[Objective]This paper is to detail the system thinking of syndrome differentiation and treatment of eczema from the spleen and provide ideas for clinical diagnosis and treatment of eczema.[Methods]Combined with the understanding of eczema in Chinese and western medicine, detailing the ideas of syndrome differentiation and treatment of eczema from the spleen,which includes the etiology and pathogenesis, the basic rule and its application ideas, to reconcile the five internal organs, the syndrome differentiation of physique and caring spleen and stomach.[Results]The basic pathogenesis of eczema is the weak spleen loss the transport function.In clinical treatment,the main method to complement the spleen is preserving its transport function.On the basis of complementing the spleen,different times have different rules.It should clarify the rule of complementing the spleen to get rid of the wet evil.Types of hot evil or hot and wet evil,the rule is to get rid of the hot and wet evil.After symptom relief,herbs to complement the spleen should be added.Types of wet evil or blood deficiency resulting in wind evil,the rule is to complement the spleen to get rid of the wet evil.Attention to regulating the function of organs, not specifically treating the spleen,but make the spleen as the center to reconcile the five internal organs. The weak spleen is the physical tendencies of eczema patients. Individual differences have targeted treatment to correct the physique bias.Medication and daily life always pay attention to caring spleen and stomach.Diagnosis and treatment of eczema from the spleen can have guiding signficance. [Conclusion]The thinking of syndrome differentiation and treatment of eczema from the spleen has a guide to clinical significance,is worthy of further study and popularization.