Objective: With the aging of the population and the accelerating process of urbanization

as well as the change of living habits and diet structure

the incidence of chronic heart failure is increasing year by year. Because of its high incidence

poor prognosis and high mortality

it has become a major public health problem. Therefore

it is of great significance to explore the pathogenesis and treatment of chronic heart failure. Chronic heart failure belongs to the range of ‘heart attack’

‘heart swelling’

and ‘heart moisture’ in traditional Chinese medicine. The nature of the disease is asthenia in origin and asthenia in superficiality as well as intermingled deficiency and excess. Asthenia in origin refers to Yang deficiency and Qi deficiency; asthenia in superficiality refers to blood stasis

water

dampness and phlegm retention. ‘All five internal organs (heart

liver

spleen

lungs and kidneys)

but not only heart

can lead to heart failure.’ The pathological changes of lung

liver

spleen and kidney can lead to chronic heart failure. Among them

the heart is the mother of the spleen

the spleen is the son of the heart

so the spleen is closely related to the occurrence of chronic heart failure. This paper discussed the relationship between the etiology and the pathology of chronic heart failure and spleen governing transportation and transformation. In the etiology

the invasion of exogenous pathogenic factors lead to deficiency of both spleen and Yang Qi. The disorders of diet leads to the spleen failing to transport and transform water and moisture. Poor mood leads to the injury of the spleen and weakness in activating blood circulation. Over exertion leads to the weakness of the spleen and retaining dampness. Loss of treatment leads to the injury of Yang Qi in the spleen and accumulation of phlegm dampness. All of these would cause heart failure. In the pathology

we discussed the pathogenesis of chronic heart failure from three aspects ‘Qi’

‘water’ and ‘blood’. Deficiency of Qi in the spleen leads to lack of Qi and blood

which can not maintain the heart

and finally leads to deficiency of both Qi and Yin. From water aspect

dysfunction of spleen leads to formation of water and moisture

which can block Qi and blood

and finally leads to the obstruction of Yang Qi in the heart. From blood

insufficient Qi in the spleen leads to formation of water and moisture

which can cause poor circulation of blood

and finally leads to obstruction of blood stasis. The etiology and pathology above could cause the heart failure. This paper provides an important theoretical basis for clinical treatment of chronic heart failure by the method of spleen governing transportation and transformation.