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Yin arises from the upper part; the Stomach, although a pure Yang organ, contains Yin Qi. Because it possesses Yin, it descends; turbid Qi descends with it, thus keeping the Stomach clear and empty, enabling it to receive and hold food well. Yang arises from the lower part; the Spleen, although a pure Yin organ, contains Yang Qi. Because it possesses Yang, it ascends; clear Yang Qi ascends with it, thus keeping the Spleen warm, enabling it to digest and transform food well.

When water and grain enter the Stomach, Spleen Yang grinds and transforms them. The dregs are transmitted downward to become feces and urine, while the essence is sent upward to transform into Qi and Blood. Qi is governed by the Lung, and Blood is stored in the Liver. When Liver Blood warms and ascends, it transforms into Yang Shen (Spirit); when Lung Qi clears and descends, it produces Yin Jing (Essence). All five Zang organs possess Jing (Essence), which is entirely received from the Kidney. All five Zang organs possess Shen (Spirit), which is entirely received from the Heart. All five Zang organs possess Blood, which is entirely received from the Liver. All five Zang organs possess Qi, which is entirely received from the Lung. All of this ultimately stems from the transformation and generation by the Earth Qi (Spleen/Stomach).

Earth has the nature of sowing and reaping; sowing and reaping produce the Sweet flavor. Grains taste sweet because they embody Earth Qi. The fragrant and sweet flavors of the five grains nourish the Spleen and Stomach. When Earth Qi is abundant, it distributes to the other four Zang organs: Ji Earth (Spleen) rotates leftward, sending Grain Qi to the Heart and Lung; Wu Earth (Stomach) rotates rightward, sending Grain Essence to the Kidney and Liver. The Spleen and Stomach are the officials responsible for storage and granaries, the sea of water and grain. If a person has Stomach Qi, they live; if Stomach Qi is absent, they die. Stomach Qi is transformed from water and grain. Food is the heaven for the people, and its importance is not slight.

Water and grain enter the Stomach and are digested by Spleen Yang. The digestion of water is more difficult than that of grain, because the grinding and transforming action of Spleen Earth relies entirely on Fire. Fire is the mother of Earth; when Fire is vigorous, Earth becomes dry, possessing the power to overcome Water. Spleen Yang steams and moves, transforming the essence of water and grain into mist. This mist floats upward and returns to the Lung. Lung Metal clears and descends, sprinkling the mist down, which transforms back into water. This is like water boiling in a pot, where steam rises as mist. The water resulting from Qi transformation has fine and coarse parts. The fine part enters the Zang and Fu organs to become Jin Ye (Body Fluids); the coarse part enters the Bladder to become Xiao Niao (Urine). When Xiao Niao flows freely, there is no stagnant water in the Stomach, waste materials are transmitted posteriorly, and thus stool becomes dry. *Ling Shu: Ying Wei Sheng Hui* states: "The Upper Jiao is like mist; the Middle Jiao is like a fermenting vat; the Lower Jiao is like a ditch." Qi and water change in the Middle Jiao. "Ao" (fermenting vat) refers to the state where Qi and water are just beginning to transform but are not yet vigorous. Once transformation is complete, Qi rises and fills the chest and diaphragm, hence resembling mist and dew. Water flows downward and fills the Bladder, hence resembling rivers and ditches. The dredging of these ditches depends on the San Jiao (Triple Burner). *Su Wen: Ling Lan Mi Dian Lun* states: "The San Jiao is the official who dredges the waters; the water passages emerge from it." Generally, if the Fire of the San Jiao is sealed, it warms the Spleen and Stomach above and ensures smooth water passages; if the Fire of the San Jiao leaks, it sinks into the Bladder below and closes the water orifices. *Ling Shu: Ben Shu* states: "The San Jiao is commanded by the Foot-Taiyang and Foot-Shaoyin meridians; it is a branch of the Taiyang meridian. At five cun above the malleolus, it branches off, penetrates through the intestines, emerges at Weiyang (BL39), runs parallel with the main channel of Taiyang, enters and connects with the Bladder, and regulates the Lower Jiao. In excess conditions, it causes Bi Long (dysuria/retention); in deficiency conditions, it causes Yi Niao (incontinence)." This is because Water nature is to hibernate and store. Foot-Taiyang Cold Water hibernates and stores; the Fire of the San Jiao is sealed within the Kidney, warming internally and clearing externally. When the Water Mansion is clear and unobstructed, the upper orifices remain open. Thus, water transformed by Qi seeps into the Bladder, and urination is smooth. If Foot-Taiyang Cold Water cannot hibernate and store, and the Fire of the San Jiao leaks into the Bladder, the Bladder suffers from Heat and Bi Long, and the water orifice does not open. If the Spleen and Stomach are cold and depressed, they can only digest grain but not water. Water fails to transform into Qi and ascend, so it mixes with grain dregs and enters the two intestines, causing Xie Li (diarrhea/dysentery). In cases of diarrhea, water enters the two intestines instead of the Bladder, leading to difficult urination. This is what is meant by "excess conditions cause Bi Long," referring to the leakage of San Jiao Fire into the Bladder.