Abstract：The author discusses that the pathogenesis of impaired glucose tolerance is in the spleen，which means the pathogenic process is due to the dysfunction of the spleen in transportation and transformation. The key to discussing the pathogenesis of impaired glucose tolerance lies in the dysfunction of the spleen in transportation and transformation，rather than yin deficiency and heat-dryness，and therefore，it belongs to splenic pure heat，not wasting-thirst. It is suggested that impaired glucose tolerance should be treated from spleen， and should activate and awaken the spleen by the product of activating the spleen with aroma. And patients who have accompanied symptoms should be treated by giving consideration to both sides.