this is the classic presentation of spleen qi deficiency, usually caused by improper eating habits, excessive deliberation, or overworking. when the spleen qi is deficient, the transformation of food into blood and qi is impaired. this manifests as a pallid complexion and a low, soft voice.

spleen deficiency also leads to a decline in that organ’s transportive functions and thus a lack of transport through the stomach. this manifests as reduced appetite and unformed stools. because the spleen governs the limbs, the patient will first experience weakness in those parts of the body. the pale tongue and the thin and/or frail pulse are typical reflections of deficient spleen qi.

(bensky & barolet)