Syndrome of failure of the spleen to govern blood refers to the syndrome of bleeding due to failure of the spleen to control blood caused by asthenia of the spleen. This syndrome is usually caused by spleen asthenia due to chronic disease, or by overstrain and impairment of the spleen which lead to asthenia of the splenic qi.
 
Clinical manifestations:
Hematemesis, or hematochezia, or hematuria, or hematohidrosis, or epistaxis, or hypermenorrhea and profuse uterine bleeding, accompanied by poor appetite, abdominal distension, loose stool, sallow complexion or lusterless complexion, dispiritedness, lassitude, lack of qi, no desire to speak, pale tongue, thin and weak pulse. Such symptoms are usually seen in various hemorrhagic diseases, such as upper digestive tract bleeding, hematuria, purpura, hematopathy and dysfunctional uterine bleeding.
 
Analysis of symptoms:
Asthenia of splenic qi, failure of the spleen to govern blood and extravasation of blood lead to various bleeding; extravasation of blood in the stomach and intestines leads to hematemesis and hematochezia; extravasation of blood in the bladder leads to hematuria; extravasation of blood in the muscles leads to hematohidrosis; extravasation of blood in the nose leads to epistaxis; weakness of the thoroughfare and conception vessels leads to hypermenorrhea and profuse uterine bleeding; asthenia of splenic qi and failure of the spleen to transport and transform lead to poor appetite, abdominal distension and loose stool; asthenia of splenic qi and insufficient production of qi and blood lead to sallow or lusterless complexion, lack of qi and no desire to speak; pale tongue, thin and weak pulse are signs of asthenia of both qi and blood.

Key points for syndrome differentiation:
Various bleeding, poor appetite, abdominal distension and loose stool.