In the previous article, we discussed about the role of the spleen in digestion and producing Qi and Blood. On top of these 2 crucial roles, the spleen has several other significant functions, further underlining the importance of maintaining a healthy spleen. > Read: Why are organs in TCM described so differently
Involvement in water metabolism
Function: In TCM, water metabolism involves several organs, including the spleen, kidneys and lungs. The spleen processes and transports fluids taken in from the digestive tract.
Ailment: If the spleen is weak and the water metabolism function is affected, the fluids in the body cannot be processed or transported properly and eventually accumulate, thus producing “dampness”. This can lead to problems such as edema (swelling due to water retention), loose and watery stools, formation of phlegm etc.
Treatment: Treatment methods usually include strengthening the spleen (by replenishing spleen Qi) to promote its water processing function, and drying up the dampness. (See below for more information on herbs.)
Control of blood flow
Function: Another function of the spleen is to control the blood flow to keep our blood within the vessels. If the spleen is weak and loses control of the blood, abnormal bleeding can occur.
Ailment: Certain cases of heavy menses may be attributed to a weak spleen that fails to restrain the blood. Other forms of abnormal bleeding such as blood in urine, bleeding in digestive tract etc. may sometimes involve a weak spleen as well.
Diagnosis: One way to determine whether one’s bleeding is due to a weak spleen is to look at the colour of the blood. In general, pale looking blood often points to deficiency (possibly deficient spleen Qi), bright red blood usually signifies heat, and dark-coloured blood with clots often indicates poor blood flow. One should also look out for other signs of a weak spleen (e.g. tiredness, poor appetite, pale tongue, weak pulse etc.) for a more accurate diagnosis.
Prevent organ prolapse
Function: The spleen prevents prolapse of organs (sagging/slipping out of place). This is because by nature, the spleen’s Qi has a tendency to rise to distribute fluids and nutrients to the appropriate organs. This rising of the spleen Qi is believed to create a lifting effect which supports the organs.
Ailment: Many cases of organ prolapse, such as prolapse of the uterus, stomach, rectum etc. are attributed to a weak spleen (insufficient spleen Qi), which has a diminished rising function.
Treatment: A 2-pronged approach of strengthening the spleen and lifting the spleen Qi is usually employed to support the organs physically.
A common herbal formula used for such conditions is the “Middle Qi Tonifying Decoction” (补中益气汤 Bǔ Zhōng Yì Qì Tāng). This tonic can be purchased over the counter in tablet or pill form in many TCM stores in Singapore. It includes herbs such as Radix Astragali (黄芪 Huáng Qí) and Radix codonopsis / poor man’s ginseng (党参 Dǎng Shēn) to strengthen the spleen, as well as Rhizoma Cimicufugae (升麻 Shēng Má) and Radix Bupleuri (柴胡 Chái Hú) to help lift the Qi upwards.
Herbs that strengthen the spleen
Ginseng
Ginseng is well known for its Qi replenishing properties. It is very commonly used to replenish the Qi of the spleen to strengthen it. The different types of ginsengs, such as poor man’s ginseng (党参), American ginseng (西洋参), Korean ginseng (高丽参) etc., can have different properties or varying efficacies and may be used in different scenarios.
More examples:
Astragalus root (黄芪 Huáng Qí)
Chinese Yam (山药 Shān Yào)
Chinese dates (大枣 Dà Zǎo)
Honey (蜂蜜 Fēng Mì)
Herbs that strengthen the spleen and dry up dampness:
Rhizoma Atractylodis Macrocephalae (白术 Bái Zhú)
Poria (茯苓 Fú Líng)
Chinese barley (薏苡仁 Yì Yǐ Rén)
上篇文章提到脾脏有助于消化系统及生产气血之功能。除此以外，脾还占有以下多项关键性的生理功能。由此可见，维持脾脏健康乃养生之首道也。
〉请阅读：了解中医脏腑
脾运化水湿
中医认为体内水液的代谢是由多个脏腑管理，如脾，肾，肺等。
功能：脾脏在消化系统内除了处理食物以外，也会运化水液。所吸收的水液将被脾脏输布到所属之器官作进一步的处理。
病变：若脾脏虚弱（多指脾气不足）而水液代谢功能失调，体内的水液不能恰当的处理和输布，这将导致体内有“湿气”。而湿气可反映为水肿，大便稀溏，生痰等病变。
治法：除了利水燥湿以外，还得健脾（补脾气）以恢复脾脏运化水湿的正常功能。（见以下关于药材的资料）
脾控制血液的流动
功能：脾能统摄或控制血液在脉中正常流动而不逸出脉外。若脾虚而固摄功能衰退，就可导致出血。
病变：脾虚而出血的例子包括月经量过多，尿血，肠胃出血等。
诊断：观察出血的血色可助于诊断。一般来说，血色淡而质稀多指虚证（包括脾气虚），鲜红色多指热证，而血色紫暗伴有瘀块多指血瘀。除了血色以外，也应确定是否有没有其他脾虚的症状（如疲乏无力，食物减退，舌淡，脉细弱等）。
防止内脏下垂
功能：脾能维持内脏位置，防止内脏下垂。主要原因乃脾的气是自然向上升动，故此能把所吸收的营养及水液输布到其他脏腑，而这上升的功能则有助于升举其他脏腑，并防止其下陷。
病变：若脾气虚弱而不能升举，其他内脏可因此而下垂。内脏下垂的例子包括子宫下垂，胃下垂，脱肛等。
治法：除了补益脾气外，还应升举中气。一个对付此症的常用方就是补中益气汤。补中益气药丸或药片可在新加坡各中药房购买。方中含有黄芪、党参补气健脾，也有升麻、柴胡升提举陷。
健脾之中药材
人参
人参闻名于其补气之功能。人参常用于补气健脾。其他参类的药物，如党参，西洋参，高丽参等都可有不同的药效或不同的功能，但一般上都能补气健脾。
其他例子：
黄芪
山药
大枣
蜂蜜
健脾燥湿药
白术
茯苓
薏苡仁
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