White tongue coating with tooth marks and loose stools—does this indicate spleen qi deficiency or spleen yang deficiency?

Under normal circumstances, white tongue coating with tooth marks and loose stools are usually signs of spleen qi deficiency. If accompanied by significant cold intolerance, it may indicate spleen yang deficiency, which should be determined based on a comprehensive assessment of symptoms. If in doubt, it is recommended to seek medical advice promptly. Detailed analysis is as follows:

If only white tongue coating with tooth marks and loose stools are present, along with poor appetite, limb fatigue, lethargy, and abdominal bloating, this is typically due to spleen qi deficiency. Weak spleen qi leads to reduced transformation and transportation function, resulting in internal retention of dampness. Damp-turbidity rising to the tongue causes white coating with tooth marks, while dampness descending into the intestines leads to loose stools. Overall, there are no obvious signs of cold.

If, in addition to the above symptoms, there are also cold intolerance, cold limbs, cold-induced abdominal pain, preference for warmth and pressure, watery diarrhea with undigested food, etc., it may indicate spleen yang deficiency. Spleen yang deficiency is an advanced stage of spleen qi deficiency. Insufficient yang qi impairs warming function, leading to more severe dysfunction in water-damp metabolism, with cold manifestations becoming the core characteristics.

Judgment should focus on the presence of cold signs; conclusions should not be drawn based on a single symptom alone. In daily life, it may be helpful to consume spleen-strengthening foods such as Chinese yam and coix seed, while avoiding raw, cold, greasy, and oily foods. If symptoms persist, it is advisable to consult a traditional Chinese medicine practitioner for pattern differentiation and proper regulation, rather than blindly taking warming or dampness-resolving herbs.