Pharmacotherapy of the spleen and stomach in Li Shizhen’s Bencao Gangmu (Compendium of materia medica, 1596): a text-statistical analysis of 994 entries and a bridge to modern pharmacology

Background Bencao Gangmu (本草纲目, 1596), Li Shizhen’s Compendium of Materia Medica, is among the most comprehensive pre-modern compilations of East Asian materia medica, yet the full-text distribution of its content on the spleen–stomach ( pi-wei 脾胃) system, the digestive functional axis of Chinese medicine, has never been systematically quantified or mapped onto modern pharmacological evidence. Aim of the study To construct a reproducible text-statistical inventory of all spleen- and stomach-related entries in Bencao Gangmu; to characterize the resulting pharmacopoeia by plant identity, taste–nature ( qi-wei ), channel tropism ( gui-jing ), declared function, indication and preparation form; and to relate the most frequently recorded botanical drugs to current pharmacological evidence on gastrointestinal disease. Materials and methods The Jinling (1596) edition was searched in full text for pi (脾), wei (胃) and pi-wei (脾胃). Candidate hits were adjudicated by two reviewers against predefined inclusion criteria (Cohen’s κ = 0.84) and coded into a relational dataset (drug, taste–nature, channel tropism, function, indication, preparation). Plant identities were authenticated against World Flora Online and the Chinese Pharmacopoeia (2025) and reported under the ConPhyMP framework. Results Of 994 retained entries, 703 specified a concrete drug or therapy. The most frequent botanical drugs were Atractylodes macrocephala Koidz. ( Baizhu , n = 26), Zingiber officinale Roscoe ( Shengjiang , n = 25) and Atractylodes lancea (Thunb.) DC. ( Cangzhu , n = 20). Sweet (n = 16), warm (n = 15) and slightly-cold (n = 14) taste–natures dominated; channel tropism converged on the spleen (32%) and the spleen–stomach pair (26%); the leading functions were spleen-tonifying (n = 46) and qi-replenishing (n = 41); the leading indication was fan-wei (food regurgitation, n = 108). Decoction accounted for 79% of preparation records and medicinal porridge ( yao-zhou ) for 11%. Conclusion Bencao Gangmu codifies a balanced spleen–stomach pharmacotherapy prioritizing sweet–warm tonification counterweighted by a deliberate cooling–draining arm. The leading botanical drugs converge on phytochemical leads, including atractylenolides, gingerols/shogaols, atractylodin/β-eudesmol, berberine and processed- Pinellia alkaloids, with documented effects on gastrointestinal motility, mucosal protection, gut-microbiota modulation and anti-inflammatory activity, providing a reproducible bridge between classical Chinese materia medica and contemporary ethnopharmacology.