportation impaired, internal dampness generated, dampness-heat scorching the spleen’s orifice, causing lip erosion and unbearable pain. The formula uses patchouli and bamboo leaf to clear and resolve dampness-heat; apricot kernel to elevate upper energizer lung Qi, enabling dampness obstruction to be resolved; poria, coix seed, yam to strengthen the spleen and resolve dampness; agastache, cardamom seed to resolve dampness aromatically; dandelion, saposhnikovia, licorice to clear heat and detoxify without hindering dampness resolution—clearing heat and resolving dampness, curing all symptoms quickly.
3. Wind-Dampness Exogenous Infection Case: Mr. Song, male, 60 years old. Head dizziness and heaviness for three days, general fatigue, limb weakness, back aversion to cold, slight fever, nausea, vomiting, poor appetite, cough, sneezing, white greasy tongue coating, floating relaxed pulse. Syndrome: exogenous wind-dampness. Treatment: dispel wind, resolve exterior, aromatic dampness-resolving. Formula: apricot kernel 10g, ephedra 6g, agastache 10g, cardamom seed 10g, cinnamon twig 6g, red peony 9g, poria 10g, kudzu root 9g, fresh ginger 3 slices, jujube 4 pieces. After two doses, symptoms improved. Still had limb heaviness, no appetite, took two boxes of Huoxiang Zhengqi Pills to continue treatment.
Exogenous diseases often originate from wind—classified as wind-cold, wind-heat, or wind-dampness. The patient is obese with excessive spleen dampness; new wind invasion forms wind-dampness combination. Treatment should expel wind externally with cinnamon twig, ephedra, kudzu root, agastache, and resolve dampness internally with cardamom seed and poria. Adding apricot kernel to promote lung Qi and relieve depression—achieving the effect of dispelling wind, resolving exterior, strengthening spleen, and drying dampness.