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I have examined the treatments for the Spleen and Stomach, none being more detailed than those of Dongyuan (Li Dongyuan). In exploring Dongyuan's methods for treating the Spleen and Stomach, none is more exquisite than the theory of Ascending and Descending (Sheng Jiang). The method of ascending and descending is easy to understand, but the principle behind it is difficult to elucidate. As stated in the *Classic* (*Huangdi Neijing*): "The Spleen and Stomach are the officials of the granary, from which come the five flavors." Generally, the Spleen governs transformation and transportation, its function manifesting in the formless aspect. Belonging to Earth, the qi of the earth primarily ascends upward, thereby enabling it to bear all things; thus, it moves vigorously without ceasing. This clearly demonstrates that it is appropriate for the Spleen to ascend. The Stomach is the sea of water and grain, receiving and containing dregs. Its primary function is reception, and reception necessitates downward movement. Just as the nature of water is invariably to flow downward, it is equally clear that it is appropriate for the Stomach to descend. Therefore, it is also said: "If clear qi is below, it generates diarrhea with undigested food (Sun Xie); if turbid qi is above, it generates distension (Zhang)." What is clear qi? It refers to Spleen Qi; otherwise, how could it cause diarrhea when located below? What is turbid qi? It refers to Stomach Qi; otherwise, how could it cause distension when located above? Is this not a definitive proof of the Spleen ascending and the Stomach descending? By extension, formulas such as Qinglong Tang (Blue Dragon Decoction) and Yueshi Tang (Yue Bi Decoction) established by Zhang Zhongjing can be considered as methods to ascend the clear qi of the Spleen; similarly, the various Chengqi formulas (Chengqi Decoctions) he established can be considered as methods to descend the turbid qi of the Stomach. Drawing analogies and extending principles, the logic remains consistent; whether ancient or later sages, their underlying principles are one. Examining Dongyuan's works, including Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Tiaozhong Yiqi Tang (Regulate the Middle and Augment the Qi Decoction), and Shengyang Yiewei Tang (Raise the Yang and Benefit the Stomach Decoction), although his discussions detail the treatment of the Spleen while briefly mentioning the Stomach, his intent is clear: the Zang organs and Fu organs each have their specific governance, and ascending and descending have distinct indications, obviously not to be confused. How does this contradict the principles of the ancient sages? Their contributions shine together, illuminating truths for millennia, truly worthy of emulation. If these processes are inverted and misapplied, causing ascending and descending to become inappropriate, the Spleen and Stomach will be injured. Once injured, the mechanisms of intake and output will lose their normal rhythm, and the postnatal vital qi will cease. Few people would avoid premature death. Having occasionally read Dongyuan's books and thoroughly investigated the Spleen and Stomach, I have analyzed their principles of ascending and descending as follows.

An ancient sage once said: "Excess of Qi becomes Fire." This statement should be interpreted specifically regarding pathogenic Qi. What if Yuan Qi (Original Qi) is deficient rather than excessive? Why? Qi transforms from Essence, and Essence is generated from water and grain. Thus, if a person does not eat twice a day, they feel hungry; hunger leads to weak Qi and fatigue. Only with appropriate diet and regulated daily life can Yuan Qi be abundant and flowing freely. In a full day and night, there are exactly 13,500 breaths, which is the standard measure for the human body. Therefore, sages treat Qi as a supreme treasure, precisely because Qi is prone to deficiency. When the six pathogenic factors—Wind, Cold, Summerheat, Dampness, Dryness, and Fire (Liu Yin)—invade the Ying and Wei levels and the meridians and fu organs externally, they obstruct the circulation and entry-exit pathways of righteous Qi. This results in closed pores, chest and abdominal fullness and stuffiness, and obstruction of urination and defecation. These manifest as signs of excess pathogenic Qi, while the internal state of Yuan Qi shows signs of depletion. Physicians should only investigate the cause: for Wind, use harmonizing methods; for Cold, use diaphoretic methods, etc. In doing so, transformation into Fire is avoided, and Yuan Qi is restored. However, if treatment misses the key point and pathogenic Qi lingers, any of the six factors can transform into Fire. For instance, heat diseases falling under the category of Cold Damage (Shang Han) are common; among the Nineteen Pathogenesis Patterns, many belong to Heat. Hence, it is said that "excess of Qi becomes Fire." This applies equally to diseases caused by the Seven Emotions. For example, excessive joy leads to an excess of Joyful Qi and blazing Heart Fire; excessive anger leads to an excess of Angry Qi and flaming Liver Fire. In such cases, regulation must be based on the yin-yang and deficiency-excess states of the Zang organ Qi. If one rigidly adheres to this saying, employing only methods to break or descend Qi, or to clear and purge Fire, I fear that the Mild Fire (Shao Huo, which generates Qi) will be damaged, leading to total collapse and irreparable loss. This is not the way to preserve health, nor is it the true intent behind the words of the ancients!