1: Diagnosis of spleen and stomach diseases should focus on tongue and pulse
Guan region on the right hand represents spleen and stomach, so strong or weak pulse on guan region of right side directly reflect the functions of spleen and stomach; flabby tongue or teeth mark on the tongue border indicates spleen deficiency, pale tongue body indicates spleen yang or blood deficiency, red tongue with cracks or scanty coating indicates spleen yin deficiency, sticky coating indicates phlegm and dampness, sticky and white on the middle of tongue coating indicate retention of dampness in the middle jiao, pale tongue with teeth mark on the border indicate spleen deficiency and retention of dampness and cold, so combination of tongue with pulse is the key point to differentiate spleen and stomach. On treatment, we apply Yi Yiren, Huang Lian for yellow and thick tongue coating; Sha Ren, Cao Dou Kou for white and sticky coating.
2: Selection of prescription depends on tongue and pulse
Changes of tongue and pulse have significant guidance for the treatment of spleen and stomach diseases.
a: slightly red tongue with little thick coating, thready and wiry pulse indicate spleen deficiency and retention of dampness, we should eliminate dampness and tonify spleen, so we apply modification of Xiang Sha Liu Jun Zi Tang.
b: pale tongue with white coating, thready and weak pulse with specially weak on left guan pulse indicate spleen and stomach deficiency leading to yin and blood deficiency, we should tonify spleen qi and nourish blood, so we choose modification of Gui Shao Liu Jun Zi Tang.
c: threay and wiry pulse or weak pulse on guan region on both sides indicate spleen and stomach deficiency leading to disharmony between spleen and liver, we should regulate liver qi circulation and tonify spleen and stomach, so we prefer modification of Chai Shao Liu Jun Zi Tang.
d: wiry pulse on right guan region, red tongue tip with yellow or sticky coating indicate spleen deficiency and obstruction of stomach by heat and dampness, we should clear heat and tonify spleen, so we prefer modification of Huang Lian Liu Jun Zi Tang, and dosage of Huang Lian should be 3-6g because large dosage of Huang Lian can injure stomach and small dosage can benefit stomach.
e: red tongue with no coating, thready or deficiency or thready and rapid pulse, dry mouth and throat indicate spleen qi deficiency and stomach yin deficiency, we should nourish yin and tonify spleen, stomach qi, so we use modification of
Sha Shen Mai Men Dong Tang.
3: Attention of medicine
We do not suggest too much expensive herbs and large amount, the properties of herbs should be even for protecting stomach qi, we can not use herbs with bitter and cold properties with long time that can injure stomach.
4: Relation of dysfunction of spleen and stomach with other diseases
We believe that various diseases can be caused by dysfunction of spleen and stomach and other diseases can affect spleen and stomach. So when we treat other diseases, we should tonify spleen and stomach for sufficient qi and blood.
Key Words: Experience, differentiation, spleen and stomach diseases
Writer: Liu Mei, Liu Yinru
Xi An city No.1 hospital (710002)
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