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The Spleen and Stomach are the officials of the granary. They belong to Earth and nourish all other Zang organs. By digesting food, they sustain the entire body. Therefore, the Stomach resides in the Central Palace (Middle Jiao), governing the Southern direction (symbolizing its pivotal role akin to the Heart/Fire generating Earth), and is prosperous during the transitional seasons of the year. Its condition corresponds to the four limbs. The Stomach resembles a bag and is named the "Sea of Water and Grain." The Spleen resembles a palm, ascending and descending with respiration, holding the authority over transformation and transportation. The source of this respiratory movement is Yuan Qi (Original Qi). The Spleen resides between them, attached to the Stomach and assisting in grinding, thereby facilitating the digestion and distribution of grain Qi. The Stomach belongs to Yang Earth (Wu), while the Spleen belongs to Yin Earth (Ji). Great is the Kun Yuan (Earthly Origin), from which all things grow. In humans, the primal Qi, the Qi of the San Jiao (Triple Burner), and the meridians of the Five Zang and Six Fu organs all converge upon the Stomach. Thus, humans rely on Stomach Qi as their foundation.

Those who are skilled at regulating the Spleen and Stomach must cherish their Qi. When Qi is robust, ascending and descending functions remain within proper limits; when Qi is weak, stagnation occurs. The power that moves food is Yuan Qi, while diet and drink are the sources that generate Blood and Qi. It is present everywhere and at all times, so it has no specific name or fixed location. The Classics state that the pulse of Stomach Qi cannot be distinctly seen; it only becomes apparent when it declines. If the six pulses show excessiveness, manifesting as exclusively wiry, floating, flooding, or deep pulses, these pulses lack the spirit of Stomach Qi. Even worse, pulses resembling dripping water from a leaking roof or birds pecking at grain indicate that Yuan Qi has first exhausted itself, causing Stomach Qi to fail in mutual support. When Qi is about to perish, the pathways of ascending and descending cease, and the mechanism of transformation relaxes. Generally, chest discomfort and poor appetite indicate Qi deficiency. If one occasionally overindulges in food, the resulting injury causes temporary bloating and fullness, which resolves afterward. However, if the injury persists for a long time and discomfort remains, is it not due to the depletion of Yuan Qi and weakness of Stomach Qi?

Throughout history, regarding discussions on the Spleen and Stomach and the differentiation of internal versus external injuries, only Master Dongyuan (Li Dongyuan) exerted profound effort. Yet his writings are verbose and complex, making them difficult to apply directly. The essentials of internal injury stem from three causes: First, improper diet and fatigue injure the Spleen, a common affliction of ordinary people. This leads to insufficiency of Qi and Blood, and failure of the Yang Qi in the epigastrium to ascend. One should primarily use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Second, excessive thinking injures the Spleen, a common affliction of the wealthy. Rich and greasy foods generate phlegm and obstruct the chest diaphragm; indulging desires consumes Essence and scatters Qi. The Inner Canon states: "The Kidney is the gate of the Stomach." The Kidney Meridian originates from the Yongquan point (KI-1) at the sole of the foot, ascends along the medial aspect of the thigh, runs alongside the Ren Mai (Conception Vessel), and reaches the throat. When Essence and Blood are dry, there is a lack of moistening and downward-moving force, leading to acid regurgitation and difficulty in defecation, with gradual discomfort in the chest and diaphragm. One should use Jiawei Liujunzi Tang (Modified Six Gentlemen Decoction) added with 3 fen of Honghua (Carthami Flos) and 1 qian of Zhimu (Anemarrhenae Rhizoma, stir-fried with salt). Third, overeating injures the intestines and stomach, a common affliction of laborers. One should use Baohe Wan (Harmonize the Interior Pill) or adjust with Sanyin Hezhong Wan (San-Yin Harmonize the Middle Pill). These are the origins of internal injury. To treat the root, one must prioritize nourishing the Heart, strengthening the Spleen, and soothing the Liver.

When Heart Qi is harmonious, Spleen Earth flourishes. Heart Fire is the mother of Spleen Earth, while Liver Wood is the thief (overcontroller) of Spleen Earth. Wood's nature is bending and straightening, producing sourness. Therefore, soothing the Liver allows Stomach Qi to flow freely. The Lung is the official of transmission; it governs Qi and belongs to Metal. When Lung Metal is strong, it can pacify Liver Wood, preventing chest oppression. Many people stubbornly adhere to old prescriptions containing aromatic, drying, and Qi-consuming herbs, leading to many errors. My family's inherited formula, Sanyin Hezhong Jianpi Wan (San-Yin Harmonize the Middle and Strengthen the Spleen Pill), is a general-purpose remedy for Spleen and Stomach disorders; its efficacy cannot be fully described. Secular people mistakenly believe that Zhizhu Wan (Aurantii Fructus and Atractylodis Macrocephalae Rhizoma Pill) is the essential medicine for the Spleen and Stomach, which is a superficial transmission. If one believes it is a medicine for strengthening the Spleen and nourishing the Stomach that can be taken for a long time, the error is severe. Not only is it ineffective, but it also depletes True Qi. Those who understand the main principles of the Suwen (Basic Questions) and Nanjing (Classic of Difficult Issues) know that observing safety and danger depends entirely on Stomach Qi. Since the San Jiao is responsible for receiving, transforming, and excreting, all these functions originate from Yuan Qi. Anyone treating internal injuries without cherishing Qi commits the error of "reinforcing the excess and depleting the deficient" (Shi Qi Shi, Xu Qi Xu). Students of medicine should reflect deeply on this.