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The spleen is situated in the middle jiao. Its meridian connects with the stomach, with which it is internally-externally related. Its main physiological functions are governing transportation and transformation, controlling blood, dominating the muscles and limbs, opening into the mouth and manifesting on the lips.

Governing transportation and transformation

Transportation implies transmission and transformation implies digestion and absorption. This function of the spleen involves transportation and transformation of water and food on the one hand, and of damp on the other.

The function of the spleen in transporting and transforming essential substances refers to the digestion, absorption and transmission of nutrient substance. Since water and food are the main source of the nutrient substance required by the body after birth, as well as being the main material base for the manufacture of qi and blood, the spleen is considered to be the main zang organ for manufacturing qi and blood. When spleen qi is vigorous, digestion, absorption and transmission are normal. Deficiency of spleen qi and dysfunction of the spleen in transportation and transformation may lead to poor appetite, abdominal distention, loose stools, lassitude, emaciation and malnutrition.

The function of the spleen in transporting and transforming damp refers to the spleen's role in water metabolism. The spleen transports the excess fluid of the meridians, tissues and organs and helps discharge it from the body. It ensures that the various tissues of the body are both properly moistened and at the same time free from retention of damp. Dysfunction of the spleen in transportation and transformation may lead to retention of damp, with such clinical manifestations as oedema, diarrhoea, phlegm and retained fluid.

The spleen's functions of transporting and transforming water and food on the one hand, and water damp on the other are interconnected, and failure of the transportation and transformation function may give rise to clinical manifestations of either.

The transportation and transformation function of the spleen relies on spleen qi, which is characterized by ascending. If the spleen qi does not ascend, or indeed sinks, there may be vertigo, blurred vision, prolapse of the rectum after prolonged diarrhoea, or prolapse of various other internal organs. Treatment is aimed at strengthening the ascending function of spleen qi.

Controlling blood

Controlling blood means that the spleen qi has the function of keeping the blood circulating in the vessels and preventing extravasation. When the spleen qi is strong, the source for manufacturing blood will also be strong, there will be ample qi and blood in the body, and the blood will be prevented from extravasation. If the spleen qi is weak and fails to control blood, there may be various kinds of haemorrhage, such as bloody stool, uterine bleeding and purpura.

Dominating the muscles and four limbs

The spleen transports and transforms the essence of food and water to nourish the muscles and the four limbs. Adequate nourishment ensures well-developed muscles and proper function of the limbs. If nourishment is inadequate, the muscles of the four limbs will, be weak and soft. The forty-fourth chapter of Plain Questions therefore says: "The spleen is in charge of muscles."

Opening into the mouth and manifesting on the lips

The spleen's function of transportation and transformation is closely related to food intake and the sense of taste. When the spleen functions normally, there will be good appetite and a normal sense of taste; when there is dysfunction of the spleen, there will be poor appetite, impaired sense of taste and a sticky, sweetish sensation in the mouth due to retention of pathogenic damp in the spleen.

The spleen dominates musc]es, and the mouth is the aperture of the spleen. For this reason, the lips reflect the condition of the spleen's function of transporting and transforming water and food. When the spleen is healthy, there will be ample qi and blood and the lips will be red and lustrous. Deficiency of spleen qi will lead to deficiency of qi and blood, and the lips will be pale or sallow.

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