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TCM Pattern · Tag

Spleen deficiency (pí xū)

pí xū · 脾虚

Last reviewed: June 29, 2026

Weak digestion and chronic fatigue — "spleen" here is a TCM concept, not the anatomical organ

About this page

This page is a cultural reference, not a diagnostic tool. TCM patterns are tags that explain why certain formulas are discussed together — they do not map 1:1 to Western medical diagnoses.

Background

In TCM, "spleen" (pí) does not refer to the anatomical organ that sits under the left rib cage and filters blood. It refers to the functional sphere responsible for transforming food into usable substance and transporting that substance where it needs to go — in Western shorthand, it is closer to "digestive fire plus metabolic efficiency." When the spleen is weak, food doesn't transform properly (bloating, loose stools, poor appetite), energy doesn't generate efficiently (chronic fatigue), and dampness accumulates (a feeling of heaviness). Shenling Baizhu San is the canonical spleen-qi formula with a dampness-draining emphasis — "nourish the earth so the metal can breathe." Jianpi Wan addresses spleen weakness that has led to food stagnation. Xiangsha Liujun Wan adds qi-moving and dampness-transforming herbs to the basic spleen-tonifying structure, for when the stagnation is more about qi and phlegm than pure dampness. All three sit under the digestion concern, because the TCM "spleen" is primarily about what happens after you eat.

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Medicines traditionally associated with this pattern

  • Formula · Guī Pí Wán

    Spleen-Restoring

    归脾丸

    A "heart-and-spleen tonifying" formula with a strong reputation in Chinese households for two connected complaints: difficulty falling asleep due to overthinking, and the kind of tiredness that comes from working or worrying too hard.

  • Formula · Shēn Líng Bái Zhú Sǎn

    Ginseng and Atractylodes Powder

    参苓白术散

    A "tonify spleen qi, leach dampness, stop diarrhea" formula from the Song dynasty, the gentlest of the major spleen-tonifying formulas, often chosen for chronic digestive weakness in thin, tired patients.

  • Formula · Jiàn Pí Wán

    Spleen-Strengthening Pills

    健脾丸

    A "jian-pi xiao-shi" (strengthen the spleen and digest food) formula from Wang Kentang's "Standards for Diagnosis and Treatment", the classical TCM "weak digestion" formula.

  • Formula · Xiāng Shā Liù Jūn Wán

    Aucklandia-Amomum Six Gentlemen

    香砂六君丸

    A "jian-pi he-wei, li-qi zhi-tong" (strengthen the spleen, harmonize the stomach, regulate qi, stop pain) formula from the Qing-dynasty "Golden Mirror of Medicine", the "qi-regulating" expansion of the classical Liu Jun Zi Tang.