Deficiency of the yang of the spleen and kidney

Clinical manifestations : Pallor, cold limbs ; soreness and weakness of the lumbar region and knee joints ; loose stools or diarrhea at dawn ; facial puffiness and edema of the limbs ; a pale swollen delicate tongue with thin white coating and a deep weak pulse.

Etiology and pathology : This syndrome is often due to a prolonged illness which consumes qi and injures yang, the disease spreading from the spleen to the kidney. It may also result from deficiency of the kidney yang with the spleen yang failing to be warmed and thus producing injury of the yang qi of both organs. Dysfunction of the yang of the spleen and kidney in providing warmth causes pallor, cold limbs and soreness and weakness of the lumbar region and knee joints. Insufficiency of yang qi does not allow normal digestion, transportation and transformation of food ; the result is loose stools or diarrhea at dawn. Deficiency of yang qi implies inability to transport and transform body fluid ; the result is accumulation of harmful water and damp on the body surface, which manifests as facial puffiness and edema of the limbs. A pale swollen and delicate tongue with thin white coating and a deep, weak pulse are both signs of deficiency of yang.