Poor Appetite, Fatigue, Bloating, Always Getting Sick? Why the Spleen and Stomach Are the Root of Health — the “Kingly Way” of Chinese Medicine
Patient search terms: poor appetite / fatigue and weakness / bloating after meals / loose stool / getting sick easily / tonifying the spleen and stomach / spleen qi deficiency
Corresponding medical concepts: spleen and stomach weakness (pi wei xu ruo) · the Tonifying Earth School (bu tu pai / Yishui School)
💬 Note from Doctor Luo: Today let’s pause and do a little summing up — let’s talk about the role of the spleen and stomach (pi wei). From now on, after every few medical cases, I’ll pause like this and casually share some Chinese medicine knowledge. That way, when you go back to the case studies, you’ll understand them much better.
Why did the “Tonifying Earth School” even come into being?
As you’ve seen in the cases of Doctor Li Dongyuan and his disciple Doctor Luo Tianyi, both master and student paid extraordinary attention to the spleen and stomach. Three generations of physicians — Zhang Yuansu, Li Dongyuan and Luo Tianyi — formed the Yishui School, also known as the Tonifying Earth School (bu tu pai), or the Spleen-Tonifying School.
💬 Note from Doctor Luo: Why did such a school form? Because they discovered that the spleen and stomach are simply too important — many strange, hard-to-name illnesses look at first like a cold (like an external invasion), but actually aren’t: they come from weakness of the spleen and stomach, deficiency of qi. All kinds of complaints, in the end, seem to trace back to the spleen and stomach.
And in treatment, if you can work from the spleen and stomach — tune them up, let clear qi rise and turbid qi descend, let the spleen and stomach absorb nutrients and transport them throughout the body, so that the four limbs and hundred bones are nourished — the body recovers.
Their methods were many: tonify the spleen, lift the qi, send the qi downward… Collected together, these formulas and ideas became the Tonifying Earth School.
Why is it called the “kingly way” (wang dao) of medicine?
This school is known as “the kingly way of medicine” (yi zhong wang dao).
💬 Note from Doctor Luo: What does “wang dao” (the kingly way) mean? The ancients talked about governing a country — some said you must constantly strengthen the army and wage war. That is not the best way. From Laozi to Mencius, this idea had long been formed: be benevolent and kind, make sure the people have food and a good life — that is how a country is truly governed. When other nations see that your people are so prosperous, they come to you of their own accord — this is what Mencius called the wang dao, and “the benevolent are invincible.”
Tonifying the spleen works the same way. The attacking method: fight with all your might and drive the pathogens out — but once they’re gone, your own “people” (the organs) are still starving, your qi and blood are insufficient, and the external pathogens will simply come back again. So attacking is only for the moment. True, lasting health comes from strengthening the spleen and stomach — once the qi and blood are fully supplied, the body itself can resist external pathogens. That is why this school is called “the kingly way of medicine.”
Almost every famous physician carries the shadow of this school
The Yishui School’s influence on later generations is enormous — almost every physician who ever became famous carries this shadow in his thinking.
💬 Note from Doctor Luo: Take Doctor Zhang Xichun of later times, for example — if you count, he used huai shan yao (Huai yam, Chinese yam) an enormous amount! Why? To tonify the spleen. His thinking carries Li Dongyuan’s shadow.
The later schools of Chinese medicine split into many branches and sects, but Li Dongyuan’s Tonifying Earth School is the shadow that no school can do without — it is a foundation of enormous importance.
Where did their ideas come from? Entirely from the Huang Di Nei Jing (The Yellow Emperor’s Classic of Internal Medicine) — they found the basis in the classics, expanded on it themselves, accumulated more and more experience, and produced many formulas. This is the development of the ideas of the Nei Jing.
Modern people’s spleen and stomach get injured far too often
Why is it good to understand the Tonifying Earth School? Because modern people’s spleen and stomach get injured far, far too often.
💬 Note from Doctor Luo: The ancients’ spleen and stomach injuries were simple — they were mostly just hungry. In Li Dongyuan’s era of war, people couldn’t get enough to eat; by Luo Tianyi’s time, serving as imperial physician to the nobility, the problems were unclean eating habits (too much milk, too much mutton). But modern people injure their spleen and stomach far more than they ever did:
First, we see far too many kinds of food. The best things an ancient person could see were lamb and milk. Now? Boston lobster, Australian lobster, crayfish, mala hot pot… ingredients our ancestors never even tasted, and we shovel them in recklessly; cooking methods have multiplied too — restaurant after restaurant piles on stronger flavors. How do they get that flavor? Spoon after spoon of added seasonings. And what are those seasonings? Some are genuine seasonings and medicines (Sichuan pepper and star anise are both Chinese herbs), but some are chemical compounds — they do great harm to the spleen and stomach.
Second, irregular eating. Li Dongyuan and Luo Tianyi said it again and again: eating must have rhythm and moderation. And us? No breakfast in the morning, a boxed lunch at noon, and two big dinners in the evening washed down with alcohol — not one of the three meals is normal. When something tasty appears we eat like there’s no tomorrow, and when it’s not tasty we skip it — that’s all “irregular eating.”
Third, anxiety, worry, bad emotions. This is what we call liver qi constraint (gan qi bu shu) — the liver wood runs sideways and attacks the spleen earth; wood overacts on earth, and the spleen and stomach get hurt. The ancients lived simply (when night fell, they went to sleep), but modern people have nightlife, phones, and enormous life pressure — the seven emotions (joy, anger, worry, brooding, sorrow, fear, fright) rise and fall many times a day: a customer complaint brings fright, a boss’s criticism brings fear, a bonus brings joy, a child’s failed exam brings anger… add envy, jealousy and resentment on top, and the emotional stimulation is many times greater than what the ancients endured.
Fourth, cold and heat injure the spleen and stomach. Cold drinks and air conditioning hurt it (cold); a daily mala hot pot hurts it (heat).
Three meals a day: don’t turn nourishment into harm
In daily life there are only a few things we can’t skip — sleep and three meals a day.
💬 Note from Doctor Luo: I take sleep very seriously — I pay close attention to bedding, environment, even the direction I face. Sleep well and it’s a blessing; sleep poorly and illness creeps in slowly. In the same way, three meals a day are meant to supply energy and make the body stronger, but handled badly they become a way of injuring the body at every meal. Day after day, the body starts to collapse.
Many people skip breakfast, eat a boxed lunch, then have two big dinners with alcohol — that is giving up on your own life. The ten minutes you save in the morning, and that big evening drinking session, are both ways of hurting yourself. Don’t turn eating into a way of hurting yourself — that comes first.
And if we’ve studied Chinese medicine, we can go further and turn three meals a day into a way of making the body stronger:
- Eat whole grains and vegetables, balanced and varied
- Match foods with medicinal properties to your constitution: for yin deficiency, simmer sheng di (raw rehmannia) or shu di (prepared rehmannia) with pork spine bones; for yang deficiency, use lamb and warming spices like Sichuan pepper; for spleen deficiency, eat shan yao (Chinese yam), lotus seeds, yi mi (coix seed) and qian shi (fox nuts)
- Support it with Chinese medicine when needed (for example, a little Bu Zhong Yi Qi Wan, Tonify the Middle and Augment Qi Pill) to regulate the spleen and stomach
Done this way, it is strictly comparable to drinking herbal medicine — sometimes even better — because three meals happen every single day, and food comes into direct contact with the spleen and stomach, acting on them directly. It is the most direct kind of regulation there is. Turning the three meals you must eat every day into an opportunity to stop hurting yourself and start improving your health — that is the greatest takeaway from studying the theory of the spleen and stomach.
Looking ahead: upright qi matters most
💬 Note from Doctor Luo: After the pandemic, everyone has learned that the body matters most, and upright qi (zheng qi) matters most. When the same pathogen arrives, people with abundant upright qi come through untouched, while those with insufficient upright qi get infected. Regulate the spleen and stomach well, and keep the upright qi abundant — in the long war between humanity and plagues in the years ahead, this is how we protect ourselves. That is the benefit of studying Chinese medicine.
This article is compiled from Doctor Luo Dalun’s lecture series on Doctor Li Dongyuan.