脾胃有病，自宜治脾，然脾为土脏，灌溉四傍，是以五脏中皆有脾气，而脾胃中亦皆有
五脏之气，此其互为相使，有可分而不可分者在焉，故善治脾者，能调五脏，即所以治脾胃
也；能治脾胃，而使食进胃强，即所以安五脏也。今人止知参、苓、枳、术、山楂、麦芽、
神曲、浓朴之类，乃为脾胃之药，而不知风寒湿热皆能犯脾，饮食劳倦皆能伤脾，如风邪胜
者宜散之，则麻黄、桂枝、柴胡、干葛之类皆是也。寒邪胜者宜温之，则桂、附、干姜、丁
香、茱萸之类皆是也。热邪胜者宜寒之，则芩、连、知、柏、栀子、石膏之类皆是也。湿邪
胜者宜燥之，则苍术、白术、半夏、猪苓之类皆是也。饮食停积者宜行之，则三棱、蓬术、
大黄、芒硝之类皆是也。劳倦内伤者宜补之，则人参、黄 、白术、杜仲之属皆是也。
然脏腑虽分十一，而同有阴阳，同此血气，矧太阴常多血少气，阳明常多血多气，使此
中之血瘀，则承气、抵当之类总属脾胃之药；使此中之血虚，则四物、五物、理阴、五福之
类又孰非脾胃之药乎？再若五脏之邪皆通脾胃，如肝邪之犯脾者，肝脾皆实，单平肝气可也
；肝强脾弱，舍肝而救脾可也。心邪之犯脾者，心火炽盛，清火可也；心火不足，补火以生
脾可也。肺邪之犯脾者，肺气壅塞，当泄肺以苏脾之滞；肺气不足，当补肺以防脾之虚。肾
邪之犯脾者，脾虚则水能反克，救脾为主；肾虚则启闭无权，壮肾为先。至若胃司受纳，脾
主运化，若能纳而不化，此脾虚之兆易见；若既不能纳，又不能运，此脾胃之气俱已大亏，
即速用十全大补、六味回阳等剂尤恐不及，而尚欲以楂、苓、枳术之类，冀为脾胃之永赖乎
？是以脾胃受伤，但使能去伤脾者，即俱是脾胃之药。此中理奥机圆，姑举此以见其概，而
随宜应变，诚有非言能尽悉者。且诸药入口，必先入胃而后行及诸经，若妄用相妨相碍等物
，亦岂有既入其腑，能不先犯脾胃，而竟走他脏者乎？倘不明此理，而徒执一二成方，曰∶
此可攻邪，此可健胃，则其胸次可知矣。
脾胃发生疾病，自然应当治疗脾脏，然而脾属于土脏，负责向四周脏腑输送水谷精微，因此在五脏之中都包含有脾气的功能，而在脾胃之中也蕴含了五脏的气机，这种相互辅助的关系，既有可以区分的一面，又有不可分割的一面。所以善于治疗脾病的人，能够通过调理五脏来达到治疗脾胃的目的；能够治疗脾胃，使食欲增进、胃气强健，也就达到了安养五脏的效果。
现在的人只知道人参、茯苓、枳实、白术、山楂、麦芽、神曲、厚朴这一类药物，才是治疗脾胃的药物，却不知道风寒湿热等外邪都能侵犯脾脏，饮食不节和劳倦过度都能损伤脾脏。例如风邪偏盛者适宜用发散法治疗，那么麻黄、桂枝、柴胡、葛根这一类药都是适用的；寒邪偏盛者适宜用温里法治疗，那么肉桂、附子、干姜、丁香、吴茱萸这一类药都是适用的；热邪偏盛者适宜用清热法治疗，那么黄芩、黄连、知母、黄柏、栀子、石膏这一类药都是适用的；湿邪偏盛者适宜用燥湿法治疗，那么苍术、白术、半夏、猪苓这一类药都是适用的；饮食停滞积结者适宜用消导法治疗，那么三棱、莪术、大黄、芒硝这一类药都是适用的；劳倦内伤导致虚弱者适宜用补益法治疗，那么人参、黄芪、白术、杜仲这一类药都是适用的。
然而脏腑虽然分为十一（注：此处指五脏六腑），但都同样具有阴阳属性，都同样依赖气血运行。况且足太阴脾经通常多血少气，足阳明胃经通常多血多气，如果其中的血液发生瘀滞，那么承气汤、抵当汤这一类方剂总归属于治疗脾胃的药物；如果其中的血液亏虚，那么四物汤、五物汤、理阴煎、五福饮这一类方剂又哪一款不是治疗脾胃的药物呢？
再者，五脏的病邪都会影响脾胃。例如肝邪侵犯脾脏，若肝脾两脏皆实证，只需平抑肝气即可；若肝气强盛而脾气虚弱，则应舍弃对肝的直接治疗而救助脾脏。心邪侵犯脾脏，若心火炽盛，只需清泻心火即可；若心火不足，则需补益心火以生助脾土。肺邪侵犯脾脏，若肺气壅塞，应当宣泄肺气以解除脾气的阻滞；若肺气不足，应当补益肺气以防备脾气的虚弱。肾邪侵犯脾脏，若脾气虚弱导致水湿反克脾土，应以救脾为主；若肾气虚弱导致开阖失司，应以壮补肾气为先。
至于胃主管受纳食物，脾主管运化水谷，如果能进食但不能运化，这是脾气虚弱的征兆，容易察觉；如果既不能受纳，又不能运化，这说明脾胃之气已经严重亏损，此时即使迅速使用十全大补汤、六味回阳饮等峻补剂恐怕都来不及，难道还指望依靠山楂、茯苓、枳实、白术这一类温和药物，作为脾胃长久的依靠吗？
因此，脾胃受到损伤，只要能去除伤害脾胃的因素，这些药物就都可以视为治疗脾胃的药物。其中的道理深奥且机制圆融，暂且列举这些来展示其大概，至于随病情变化而灵活应变，确实不是言语所能完全详尽的。况且所有药物入口，必定先入胃中然后才运行到各条经络，如果胡乱使用相互冲突或阻碍的药性，既然已经进入胃腑，怎么可能不先侵犯脾胃，而直接作用于其他脏腑呢？如果不明白这个道理，只是固执地拘泥于一两个固定方剂，说：“这个可以攻邪，那个可以健胃”，那么他的见识浅陋也就可想而知了。
When the Spleen and Stomach are diseased, it is appropriate to treat the Spleen. However, as the Spleen is an Earth organ responsible for irrigating the four peripheries (distributing nutrients to surrounding organs), the Qi of the Spleen exists within all five Zang organs, while the Qi of the five Zang organs also exists within the Spleen and Stomach. This mutual assistance implies that there are aspects that can be distinguished and aspects that cannot. Therefore, a skilled practitioner who treats the Spleen can regulate the five Zang organs, which is essentially treating the Spleen and Stomach; conversely, by treating the Spleen and Stomach to improve appetite and strengthen Stomach Qi, one thereby pacifies the five Zang organs.
Currently, people only recognize herbs such as Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Zhishi (Immature Bitter Orange), Baizhu (Atractylodis Macrocephalae Rhizoma), Shanzha (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), Shenqu (Massa Medicata Fermentata), and Houpo (Magnoliae Officinalis Cortex) as medicines for the Spleen and Stomach. They fail to realize that Wind, Cold, Dampness, and Heat pathogens can all invade the Spleen, and improper diet and fatigue can all injure the Spleen. For instance, if Wind pathogen predominates, dispersing methods should be used; thus, Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Chaihu (Bupleuri Radix), and Genge (Puerariae Lobatae Radix) are applicable. If Cold pathogen predominates, warming methods should be used; thus, Rougui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma), Dingxiang (Eugeniae Flos), and Zhuyu (Evodiae Fructus) are applicable. If Heat pathogen predominates, cooling methods should be used; thus, Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Zhizi (Gardeniae Fructus), and Shigao (Gypsum Fibrosum) are applicable. If Dampness pathogen predominates, drying methods should be used; thus, Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Banxia (Pinelliae Rhizoma), and Zhuling (Polyporus) are applicable. If food stagnation occurs, promoting movement methods should be used; thus, Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Dahuang (Rhei Radix et Rhizoma), and Mangxiao (Natrii Sulfas) are applicable. If injury from fatigue and overwork occurs, tonifying methods should be used; thus, Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Duzhong (Eucommiae Cortex) are applicable.
Although the Zang-Fu organs are divided into eleven, they all share Yin-Yang attributes and rely on Blood and Qi. Moreover, the Taiyin (Spleen) channel typically has abundant Blood and deficient Qi, while the Yangming (Stomach) channel typically has abundant Blood and abundant Qi. If Blood stasis occurs within them, formulas such as Chengqi Tang (Gastrointestinal Releasing Decoction) and Didang Tang (Blood-Invigorating Decoction) belong to medicines for the Spleen and Stomach. If Blood deficiency occurs within them, formulas such as Siwu Tang (Four Substances Decoction), Wuwu Tang (Five Ingredients Decoction), Liyin Jian (Yin-Nourishing Decoction), and Wufu Yin (Five Blessings Decoction) are none other than medicines for the Spleen and Stomach.
Furthermore, pathogens from the five Zang organs affect the Spleen and Stomach. For example, when Liver pathogen invades the Spleen: if both Liver and Spleen are excess patterns, one may simply soothe the Liver Qi; if the Liver is strong and the Spleen weak, one should abandon direct treatment of the Liver and rescue the Spleen. When Heart pathogen invades the Spleen: if Heart Fire is blazing, one should clear the Fire; if Heart Fire is insufficient, one should tonify Fire to generate Spleen Earth. When Lung pathogen invades the Spleen: if Lung Qi is obstructed, one should drain the Lung to relieve Spleen stagnation; if Lung Qi is insufficient, one should tonify the Lung to prevent Spleen deficiency. When Kidney pathogen invades the Spleen: if Spleen deficiency allows Water to counter-attack the Spleen, saving the Spleen is primary; if Kidney deficiency leads to loss of opening and closing control, strengthening the Kidney is paramount.
Regarding the Stomach's function of receiving and the Spleen's function of transportation and transformation: if one can receive food but not transform it, this is an obvious sign of Spleen deficiency. If one cannot receive nor transform, this indicates a severe depletion of Spleen and Stomach Qi. In such cases, even urgently using potent tonics like Shiquan Dabu Tang (Ten Significant Tonifying Decoction) or Liuwei Huiyang Tang (Six-Ingredient Return-to-Yang Decoction) might still be insufficient. How could one rely merely on mild herbs like Shanzha, Fuling, Zhishi, and Baizhu for the long-term sustenance of the Spleen and Stomach?
Therefore, when the Spleen and Stomach are injured, any medicine that removes the cause of injury can be considered a medicine for the Spleen and Stomach. The principles here are profound and the mechanisms circular. I have briefly mentioned these to illustrate the general idea. Adapting to changes according to circumstances is indeed beyond what words can fully exhaust. Furthermore, all medicines enter the mouth and must first enter the Stomach before circulating to the meridians. If inappropriate or conflicting substances are used recklessly, having entered the Fu organ (Stomach), how could they avoid injuring the Spleen and Stomach first and directly act on other Zang organs? If one does not understand this principle and rigidly adheres to fixed prescriptions, claiming "this attacks pathogens" or "this strengthens the stomach," their limited understanding is evident.