The first stage is Spleen Qi Deficiency. This is mostly caused by irregular diet, excessive fatigue, or emotional distress damaging the Spleen. In Traditional Chinese Medicine (TCM), the Spleen is responsible for "ascending the clear." Only when Spleen Qi ascends properly can nutrients and the essence of water and grain be transported to the Heart, Lungs, and head; the Heart and Lungs then transform this essence into Qi and Blood to nourish the entire body. Common symptoms include mental fatigue, lack of strength, shortness of breath, reluctance to speak, abdominal distension, poor appetite, and a pale tongue with a white coating. At this stage, it is necessary to supplement Qi and strengthen the Spleen; Liu Jun Zi Tang (Six Gentlemen Decoction) may be considered.

The second stage is Spleen Yang Deficiency. If Spleen Qi Deficiency persists for a long time and Yang Qi is excessively dissipated, Yang Deficiency will occur. Symptoms include cold intolerance, diarrhea, abdominal pain, frequent nasal congestion, low food intake, and borborygmus (stomach growling). At this stage, it is necessary to warm the Yang; Li Zhong Wan (Center-Regulating Pill) may be considered.

The third stage is Spleen Yin Deficiency. Starting from Yang Deficiency, the imbalance between Yin and Yang occurs; Yang Deficiency eventually damages Yin, leading to Yin Deficiency. Manifestations include dry mouth and tongue, sore and swollen throat, flushed face and red eyes, and dry, bound stools. Shashen Maidong Wan may be considered for reference.

The fourth stage is Spleen Deficiency with Dampness Stagnation. Prolonged Spleen Qi Deficiency leads to a decline in the Spleen's function of transporting and transforming water-dampness. Pathogenic dampness accumulates within the body, resulting in heavy limbs, abdominal discomfort, poor appetite, and an aversion to greasy food. At this stage, it is necessary to strengthen the Spleen, dispel dampness, and resolve phlegm.

The fifth stage is Spleen Qi Sinking (Sinking of Middle Qi). This is an advanced version of Spleen Qi Deficiency. At this point, the Spleen Qi is even weaker—so deficient that it can no longer consolidate and hold. Instead of ascending as it should, the Spleen Qi sinks. Manifestations include not only abdominal distension but also a bearing-down sensation in the abdomen, chronic diarrhea, rectal prolapse, and uterine prolapse in women. The refined substances (essence) that were meant to be ascended to the Heart, Lungs, and head instead pour down into the bladder, leading to cloudy urine, shortness of breath, reluctance to speak, and fatigue in the limbs. Buzhong Yiqi Wan may be considered for reference.

The sixth stage is Spleen Failing to Control Blood. In this situation, various types of bleeding occur, primarily manifesting as epistaxis (nosebleeds), bleeding gums, subcutaneous hemorrhage (purpura), hematuria (blood in urine), and hematochezia (blood in stool). In women, symptoms of blood failing to follow its normal pathways include menorrhagia (excessive menstruation) and flooding and spotting (metrorrhagia and metrostaxis). At this stage, it is necessary to supplement Qi to contain the blood. Gui Pi Wan may be considered for reference.

However, a reminder to everyone: Traditional Chinese Medicine (TCM) medication requires syndrome differentiation (Bian Zheng). If needed, please consult a professional physician promptly for diagnosis, treatment, and conditioning.