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The Spleen and Stomach belong to Earth in the Five Elements; all things are borne by the Earth. They reside in the central region (Zhongzhou) of the body, governing the transformation and transportation of food and fluids, and nourishing the bones and meridians. The *Neijing* states: "When grain enters the Stomach, the pulse pathways begin to circulate; when liquids enter the vessels, blood is formed." It also says: "Abundance of food leads to prosperity; absence of food leads to decline." Generally, the Spleen must be nurtured, and the Stomach must be warmed. The method of warming and nurturing lies in maintaining appropriate temperature balance and regulating diet. In this way, the body remains harmonious, and diseases do not arise. However, if one fails to care for oneself properly, mishandles regulation, damages the Stomach through improper diet, or injures the Spleen through overexertion, various diseases will emerge. Once the Spleen and Stomach are deficient, how can the Zang and Fu organs receive nourishment? The treatment principle should first determine excess or deficiency and identify the cause. If the injury is due to excessive fluid intake, which constitutes a formless pathogen, it may be dispersed through mild diaphoresis (sweating) or drained through diuresis. If the injury is due to food stagnation, digestive and guiding methods should be used to grind down the accumulation. If solid matter such as fruits has remained stagnant for a long time causing chest oppression, emetic or purgative methods should be used to expel it. Cold patterns are treated with warming methods; heat patterns are treated with clearing methods. One must not indiscriminately use aromatic and drying herbs, as this may stir up fire pathogens and cause great harm. As for injuries to the Spleen Qi caused by overexertion, leading to sinking of Yuan Qi and insufficiency of Middle Qi, this is referred to as "self-injury resulting in the depletion of Qi." Treatment should follow Li Dongyuan's internal injury methods, necessarily employing herbs that lift and tonify Qi and Blood, warming and nurturing the Spleen and Stomach so that the transformative and generating Qi increases. When the Spleen and Stomach become strong, the disease will naturally resolve.

1. For irregular diet and inappropriate cold/heat exposure damaging the Spleen and Stomach, presenting with heavy body, painful joints feeling hot, lassitude of the four limbs, loss of taste, undigested stool in diarrhea, hematochezia, or passage of white pus, use Tiao Zhong Yi Qi Tang (Regulate the Middle and Boost Qi Decoction).
2. For Spleen and Stomach deficiency-cold presenting with vomiting and regurgitation, nausea, fullness and oppression in the chest and epigastrium, borborygmus, abdominal pain, and diarrhea, use Yang Wei Tang (Nourish the Stomach Decoction).
3. For disharmony of the Spleen and Stomach presenting with anorexia, distension and oppression in the heart and abdomen, nausea, and belching, use Ping Wei San (Calm the Stomach Powder).
4. For Spleen and Stomach deficiency-cold presenting with indigestion, vomiting, and abdominal pain, use Li Zhong Tang (Regulate the Middle Decoction).
5. For Spleen and Stomach weakness presenting with reduced appetite, weakness of the four limbs, and shortness of spirit/vitality, use Si Jun Zi Tang (Four Gentlemen Decoction).
6. For fluid injury to the Stomach presenting with headache and nausea, treat with mild diaphoresis using Xiang Sha Zao Wei Tang (Aromatic Amomum Drying Stomach Decoction).
7. For fluid injury presenting with scanty and difficult urination, use Wu Ling San (Five-Ling Powder).
8. For food injury to the Spleen and Stomach presenting with chest tightness, anorexia, and nausea, use Kuan Zhong Jin Shi Wan (Widen the Middle and Promote Appetite Pill), Xiao Shi Wan (Digest Food Pill), Bao He Wan (Preserve Harmony Pill), Shen Qu (Medicated Leaven), and Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill).
9. For Spleen and Stomach weakness presenting with inability to eat, vomiting, and diarrhea, use Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder).
10. For Spleen Qi deficiency-cold presenting with diarrhea, abdominal pain, and rebellious Qi, use Bu Pi Tang (Tonify the Spleen Decoction) and Zhi Zhong Tang (Regulate the Middle Decoction).
11. To regulate the Spleen and Stomach, relieve chest oppression, and dissipate nodular qi/stagnation, use Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill) with modifications.