To govern transportation and transformation and to command blood are two major physiological functions of the spleen.

     

The function of the spleen to govern transportation and transformation means that the spleen can digest food, absorb nutrients of food and water, and then transport them to the heart and the lung. 

When taken into the stomach, food is digested and absorbed by the stomach and the small intestine. But it must depend on the transporting and transforming functions of the spleen to transform into nutrients which, relying on the functions of the spleen to transmit and dispersing essence, are distributed to the four limbs and the other parts of the body. The rest of the water absorbed from the food nutrients is transported to the lung and the kidney and, by means of qi transformation taking place in the lung and the kidney, transformed into sweat and urine to be excreted out of the body. 

So the transporting and transforming functions of the spleen are usually divided into two parts, transporting and transforming food nutrients, and transporting and transforming water. Since the transporting and transforming of food nutrients and water take place at the same time in the process of digesting, absorbing and transmitting food, they are closely related to each other and pathologically affect each other.

The transporting and transforming functions of the spleen are mainly concerned with, apart from the warming function of spleen-yang, the propelling function of spleen-qi. The movement of spleen-qi is marked mainly by elevation. That is why it is said in TCM that "the spleen governs the activity of elevating the lucid". To elevate means to ascend and transmit; the lucid refers to the food nutrients.

The idea that "the spleen governs the activity of elevating the lucid" indicates that the function of spleen-qi is to transmit food nutrients to the heart and the lung. If the function of the spleen to elevate the lucid is normal, qi and blood will be sufficient, and there will be exuberant vitality in the activities of life. Besides, to elevate also means to lift and fixate. The elevation of spleen-qi can also fixate the viscera and prevent them from prolapse.

      

The normal state of the functions of the spleen to transport and transform is called healthy transformation of spleen-qi while the abnormal state of the functions of the spleen to transport and transform is called unhealthy transformation of spleen-qi. The main clinical manifestations of the latter can be divided into four groups: anorexia, abdominal distension, abdominal pain and loose stool if the digesting and absorbing functions are weak; phlegm, rheum and edema if dampness and water are retained due to disturbance of water metabolism; dizziness and spiritual lassitude if the spleen fails to elevate the lucid; visceroptosis, prolonged diarrhea and proctoptosis if spleen-qi sinks.

     

To command means to control. To command blood means that the spleen controls blood circulation inside the vessels and prevent it from flowing out of the vessels. The spleen commands blood with its fixating function. If spleen-qi is sufficient, it can control blood and directs blood to circulate inside the vessels. Such a function of the spleen is also related to spleen-yang. Thus deficiency of spleen-qi and spleen-yang will impair the function of the spleen to command blood, leading to hematochezia, hematuria, sudden profuse uterine bleeding and subcutaneous purpura.