《内经》曰∶脾胃者，土也，孤脏以灌四傍者也。善者不得见，恶者可见。其来如
水之流，此谓太过，病在外；如鸟之啄，此谓不及，病在中。太过则令人四肢不举，不及则令
人九窍不通。
脉不得胃气者，肝不弦肾不石也。
平人之常气禀于胃。胃者，平人之常气也。人无胃气曰逆，逆者死。上部有脉，下部无
脉，为食塞胸中，宜吐之。寸口洪大，按之反涩，尺脉亦微而涩，或寸口紧如转索，左
右无常，或滑而数者下之。或浮而滑，凡脉沉，病若伤寒者，宿酒，宜下。短疾而滑，酒病。
浮细而滑，伤饮。气口紧盛，或浮细而滑疾，皆伤饮食。
关沉而滑为食不消。上关沉迟为脾胃虚寒。右手脉紧盛者伤食。两关弦大者，主脾胃饱
胀。腹饱胀而脉细者危，浮大者可治。
上关脾胃所主，其脉缓大为土气冲和，百病不生。但有浮沉洪细长短滑涩，则各司其病，
宜按脉对证而调治之。如脾胃脉弦而紧者，则是木邪刑土，脾胃有积，或痛或胀。（宜保和丸
中加柴胡、川芎、骨皮之类，制肝木也。）洪大者则胃中有火。（治宜泻黄散承气汤之类。）
滑大者则是痰饮。（宜二陈橘半枳术丸之类，气不利上急者可吐。）涩者则是气血两虚。
（宜八珍汤或异功散加当归、生地黄之类。）短涩之脉，若在前短为外，以候胃，主胃弱
病；（不思食，恶心呕吐，或恶闻食气者皆是也。）在后短为内，以候脾，主脾病。（胸膈
作胀，食下不化反泄泻之类皆是也。）
《黄帝内经》说：脾胃属土，是单独一脏，负责灌溉滋养四周的其他脏腑。正常的脾胃功能表现通常不可见，只有异常时才显现出来。脉象如果像水流一样滑利通畅，这叫做“太过”，病邪在体表；如果脉象像鸟啄食一样短促有力，这叫做“不及”，病邪在体内。“太过”会导致四肢无法抬起，“不及”会导致九窍（耳、目、口、鼻及前后二阴）不通畅。
健康人的常气来源于胃。胃就是健康人常气的根本。人如果没有胃气，就叫作“逆”，属于死证。如果上部有脉搏而下部没有脉搏，这是食物堵塞在胸中，适宜用催吐法治疗。寸口脉洪大，但重按反而涩滞，尺脉也微弱且涩滞，或者寸口脉紧硬如转动的绳索，左右无常定形态，或者脉滑数有力的，适宜用泻下法治疗。如果脉浮而滑，凡是脉沉的病症，如果是伤寒类疾病，或者是宿酒积滞，适宜用泻下法。脉短疾而滑，是饮酒致病。脉浮细而滑，是伤于饮水。气口脉紧盛，或者浮细而滑疾，都是饮食损伤的表现。
关部脉沉而滑，是食物不消化。上关脉沉迟，是脾胃虚寒。右手脉紧盛，是伤食。两关脉弦大，主脾胃饱胀。腹部饱胀而脉细弱的病情危重，脉浮大的可以治愈。
上关部由脾胃所主，其脉缓大表示土气冲和，百病不生。但如果出现浮、沉、洪、细、长、短、滑、涩等变化，则分别对应不同的病症，应当依据脉象对证调理治疗。例如，脾胃脉弦而紧，则是木邪克制脾土，脾胃有积滞，或痛或胀。（适宜在保和丸中加入柴胡、川芎、牡丹皮之类，以制约肝木。）脉洪大，则是胃中有火。（治疗适宜用泻黄散、承气汤之类。）脉滑大，则是痰饮。（适宜用二陈汤、橘半枳术丸之类，气机不利且急迫在上部的可以用吐法。）脉涩，则是气血两虚。（适宜用八珍汤或异功散加入当归、生地黄之类。）脉短涩，如果在寸部（前）为外，用以候胃，主胃弱病；（如不思饮食、恶心呕吐，或厌恶闻见食物气味等都是此类症状。）如果在尺部（后）为内，用以候脾，主脾病。（如胸膈胀满，进食后不消化反而泄泻等都是此类症状。）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Spleen and Stomach belong to Earth; they are the solitary Zang organ that irrigates and nourishes the four directions. When functioning well, this is not visible; when malfunctioning, it becomes visible. If the pulse comes like flowing water, this is termed "Excess" (Tai Guo), indicating disease in the exterior; if it comes like a bird pecking, this is termed "Deficiency" (Bu Ji), indicating disease in the interior. Excess causes the limbs to be unable to move, while Deficiency causes the Nine Orifices to be obstructed.
If the pulse lacks Stomach Qi, the Liver pulse will not present as Wiry (Xian) and the Kidney pulse will not present as Stone-like (Shi).
The normal Qi of a healthy person is derived from the Stomach. The Stomach is the source of normal Qi for a healthy person. A person without Stomach Qi is said to have "Reversal" (Ni), which indicates death. If there is a pulse at the upper part but none at the lower part, it is due to food blocking the chest; emesis (inducing vomiting) is indicated. If the Cun Kou (radial artery at the wrist) pulse is Surging (Hong Da) but feels Choppy (Se) upon deep pressure, and the Chi pulse is also faint and Choppy, or if the Cun Kou pulse is Tight (Jin) like a turning rope with no consistency between left and right, or if it is Slippery (Hua) and Rapid (Shu), purgation (downward draining) is indicated. If the pulse is Floating (Fu) and Slippery, in cases of pulse Deep (Chen) resembling Taiyang Cold Damage (Shang Han) or due to accumulated alcohol, purgation is indicated. A Short (Duan) and Rapid pulse that is Slippery indicates disease from alcohol. A Floating, Fine (Xi), and Slippery pulse indicates injury from drinking fluids. A Tight and full pulse at the Qi Kou (radial pulse position), or one that is Floating, Fine, and Rapid, all indicate dietary injury.
A Chen (Deep) and Slippery pulse at the Guan position indicates indigestion. A Chen and Chi (Slow) pulse at the upper Guan indicates deficiency-cold of the Spleen and Stomach. A Tight and full pulse on the right hand indicates food stagnation. Wiry (Xian) and large pulses at both Guan positions indicate Spleen and Stomach fullness and distension. Abdominal fullness with a Fine pulse is critical; fullness with a Floating and Large pulse is treatable.
The upper Guan position is governed by the Spleen and Stomach. A Huan (Relaxed) and Da (Large) pulse indicates harmonious Earth Qi, preventing various diseases. However, if variations such as Floating, Deep, Surging, Fine, Long, Short, Slippery, or Choppy appear, each corresponds to specific pathologies, requiring treatment based on pulse diagnosis and symptom differentiation. For instance, if the Spleen-Stomach pulse is Wiry and Tight, it indicates Wood evil attacking Earth, with accumulation in the Spleen/Stomach causing pain or distension. (It is appropriate to add Chai Hu [Bupleuri Radix], Chuan Xiong [Ligustici Chuanxiong Rhizoma], and Mu Dan Pi [Moutan Cortex] to Bao He Wan to restrain Liver Wood.) A Surging and Large pulse indicates Fire in the Stomach. (Treatment should use formulas like Xie Huang San or Cheng Qi Tang.) A Slippery and Large pulse indicates Phlegm-Fluid retention. (Formulas like Er Chen Tang or Ju Ban Zhi Zhu Wan are appropriate; if Qi obstruction is urgent in the upper jiao, emesis may be used.) A Chopse pulse indicates dual deficiency of Qi and Blood. (Formulas like Ba Zhen Tang or Yi Gong San added with Dang Gui [Angelicae Sinensis Radix] and Sheng Di Huang [Rehmanniae Radix] are appropriate.) A Short and Choppy pulse, if located at the front (Cun), relates to the exterior and observes the Stomach, indicating Stomach weakness disease (such as lack of appetite, nausea, vomiting, or aversion to the smell of food). If located at the rear (Chi), it relates to the interior and observes the Spleen, indicating Spleen disease (such as chest and diaphragm distension, postprandial indigestion leading to diarrhea).