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Home > Education > Zang Fu > Spleen Qi not Governing Blood

Spleen Qi Not Governing Blood

From "Zang Fu Syndromes," by McDonald and Penner


SP Qi Xu or SP Yang Xu causes failure of SP's function of keeping Blood flowing within the vessels. This is intimately connected with Qi's function of "leading" or "commanding" Blood, hence this condition can also be called Qi Not Governing Blood.

Clinical Manifestations

Sallow complexion

Abdominal and epigastric distention after eating

Physical and mental exhaustion

Maybe acid regurgitation or vomiting


Loose or unformed stools

Four limbs feel tired and heavy

Shortness of breath



The above symptoms occur with bleeding, which can manifest as any of the following:

Functional Uterine Bleeding








T: Pale and flabby - may have teethmarks
C: White
P: Thready and weak


Bleeding of the Xu type (or indeed any bleeding) can cause Blood Xu conditions such as:

  • LIV Blood Xu.

  • HT Blood Xu (usually HT Blood and SP Qi Xu).

Associated Western Conditions

Functional Uterine Bleeding

Allergic purpura (Schoenlein-Henoch purpura)

Bleeding hemorrhoids


Thrombocytopenic purpura



Differential Diagnosis

Bleeding of the Xu type (SP Not Governing Blood) must be differentiated from other types of bleeding such as Hot Blood bleeding or bleeding due to extravasated Blood:

Qi Xu Heat in Blood Extravasated Blood

Qi Xu signs

Shi Heat signs

Stuck blood signs

Rarely epistaxis,

Heavy bleeding

Recurrent bleeding

hematemesis or hemoptysis

Bright red blood

Often post partum or menstrual bleeding


Can be any type of bleeding

Dull purple blood with clots





Treatment Principle

Benefit Qi and Conserve Blood.

Common Acupuncture Points

SP-1 / Yinbai

Main point to strengthen SP's function of governing Blood.

UB-20 / Pishu

Reinforces SP.

ST-36 / Zusanli

Reinforces SP.

SP-3 / Taibai

Reinforces SP.

Other points are selected according to signs and symptoms.

Xu type uterine bleeding:

REN-4 / Guanyuan

Regulates Chong Mai and Ren Mai.

DU-20 / Baihui

Raises Yang Qi.

SP-1 / Yinbai

Main point for SP Not Governing Blood.

SP-4 / Gongsun

Promotes function of Chong Mai and Ren Mai in controlling Blood.

SP-10 / Xuehai

Used mainly for Hot Blood or extravasated Blood.

LI-11 / Quchi

Used mainly for Hot Blood skin rashes.

UB-17 / Geshu

Used mainly for extravasated Blood.

Common Herbal Formulae

Gui Pi Tang / Decoction to Strengthen the Heart and Spleen

Bu Zhong Yi Qi Tang plus E Jiao and Ai Ye / Decoction for Reinforcing the Center and Benefiting Qi plus Donkey-Skin Glue and Artemisia Argyi

Gui Pi Tang plus Jiao Ai Tang / Decoction to Strengthen the Heart and Spleen plus Decoction of Donkey-Skin Glue and Artemisia

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