Spleen is a highly valued viscera among the five internal organs, which mainly depends on its physiological function of controlling transportation and transformation. Spleen is the main organ for human body to absorb nutrients (these nutrients are the raw materials for the generation of qi, blood and body fluids), thus establishing the special position of spleen as the foundation of the day after tomorrow. However, because the physiological activities of spleen governing transport and transformation are carried out on the basis of stomach governing reception and decomposition, both spleen and stomach participate in human digestion and absorption, so spleen and stomach have always been integrated into one, and spleen and stomach are called the foundation of the day after tomorrow. In order to study the function of spleen and stomach more deeply and apply it to clinic, there even appeared a special "spleen and stomach theory" in history, and its representative was Gao Li (Dongyuan) in the Jin and Yuan Dynasties. In the book Spleen and Stomach Theory, Li Dongyuan repeatedly emphasized the extreme importance of spleen and stomach to human life activities, and advocated nourishing spleen and stomach, which was called "School of Tonifying the Earth" and "School of Spleen and Stomach Theory". This section focuses on the spleen, but in fact we can't completely rule out the description of the stomach. Physiological function of spleen (1) Spleen governs transportation and transformation. Nowadays, most people understand transportation and transformation as "digestion and absorption". Actually, this explanation is too "vernacular". It is true that transportation means digestion and absorption, but transportation does not mean digestion and absorption. "Transportation" is a concept that combines "transportation" and "transformation". "Yun" means transportation and transshipment, and the words "San" and "Chuan" are also used in Neijing. Su Wen Bian Jing Lun said: "If you drink in the stomach, you will overflow essence; if you drink in the spleen, you will disperse essence; if you drink in the lungs ..." Lingshu Nutrition Society said: "When people suffer from the qi in the valley, the valley enters the stomach, but it is distributed in the lungs, and all the five internal organs suffer from qi ..." "Hua" means change, including direct digestion of food and drinks. It can be seen that the function of spleen governing transport and transformation on diet includes a series of life processes such as digestion and absorption of diet, transport and transformation of subtle substances and their transformation into qi, blood and body fluid. Qu Yanqing once pointed out that the spleen's main transport does not include digestion and absorption, which is completely the function of six fu-organs such as gastrointestinal tract. The "transformation" of spleen governing transport and transformation mainly means that the spleen absorbs Shui Gu's subtle qi and further transforms it, so as to facilitate the utilization of other viscera, generate essence, qi, blood and body fluid, and nourish the whole body. This view completely excludes the digestion and absorption of food by the spleen, which is the other extreme. In fact, six fu organs spread chemicals, focusing on "spreading" tangible Shui Gu, and in the process of "spreading", they digested and absorbed Shui Gu's diet. The physiological function of the spleen is mainly "transport", which transports the subtle Shui Gu, and realizes the digestion and absorption of food and drink in this process. The word "digestion and absorption" is not inherent in Chinese medicine, but a modern medical vocabulary borrowed. This vocabulary actually summarizes some functions of the spleen and stomach, including the decomposition of the stomach and the transport of the spleen, but "digestion and absorption" cannot summarize all functions of the spleen and stomach. In other words, it seems that digestion and absorption are mainly carried out in the small intestine, but the actual function cannot be separated from the transportation and transformation of the spleen. Only when the spleen can subtly transport Shui Gu out of the small intestine can the digestion and absorption of the small intestine be truly realized. In recent twenty years, people have done a lot of research on the essence of spleen, mainly focusing on the internal mechanism of spleen governing transport and transformation. Studies by Beijing College of Traditional Chinese Medicine, Beijing Institute of Traditional Chinese Medicine and other units have found that the gastrin secretion function of patients with spleen deficiency is obviously reduced, and the urine amylase content (reflecting the pancreatic amylase secretion function) is low; In the xylose excretion test, it was found that the xylose excretion rate of spleen deficiency or spleen deficiency witnesses decreased or increased abnormally, indicating that the absorption function of small intestine was disordered. It was also found that gastric peristalsis was weakened and emptying was delayed in patients with spleen deficiency, but the whole digestive tract movement emptying was obviously accelerated. Guangzhou College of Traditional Chinese Medicine and other studies have found that there is no significant difference in serum gastrin value between people with spleen deficiency and normal people. It is also found that the whole gastrointestinal tract contains many endocrine cells, the total number of which exceeds that of any endocrine gland. Hormones secreted by islets of Langerhans and hormones secreted by gastrointestinal tract have the same laws in structure and function, and influence each other, so some people call it gastrointestinal pancreatic endocrine (GEP system for short). At present, GEP hormones are gastrin, gastrin, intestinal vasoactive peptide, incretin, motilin, glucagon and insulin. It can be seen that GEP system mainly has digestive function and participates in the metabolic process of sugar, protein and blood circulation system. Traditional Chinese medicine believes that spleen is "saliva in body fluid", while modern medicine believes that saliva is produced on the basis of "salivary glands" existing in oral tissues. Histologically, although these glands are small, they are similar to pancreatic tissues that secrete various digestive enzymes. There are digestive enzymes mainly amylase in saliva secreted by these "salivary glands". According to the determination of salivary amylase activity in patients with spleen deficiency, it is generally found that salivary amylase activity is higher when there is no load, but it decreases under the effective load of acid, indicating that its reserve capacity is insufficient. In addition, there is a substance called "salivary gland" in saliva. Chen Shuying and others found that the content of muscle glycogen increased significantly after feeding mice salivary glands, suggesting that salivary glands can increase the synthesis and storage capacity of muscle glycogen; It was also found that salivary glands can promote the absorption of 〓H- glucose in gastrointestinal tract of mice, and promote the uptake and utilization of glucose in muscle and liver tissues, which is basically consistent with the significant increase of muscle glycogen. (2) Spleen governs blood, that is, governs blood. Unity means unified management, and photos are fixed. It is not perfect to understand the unity of blood only in a fixed sense. The blood regulating function of the spleen not only includes the function of storing blood in the spleen, making it run in the pulse without falling off the pulse, but also includes the function of transporting and transforming Shui Gu's subtle blood to produce blood. Because the normal operation of blood depends not only on the fixation of temper, but also on the health of blood itself. Spleen health is full of qi, blood is full of blood, and vice versa. Therefore, in clinic, people who see bleeding due to spleen failing to control blood have both spleen deficiency and blood stasis, and both bleeding and blood deficiency can be seen. In the diagnosis of traditional Chinese medicine, it will be introduced that bleeding due to spleen failing to control blood often leads to dull blood color and thin blood quality, which is the proof of incomplete blood. Some people think that spleen governing blood in TCM seems to be related to hematopoietic function. Shen Ying and others saw in the study of "biochemical deficiency" animals that with the deepening of nutritional deficiency, anemia gradually worsened, indicating that spleen and stomach weakness led to disorder of qi and blood production. Li directly discusses the essence of spleen in traditional Chinese medicine from the "spleen" of modern anatomy. He said: "Spleen in traditional Chinese medicine includes spleen and pancreas", "Spleen is a part of reticuloendothelial cells, which destroys blood. In order to regulate the number of blood cells in the circulatory system, the spleen usually stores the largest and least damaged red cells. When the blood lacks oxygen, the spleen contracts and releases red blood cells into the blood to meet its needs. This is the true meaning of' spleen regulating blood'. The first affiliated hospital of Xi 'an Medical College observed the coagulation state of patients with spleen incompatible blood group bleeding. It was found that the content of plasma fibrinogen was significantly lower than that of normal people, and the euglobulin lysis time was significantly shorter than that of normal people, so there was active fibrinolysis, which destroyed the dynamic balance of coagulation system and anticoagulation system, so the bleeding was more than normal. Jiang Zhigang's clinical research on the dysfunction of spleen and blood coagulation in patients with metrorrhagia also reached a consistent conclusion. From the above description, we can understand the blood regulating function of the spleen as the influence of the spleen's gasification on the blood running state. It is very important to realize this because it distinguishes the spleen from the heart and the spleen from the liver. Heart governs blood, driven by heart qi, described from the aspect of power; Spleen governs blood, and blood is influenced by temper in the form of gasification, so that blood is kept in the state of being governed by pulse. The reason why the liver stores blood is because the liver is a sea of blood, and blood belongs to it. Just like things are put into storage, they can not only be stored in the library, but also run outside again and exchange with the needs of human physiological activities like tides. Spleen holds blood with invisible temper, infiltrates the veins of the whole body, protects blood, and maintains it between blood and veins, so that it does not lose money. This function can only be achieved through special gasification activities, and the spleen can not be relaxed for a moment, otherwise the blood will escape from the vein. Therefore, the concept of "spleen wrapped in blood" was put forward in Difficult Classics. The word "wrapped" is a description of the mode of action of temper, which expresses the meaning that temper is wrapped in blood. Spleen controlling blood, or spleen controlling blood, is actually an invisible "interception" effect. The blocking effect of spleen controlling blood is just combined with the inhibition effect of blood vessels on blood, so that the pulse channels are truly closed. In other words, the restriction of blood vessels on blood is a tangible macro fence, but it is actually omitted. Spleen, with its special gasification mode, is engaged in invisible and microscopic cooperation, which just fills the natural omission of blood vessels. Here, the control of temper and the fencing of blood vessels are irreplaceable. Blood vessels can't close their ubiquitous tiny omissions, and temper can't contain the surging blood in the macro.
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