《五脏别论篇》曰∶胃、大肠、小肠、三焦、膀胱，此五者，天气之所生也。其
气象天，故泻而不藏，此受五脏浊气，名曰传化之腑，此不能久留而输泻者也。所
谓五脏者，藏精气而不泄，故满而不能实。六腑者，传化物而不藏，故实而不能满。所
以然者，水谷入口，则胃实而肠虚，食下则肠实而胃虚，故曰实而不满，满而不实
也。《阴阳应象大论》云∶谷气通于脾，六经为川，肠胃为海，九窍为水注之器。九
窍者，五脏之官也，皆得胃气，乃能通利。《通评虚实论》云∶头痛耳鸣，九窍不利，
肠胃之所生也。胃气一虚，耳目口鼻俱为之病。《经脉别论》云∶食气入胃，散精于
肝，淫气于筋，食气入胃，浊气归心，淫精于脉，脉气流经，经气归肺，肺朝百脉，
输精于皮毛，毛脉合精，行气于腑，精神明，留于四脏，气归于权衡，权衡以平，气
口成寸，以决生死。饮入于胃，游溢精气，上输于脾，脾气散精，上归于肺，通调水
道，下输膀胱，水精四布，五经并行，合于四时五脏阴阳，揆度以为常也。又云∶阴
之所生，本于五味，阴之五官，伤在五味，至于五味，口嗜而欲食之，必自裁度，勿
使过焉，过则伤其正也。谨和五味，骨正筋柔，气血以流，腠理以密，如是则骨气
以精，谨道如法，是有天命。《平人气象论》云∶人以水谷为本，故人绝水谷则死。
脉无胃气亦死。所谓无胃气者，非肝不弦，肾不石也。历观诸篇而参考之，则元气之
充足，皆由脾胃之气无所伤，而后能滋养元气，若胃气之本弱，饮食自倍，则脾胃
之气既伤，而元气亦不能充，而诸病之所由生也。《内经》之旨，皎如日星，犹恐后
人有所未达，故《灵枢经》中复申其说。经云∶水谷入口，其味有五，各注其海，津
液各走其道。胃者水谷之海，其输上在气冲，下至三里，水谷之海有余则腹满，水
谷之海不足则饥不受谷食。人之所受气者，谷也；谷之所注者，胃也；胃者水谷气血
之海也；海之所行云气者，天下也；胃之所出气血者，经隧也；经隧者，五脏六腑
之大络也。又云∶五谷之入于胃也，其糟粕、津液、宗气分为三隧。故宗气积于胸
中，出于喉咙，以贯心肺，而行呼吸焉。营气者，泌其津液，注之于脉，化而为血，以
营四末，内注五脏六腑，以应刻数焉。卫气者，出其悍气之剽疾，而行于四末、分
肉、皮肤之间，而不休者也。又云∶中焦之所出，亦并胃中，出上焦之后，此所受
气者，泌糟粕，蒸津液，化为精微，注于肺脉，乃化而为血，以奉生身，莫贵于此。
圣人谆复其辞而不惮烦者，仁天下后世之心，亦 矣。故饮食失节，寒温不适，脾
胃乃伤，此因喜怒忧恐，损耗元气，资助心火，火与元气不两立，火胜则乘其土位，
所以病也。《调经篇》云∶病生阴者，得之饮食居处，阴阳喜怒。又云∶阴虚则内热，
有所劳倦，形气衰少，谷气不盛，上焦不行，下脘不通，胃气热，热气熏胸中，故
为内热。脾胃一伤，五乱互作，初病遍身壮热，头痛目眩，肢体沉重，四肢不收，怠
惰嗜卧，为热所伤，元气不能运用，故四肢困怠如此，圣人着之于经，谓人以胃土
为本，成文演义，互相发明，不一而止，粗工不解读，妄意施用，本以活人，反以害
人，今举经中言，病从脾胃所生，及养生当实元气者，条陈之。《生气通天论》云∶
苍天之气清净，则志意治，顺之则阳气固，虽有贼邪，勿能害也。此因时之序，故圣
人传精神，服天气而通神明；失之，内闭九窍，外壅肌肉，卫气散解，此谓自伤，气
之削也。阳气者，烦劳则张，精绝辟积于夏，使人煎厥，目盲耳闭，愦愦乎若坏都，
故苍天之气贵清静，阳气恶烦劳，病从脾胃生者，一也。《五常政大论》云∶阴精所
奉其人寿，阳精所降其人夭。阴精所奉，谓脾胃即和，谷气上升，春夏令行，故其人
寿，阳精所降，谓脾胃不和，谷气下流，收藏令行，故其人夭，病从脾胃生者，二也。
《六节藏象论》云∶脾、胃、大肠、小肠、三焦、膀胱者，仓廪之本，营之居也，名
曰器，能化糟粕，转味而出入者也，其华在唇四白，其充在肌，其味甘，其色黄，此
至阴之类，通于土气，凡十一脏，皆取决于胆也。胆者，少阳春生之气，春气升则
万化安，故胆气春升，则余脏从之，胆气不升，则飧泄肠 ，不一而起矣。病从脾
胃生者，三也。经云∶天食人以五气，地食人以五味，五气入鼻，藏于心肺，上使
五色修明，声音能彰。五味入中，藏于肠胃中，味有所藏，以养五气，气和而生，津
液相成，神乃自生。谓之气者，上焦开发，宣五谷味，熏肤充身泽毛，若雾露之溉，气
或乖错，人何以生？病从脾胃生者，四也。岂特四者，天地之邪气，感则害人五脏六
腑，乃形气俱虚，乃受外邪，不因脾胃虚弱，贼邪不能独伤人，则病从脾胃而生者
愈明矣。圣人意旨，重见叠出，详明如此，且垂戒云∶法于阴阳，和于术数，饮食有
节，起居有常，不妄作劳，故能形与神俱，而尽终其天年，度百岁乃去。由是言之，则
人之饮食起居之际，可不慎哉。
《五脏别论篇》说：胃、大肠、小肠、三焦、膀胱，这五个器官，是受天气（自然界清阳之气）所生的。它们的形态象天一样，所以特点是“泻而不藏”（传导排泄糟粕而不贮藏精气），这里接受五脏产生的浊气，被称为“传化之腑”，这些脏腑不能长久停留食物残渣而必须及时输注排泄。所谓五脏，是贮藏精气而不泄出的，所以特点是“满而不能实”（精气充满但不能被水谷充实）。六腑，是传导消化物而不贮藏的，所以特点是“实而不能满”（可以被水谷暂时充实但不能像五脏那样充满精气）。之所以这样，是因为水谷入口后，则胃充实而肠空虚；食物下行后，则肠充实而胃空虚，所以说六腑是“实而不满”，五脏是“满而不实”。
《阴阳应象大论》说：谷气通应于脾，六经如同河流，肠胃如同大海，九窍（眼、耳、口、鼻及前后二阴）是水液注入的器具。九窍，是五脏的外在官窍，都必须依赖胃气的作用，才能通畅便利。《通评虚实论》说：头痛耳鸣，九窍不通利，是由肠胃的问题引起的。胃气一旦虚弱，耳、目、口、鼻都会发生病变。《经脉别论》说：饮食之气进入胃中，将精微散布到肝，使津液浸润筋脉；饮食之气进入胃中，浊气归于心，使精微浸润血脉；脉气流经经络，经气归于肺，肺朝会百脉，将精微输布于皮毛，毛与脉中的精气结合，运行气于腑，精神光明，留驻于四脏，气机归于平衡协调，气口（寸口脉）形成脉搏，以此来判断生死。饮水进入胃中，游溢产生精气，向上输送给脾，脾气散播精微，向上归于肺，肺通调水道，向下输送到膀胱，水精四布，五经并行，符合四时五脏阴阳的变化规律，这是正常的生理状态。又说：阴精的产生，根本在于五味；阴精所属的五官，损伤也在于五味。对于五味，口中嗜好想要食用它，必须自我节制，不要过量，过量就会损伤正气。谨慎调和五味，骨骼端正筋脉柔和，气血流畅，腠理致密，像这样则骨气精坚，遵循养生之道，就能享有天命。
《平人气象论》说：人以水谷为根本，所以人断绝水谷就会死亡。脉象如果没有胃气也会死亡。所谓没有胃气，并不是指肝脏没有弦脉、肾脏没有石脉。纵观各篇并加以参考，那么元气的充足，都因为脾胃之气没有受到损伤，之后才能滋养元气，如果胃气本来虚弱，饮食加倍（过度进食），那么脾胃之气既已受伤，而元气也不能充盈，各种疾病就是由此产生的。《内经》的宗旨，明亮如日月星辰，还担心后人有所不理解，所以在《灵枢经》中再次申述这一说法。经文说：水谷入口，其味道分为五种，各自注入相应的海（指脏腑之海），津液各自走它的通道。胃是水谷之海，它的输注穴位上在气冲穴，下至足三里穴，水谷之海有余则腹部胀满，水谷之海不足则饥饿却不想吃谷物食物。人所受纳的气，是谷气；谷气所注的地方，是胃；胃是水谷气血的海；海中运行的云气，就像天下的风气；胃所输出的气血，通过经隧（经络）；经隧，是五脏六腑的大络。又说：五谷进入胃中，其糟粕、津液、宗气分为三条通道。所以宗气积聚在胸中，出于喉咙，贯通心肺，以推动呼吸。营气，分泌津液，注入脉中，变化成为血，以营养四肢末端，向内注入五脏六腑，以对应刻漏的时间节律。卫气，发出其剽悍疾速的气，运行于四肢末端、分肉之间、皮肤之中，而不休息。又说：中焦所发出的气，也在胃中，出于上焦之后，这里所受的气，泌出糟粕，蒸化津液，化为精微，注入肺脉，于是变化成为血，以奉养身体，没有比这更珍贵的了。圣人反复叮咛而不怕麻烦，是为了仁爱天下后世的心意啊。所以饮食失去节制，寒温不适，脾胃就会受伤，这是因为喜怒忧恐，损耗元气，资助心火，火与元气不两立，火胜则乘袭土位（脾胃），所以生病。《调经篇》说：病生于阴的，是由于饮食起居、阴阳失调、喜怒情绪引起的。又说：阴虚则内热，如果有劳倦过度，形体和气衰少，谷气不盛，上焦不通行，下脘不通畅，胃气发热，热气熏蒸胸中，所以产生内热。脾胃一受伤，五乱交互发作，初病时遍身壮热，头痛目眩，肢体沉重，四肢无力收持，倦怠嗜卧，是被热邪所伤，元气不能运用，所以四肢困倦怠惰如此。圣人在经文中记载，认为人以胃土为本，成文演义，互相发明，不止一次。粗劣的医生不能解读，随意施用，本意是救人，反而害人。现在列举经文中所说的，病从脾胃所生，以及养生应当充实元气的情况，分条陈述。
《生气通天论》说：苍天的气候清净，则人的志意安定，顺应它则阳气固密，虽然有贼邪，也不能伤害。这是顺应时序，所以圣人保养精神，服膺天气而通达神明；如果不顺应，则内闭九窍，外壅肌肉，卫气散解，这叫自伤，是元气的削弱。阳气方面，烦劳过度则亢张，精气枯竭积累于夏季，使人发生煎厥，眼睛失明耳朵闭塞，昏乱好像都城崩塌，所以苍天的气候贵在清净，阳气厌恶烦劳，病从脾胃生，这是一点。《五常政大论》说：阴精所奉养的人长寿，阳精所下降的人短命。阴精所奉，是说脾胃调和，谷气上升，春夏令施行，所以人长寿；阳精所降，是说脾胃不和，谷气下流，收藏令施行，所以人短命，病从脾胃生，这是第二点。《六节藏象论》说：脾、胃、大肠、小肠、三焦、膀胱，是仓廪的根本，营气居住的地方，名叫器，能转化糟粕，转输味道而出入，其荣华表现在口唇四周的白色皮肤，其充实在肌肉，其味甘甜，其色黄，这是至阴的一类，通于土气，凡十一脏，都取决于胆。胆，是少阳春生之气，春气升发则万物安宁，所以胆气春升，则其余脏腑跟随它，胆气不升，则飧泄、肠鸣等病不一而起。病从脾胃生，这是第三点。经文说：天给人提供五气，地给人提供五味，五气从鼻吸入，藏于心肺，向上使五色明润，声音能彰显。五味进入体内，藏于肠胃中，味道有所藏蓄，以滋养五气，气和平而生化，津液相互成就，神自然产生。称为气，是指上焦开发，宣发五谷的味道，熏肤充身泽毛，像雾露灌溉一样，气如果乖错，人怎么能生存？病从脾胃生，这是第四点。岂止这四点，天地的邪气，感之则伤害五脏六腑，必须是形气俱虚，才受外邪，如果不因脾胃虚弱，贼邪不能单独伤人，那么病从脾胃而生的道理就更加明白了。圣人的意旨，重见叠出，详细明确如此，并且留下告诫说：效法阴阳，和于术数，饮食有节制，起居有常规，不妄作劳苦，所以能形与神俱在，而尽终其自然寿命，度过百岁才离去。由这些来说，那么人的饮食起居之间，能不谨慎吗？
The *Ling Shu: Treatise on the Distinctions of the Five Zang Organs* states: The Stomach, Large Intestine, Small Intestine, San Jiao (Triple Burner), and Bladder—these five organs—are generated by Heaven's Qi (clear Yang Qi of nature). Their form resembles Heaven; therefore, their function is to discharge without storing. They receive turbid Qi from the Five Zang Organs and are named "Fu Organs of Transmission and Transformation." These organs cannot retain contents for long but must transmit and discharge them. The so-called Five Zang Organs store Essence and Qi without leaking; thus, they are full (with Essence) but not solid (with food/water). The Six Fu Organs transmit and transform substances without storing; thus, they can be solid (with food/water) but not full (with Essence). This is because when food and water enter the mouth, the Stomach becomes solid while the Intestines are empty; when food moves down, the Intestines become solid while the Stomach becomes empty. Hence, it is said that Fu Organs are "solid but not full," while Zang Organs are "full but not solid."
The *Ling Shu: Great Discussion on the Correspondence of Yin and Yang* says: Grain Qi connects with the Spleen. The Six Meridians are like rivers, the Gastrointestinal tract is like a sea, and the Nine Orifices (eyes, ears, nostrils, mouth, urethra, and anus) are vessels into which water flows. The Nine Orifices are the external orifices of the Five Zang Organs; they require Stomach Qi to function smoothly. The *Ling Shu: Comprehensive Review of Deficiency and Excess* states: Headache, tinnitus, and dysfunction of the Nine Orifices arise from disorders of the Gastrointestinal tract. If Stomach Qi is deficient, the ears, eyes, mouth, and nose will all suffer. The *Ling Shu: Distinctions of the Meridians* explains: When dietary Qi enters the Stomach, its essence is dispersed to the Liver, moistening the sinews. Dietary Qi entering the Stomach sends turbid Qi to the Heart, where essence nourishes the vessels. Vessel Qi flows through the meridians, and meridian Qi returns to the Lung. The Lung governs all vessels, transmitting essence to the skin and hair. Hair and vessel essence combine, circulating Qi through the Fu Organs. Spirit becomes bright, residing in the Four Zang Organs. Qi returns to balance and equilibrium. The Cun Kou pulse forms at the radial artery, allowing one to determine life and death. When drinks enter the Stomach, clear Qi overflows and is transported upward to the Spleen. The Spleen disperses essence upward to the Lung, which regulates water passages and transports fluids downward to the Bladder. Water essence distributes throughout the body, and the Five Meridians run in parallel, harmonizing with the Four Seasons and the Yin-Yang of the Five Zang Organs. This is the normal physiological state. It further states: The generation of Yin Essence originates from the Five Flavors; injury to the Five Orifices associated with Yin also stems from the Five Flavors. Although one may crave and desire certain flavors, one must exercise self-restraint and avoid excess, as excess damages healthy Qi. Carefully harmonizing the Five Flavors ensures straight bones and flexible sinews, flowing Qi and Blood, and dense interstices (Cou Li). In this way, bone Qi becomes refined. Following these methods aligns one with the Mandate of Heaven.
The *Ling Shu: Normal People and Phenomenological Theory* states: Humans rely on water and grain as their foundation; thus, humans die when deprived of water and grain. A pulse lacking Stomach Qi also indicates death. "Lacking Stomach Qi" does not mean the absence of the string-like pulse of the Liver or the stone-like pulse of the Kidney. Reviewing various chapters confirms that sufficient Yuan Qi (Original Qi) depends on the undamaged Qi of the Spleen and Stomach, which subsequently nourish Yuan Qi. If Stomach Qi is inherently weak and diet is excessive, Spleen and Stomach Qi are injured, Yuan Qi cannot be replenished, and diseases arise. The principles of the *Nei Jing* are as clear as the sun and stars. Fearing later generations might not fully understand, the *Ling Shu* reiterates these concepts. The classic states: Food and drink enter the mouth, yielding five flavors that each enter their respective "Sea" (organs). Fluids follow their own pathways. The Stomach is the Sea of Water and Grain; its acupoints include Qichong (ST 30) above and Zusanli (ST 36) below. Excess in the Sea of Water and Grain causes abdominal fullness; deficiency causes hunger but an inability to eat. Humans derive Qi from grain; grain enters the Stomach; the Stomach is the Sea of Water, Grain, Qi, and Blood. Just as clouds and wind circulate in the world, Qi and Blood exit the Stomach via the Jing-Sui (Meridian-Tunnels). The Jing-Sui are the great collaterals of the Five Zang and Six Fu Organs. Furthermore, when grains enter the Stomach, their dregs, fluids, and Zong Qi (Pectoral Qi) divide into three pathways. Zong Qi accumulates in the chest, exits through the throat, penetrates the Heart and Lung, and governs respiration. Ying Qi (Nutritive Qi) secretes fluids, injects them into the vessels, transforms them into Blood, and nourishes the four extremities, internally supplying the Five Zang and Six Fu Organs in rhythm with timekeeping. Wei Qi (Defensive Qi) issues forth its fierce and rapid energy, circulating through the four extremities, muscle intervals, and skin without rest. Additionally, Qi issued from the Middle Jiao also originates in the Stomach, emerging after the Upper Jiao. Here, Qi separates dregs, steams fluids, transforms them into fine essence, injects them into the Lung vessels, and transforms into Blood to sustain life. Nothing is more precious than this. The sages repeated these teachings tirelessly out of benevolence for future generations. Therefore, irregular diet and inappropriate temperature injure the Spleen and Stomach. Anger, joy, worry, and fear deplete Yuan Qi and assist Heart Fire. Fire and Yuan Qi cannot coexist; if Fire prevails, it attacks the Earth position (Spleen/Stomach), causing disease. The *Tiao Jing Pian* states: Diseases arising from Yin result from diet, living habits, Yin-Yang imbalance, and emotions. It also states: Yin deficiency leads to internal heat. Fatigue deforms Qi and reduces vitality; Grain Qi fails to flourish. The Upper Jiao ceases to function, and the lower Wan (pylorus/abdomen) becomes obstructed. Stomach Qi generates heat, which steams the chest, causing internal heat. Once the Spleen and Stomach are injured, the "Five Chaos" interact. Initially, there is generalized fever, headache, vertigo, heavy limbs, inability to control the limbs, lethargy, and drowsiness. This is due to heat injury preventing Yuan Qi from functioning, resulting in limb fatigue. The sages recorded in the classics that humans rely on Stomach Earth as their foundation, elaborating on this repeatedly. Unskilled physicians fail to interpret this correctly and apply treatments arbitrarily, intending to save lives but instead harming them. Here, I list conditions arising from Spleen and Stomach disorders and health preservation methods to strengthen Yuan Qi.
The *Sheng Qi Tong Tian Lun* states: When the Qi of Heaven is pure and clear, human will and intent are regulated. Adhering to this secures Yang Qi; even if pathogenic factors attack, they cannot cause harm. This follows the order of seasons. Thus, sages conserve spirit, align with Heaven's Qi, and achieve spiritual clarity. Deviation causes internal closure of the Nine Orifices, external blockage of muscles, and dispersion of Wei Qi. This is self-injury and depletion of Qi. Overexertion causes Yang Qi to hyperactive; exhaustion of Essence accumulating in summer leads to Jian Jue (Frying Collapse), characterized by blindness, deafness, and confusion resembling a collapsing city. Thus, Heaven's Qi values purity, and Yang Qi abhors overexertion. Disease arising from Spleen and Stomach is the first point. The *Wu Chang Zheng Da Lun* states: Those whose Yin Essence is upheld live long; those whose Yang Essence descends die young. "Yin Essence upheld" means Spleen and Stomach are harmonious, Grain Qi ascends, and Spring/Summer functions operate, leading to longevity. "Yang Essence descends" means Spleen and Stomach are disharmonious, Grain Qi flows downward, and Autumn/Winter functions dominate, leading to early death. Disease arising from Spleen and Stomach is the second point. The *Liu Jie Zang Xiang Lun* states: The Spleen, Stomach, Large Intestine, Small Intestine, San Jiao, and Bladder are the root of granaries, the residence of Ying Qi, named "vessels." They transform dregs and transport flavors in and out. Their brilliance manifests in the white skin around the lips; their substance fills the muscles. Their flavor is sweet, color yellow. They belong to extreme Yin and connect with Earth Qi. All eleven Zang-Fu organs depend on the Gallbladder. The Gallbladder possesses the Shaoyang Spring-ascending Qi. When Spring Qi ascends, all transformations are peaceful. If Gallbladder Qi ascends, other organs follow; if it fails to ascend, diarrhea and intestinal rumbling arise. Disease arising from Spleen and Stomach is the third point. The classic states: Heaven feeds humans with Five Qi, Earth with Five Flavors. Five Qi enter via the nose, store in the Heart and Lung, and manifest as clear complexion and distinct voice. Five Flavors enter the interior, store in the Gastrointestinal tract, and nourish Five Qi. Harmonized Qi generates life; fluids complement each other; Spirit arises naturally. Qi refers to the Upper Jiao opening and disseminating grain flavors, warming the skin, filling the body, and moistening hair like mist and dew. If Qi is disordered, how can life exist? Disease arising from Spleen and Stomach is the fourth point. Moreover, pathogenic Qi of Heaven and Earth harms the Five Zang and Six Fu Organs only when both Form and Qi are deficient. Without Spleen-Stomach weakness, pathogenic factors cannot attack alone. Thus, the principle that disease arises from Spleen and Stomach is clarified. The sages' intentions are reiterated clearly, warning: "Model yourself on Yin and Yang, harmonize with techniques and numbers, regulate diet, maintain regular起居 (daily routine), and do not exert yourself improperly. Thus, Form and Spirit remain united, allowing you to complete your natural lifespan and pass away after a hundred years." From this, one sees how crucial caution must be regarding diet and daily life.