删繁论曰∶中焦如沤，（沤者在胃中如沤也）起于胃中管，在上焦之后此受气泌糟粕，
蒸
津液，化其精微，上注于肺脉，乃化而为血，奉以生身，莫贵于此，故独得行于经隧，名曰
营气，主足阳明，阳明别号曰丰隆，在外踝上，去踝八寸，别走太阴络诸经之脉，上下络太
仓，主热五谷，不吐不下，实则生热，热则闭塞不通，上下隔绝，虚则生寒，寒则洞泄便痢
霍乱，主脾胃之病，夫血与气异形而同类，卫是精气，营是神气，故血与气异形而同类焉，
夺血无汗，（此是神气）夺汗无血，（此是精气）故人有一死而无再生也。犹精神之气隔绝也。
若虚则补于胃，实则
又疗中焦实热闭塞，上下不通，隔绝关格，不吐不下，腹满彭彭，喘急，大黄泻热，开
关格通隔绝汤方。
大黄（三两切别渍） 黄芩（三两） 泽泻（三两） 升麻（三两） 羚羊角（四两） 栀
子仁（
四两） 生地黄汁（一升） 玄参（八两） 芒硝（三两）
上九味切，以水七升，先煮七味，取二升三合，下大黄更煎数沸，绞去滓，下消，分三
服。忌芜荑。（千金同）
千金疗中焦热，水谷下痢，蓝青丸方。
蓝青汁（三升） 黄连（八两） 黄柏（四两） 白术（三两） 地榆（二两） 地肤
子（二两） 阿胶（五分炙） 乌梅肉（三两）
上八味下筛，用蓝汁和微火上煎，为丸如杏仁大，饮服三丸，日再，七月七日合之良，
当并手丸之。忌猪肉冷水桃李雀肉等。
又疗中焦虚寒，四肢不可举动，多汗洞痢方。
灸大横随年壮大横侠脐旁行相去两边各两寸五分（删繁同出第二七卷中）
The *Shanfan Lun* (Abridged and Simplified Treatise) states: The middle jiao (Middle Burner, referring to the digestive functions of the spleen and stomach) is like a fermenting vat. ("Fermenting" refers to the state of food undergoing fermentation and decomposition in the stomach.) It originates from the stomach, located posterior to the upper jiao (Upper Burner). Here, it receives the qi of water and grain, separates the dregs, steams the body fluids, and transforms them into fine essences. These essences ascend and pour into the lung vessels, where they are further transformed into blood. This blood nourishes the body for growth and life; nothing is more precious than this. Therefore, it alone travels through the meridians and collaterals, known as Ying Qi (Nutritive Qi), which primarily governs the Foot-Yangming Stomach Meridian. The Yangming meridian has an alternative name, Fenglong (ST40), located above the lateral malleolus, eight cun away from the ankle tip. From here, it branches off to connect with the Hand-Taiyin Lung Meridian and other meridian networks, linking upwards and downwards to the Tai Cang (Grand Granary, i.e., the Stomach). It governs heat syndromes and conditions such as food retention without vomiting or defecation. In excess patterns, internal heat is generated; excessive heat leads to blockage and obstruction, causing separation between the upper and lower parts. In deficiency patterns, internal cold is generated; excessive cold leads to copious diarrhea, dysentery, and cholera-like disorders. These diseases are primarily attributed to the Spleen and Stomach.
Blood and Qi differ in form but share the same origin. Wei Qi (Defensive Qi) is refined essence, while Ying Qi is spiritual qi; thus, blood and Qi differ in form but are of the same kind. Therefore, one who has lost blood should not undergo sweating therapy (as sweat is derived from blood), and one who has suffered excessive sweating should not undergo bloodletting or further depletion of Yin and Blood (as excessive sweating damages both Qi and Yin/Yang). Hence, once a person dies, they cannot be revived, just as the spirit and qi have completely severed their connection.
If the condition is due to deficiency, tonification of the Stomach is indicated. If the condition is due to excess, there is another treatment for middle jiao excess heat causing blockage, characterized by obstruction between the upper and lower parts, Guan Ge syndrome (a critical condition involving vomiting and inability to urinate), absence of vomiting or defecation, abdominal distension resembling a drum, and rapid breathing. To purge heat using Rhubarb and open Guan Ge and unblock obstruction, the following decoction is prescribed:
Rhubarb Root and Rhizome (Sanliang, cut and soaked separately) Scutellaria Root (Sanliang) Alisma Rhizome (Sanliang) Cimicifuga Rhizome (Sanliang) Antelope Horn (Siliang) Gardenia Seed (Siliang) Fresh Rehmannia Juice (Yisheng) Scrophularia Root (Baliang) Mirabilite (Sanliang)
Cut the above nine ingredients. Add seven sheng of water, and first decoct the initial seven ingredients until two sheng and three he remain. Then add Rhubarb and boil for a few more boils. Strain to remove the dregs, add Mirabilite to dissolve, and divide into three doses. Avoid eating Coix Seed (or potentially Wormseed/Chen Pi depending on textual variant interpretation, but literally "Wuyi"). (The usage in *Qianjin Fang* is the same.)
*Qianjin Fang* treats middle jiao heat leading to watery and undigested food diarrhea with the Lanqing Pill formula:
Isatis Leaf Juice (Sansheng) Coptis Rhizome (Baliang) Phellodendron Bark (Siliang) Atractylodes Macrocephala Rhizome (Sanliang) Sanguisorba Root (Liang) Kochia Fruit (Liang) Donkey-Hide Gelatin (Wufen, processed by roasting) Dried Plum Flesh (Sanliang)
Sieve the above eight ingredients. Mix with Isatis Leaf Juice and decoct over mild heat. Form pills the size of apricot kernels. Take three pills per dose with warm water, twice daily. It is auspicious to prepare this on the seventh day of the seventh lunar month. When making, knead the pills with both hands. Avoid pork, cold water, plums, peaches, and sparrow meat.
Additionally, for treating middle jiao deficiency-cold resulting in immobility of the four limbs, profuse sweating, and copious dysentery, use moxibustion on the Dahuang acupoint. The number of moxa cones should correspond to the patient's age. Dahuang (SP15) is located beside the umbilicus, two cun and five fen laterally on each side. (This method is identical to that found in Volume 27 of *Shanfan*).