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Humans rely on water and grain as their foundation; therefore, the Spleen and Stomach are the root of health preservation. Only Li Dongyuan alone comprehended this principle, expounding it in his *Pi Wei Lun* (Treatise on the Spleen and Stomach): "Examining various chapters of the *Nei Jing* (Inner Canon) and cross-referencing them, one finds that the sufficiency of Yuan Qi (Original Qi) depends entirely on the Qi of the Spleen and Stomach remaining unharmed, thereby nourishing Yuan Qi. If the fundamental Qi of the Stomach is weak, and food intake doubles, the Qi of the Spleen and Stomach will be injured, and Yuan Qi cannot be replenished. This is the origin of various diseases." He then cites principles from the *Nei Jing*. For instance, the *Sheng Qi Tong Tian Lun* (Treatise on the Unity of Life with Heaven) states: "The Qi of the clear Heaven, when pure and tranquil, governs the mind and will; adhering to it consolidates Yang Qi, so that even pathogenic evils cannot harm. Yang Qi, when subjected to excessive toil, becomes hyperactive. Thus, the clear Heaven values tranquility, and Yang Qi abhors excessive toil. This is the first way diseases arise from the Spleen and Stomach." He further cites the *Wu Chang Zheng Da Lun* (Great Treatise on the Five Regular Movements): "Those whose Yin Essence is offered upward live long; those whose Yang Essence descends die young. 'Yin Essence offered upward' means that when the Spleen and Stomach are harmonious, Grain Qi ascends, executing the functions of Spring and Summer, thus ensuring longevity. 'Yang Essence descending' means that when the Spleen and Stomach are disharmonious, Grain Qi flows downward, executing the functions of Storage and Collection, thus leading to premature death. This is the second way diseases arise from the Spleen and Stomach." He also cites the *Liu Jie Zang Xiang Lun* (Treatise on the Six Nodes and Viscera Manifestations): "The Spleen, Stomach, Large Intestine, Small Intestine, San Jiao (Triple Burner), and Bladder are the roots of the granary, the dwelling place of Ying Qi (Nutritive Qi). These belong to the category of Extreme Yin and connect with Earth Qi. All eleven Zang-Fu organs depend on the Gallbladder. The Gallbladder possesses the Qi of Shaoyang Spring generation; when Spring Qi generates, all transformations are peaceful. Thus, when Gallbladder Qi rises like Spring, the other organs follow; if Gallbladder Qi does not rise, symptoms such as undigested stool in diarrhea (Sun Xie) and bloody dysentery (Chang Pi) arise. This is the third way diseases arise from the Spleen and Stomach."

He further cites the *Ben Lun* (Basic Treatise): "Heaven feeds humans with Five Qi, and Earth feeds humans with Five Flavors. The 'Qi' referred to here is developed by the Upper Jiao (Upper Burner), which disseminates the flavors of five grains, steams the skin, fills the body, and moistens the hair, like mist and dew irrigating. This is called Qi. If Qi is disordered, how can life exist? This is the fourth way diseases arise from the Spleen and Stomach." Internal injury to the Spleen and Stomach damages Qi, whereas external contraction of Wind-Cold damages the Form. Damage to the exterior manifests as Excess (You Yu); Excess requires Purging (Xie). Damage to the interior manifests as Deficiency (Bu Zu); Deficiency requires Tonification (Bu). In diseases of internal injury and deficiency, if mistakenly diagnosed as external excess and treated with purging, it exacerbates the deficiency. To tonify the excess and purge the deficiency leads to death; such deaths are caused by the physician. So, what should be done? One must use Pungent-Sweet-Warm formulas to tonify the Middle and raise Yang, and Sweet-Cold formulas to clear Fire, and the condition will heal. The Classics state: "For exhaustion, use warmth; for loss, use warmth." It also states: "Warmth can eliminate great heat." Bitter-Cold medicines are strictly forbidden. Such arguments represent Li Dongyuan's unique insights.

Upon examining his statement that "Heaven values purity and clarity, and Yang Qi abhors excessive toil," this refers to illness caused by fatigue and overwork. His statement that "the function of Storage and Collection prevails, leading to early death" refers to illness caused by Yin Excess and Yang Deficiency. His statement that "when Spring Qi rises, all things are at peace" refers to illness caused by the failure of Qi to ascend, resulting in a lack of vitality. His statement that "if Qi is disordered, how can life exist" refers to illness caused by damage to Yang Qi. Li Dongyuan's words have indeed benefited future generations and guided scholars, a merit not to be underestimated. However, I am surprised by the contradictions in his earlier theories. For example, he says: "Irregular diet and inappropriate cold/heat injure the Spleen and Stomach. This inevitably involves Joy, Anger, Worry, and Fear depleting Yuan Qi and assisting Heart Fire. When the Heart fails to command, Ministerial Fire (Xiang Huo) takes over. Ministerial Fire is the fire of the Pericardium in the Lower Jiao, the thief of Yuan Qi. Fire and Yuan Qi cannot coexist; if Fire prevails, it attacks the Earth position, causing disease." These sentences reveal significant contradictions. Looking at his previous four points, he consistently worries about damage to Yang Qi, hence stating "strictly forbid bitter-cold medicines." Yet this section discusses illness caused by Fire prevalence. How should it be treated? Furthermore, he claims that Joy, Anger, Worry, and Fear deplete Yuan Qi and assist Heart Fire, and that Fire prevailing attacks the Earth position. What is the rationale? If Yuan Qi is damaged, one typically sees daily shrinkage of Sheng Yang (Generating Yang) and daily消 (decline) of Shen Qi (Spiritual Qi). How can this assist Heart Fire? The Spleen and Stomach belong to Earth; Earth is generated by Fire. Why say Fire prevailing attacks the Earth position? Moreover, human Yuan Qi values clarity and harmony. Cold certainly causes disease, but Heat also causes disease. While Heat damaging Yuan Qi due to labor-induced Fire is common, requiring Clear-Tonification, cases where labor induces Cold injuring the Spleen and Stomach are even more severe. Can these generally be attributed to Fire? Heat syndromes are obvious while Cold syndromes are hidden; thus Heat is easy to see and Cold is hard to perceive. True Heat is easier to distinguish than False Heat. Since Yuan Qi belongs to Yang, and Fire is its category, and Heat shares the same nature, pathogenic factors can be controlled. Yin is the thief of Yang, and Cold is its enemy; when vitality is destroyed, death follows swiftly. Thus, the Classics say "Lesser Fire generates Qi," but never "Lesser Cold generates Qi." We hear "Avoid wind as if avoiding arrows," but never "Avoid heat as if avoiding arrows." Therefore, why not say "Cold and Yuan Qi cannot coexist," but instead "Fire and Yuan Qi cannot coexist"? By emphasizing "Fire," he has inadvertently led later generations who rashly speak of Fire to forget his earlier maxims and solely adhere to the "non-coexistence" theory as a standard treatment for Fire. This is a flaw in an otherwise perfect jade, and I truly regret this for Li Dongyuan.

Re-examining Li Dongyuan's formulas, such as Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Sheng Yang Yi Wei Tang (Raise Yang and Benefit the Stomach Decoction), Huang Qi Ren Shen Tang (Astragalus and Ginseng Decoction), and Qing Shu Yi Qi Tang (Clear Summerheat and Augment Qi Decoction), he frequently uses Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix), reflecting his intent to cultivate the spirit of Spring generation. He frequently uses Huang Qin (Scutellariae Radix) and Lian Zi (Nelumbinis Semen, likely referring to Lian Zi or Lian Pei in context of clearing heat, though usually Huang Lian is paired with Huang Qin here, let's assume Huang Qin and Huang Lian based on text "Qin Lian"), reflecting his intent to subdue Fire pathogens. However, using only two or three fen of Huang Qin and Huang Lian hardly damages Yang Qi, whereas using five or seven qian of Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma), can they truly regulate Yuan Qi? This leads me to consider Zhang Zhongjing. Observing his formula construction, he used no more than three or four herbs per formula, yet dosages reached two or three liang. Human Qi and Blood are fundamentally similar, and diseases are often comparable. Yet Zhang Zhongjing's formulas are grand and simple, while Li Dongyuan's are small and complex. Why is the disparity so extreme? There must be profound principles involved. As a junior scholar, I dare not directly judge right from wrong, but my private admiration creates a chasm between the two approaches. [Note: The text ends with a reference to previous discussions on Spleen/Stomach formulas.]