Anorexia is a disorder characterized by poor appetite or even refusal to eat and is mostly seen in children one to six years of age. It may lead to deficiency of healthy qi and maldevelopment when the disorder is longstanding.

Etiology and Pathogenesis

Impairment of the spleen and stomach resulting from immoderate eating, improper feeding or limited food indulgence are the common causes of anorexia. It may also be a result of congenital weakness of the spleen and stomach or consumption of stomach-fluid after a febrile disease.

Syndrome Differentiation and Therapeutic Principles

A. Syndrome differentiation

(a) Differentiation of the predominant syndrome: Cases with insufficiency of stomach-yin manifest themselves as anorexia accompanied by thirst, polydipsia and constipation. Those cases with dysfunction of the spleen manifest themselves as anorexia accompanied by lusterless complexion but no disturbance of the spirit. In cases with deficiency of both the spleen and the stomach, mental fatigue, sallow complexion, emaciation and a tendency to sweat may accompany the disease.

(b) Observation of tongue condition: A greasy tongue coating indicates dysfunction of the spleen. A red and dry tongue with a little or no coating signifies insufficiency of stomach-yin. A Pale and corpulent tongue with thin coating designates deficiency of spleen-qi and stomach-qi.

B. Therapeutic principles

Activating the spleen for cases of spleen dysfunction, nourishing the stomach for cases of stomach-yin insufficiency and invigorating the spleen and stomach for cases of spleen-stomach deficiency are the main therapeutic principles. However, no matter what kind of anorexia, is present, the principle to restore the function of the spleen must be stressed.

Classification and Treatment

A. Dysfunction of the spleen

Manifestations: Poor appetite, lusterless complexion, emaciation, white or thin and greasy tongue coating and soft-floating and slow pulse.

Therapeutic principles: Regulate the spleen.

Prescription: The Modification of Pill of Massa Fermentata Medicinalis

Massa Fermentata Medicinalis 10 g
Fructus Hordei Germinatus 10 g
Rhizoma Atractylodis Macrocephalae 10 g
Fructus Aurantii Immaturus 5 g
Pericarpium Citri Reticulatae 6 g
Endothelium Corneum Gigeriae Galli 6 g
Remarks: Add Rhizoma Pinelliae (6 g) and Caulis Bambusae in Taeniam (10 g) for cases with vomiting. Add Herba Agastachis (10 g) and Fructus Cardamomi (10 g) for those with thick, white, greasy tongue coating. Add Semen Raphani (6 g) and Radix Aucklandiae (3 g) for those with abdominal distention and eructation.

B. Insufficiency of stomach-yin

Manifestations: Dryness of mouth, polydipsia, poor appetite, constipation, red tongue with little or no coating and thready and weak pulse.

Therapeutic principles: Benefit the stomach, and nourish yin.

Prescription: Decoction for Nourishing Yin and Increasing Body Fluids

Radix Adenophorae Strictae 10 g
Rhizoma Polygonati Odorati 10 g
Herba Dendrobii 10 g
Radix Paeoniae Alba 10 g
Radix Glycyrrhizae 3 g
Rhizoma Dioscoreae 10 g
Radix Rehmanniae 10 g

Remarks: Add Cortex Moutan Radicis (10 g) and Rhizoma Picrorrhizae (6 g) for cases with restlessness during sleep, feverish sensation of palms and soles, dryness of the mouth and redness of the tongue. Add Fructus Hordei Germinatus (fried, 10 g) and Fructus Oryzae Germinatus (10 g) for those with dyspepsia. Add Semen Pruni (10 g) and Fructus Cannabis (10 g) for those with constipation.

C. Deficiency of spleen-qi and stomach-qi

Manifestations: Sallow complexion, emaciation, fatigue, loss of appetite, abdominal distention, loose stool, pale tongue with thin, white coating and thready and weak pulse.

Therapeutic principles: Invigorate the spleen, and benefit qi.

Prescription: The Modified Powder of Codonopsis Pilosulae, Poria and Atractylodis Macrocephalae

Radix Codonopsis Pilosulae 10 g
Poria 10 g
Rhizoma Atractylodis Macrocephalae 10 g
Rhizoma Dioscoreae 10 g
Semen Coicis 10 g
Semen Dolichoris 10 g
Pericarpium Citri Reticulatae 6 g
Fructus Amomi 3 g
Radix Platycodi 3 g

Remarks: Add Massa Fermentata Medicinalis (fried, 10 g), Fructus Hordei Germinatus (fried, 10 g) and Fructus Crataegi (fried, 10 g) for cases with dyspepsia.

Experiential Prescriptions

A. Pulvis Endothelium Corneum Gigeriae Galli; 0.5 to 2.0 grams thrice a day; applicable to cases with dysfunction of the spleen.

B. Extractum Fructus Crataegi; 10 grams thrice daily; applicable to cases with dysfunction of the spleen.

Copyright 1995 Hopkins Technology