🌿 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:
I. The Physiological Characteristics of the Spleen and Stomach Lie in Rising and Descending
The spleen and stomach are the foundation of postnatal life and the source of qi and blood. Their functional characteristics center on rising and descending. The spleen governs transportation and transformation, distributing essence and raising clear qi; the stomach receives and ripens food and drink, governing the descent of turbid qi. Spleen rising ensures health; stomach descending ensures harmony. If the spleen fails to transport and transform, clear qi cannot rise; if the stomach fails to descend, turbid qi cannot descend and instead rises abnormally. The spleen is a yin organ, the stomach a yang organ, mutually related as interior and exterior, one rising, one descending, mutually dependent. They not only manage the ripening of food and distribution of essence but also influence the overall body’s yin-yang, qi-blood, and water-fire balance—thus serving as the pivot of bodily rise and fall. The rise and fall of the spleen and stomach are interdependent: stomach dysfunction prevents spleen rising; spleen dysfunction prevents stomach descending. As Yu Jiayan said: “When the middle energizer is strong, clear qi from food and drink ascends to nourish all meridians, while turbid qi descends to the large and small intestines via urination and defecation.” When the spleen raises clear qi and the stomach descends turbid qi, qi and blood generation has a source, and their movement is orderly. Without transportation and rising, generation has no beginning; without descending, transmission has no way—leading to stagnation and disease.
II. Spleen and Stomach Disorders Manifest Primarily as Dampness and Stagnation
Although spleen and stomach disorders are diverse, dampness and stagnation are common underlying mechanisms. The spleen and stomach are the granaries of the body, the ocean of grains. They receive everything, making them vulnerable to pathogenic invasion and lodging within, disrupting their rise and fall, obstructing qi movement, causing water to turn into dampness and food to become stagnant. Dampness, food accumulation, phlegm, qi stagnation, blood stasis, and fire stagnation arise consequently. Pathogens and righteousness clash, blocking the middle energizer—this is real stagnation. If the spleen and stomach are weak, their transformation and transportation fail, leading to imbalance in rise and fall, mixing of clear and turbid, and dampness and stagnation originating internally—what is called deficiency leading to excess, deficiency with stagnation. As *Su Wen·Tiao Jing Lun* states: “Excessive labor and fatigue weaken the body, reduce grain qi, prevent upper energizer function, and obstruct lower energizer.” Because dampness and stagnation are central to the pathology, 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.
III. The Key to Treating Spleen and Stomach Disorders Lies in Regulation, with Additional Attention to Lung Qi Promotion
Spleen and stomach disorders often involve dampness and stagnation. Spleen disorders are mostly dampness-prone, easily overwhelmed by dampness; stomach disorders are often heat-prone, easily obstructed by heat. All stem from improper rise and fall of qi. Thus, spleen and stomach disorders should not be treated with drastic tonification or purgation but with regulation—seeking the root cause of qi imbalance, diagnosing the cause, treating accordingly, restoring normal rise and fall of spleen and stomach, eliminating dampness and stagnation, achieving harmony, and resolving all symptoms.
During regulation of the spleen and stomach, we should also promote lung qi. Since the spleen governs transformation of food and drink, like fermenting, and the lung distributes essence and spreads it like mist, the spleen requires lung assistance to complete the distribution of food essence. As *Su Wen·Jing Mai Bie Lun* states: “The spleen disperses essence, sending it upward to the lung, regulating water pathways, and directing fluids downward to the bladder.” The lung governs promotion and descent, while the spleen and stomach govern rising clear and descending turbid. Both oversee qi movement. Therefore, treating the spleen must not neglect the lung, and treating the lung must investigate the spleen. In clinical prescriptions, add herbs to promote lung qi and relieve depression—such as apricot kernel, trichosanthes, ephedra—to the spleen-strengthening and stomach-harmonizing formulas. Ye Tianyi, in *Clinical Guide to Medical Cases*, used apricot kernel to promote lung qi and relieve depression, pioneering the method of promoting lung qi, resolving dampness, and strengthening the spleen.
IV. Clinical Experience
1. Spleen Dampness with Exogenous Invasion: Wind is the leader of all diseases, often bringing other pathogens. Wind with dampness invading externally presents with fever, chills, epigastric fullness, nausea, vomiting, dizziness, head heaviness as if wrapped, neck and back stiffness. Use Ping Wei San plus 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-type colds.
2. Cold-Dampness Overwhelming the Spleen: Cold and dampness are both yin pathogens, easily overwhelming spleen yang and obstructing qi. Symptoms include back coldness, cold aversion, epigastric fullness, poor appetite, loose stools, nausea, vomiting. Use Wu Ling San combined with Ping Wei San, apricot kernel, ephedra, agastache, cardamom, and fresh ginger—enhancing dampness removal and supporting spleen function. If cold predominates over dampness, replace cardamom with sand ginger, 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 Damp-Heat: Damp-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 San Ren Tang with modifications, often adding winter melon peel and patchouli to clear heat and resolve dampness, restoring spleen and stomach harmony. For damp-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: Spleen and stomach rise and fall are closely linked to liver qi dispersion. If emotions are depressed, liver qi stagnates, fails to disperse, and invades the spleen and stomach, disrupting their rise and fall, generating dampness internally, obstructing the middle energizer—manifesting as epigastric distension, bilateral rib pain, chest fullness, frequent sighing, loose stools, poor appetite, limb heaviness, symptoms worsening with emotional distress. Treatment: soothe liver, relieve depression, strengthen spleen, dry dampness. If stomach qi fails to descend, use Chai Hu Shu Gan San with modifications. If spleen deficiency predominates, use Xiao Yao San combined with Ping Wei San. For abdominal pain and diarrhea due to liver-spleen disharmony, use Tong Xie Yao Fang as the primary formula, adding patchouli, cyperus, green tangerine peel, agastache, cardamom to open depression and resolve dampness—so liver qi disperses, spleen dampness moves, rise and fall harmonize, turbidity clears.
5. Spleen and Stomach Deficiency: Constitutional weakness, coupled with irregular diet, damages the spleen and stomach, impairing transformation and transportation—manifesting as shortness of breath, fatigue, pale complexion, poor appetite, loose stools. If yang deficiency is present, symptoms include epigastric pain, preference for warmth and pressure, cold limbs, fatigue, poor appetite, worsened by cold, relieved by warmth, clear diarrhea. Long-standing spleen qi deficiency may lead to sinking of middle energizer—prolapsus, chronic diarrhea, metrorrhagia. For qi deficiency, use Liu Jun Zi Tang to strengthen spleen and tonify qi—where tangerine peel and pinellia prevent stagnation. For spleen-stomach deficiency-cold, warm and dispel cold—use Liang Fu Wan, Li Zhong Tang, or Huang Qi Jian Zhong Tang with modifications. For sinking of middle energizer, tonify qi and lift yang—use Bu Zhong Yi Qi Tang with modifications.
6. Spleen Deficiency with Dampness: This condition is deficiency with excess, requiring both reinforcing the root and removing the pathogen—treating both root and branch. Commonly used formula: party ginseng, atractylodes, poria, agastache, cardamom, magnolia bark, citri aurantium, apricot kernel, ephedra. Party ginseng is neutral, sweet, enters spleen and lung meridians, with effects of tonifying qi and strengthening the middle energizer. Atractylodes is sweet, bitter, slightly warm, specifically targeting spleen and stomach meridians, with effects of strengthening spleen, harmonizing stomach, drying dampness, and promoting urination—especially effective for strengthening spleen and tonifying qi. Poria strengthens spleen, resolves dampness, harmonizes stomach, and calms the spirit—paired with atractylodes to enhance spleen-strengthening and dampness-resolving power, supporting the root and removing the pathogen. Agastache is pungent, slightly warm, with fragrant dampness-resolving and qi-regulating effects—paired with cardamom to support pathogen removal and reinforce the body. Apricot kernel and ephedra are both bitter and warm, entering the lung meridian—opening the upper energizer lung qi, enabling lung qi to circulate, thus resolving dampness obstruction. Magnolia bark and citri aurantium regulate qi and resolve phlegm, elevating clear and descending turbid. Combined, these herbs have effects of strengthening spleen, drying dampness, promoting lung function, and resolving phlegm—used for various spleen-dampness-related edema, diarrhea, and cough. Applicable to all cases of spleen deficiency with dampness, regardless of cold or heat, can be adjusted accordingly.
V. Case Examples:
1. Gastric Pain Case: Mr. Zhang, male, 45 years old. Epigastric distension and pain, chest and rib fullness, frequent sighing, frequent belching, poor appetite, heavy limbs, drowsiness, loose stools not fully passed, pale tongue with thick greasy coating, deep wiry slippery pulse. Diagnosis: liver qi stagnation with spleen dampness. Treatment: soothe liver, harmonize stomach, strengthen spleen, resolve dampness. Formula: apricot kernel 10g, trichosanthes peel 12g, bupleurum 6g, cyperus 9g, poria 20g, agastache 12g, cardamom 9g, magnolia bark 9g, citri aurantium 9g, paeoniae alba 12g, licorice 6g, pinellia 6g. After three doses, epigastric pain decreased, bowel movements normalized, appetite improved, thick greasy coating faded. Continued for four more doses—complete recovery.
Gastric pain often results from emotional distress, fatigue, irregular eating, or exposure to cold, leading to impaired spleen-stomach qi movement. Though causes vary, the mechanism is gastric qi obstruction—obstruction leads to pain. Given the characteristic of epigastric distension and pain worsening with emotional distress, treatment often targets the liver. Thus, the formula uses bupleurum and cyperus to soothe liver and regulate qi; agastache and cardamom 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 to move; paeoniae alba and licorice to relieve spasms and stop pain. Together, these herbs achieve the effect of soothing liver, harmonizing stomach, strengthening spleen, and drying dampness.
2. Damp-Heat Oral Ulcer Case: Mr. Li, male, 50 years old. Recurrent oral ulcers for over three years. Cold-clearing herbs cure ulcers but worsen loose stools. Switching to warm-tonifying herbs improves loose stools but aggravates ulcers, causing unbearable pain, inability to eat, and recurrence linked to fatigue. Present symptoms: headache, dry mouth without desire to drink, loose stools, fatigue, pale tongue with yellow thick coating, slippery rapid pulse, oral mucosa congested, two ulcers on edges and tip with red margins. Diagnosis: damp-heat in spleen and stomach, fire toxin scorching. Treatment: clear heat, detoxify. Formula: apricot kernel 10g, coix 15g, cardamom 6g, poria 15g, dandelion 15g, saposhnikovia 9g, yam 20g, agastache 10g, bamboo leaf 6g, patchouli 10g, licorice 6g. After four doses, ulcers healed, pain disappeared, stools normalized. Continued original formula for one week—stopped treatment. Follow-up for one year—no recurrence.
Oral ulcers are often due to stomach heat scorching or yin deficiency with fire. However, this case recurs persistently, is difficult to cure, and shows signs of spleen deficiency and dampness—such as abdominal distension and loose stools, dry mouth without desire to drink. Unable to supplement or purge effectively, a comprehensive analysis reveals damp-heat in spleen and stomach, stomach heat scorching the mouth. Due to overwork and fatigue, the spleen and stomach are damaged, transformation and transportation fail, dampness accumulates internally, and damp-heat scours the spleen’s orifice, causing mouth sores and unbearable pain. The formula uses patchouli and bamboo leaf to clear damp-heat; apricot kernel to elevate upper energizer lung qi, enabling dampness to move; poria, coix, yam to strengthen spleen and resolve dampness; agastache and cardamom to resolve dampness with fragrance; 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 coldness, slight fever, nausea, vomiting, poor appetite, cough, sneezing, white greasy coating, floating relaxed pulse. Diagnosis: exogenous wind-dampness. Treatment: dispel wind, resolve exterior, aromatically resolve dampness. Formula: apricot kernel 10g, ephedra 6g, agastache 10g, cardamom 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 felt heavy limbs, no appetite. Took two boxes of Huo Xiang Zheng Qi Wan to continue treatment.