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The pathogenic qi of Heaven, when invading, harms the Five Zang organs. Among the Eight Winds (wind pathogens from eight directions), humans are most susceptible at high altitudes; the cold and heat of food and drink, when invading, harm the Six Fu organs. This refers to food and drink entering the Stomach, where their essence is directed upward to the Lungs, while turbid qi remains in the intestines and stomach; this causes disease due to irregular diet. The dampness of Earth, when invading, harms the skin and sinews, and must begin from the feet. The *Neijing* states that all diseases arise from the Upper, Middle, and Lower Jiao. When discussing the deficiency of both form and Qi, it does not mention heaven-and-earth pathogens; thus, we know that insufficiency of the Spleen and Stomach is the beginning of all diseases. For a long time, physicians have been unable to distinguish between excess and deficiency.

In the past, during the turmoil of the Renchen year, within fifty or sixty days, nearly a million people died from injuries caused by diet and overexertion. Everyone believed they died from Cold Damage (Shanghan). Later, seeing Li Dongyuan's (courtesy name Mingzhi) treatise distinguishing internal injury from external contraction, as well as injuries from diet and overexertion, I realized the errors of contemporary physicians. How tragic that unclear scholarship leads to such harm! Since Mingzhi had already written his treatise, fearing that popular prejudices could not be dispelled suddenly, he further composed the *Pi Wei Lun* (Treatise on the Spleen and Stomach) with earnest admonitions. Revealing the subtleties of these two works, removing doubts of a millennium, if this book circulates, the medicinal disasters of the Renchen year will have no basis to occur. The words of a benevolent person are indeed broad in intent!

On the fifteenth day of the seventh month of the Jiyi year, Yuan Haowen of Yishan wrote the preface.

The *Wu Zang Bie Lun* (Treatise on the Distinction of the Five Zang Organs) says: The Stomach, Large Intestine, Small Intestine, Sanjiao (Triple Burner), and Bladder—these five—are generated by the Qi of Heaven. Their form resembles Heaven, so they excrete but do not store. They receive turbid Qi from the Five Zang organs and are named the "Fu organs of transmission and transformation." These cannot remain for long; they are organs of transport and excretion. The so-called Five Zang organs store essence and Qi without excreting, so they are full but not solid. The Six Fu organs transmit and transform substances without storing, so they are solid but not full. The reason for this is that when food and drink enter the mouth, the Stomach becomes solid and the Intestines empty; when food moves down, the Intestines become solid and the Stomach empty. Thus, it is said: "Solid but not full, full but not solid."

The *Yin Yang Ying Xiang Da Lun* (Great Treatise on Yin-Yang Correspondences) says: Grain Qi connects with the Spleen. The Six Channels are like rivers, the intestines and stomach are like the sea, and the Nine Orifices are where water Qi flows. The Nine Orifices are governed by the Five Zang organs. The Five Zang organs must receive Stomach Qi to function smoothly. The *Tong Ping Xu Shi Lun* (Treatise on Uniform Assessment of Deficiency and Excess) says: Headache, tinnitus, and dysfunction of the Nine Orifices originate from the intestines and stomach. If Stomach Qi is deficient, the ears, eyes, mouth, and nose will all suffer. The *Jing Mai Bie Lun* (Treatise on the Distinction of the Meridian Channels) says: When food Qi enters the Stomach, its essence is scattered to the Liver, nourishing the sinews. When food Qi enters the Stomach, its turbid part goes to the Heart, and its essence permeates the vessels. Vessel Qi flows through the meridians, and meridian Qi returns to the Lungs. The Lungs direct all vessels, distributing essence to the skin and hair. Skin and vessel Qi combine, circulating Qi in the Fu organs. Fu organ Qi becomes spiritual and bright, remaining in the four Zang organs. Qi returns to balance; when balanced, the Cun pulse forms at the wrist, used to determine life and death. When water enters the Stomach, its essence floats up and is transported to the Spleen. The Spleen scatters essence upward to the Lungs, regulating water passages, and transporting it downward to the Bladder. Water essence distributes everywhere, the Five Channels run together, harmonizing with the Four Seasons and the Yin-Yang of the Five Zang organs, serving as the constant standard. It also says: The harmony of Yin is based on the Five Flavors; the damage to the Five Orifices of Yin is caused by the Five Flavors. Although one may crave and desire to eat the five flavors, one must exercise self-restraint and avoid excess, for excess damages healthy Qi. Carefully harmonizing the five flavors ensures straight bones, flexible sinews, flowing Qi and Blood, and dense interstices. In this way, bone Qi becomes refined. Following the Dao and methods diligently allows one to enjoy their natural lifespan. The *Ping Ren Qi Xiang Lun* (Treatise on the Pulse Signs of Healthy People) says: Humans rely on water and grain as their root; thus, humans die when cut off from water and grain, and also die when the pulse lacks Stomach Qi. By "lacking Stomach Qi," it does not mean the Liver lacks the string-like pulse or the Kidney lacks the stone-like pulse. Reviewing various chapters and cross-referencing them, we see that sufficient Yuan Qi (Primal Qi) depends on the Qi of the Spleen and Stomach being unharmed, thereby nourishing Yuan Qi. If the root of Stomach Qi is weak, and diet doubles, the Qi of the Spleen and Stomach is injured, Yuan Qi cannot be sufficient, and various diseases arise.

The purport of the *Neijing* is as bright as the sun and stars. Fearing future generations might not fully understand, the *Ling Shu Jing* (Spiritual Pivot) reiterates this theory. The classic says: Food and drink enter the mouth, having five flavors, each pouring into its respective Sea. Fluids and juices follow their own pathways. The Stomach is the Sea of food and drink; its acupoints are above at Qichui (St30) and below at Zusanli (ST36). If the Sea of food and drink has excess, there is abdominal fullness; if deficient, there is hunger but an inability to accept grain. What humans receive as Qi comes from grain; what grain pours into is the Stomach. The Stomach is the Sea of food, drink, Qi, and Blood. The clouds and Qi moving in the Sea are like the winds of the world. The Qi and Blood exiting the Stomach travel through the Jing-Sui (Meridian Tunnels). The Jing-Sui are the great collaterals of the Five Zang and Six Fu organs. It also says: When five grains enter the Stomach, their dregs, fluids, and Zong Qi (Pectoral Qi) divide into three tunnels. Thus, Zong Qi accumulates in the chest, exits through the throat, penetrates the Heart and Lungs, and governs respiration. Ying Qi (Nutritive Qi) separates fluids and juices, injecting them into the vessels to transform into Blood, nourishing the four extremities and internally supplying the Five Zang and Six Fu organs, corresponding to the time of the clepsydra. Wei Qi (Defensive Qi) issues its fierce and rapid Qi, moving swiftly through the four extremities, muscles, and skin without rest. It also says: Qi issuing from the Middle Jiao also resides in the Stomach, emerging after the Upper Jiao. Here, the received Qi separates dregs, steams fluids, transforms them into essence and subtleties, directs them upward to the Lung vessels, transforms them into Blood, and uses them to sustain the body. Nothing is more precious than this. The Sages repeated these words tirelessly because their hearts of benevolence toward future generations were earnest and unwearying.

Therefore, irregular diet and inappropriate temperature cause injury to the Spleen and Stomach. This occurs because anger, joy, worry, and fear deplete Yuan Qi and assist Heart Fire. Fire and Yuan Qi cannot coexist; if Fire prevails, it attacks the Earth position (Spleen/Stomach), causing disease. The *Tiao Jing Pian* (Chapter on Regulating the Channels) says: Diseases arising from Yin result from improper diet and living, and imbalances of Yin-Yang and emotions. It also says: Yin deficiency leads to internal heat. Due to fatigue and exertion, form and Qi decline, Grain Qi fails to flourish, the Upper Jiao does not function, and the lower Wan (pylorus) is blocked. Stomach Qi becomes hot, and hot Qi steams the chest, causing internal heat. Once the Spleen and Stomach are injured, the Five Disorders interact. Initially, the illness presents as generalized fever, headache, dizziness, heavy limbs, inability to hold the limbs, lethargy, and drowsiness. Injured by heat, Yuan Qi cannot function, hence the limbs are so fatigued. The Sages recorded this in the classics, stating that humans take Earth (Stomach/Spleen) as their root. Through writing and interpretation, they illuminate each other repeatedly. Unskilled physicians fail to read and interpret correctly, using treatments arbitrarily. Intending to save lives, they instead harm them.

If the spirit is pure, the mind is orderly. Following this, Yang Qi remains secure; even if hostile pathogens attack, they cannot cause harm. This follows the order of seasons. Thus, the Sages conserve their spirit, assimilate Heavenly Qi, and communicate with divine clarity. Failure results in the closure of the Nine Orifices internally and blockage of muscles externally, with Wei Qi dissipating. This is called self-injury and the depletion of Qi. Yang Qi, when subjected to excessive labor, expands excessively; essence is exhausted. Accumulated through summer, this causes Jian Jue (Frying Collapse), characterized by blindness, deafness, and a crumbling state like a collapsing city. Therefore, the Qi of Heaven values purity, and Yang Qi abhors excessive labor. Disease originating from the Spleen and Stomach is the first point. The *Wu Chang Zheng Da Lun* (Great Treatise on the Five Constant Policies) says: Those whose Yin Essence is offered upward live long; those whose Yang Essence descends die young. "Yin Essence offered upward" means when the Spleen and Stomach are harmonious, Grain Qi rises, and the commands of Spring and Summer prevail, leading to longevity. "Yang Essence descending" means when the Spleen and Stomach are disharmonious, Grain Qi flows downward, and the commands of Autumn and Winter prevail, leading to premature death. Disease originating from the Spleen and Stomach is the second point. The *Liu Jie Zang Xiang Lun* (Treatise on the Six Nodes and Organ Manifestations) says: The Spleen, Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder are the foundation of the granary and the residence of Ying Qi. They are called vessels, capable of transforming dregs and transmitting flavors in and out. Their brilliance manifests in the lips and the white area around them; their substance fills the muscles; their flavor is sweet; their color is yellow. These belong to extreme Yin, connecting with Earth Qi. All eleven organs depend on the Gallbladder. The Gallbladder possesses the Qi of Shaoyang Spring generation. When Spring Qi ascends, all transformations are peaceful. Thus, when Gallbladder Qi ascends in spring, the other organs follow; if Gallbladder Qi does not ascend, diarrhea and intestinal disorders arise simultaneously. Disease originating from the Spleen and Stomach is the third point. The classic says: Heaven feeds humans with Five Qi, and Earth feeds humans with Five Flavors. Five Qi enter the nose, store in the Heart and Lungs, and above make the complexion bright and voice clear. Five Flavors enter the mouth, store in the intestines and stomach, and their stored flavors nourish the Five Qi. When Qi is harmonious, life arises; fluids and juices form together, and Spirit naturally generates. This is called Qi, developed by the Upper Jiao, disseminating the flavors of five grains, warming the skin, filling the body, and moistening the hair, like mist and dew. If Qi is disordered, how can humans survive? Disease originating from the Spleen and Stomach is the fourth point. Are there only these four? Regarding the classic discussion of heaven-and-earth pathogens, invasion harms the Five Zang and Six Fu organs. Only when form and Qi are both deficient does one receive external pathogens. Without deficiency, hostile pathogens cannot injure humans alone. Thus, it is clear that all diseases originate from the Spleen and Stomach. The Sage's intent is repeated and detailed. He warns: Follow the laws of Yin and Yang, harmonize with techniques and numbers, regulate diet and drinking, maintain regular daily routines, and do not exert yourself improperly. Thus, form and Spirit remain united, allowing one to complete their natural lifespan and pass away after a hundred years. From this, we see how crucial it is to be cautious regarding diet and daily routine.