Confusion of TCM: Does "spleen strengthening" for treating liver and spleen replenish spleen and stomach?

"Synopsis of the Golden Chamber: the First Syndrome of Diseases Associated with Zang-fu Organs and Meridians" points out: "When you see the diseases of the liver, you should know that the liver transmits the spleen first, so you should strengthen the spleen first", which shows the pathological argument that liver diseases are easy to transmit the spleen. First of all, it shows that spleen should be considered in the treatment of liver disease. Tracing back to the source, the theory of "strengthening the spleen due to liver disease" in the Golden Chamber is recorded in Neijing and Difficult Classic: for example, Yu Suwen's Collection and Collection Theory says: "The five internal organs are sick, and each spreads its victory", "The liver is affected by the qi in the heart and spreads to the spleen"; It is clearly pointed out in Difficult Classics 77 Difficult Classics: "The so-called person who treats the disease before it sees the disease of his liver and knows that his liver should be transmitted to the spleen, so he first consolidates his temper and suffers from the evil of his liver without making an order, so it is said that he treats the disease before it happens."

Later generations of physicians also elaborated on this. If you are in Beijing, you pointed out in the "Synopsis of the Golden Chamber, the First Syndrome of Zang-fu Meridian Diseases": "The evil spirits are also in the body, which is better than adding. Only when the liver is superior to the spleen can we know that liver disease is transmitted to the spleen. He also said that "those who strengthen the spleen help to make the qi flourish and prevent evil spirits, so it is said that the disease is not cured", and "those who treat the liver should strengthen the spleen first and take the disaster of Du Ziman".

Spleen hyperactivity liver disease is a generalized "liver disease" in traditional Chinese medicine, and its specific symptoms can be "liver depression", "hypochondriac pain" and "liver depression". These liver diseases are related to some diseases of the hepatobiliary system in modern medicine, especially the clinical manifestations of hepatitis and cirrhosis. In the course of these diseases, a series of symptoms of digestive dysfunction often appear. Therefore, the theory of liver disease transmitting spleen not only originated in ancient times, but also is a scientific summary of long-term medical clinical practice.

According to the traditional understanding, the liver disease here generally refers to the excess of the liver. The so-called "in fact, it is transmitted, and the deficiency is not transmitted." This understanding is mainly based on the theory of five elements, which has certain limitations. Judging from the physiological relationship between the liver and the spleen, the function of relieving qi of the liver plays a very important role in promoting the transport and transformation of the spleen. Therefore, whether the liver is solid or deficient, as long as the liver's qi-relieving function is abnormal, it can affect the spleen's transport and transformation function in many ways, and eventually lead to the same disease of liver and spleen.

The so-called "strengthening the spleen" is directly to enrich the temper. Treating the liver and strengthening the spleen is a preventive treatment based on mastering the evolution law of the pathogenesis of liver diseases prone to spleen. In the past, it was generally believed that strengthening the spleen was to replenish the spleen. It should be recognized that strengthening the spleen here is also a broad concept. Strengthening the spleen can not only invigorate qi, blood, yin and yang, but also clear spleen (stomach) damp heat and eliminate spleen (stomach) cold and dampness. The main purpose is to regulate the spleen, make the spleen healthy and maintain a good functional state.

According to the theory of strengthening the spleen in liver diseases, people with liver depression or spleen deficiency should take spleen-strengthening drugs even if they have not yet developed symptoms of spleen disease. For patients with liver depression and healthy spleen (stomach), it should be noted that when soothing the liver and relieving depression with fragrant and dry products, drugs that are sweet and beneficial to the spleen should be added as appropriate to prevent spleen injury.

In addition, strengthening the spleen for liver disease is a preventive early treatment, which should be distinguished from "simultaneous treatment of liver and spleen". The former is used to treat liver diseases with spleen transmission tendency or spleen deficiency, but when the spleen has not changed, the liver is the main treatment, and the spleen-nourishing products are added slightly when treating the liver; The latter is used for simultaneous onset of liver and spleen, and the proportion of treating liver and spleen is determined according to the biased lesions of the two organs. According to Synopsis of the Golden Chamber, Theory of Liver Disease with Spleen Deficiency, Syndrome of Zang-fu Meridian and Syndrome of Successive Diseases and Veins, it is pointed out that "excess viscera should follow this principle", which means that the principle of early treatment should be applied to all internal injuries and visceral diseases.