This paper compared the understandings of fire heat syndrome in spleen and stomach disease by Liu Wansu and Li Dongyuan. Both of them have different emphasis on fire heat syndrome in spleen and stomach disease. Liu Wansu thought that transformation of six qi into fire caused disease, and the treatment should open sweat pores, diffuse and smooth qi and fluid. Li Dongyuan thought the internal damage of spleen and stomach caused the disease, and the treatment should supplement the center and boost qi, raise yang and dissipate fire. These will increase our understanding of fire heat syndrome of spleen and stomach disease, so as to provide treatment ideas in clinical practice.