TCM pattern · Yang deficiency
Spleen and Kidney Yang Deficiency
脾肾阳虚 Pi Shen Yang Xu Spleen and Kidney system
Both fires are low: the stove in the gut and the pilot light in the Kidney. Diarrhea at dawn, a cold belly and a cold back, cold limbs, swelling, frequent clear urine, exhaustion, and a pale puffy face. The deep cold pattern of old age, long illness, or a lifetime of cold food.
A house where the furnace and the kitchen stove have both gone out. Nothing is warm, nothing cooks, and the pipes start to leak. Both fires must be relit.
How to recognize Spleen and Kidney Yang Deficiency
The signs that point most strongly to this pattern:
- Diarrhea at dawn, the cock-crow diarrhea
- Cold belly and cold low back together
- Cold limbs, dread of cold
- Swelling of the legs or face
- Exhaustion, a wish to sleep
Also common
- Frequent clear urine, night urination
- Pale puffy face
- Undigested food in the stool
- Low drive, infertility with cold
- Weak knees
- Tongue
- Pale, swollen, wet, with a white coat.
- Pulse
- Deep, slow, and weak.
Formulas for Spleen and Kidney Yang Deficiency
Herbs that matter most for Spleen and Kidney Yang Deficiency
- Fu Zi Prepared Aconite Lateral Root Processed aconite relights both fires; always in a formula.
- Gan Jiang Dried Ginger Dried ginger warms the Spleen.
- Rou Gui Cassia Bark Cinnamon bark warms the Kidney.
- Bu Gu Zhi Psoralea Fruit Psoralea warms the Kidney and stops dawn diarrhea.
- Bai Zhu Rhizome of Largehead Atractylodes Atractylodes strengthens the Spleen and dries damp.
- Tu Si Zi Dodder Seed Cuscuta seed warms and holds the Kidney.
How Spleen and Kidney Yang Deficiency differs from its look-alikes
- Spleen Yang Deficiency Spleen alone: a cold belly and watery stools without the cold back, the night urination, or the dawn diarrhea.
- Kidney Yang Deficiency Kidney alone: a cold back and bladder without the gut signs. When both show, both fires need lighting.
What drains into Spleen and Kidney Yang Deficiency
- Long Spleen yang deficiency reaching the Kidney, or the reverse
- Aging
- Chronic illness
- Years of cold food and cold living
- Long courses of cold medicines
Food and habits that help Spleen and Kidney Yang Deficiency
- Warm cooked food only. Lamb, ginger, cinnamon, walnuts, chestnuts, cooked grains.
- Keep the belly, back, and feet warm, day and night.
- Rest; this pattern has no reserve to spend.
- A hot water bottle on the low back in the evening.
What should change as Spleen and Kidney Yang Deficiency improves
- The dawn diarrhea settles within one to two weeks of warming.
- Cold limbs and the cold back warm over a month.
- Swelling drains and night urination drops.
- Warming formulas with aconite are a practitioner's call for dose and length.
Conditions where Spleen and Kidney Yang Deficiency shows up
Sources
- Maciocia, The Foundations of Chinese Medicine, 3rd edition Spleen and Kidney yang deficiency.
- Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition Zhen Wu Tang, Si Shen Wan, Li Zhong Wan.
Important Note
A pattern is a picture, not a diagnosis. Most people carry two patterns at once, and the signs here are the classic ones, not a checklist. Use this page to recognize yourself, read a formula label with understanding, and ask a qualified practitioner a sharper question.