Today, I want to share an approach to regulating stubborn Spleen Deficiency, especially for those friends who have taken a lot of Spleen-tonifying medicines but always feel the results are not ideal—warming and replenishing Heart Yang might be a key solution.

Why is Heart Yang so important for Spleen Deficiency?

According to TCM Five Element theory, "the Heart belongs to Fire, and the Spleen belongs to Earth." The relationship between Fire and Earth is akin to that between sunlight and soil in nature:

Heart Yang (Heart Fire): This is the "energy source" of the upper jiao (the chest) in the body. It is responsible for warming the entire body and propelling blood circulation. Blood carries nutrients and energy, nourishing the five zang and six fu organs.

Spleen (Earth): Governs transportation and transformation, responsible for digesting food, absorbing nutrients, and transporting food essence and fluids. However, the Spleen's transportation and transformation function, much like soil requiring the warmth of sunlight to generate and nurture all things, is highly dependent on the warming and propelling action of Heart Yang.

Insufficient Heart Yang can easily lead to "Cold" in the Spleen Earth.

When the heart's yang qi is deficient:

Impaired propulsion: Qi and blood circulation slows down, causing insufficient supply and momentum for the spleen. This results in delayed transportation and transformation functions.

Insufficient warming: The spleen and stomach lose their "warmth of sunlight," akin to soil turning cold and compact without sunshine—a condition known as "spleen earth deficiency cold" in traditional Chinese medicine. This significantly weakens digestion and absorption abilities.

Competition for qi and blood: The most typical manifestation is post-meal drowsiness, dizziness, and mental fogginess. After eating, qi and blood concentrate in the spleen and stomach to digest food. However, insufficient heart yang weakens the ability to generate and propel qi and blood, leading to relative ischemia and hypoxia in vital organs like the brain. The body responds by forcing you into a state of "mandatory rest."

At this point, even if you consume large quantities of spleen-strengthening herbs like Chinese yam, atractylodes, and poria, the "frozen soil" of the spleen and stomach can hardly truly "thaw" and regain vitality. This is because it lacks the source of warmth and motivation—**"heart yang"**.

Warm and Nourish Heart Yang to Activate Spleen Earth

The core approach to addressing this type of stubborn spleen deficiency caused by insufficient heart yang is to warm and unblock heart yang, helping fire generate earth.

How to Warm and Nourish Heart Yang? Commonly used are pungent, warm herbs that enter the heart meridian, such as cinnamon twigs (Guizhi), Chinese leeks (Xiebai), and licorice (Gancao). These can invigorate heart yang and promote the circulation of qi and blood. Classic formulas like the Cinnamon Twig and Licorice Decoction (Guizhi Gancao Tang) serve as fundamental prescriptions for warming and unblocking heart yang.

Signs of Effective Results: As heart yang gradually recovers, qi and blood circulation accelerates, and body metabolism becomes more active, you may experience: smoother belching (burping), increased passing of gas (flatulence), and easier bowel movements (possibly with slightly increased frequency or volume). These are not negative signs but rather indications that the stagnant "qi" in the body is starting to flow smoothly, cold stagnation is beginning to "thaw," and metabolism is being restored! Persist with your efforts, and the sense of relief from restored spleen and stomach function will become increasingly evident.

Real-life Case:

I once saw a patient, Ms. Sun, 52 years old, who works long hours at a desk. Her main complaint was that "no matter how I try to tonify my spleen, it doesn’t work": poor appetite, feeling bloated after eating just a little, loose stools, extreme fatigue, and feeling especially sleepy and mentally foggy after meals, to the point where she needed to take a nap every afternoon. She also often felt cold, with cool hands and feet. She had tried various spleen-tonifying medicines and probiotics, but the effects never lasted. When I examined her, I found a pale, swollen tongue with teeth marks on the edges, a white and slippery coating, and a deep, thready, weak pulse. This wasn’t just a simple case of spleen deficiency; it was a classic example of insufficient heart yang, unable to warm the spleen earth. I adopted an approach focused on warming and unblocking heart yang (using herbs like cinnamon twig and prepared licorice root), while also supporting spleen function and transforming dampness (with herbs like white atractylodes and poria). After some time of treatment, she happily reported: post-meal drowsiness and dizziness had significantly improved, bloating had eased, stools were gradually forming properly, she felt her hands and feet were warmer, and she had much more energy. This confirms that the principle of "fire generating earth" — warming heart yang to strengthen the spleen — is effective for such patients.

Dr. Wang's Heartfelt Summary:

"Tonifying Heart Yang to Regulate Spleen Deficiency" is a targeted approach: It is primarily suitable for patients with persistent and difficult-to-treat spleen deficiency, accompanied by obvious symptoms such as aversion to cold, cold hands and feet, severe drowsiness after meals, palpitations and shortness of breath, a pale and swollen tongue with a white, slippery coating, and a deep, weak pulse. This indicates the core pathogenesis of "insufficiency of Heart Yang leading to the loss of warmth for Spleen Earth."

Not all cases of spleen deficiency are treated this way: There are many causes of spleen deficiency! If it is due to damp-heat obstructing the spleen, liver depression overacting on the spleen, or simple spleen qi deficiency/spleen yin deficiency, the focus is not on Heart Yang. Accurate pattern differentiation must be performed by a professional TCM practitioner through observation, listening/smelling, inquiry, and palpation (especially examining the tongue coating and feeling the pulse).

Warming and tonifying Heart Yang requires caution: Warming and tonifying are only needed for insufficiency of Heart Yang. If there are heat signs such as dry mouth and throat, restlessness and insomnia, a red tongue with a yellow coating, etc., warming and tonifying may have the opposite effect. Medication should be used under the guidance of a physician.

Lifestyle habits must be coordinated: Avoiding excessive consumption of raw, cold, and cool foods (which damage both spleen yang and consume heart yang), paying attention to keeping warm (especially the chest and back), ensuring adequate sleep (to nourish the heart spirit), and engaging in moderate exercise (to promote the circulation of qi and blood) are all fundamental for aiding the recovery of both heart yang and spleen yang.