夫脾胃者属土也万物皆土之所载位乎中州司化水谷营养百骸经曰谷入于胃脉道乃行饮入
于经其血乃成又曰安谷则昌绝谷乃亡盖脾不可不养胃不可不温温养之法适其寒温节其饮食自
然平和病不生矣其或摄养不谨将理失宜饮食伤其胃劳倦损其脾由此病出百端脾胃虚矣脾胃既
虚而五脏六腑何所养耶治法当审其虚实寻其缘由若伤于饮者乃无形之物或微汗以散之或渗泄
以利之伤于食者消导以磨之果固停滞久而作闷则吐下以夺之寒者温之热者清之不可概用香燥
之药动其火邪反为大害若夫劳倦伤脾元气下陷中气不足之症此谓自伤气之削也当从东垣内伤
法必用升补气血之药温之养之使生化之气益增脾胃壮而病自瘥矣
一饮食失节寒温失宜损伤脾胃身体沉重肢节烦火疼四肢懒倦口无滋味飧泄见血或见白脓
宜用调中益气汤
一脾胃虚寒呕逆恶心胸膈饱闷肠鸣腹痛泄泻宜用 养胃汤
一脾胃不和不思饮食心腹胀闷恶心嗳气宜用 平胃散
一脾胃虚寒饮食不化呕吐腹痛宜用 理中汤
一脾胃虚弱饮食减少四肢无力精神少短宜用 四君子汤
一饮伤于胃头痛恶心宜以微汗用 香砂燥胃汤
一饮伤小便涩少宜用 五苓散
一食伤脾胃胸闷不食恶心宜用 宽中进食丸 消食丸 保和丸 曲 枳术丸
一脾胃虚弱饮食不进吐泻宜用 参苓白术散
一脾气虚寒泄泻腹痛气逆宜用 补脾汤 治中汤
一调理脾胃宽利胸膈消散痞气宜用 枳术丸加减
脾胃在五行中属土，万物皆由土地承载，脾胃位于人体中部（中州），主管消化水谷、滋养全身骨骼经脉。《内经》说：“食物进入胃后，脉道才能运行；饮水进入经络，血液才能生成。”又说：“能进食则生命力旺盛，不能进食则生命衰亡。”大概脾脏需要养护，胃腑需要温煦。温养的方法在于调节寒热适宜，节制饮食，这样身体自然平和，疾病就不会产生。如果摄生不慎，调理失当，饮食损伤了胃，劳累过度损伤了脾，由此生出各种各样的疾病。脾胃虚弱之后，五脏六腑又靠什么来滋养呢？治疗方法应当审查病证的虚实，寻找病因。如果是因饮水过量致病，这是无形之邪，可以用微汗法来发散它，或者用渗泄法来利小便排出它；如果是因饮食积滞致病，要用消导法来磨化积食；如果是果实等固形物停滞日久导致胸闷，则要用吐法或下法来攻逐排除。寒证用温法，热证用清法，不可一概使用香燥的药物，以免动火助邪，反而造成大害。至于因劳累过度损伤脾气，导致元气下陷、中气不足的病症，这叫做“自伤气之削”，应当遵循李东垣的内伤治法，必须使用升提补益气血的药物，温养脾胃，使生化之气日益增加，脾胃强壮了，疾病自然痊愈。
其一：饮食不节，寒热失调，损伤脾胃，出现身体沉重、肢节烦痛如火烧、四肢懒倦、口中无味、完谷不化的泄泻，甚至便血或排出白色脓液，宜用调中益气汤。
其二：脾胃虚寒，出现呕吐逆气、恶心、胸膈部饱闷、肠鸣、腹痛、泄泻，宜用养胃汤。
其三：脾胃不和，出现不思饮食、心腹胀闷、恶心、嗳气，宜用平胃散。
其四：脾胃虚寒，饮食不消化、呕吐、腹痛，宜用理中汤。
其五：脾胃虚弱，饮食减少、四肢无力、精神短少，宜用四君子汤。
其六：饮水损伤胃部，出现头痛、恶心，宜以微汗法治疗，用香砂燥胃汤。
其七：饮水损伤导致小便涩滞量少，宜用五苓散。
其八：饮食损伤脾胃，出现胸闷、不想进食、恶心，宜用宽中进食丸、消食丸、保和丸、神曲、枳术丸。
其九：脾胃虚弱，饮食不进、呕吐泄泻，宜用参苓白术散。
其十：脾气虚寒，出现泄泻、腹痛、气逆，宜用补脾汤、治中汤。
其十一：调理脾胃，宽利胸膈，消散痞块积气，宜用枳术丸加减。
The Spleen and Stomach belong to Earth in the Five Elements; all things are borne by the Earth. They reside in the central region (Zhongzhou) of the body, governing the transformation and transportation of food and fluids, and nourishing the bones and meridians. The *Neijing* states: "When grain enters the Stomach, the pulse pathways begin to circulate; when liquids enter the vessels, blood is formed." It also says: "Abundance of food leads to prosperity; absence of food leads to decline." Generally, the Spleen must be nurtured, and the Stomach must be warmed. The method of warming and nurturing lies in maintaining appropriate temperature balance and regulating diet. In this way, the body remains harmonious, and diseases do not arise. However, if one fails to care for oneself properly, mishandles regulation, damages the Stomach through improper diet, or injures the Spleen through overexertion, various diseases will emerge. Once the Spleen and Stomach are deficient, how can the Zang and Fu organs receive nourishment? The treatment principle should first determine excess or deficiency and identify the cause. If the injury is due to excessive fluid intake, which constitutes a formless pathogen, it may be dispersed through mild diaphoresis (sweating) or drained through diuresis. If the injury is due to food stagnation, digestive and guiding methods should be used to grind down the accumulation. If solid matter such as fruits has remained stagnant for a long time causing chest oppression, emetic or purgative methods should be used to expel it. Cold patterns are treated with warming methods; heat patterns are treated with clearing methods. One must not indiscriminately use aromatic and drying herbs, as this may stir up fire pathogens and cause great harm. As for injuries to the Spleen Qi caused by overexertion, leading to sinking of Yuan Qi and insufficiency of Middle Qi, this is referred to as "self-injury resulting in the depletion of Qi." Treatment should follow Li Dongyuan's internal injury methods, necessarily employing herbs that lift and tonify Qi and Blood, warming and nurturing the Spleen and Stomach so that the transformative and generating Qi increases. When the Spleen and Stomach become strong, the disease will naturally resolve.
1. For irregular diet and inappropriate cold/heat exposure damaging the Spleen and Stomach, presenting with heavy body, painful joints feeling hot, lassitude of the four limbs, loss of taste, undigested stool in diarrhea, hematochezia, or passage of white pus, use Tiao Zhong Yi Qi Tang (Regulate the Middle and Boost Qi Decoction).
2. For Spleen and Stomach deficiency-cold presenting with vomiting and regurgitation, nausea, fullness and oppression in the chest and epigastrium, borborygmus, abdominal pain, and diarrhea, use Yang Wei Tang (Nourish the Stomach Decoction).
3. For disharmony of the Spleen and Stomach presenting with anorexia, distension and oppression in the heart and abdomen, nausea, and belching, use Ping Wei San (Calm the Stomach Powder).
4. For Spleen and Stomach deficiency-cold presenting with indigestion, vomiting, and abdominal pain, use Li Zhong Tang (Regulate the Middle Decoction).
5. For Spleen and Stomach weakness presenting with reduced appetite, weakness of the four limbs, and shortness of spirit/vitality, use Si Jun Zi Tang (Four Gentlemen Decoction).
6. For fluid injury to the Stomach presenting with headache and nausea, treat with mild diaphoresis using Xiang Sha Zao Wei Tang (Aromatic Amomum Drying Stomach Decoction).
7. For fluid injury presenting with scanty and difficult urination, use Wu Ling San (Five-Ling Powder).
8. For food injury to the Spleen and Stomach presenting with chest tightness, anorexia, and nausea, use Kuan Zhong Jin Shi Wan (Widen the Middle and Promote Appetite Pill), Xiao Shi Wan (Digest Food Pill), Bao He Wan (Preserve Harmony Pill), Shen Qu (Medicated Leaven), and Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill).
9. For Spleen and Stomach weakness presenting with inability to eat, vomiting, and diarrhea, use Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder).
10. For Spleen Qi deficiency-cold presenting with diarrhea, abdominal pain, and rebellious Qi, use Bu Pi Tang (Tonify the Spleen Decoction) and Zhi Zhong Tang (Regulate the Middle Decoction).
11. To regulate the Spleen and Stomach, relieve chest oppression, and dissipate nodular qi/stagnation, use Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill) with modifications.