Diabetes mellitus is characterized by excessive drinking, polyuria, polyphagia, and emaciation, and it mostly belongs to the category of “thirst” in Chinese medicine. Its clinical manifestations are varied and its etiology is complex. The characteristics of the pathogenesis are mostly summarized as “Yin deficiency as the basis, dryness and heat as the symptoms”. Based on more than 10 years of clinical observation, the author concluded that although diabetes is related to yin deficiency and dry heat, the deficiency of qi and yin of the spleen and the weakness of the spleen and the strength of the stomach are present in the whole process of diabetes, and clinical treatment by supporting the spleen and suppressing the stomach has achieved better results. The main features of thirst in response to a weak spleen and a strong stomach are polydipsia, polyuria, polyphagia and emaciation, which are the main clinical features of diabetes mellitus. In the author’s opinion, the pathology of Yin deficiency and dry heat is related to the ancient living and historical conditions, while nowadays diabetic patients are mostly obese, have little food, loose stools, and do not drink and urinate much, and only at a later stage do they lose weight. Therefore, it is no longer consistent with the whole course of the disease to discuss the pathogenesis of diabetes mellitus in terms of Yin deficiency and dry heat. In our opinion, if the spleen is deficient in clear qi, water and fluid cannot be transferred upward, then thirst will occur; if the stomach is strong and over-ripe, then overeating will occur; if the clear qi does not rise, then the fluid will be out of order and the clear and turbid will not be separated and mixed, then the urine will be like fat and paste; if the spleen and stomach are not in harmony, then the qi and blood cannot be distributed in all directions, then the disease will be prolonged and emaciated. Therefore, a weak spleen and a strong stomach can reflect the characteristics of the main evidence of thirst. The common complications of diabetes mellitus are actually caused by the malfunction of the spleen and stomach and the pathological phenomenon of a weak spleen and stomach. For example, when the spleen is weak and the stomach is strong, the clear qi does not rise and the turbid qi does not descend, resulting in dizziness (cerebral arteriosclerosis, hypertension, etc.); when the spleen is not healthy, phlegm and blood stagnate within the body, and phlegm and blood stagnate within the body, blocking each other’s meridians, resulting in stroke (cerebral hemorrhage, cerebral infarction, etc.); when the spleen and stomach are not in harmony, the qi and blood have no source of biochemistry, and the qi and blood cannot be carried upward, resulting in eye diseases (cataract, retinal lesions, etc.); when the spleen is weak, water and dampness gather and become phlegm, and when the stomach is strong, the qi and heat are reversed, resulting in heat and phlegm clouding the ears. If the spleen is weak, water-dampness collects as phlegm; if the stomach is strong, phlegm-heat is obscured in the ears, resulting in tinnitus and deafness; if the spleen is weak, qi-blood cannot go up to the heart; if the qi is deficient, the blood vessels do not function well; if the spleen is weak, water and fluid do not spread; if phlegm-dampness stagnates within the heart, the heart vessels become unfavorable, resulting in palpitations and chest pains (coronary heart disease, etc.); if the stomach is strong, heat and toxins attack the lungs and gold are burned; if the spleen is weak, earth does not produce gold, resulting in coughing and coughing of blood, resulting in pulmonary consumption (tuberculosis); if the spleen is deficient, toxins cannot go out; if the stomach is strong, heat and flesh rot, resulting in carbuncles and sores; Spleen deficiency leads to oedema (renal impairment, proteinuria); Spleen qi sinking, clear and turbid, and mixed down leads to diarrhea. A weak spleen and a strong stomach reveal the pathogenesis of the internal organs of thirst. The “meridians and veins” cloud: “drink into the stomach, overflowing essence, upward transmission to the spleen, spleen qi dispersion of essence, up to the lungs, through the water channel, downward transmission to the bladder, water and fluid four cloth, five parallel.” This is the theoretical basis for the evidence of spleen weakness, and the key to understanding the pathogenesis of thirst. According to clinical observation, I divide the degree of weak spleen and strong stomach into the following stages: First, the spleen is not very weak, the stomach is strong and generates heat: the stomach eats a little more, feels weak, the rest of the evidence is not obvious; second, the spleen is deficient, the ascending and clearing is out of duty: the spleen is deficient, the essence cannot return to the lungs in time, part of the stagnation and turn into phlegm, causing the spleen to be trapped by dampness; at this time, the patient may not have three symptoms, more obvious in those who are obese; phlegm stagnation for a long time, can turn into heat In this case, the patient may not have three symptoms, and it is more obvious in those who are obese. Third, spleen deficiency and kidney, Yin and Yang deficiency: with the further development of the disease, spleen deficiency and loss of unity, essence and fluid flow down, appearing polyuria, urine has a sweet taste or like fat like paste. For example, in the “Treatment of the Classes”, it is said that “the small water is sweet instead of smelly, this is the spleen qi down off.” At this time, the three organs of the lungs, spleen and kidneys are in deficit, the qi is lost and the yin is lost, the yin is lost and the yang is lost, and finally the yin and yang are both deficient, and the evidence of change is numerous. It can be seen that a weak spleen, a strong stomach, and a dysregulation of the lungs and kidneys are the main features of the pathogenesis of thirst. From the physiological function of the pancreas in modern times, the pancreas belongs to the “spleen” in Chinese medicine. The nutrients in food such as sugar, fat, protein and various trace elements must be digested by pancreatic amylase, pancreatic lipase and pancreatic protease secreted by the exocrine cells of the pancreas before they can be absorbed and utilized by the body. On the contrary, the phenomenon of spleen deficiency, which is a deficiency of Qi and blood biochemistry, will occur. This phenomenon is called “weakness of the spleen”. Insulin is the driving force of the body’s energy use and the initiating link between glycogen decomposition and synthesis. The absence of insulin can lead to the inability to use sugar, increased decomposition of fat and protein, lactic acid accumulation, ketone body production, and the appearance of heat. This phenomenon is called “stomach strength”. Long-term diet does not nourish the skin, and the body gradually loses weight. The spleen digests and absorbs the water and grain essence, and the stomach receives and excretes the feces, which is the function of lowering the turbidity, the two complement each other, and the elevation is coordinated, which is equivalent to the exocrine function of the pancreas, and various digestive enzymes are the main material basis for its function. Experimental studies have confirmed that the formula of benefiting Qi and strengthening the spleen can increase the number of pancreatic β-cells and restore the function of pancreatic β-cells, which proves that deficiency of the spleen is the main pathogenesis of diabetes. The pathological nature of diabetes is not based on a single spleen deficiency, but on a mixture of spleen weakness, stomach strength, deficiency and reality. It is centered on spleen and stomach disorders, forming a deficiency of Qi and Yin in the spleen and stomach as the root, and dry heat, phlegm and dampness, and blood stasis as the symptoms. In response to the basic pathogenesis of diabetes, the coordination of the spleen and stomach and the balance of the Qi flow should be taken care of at every stage of treatment. The key to the treatment of diabetes is to use a comprehensive treatment that strengthens the spleen, strengthens the qi, clears heat, harmonizes the stomach, raises the clear and lowers the turbidity, and activates blood circulation to remove blood stasis. It has been clinically proven that the treatment of diabetes mellitus has achieved good results with the use of hemp seed pill, elevation and dispersion, and clearing summer heat and benefiting qi soup. We have formulated our own formula to support the spleen and suppress the stomach (Astragalus membranaceus 30g, Radix Astragali 30g, Radix et Rhizoma Polygonati 30g, Radix et Rhizoma Polygonati 30g, Radix Salviae Miltiorrhizae 30g, Radix Panax Notoginseng 10g, Atractylodes Macrocephala 10g, Radix Rehmanniae 30g, Rhizoma Polygonati 10g, Radix et Rhizoma Polygonati 15g) plus reduction to treat more than 80 cases of diabetes mellitus with satisfactory results.