Spleen yang deficiency describes the classical picture in which the warming and transforming function attributed to the spleen is underactive. The spleen in this vocabulary is not the anatomical organ that can be removed without digestion stopping; it is a way of grouping appetite, abdominal comfort, stool form and the sense of having enough energy.
The recorded features are: poor appetite and a bland taste in the mouth; abdominal fullness, especially after eating; loose stools, sometimes containing undigested food; a dragging or cold discomfort in the abdomen that improves with warmth and with pressure; cold limbs; fatigue and bodily heaviness; absence of thirst, or a preference for warm drinks; a pale, swollen tongue with teeth marks along the edges; and a deep, slow, weak pulse. It is commonly described as developing out of spleen qi deficiency, and the classical literature attributes it to prolonged illness, to excessive consumption of cold or raw food, and to the overuse of cold-natured or bitter medicinals.
The same symptom cluster appears in coeliac disease, chronic pancreatitis, bile acid diarrhoea, small intestinal bacterial overgrowth, diarrhoea-predominant irritable bowel syndrome, hypothyroidism and chronic kidney disease, among others. The pattern name does not sort them out.
What does sort some of them out is investigation. Blood in the stool or black stools, unintentional weight loss, diarrhoea that wakes a person from sleep, fever, the first appearance of digestive symptoms after the age of forty, and signs of dehydration in an infant or an older adult are reasons to be examined rather than described. Liking warmth and pressure is not a discriminating sign either: functional pain often does, and the classical peritoneal signs of an acute abdomen can be absent in older people, in people who are immunosuppressed, and in people taking corticosteroids.
Whether the warming methods recorded for this pattern change any outcome has not been established. This entry does not diagnose and does not recommend a treatment.
脾阳虚指古典语境中与脾相关的温煦与运化作用被描述为不足。这里的脾不是那个切除后消化照旧进行的解剖器官，而是把食欲、腹部舒适与否、大便形态与精力是否够用归在一起的一种说法。
记载中的表现包括：食欲不振、口淡无味；脘腹胀满，食后尤甚；大便溏薄，或完谷不化；腹部冷痛而喜温喜按；四肢不温；倦怠乏力、身体沉重；口不渴或喜热饮；舌淡胖、边有齿痕；脉沉迟无力。通常理解为由脾气虚进一步发展，古典文献归因于久病、过食生冷，以及寒凉苦燥之品的过用。
同一组症状也见于乳糜泻、慢性胰腺炎、胆汁酸性腹泻、小肠细菌过度生长、腹泻型肠易激综合征、甲状腺功能减退、慢性肾脏病等。证名无法把它们分开。
能分开一部分的是检查。便血或黑便、非意愿的体重下降、把人从睡梦中叫醒的腹泻、发热、四十岁以后新出现的消化道症状，以及婴幼儿或老人出现脱水征象，都需要检查而不是描述。「喜温喜按」同样不是鉴别要点：功能性腹痛常喜按，而急腹症典型的腹膜刺激征在老人、免疫抑制者、正在使用糖皮质激素的人身上可以不出现。
针对本证的温中健脾之法是否改变任何结局，未被证实。本条不诊断，也不推荐任何处理。
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