胃属土，胃气即土气也。土为万物之源，胃为养生之本。胃强则人强，胃弱则人弱；有
胃气
心，淫精于脉，脉气流经，经气归于肺，肺朝百脉，输精于皮毛，毛脉合精，行气于腑，腑
精神明，留于四脏。此可知脏腑形体，莫不皆有胃气也。凡证之现五善、七恶者，非脏腑胃
气存亡之明征乎。胃气一失，便为凶候，故善治外证者，无论大小轻重，必先顾其胃气，察
其能食不能食以验之。能食者，胃气强，内顾无忧，固可专治外证。不能食者，胃气弱，中
州坐困，祸起萧墙。必须先定内患，令其能食，待血气有所资赖，然后再治外证，所谓本立
而道生也。然理脾胃者，人只知参、苓、术、草、楂、朴、麦芽之类为脾胃之药，而不知风
寒湿热、饮食劳倦，皆能伤脾。如风邪伤者宜散之，寒邪伤者宜温之，湿邪伤者宜燥之，热
邪伤者宜清之，饮食伤者宜行之，劳倦伤者宜补之。但去其伤脾胃之病，即是理脾胃之正药
也。奈何今之业外科，漫守一、二成方，开口便云有毒，概用寒凉，漫施攻伐，以致受害而
毙命者，不可胜数。岂古方之不宜于今也，抑药证之大相背谬耶；盖不察其胃气之强弱，病
因之虚实为何如耳。且夫古人资禀朴质，其从七情干涉者少，而从风寒湿热外感凝滞者多，
故证之初起，每每用霸药取效。今之穿凿太过，七情六欲烦扰之甚，而阴阳血气无有不亏伤者
，亦偏用霸药成方以试之，是投之于井而更加之以石也。吾知其胃气微虚者，犹可出入，而胃
气大虚者，断难假借也。故曰痈疽外证，肌肉之病，所用之药，有病则病受之，于脾胃何涉乎。
殊不知肌肉乃脾胃所主，治药乃胃气所关，肌肉不能自病，脾胃病之；诸药不能自行，胃气行之
。诸药入口，必先入胃，而后行及诸经，以治其病也。未有药伤其脾胃而能愈病者，亦未有不
能营运饮食之脾胃，而反能营运诸药者也。惟明鉴
胃属于土，胃气就是土气。土是万物的源头，胃是养生的根本。胃气强盛则人体强健，胃气虚弱则人体衰弱；有胃气，心将精气灌注于脉中，脉气流经经脉，经气汇聚于肺，肺朝会全身百脉，将精微物质输布至皮毛，毛与脉中的精气相合，运行气机于六腑，使精神清明，留存于五脏。由此可知，脏腑形体，无不都有胃气的存在。凡是病症出现五善、七恶的情况，难道不是脏腑胃气存亡的明显征兆吗？胃气一旦丧失，就会变成凶险的候象，所以善于治疗外科证候的人，无论病情大小轻重，必定先顾护其胃气，通过观察患者能否进食来验证它。能进食的，说明胃气强盛，内部没有后顾之忧，固然可以专门治疗外部证候。不能进食的，说明胃气虚弱，中焦（脾胃）处境困窘，祸患将从内部产生。必须先安定内部的隐患，使其能够进食，等到气血有所依赖滋养之后，然后再治疗外部证候，这就是所谓根本确立而道法自然生发。然而调理脾胃的方法，人们只知道人参、茯苓、白术、甘草、山楂、厚朴、麦芽之类的药物是调理脾胃的药，却不知道风寒湿热、饮食不节、劳倦过度，都能损伤脾胃。如风邪损伤的适宜用发散法，寒邪损伤的适宜用温里法，湿邪损伤的适宜用燥湿法，热邪损伤的适宜用清热法，饮食积滞损伤的适宜用消导行气法，劳倦损伤的适宜用补益法。只要去除那些损伤脾胃的病邪，就是调理脾胃的正治之法。奈何当今从事外科的人，盲目固守一两个成方，开口便说药性有毒，一概使用寒凉药物，随意施用攻伐之法，导致受害而死亡的人，数不胜数。难道是古方的不适用于今天呢，还是药性与证候大相径庭呢？大概是因为不考察其胃气的强弱，以及病因的虚实情况罢了。况且古人的资质朴实单纯，受七情（喜、怒、忧、思、悲、恐、惊）干扰的少，而受风寒湿热等外感邪气凝滞的多，所以在证候初起时，常常使用药力峻猛的药物取得疗效。如今之人穿凿附会太过，七情六欲烦扰甚重，而阴阳气血无不亏损损伤，却偏执地使用峻猛药物的成方去试探，这就像把人投进井里再加上石头一样。我知道胃气轻微虚弱的，还可以灵活出入调整，而胃气大虚的，绝对难以借用这些峻猛之药。所以说痈疽的外部证候，是肌肉的疾病，所使用的药物，有病处则病处承受药力，与脾胃有什么关系呢？殊不知肌肉是由脾胃所主管的，治疗用药关乎胃气的运转，肌肉不能自己生病，是脾胃的功能失调导致了疾病；各种药物不能自行运行，是靠胃气来推动运行的。各种药物入口，必定先入胃，然后才运行到各条经脉，以治疗疾病。从来没有药物损伤了脾胃而能治愈疾病的，也没有不能运化饮食的脾胃，反而能运化各种药物的道理。只有明察秋毫者才能明白。
The Stomach belongs to Earth, and Stomach Qi (Wei Qi) is the Qi of Earth. Earth is the source of all things, and the Stomach is the foundation of nourishing life. When Stomach Qi is strong, the person is strong; when Stomach Qi is weak, the person is weak. With Stomach Qi present, the Heart (Xin) pours essence into the vessels, vessel Qi flows through the meridians, meridian Qi converges in the Lungs, the Lungs direct the hundred vessels, and transmit essence to the skin and hair. The essence of skin and vessels combines, circulating Qi in the Fu organs, clarifying spirit and mind, and retaining it in the Zang organs. From this, it can be known that no Zang or Fu organ, nor any body form, exists without Stomach Qi. Whenever symptoms manifest as the Five Goods (Wu Shan) or Seven Evils (Qi E), are these not clear signs of the existence or extinction of Stomach Qi in the Zang and Fu organs? Once Stomach Qi is lost, it becomes a ominous prognosis. Therefore, those skilled in treating external disorders must always first protect the Stomach Qi, regardless of the severity or lightness of the condition, verifying it by observing whether the patient can eat. If the patient can eat, Stomach Qi is strong, there is no internal worry, and one can focus solely on treating the external disorder. If the patient cannot eat, Stomach Qi is weak, the Middle Jiao (Zhong Zhou) is in distress, and disaster arises from within. One must first resolve the internal trouble, enable eating, wait for Qi and Blood to have sufficient support, and then treat the external disorder. This is what is meant by "when the root is established, the Dao arises." However, regarding methods to regulate the Spleen and Stomach, people only know that herbs such as Ginseng Radix (Renshen), Poria (Fuling), Atractylodis Rhizoma (Baizhu), Licorice Root (Gancao), Hawthorn Fruit (Shanzha), Magnolia Bark (Houpo), and Malt (Maiya) are medicines for the Spleen and Stomach, but do not realize that Wind, Cold, Damp-Heat, dietary irregularities, and fatigue can all injure the Spleen. For injuries caused by Wind pathogen, dispersion is appropriate; for Cold, warming is appropriate; for Dampness, drying is appropriate; for Heat, clearing is appropriate; for dietary injury, promoting movement/digestion is appropriate; for fatigue injury, tonification is appropriate. Merely removing the pathogenic factors that injure the Spleen and Stomach constitutes the correct method for regulating them. Alas, nowadays, practitioners of surgery blindly adhere to one or two fixed formulas, immediately claiming toxicity and indiscriminately using cold-cooling herbs, arbitrarily applying purgative/attacking methods, resulting in countless victims who suffer and die. Is it that ancient formulas are unsuitable for today, or that the medicine and syndrome are greatly contradictory? It is likely due to failing to examine the strength of Stomach Qi and the deficiency/excess nature of the etiology. Moreover, ancients had simple constitutions, were less affected by the Seven Emotions (Qi Qing), and more often affected by external stagnation from Wind, Cold, Damp, and Heat. Thus, at the onset of disease, they often used potent/herbaceous-strong drugs (Ba Yao) to achieve efficacy. Today, people are overly pedantic, heavily disturbed by the Seven Emotions and Six Desires, with Yin-Yang, Qi, and Blood invariably damaged, yet they stubbornly use potent/fixed formulas to test treatments. This is like throwing someone into a well and adding stones. I know that for those with slight Stomach Qi deficiency, adjustments can still be made flexibly, but for those with severe Stomach Qi deficiency, borrowing such potent drugs is absolutely difficult. Therefore, some say: "External manifestations of carbuncles and sores are diseases of the muscles; the medicines used are accepted by the diseased area, what does this have to do with the Spleen and Stomach?" They do not realize that muscles are governed by the Spleen and Stomach, treatment relies on Stomach Qi operation, muscles cannot get sick by themselves (it is Spleen/Stomach dysfunction causing illness), and various medicines cannot move by themselves (they are moved by Stomach Qi). All medicines enter the mouth, must first enter the Stomach, and then circulate to the various meridians to treat the disease. There has never been a case where damaging the Spleen and Stomach with medicine could cure the disease, nor a Spleen and Stomach unable to transform food and drink that could instead transform various medicines. Only those with clear insight can understand this.