《内经》曰∶胃者,仓廪之官,五味出焉,又曰∶胃为黄肠。
五味入口藏于胃,以养五脏气。胃者,水谷之海,六腑之大原也。是以五脏六腑之气味
,皆出于胃。
四十五穴足阳明,头维、下关、颊车停,承泣、四白 巨 经,地仓、大迎对人迎。水突
气舍、连缺盆,气户、库房、屋翳屯,膺窗、乳中延乳根,不容、承满、梁门起,关门、太
乙、滑肉门。天枢、
外陵、大巨存,水道、归来、气冲次,髀关、伏兔走阴市,梁丘、犊鼻、足三里,上巨虚连条
口位,下巨虚跳上丰隆,解溪、冲阳陷谷中,内庭、历兑经穴终(左右九十穴)。
此一经起于头维,终于历兑,取历兑、内庭、陷谷、冲阳、解溪、三里,与井荥俞原经
脉起于鼻交 中,旁约太阳之脉,下循鼻外,上入齿中,还出挟口,环唇,下交承浆
,循颐后下廉,出大迎,循颊车,上耳前,过客主人,循发际至额颅。其支别者,从大迎
前下人迎,循喉咙入缺盆,下膈,属胃,络脾;其直行者,从缺盆下乳内廉,挟脐入气冲
中;其支者,起胃下口,循腹里,下至气冲而合,以下髀关,抵伏兔,下入膝膑中,下循
外廉,下足跗,入中趾外间;其支者,下膝三寸而别,以下入中趾外间;其支者,别跗上
,入大趾间,出其端,以交于太阴也。多血多气,辰时气血注此。
戊土之腑,脉右关部。胃气平调,五脏安堵。实则脉实,唇口干而腋下肿疼,宜泻胃土
;虚则脉虚,腹痛鸣而面目虚浮,药行温补。验实热兮,必口内壅干,泻黄散而得效;审虚
寒兮,须骨节皆痛,人参散而最奇。橘皮竹茹汤,治热渴而频频呕哕;乌药沉香散,疗寒痛
而
香附乌沉。胃冷生痰,半夏姜煎生附子;中寒停水,曲丸苍术久陈皮。芫花消症癖,丸共
朱砂;黄 治消渴,煎同甘草。硫汞结成砂子,吐逆立痊;参茱煎用枣姜,酸咽即可。霍乱
转筋肢逆冷,木瓜盐炒吴茱萸;食瘕酒癖胁胸疼,莪术芫棱同醋煮。胃虚咳逆,人参甘草倍
陈皮;胃实痰喘,藿叶丁皮增半夏。补虚降火,竹茹甘草橘皮红,或加枳术;扶弱驱寒,橘
皮良姜丁半夏,参草姜苓。抑闻上部有脉,下部无脉者为食寒,点盐汤探吐宽舒;倘或三部
俱急,人迎带数者号内壅,服灵丸泻利便宜。调脾助胃之药最难,热则消于肌肉,须用中和
饮子;变通加减之法不易,寒则减于饮食,要施仁义丹头。如心不在焉,食而不知其味,正
心为剂,口不谨兮,饮而不中其节,缄口良方。须知病后能服药,孰若病前能自防。
《黄帝内经》说:胃是掌管饮食仓储的官员,五味(酸、苦、甘、辛、咸)由此产生;又说:胃被称为“黄肠”。
五味进入口中后贮藏于胃中,用来滋养五脏之气。胃是水谷汇聚的大海,也是六腑的根本源头。因此,五脏六腑的精微物质,都来源于胃。
足阳明胃经共有四十五个穴位:头维穴、下关穴、颊车穴停驻于此,承泣穴、四白穴、巨髎穴,地仓穴、大迎穴正对水突穴。水突穴与气舍穴相连至缺盆穴,气户穴、库房穴、屋翳穴依次屯聚,膺窗穴、乳中穴延伸至乳根穴,不容穴、承满穴、梁门穴起始,关门穴、太乙穴、滑肉门穴。天枢穴、外陵穴、大巨穴存留,水道穴、归来穴、气冲穴依次排列,髀关穴、伏兔穴走向阴市穴,梁丘穴、犊鼻穴、足三里穴,上巨虚穴连接条口穴的位置,下巨虚穴跳跃而上至丰隆穴,解溪穴、冲阳穴、陷谷穴之中,内庭穴、厉兑穴为经脉穴位的终结(左右两侧共九十穴)。
这条经脉起始于头维穴,终止于厉兑穴。取用历兑、内庭、陷谷、冲阳、解溪、足三里等穴。该经脉起于鼻翼旁,交叉于鼻根部,旁边约束足太阳膀胱经的脉气,向下沿鼻外侧,向上进入上齿中,复出环绕口唇,向下交会于承浆穴,沿下颌后下方下行,出于大迎穴,沿颊车穴上行至耳前,经过客主人穴,沿发际到达额颅部。其分支从大迎穴前方下行至人迎穴,沿喉咙进入缺盆穴,向下穿过膈肌,属于胃,联络脾脏;其直行者,从缺盆穴下行沿乳房内侧,挟脐两旁进入气冲穴;其支脉,起于胃的下口,沿腹腔内部下行至气冲穴处汇合,向下经过髀关穴,抵达伏兔穴,向下进入膝盖髌骨中,向下沿小腿外侧前缘,下行至足背,进入中趾外侧间隙;另一支脉,从膝下三寸处分出,向下进入中趾外侧间隙;又一支脉,从足背分出,进入大趾之间,出于趾端,以交于足太阴脾经。本经多血多气,在辰时气血灌注于此。
胃属戊土之腑,脉象见于右手关部。胃气平和调顺,则五脏安泰。若实证则脉象实,表现为嘴唇干燥、口干以及腋下肿痛,适宜泻胃土之法;若虚证则脉象虚,表现为腹痛肠鸣以及面目虚浮,药物宜用温补之法。验证实热证,必定口腔内部壅塞干燥,服用泻黄散可获效;审察虚寒证,必须骨节皆痛,服用人参散最为神奇。橘皮竹茹汤,治疗热渴且频繁呕吐呃逆;乌药沉香散,治疗寒痛而香附配伍乌药沉香。胃冷生痰,用半夏、生姜煎煮加生附子;中焦受寒停水,用神曲丸配合苍术和陈久陈皮。芫花消除症癖积聚,制成丸剂配合朱砂;黄连治疗消渴病,煎煮同甘草。硫磺与水银结成的丹砂,吐逆立即可愈;人参、吴茱萸煎煮用大枣生姜,酸咽症状即可缓解。霍乱转筋四肢逆冷,用木瓜盐炒吴茱萸;食瘕酒癖导致胁胸疼痛,莪术、芫棱同醋煮制。胃虚咳逆,人参甘草加倍陈皮;胃实痰喘,藿香叶、丁香皮增加半夏。补虚降火,用竹茹、甘草、橘皮、红参,或加枳实、白术;扶弱驱寒,用橘皮、良姜、丁香、半夏,参草姜苓。曾听闻上部有脉,下部无脉者为食积寒凝,点盐汤探吐可使宽舒;倘若三部脉俱急,人迎脉搏带数者称为内壅,服用灵丸泻利为宜。调理脾胃助胃的药物最难掌握,热邪则消耗肌肉,须用中和饮子;变通加减的方法不易,寒邪则减少饮食,要施仁义丹头。如果心不在焉,吃东西不知道味道,这是正心为剂;如果口不谨慎,饮食没有节制,缄口良方是良药。须知生病后能服药,不如生病前能自我预防。
The *Neijing* (Inner Canon) states: The Stomach is the official in charge of granaries, from which the Five Flavors (sour, bitter, sweet, pungent, salty) emerge; it also states: The Stomach is referred to as the "Yellow Intestine."
When the Five Flavors enter the mouth, they are stored in the Stomach to nourish the Qi of the Five Zang Organs. The Stomach is the sea of water and grain, and the great source of the Six Fu Organs. Therefore, the qi and flavor of all Zang and Fu Organs originate from the Stomach.
There are forty-five acupoints on the Foot-Yangming Meridian: Touwei (ST8), Xiaguan (ST7), Jiache (ST6) are stationed here; Chengqi (ST1), Sibai (ST2), Juliao (ST3); Dicang (ST4), Daying (ST5) face Shuigu (ST9). Shuigu (ST9) and Qishe (ST11) connect to Quepen (ST12); Qihu (ST15), Kukufang (ST16), Wuyi (ST17) are gathered; Yingchuang (ST18), Ruzhong (ST18), Rugen (ST18) extend; Burong (ST21), Chengman (ST22), Liangmen (ST23) begin; Guanmen (ST24), Taiyi (ST25), Rouhoumen (ST26). Tianshu (ST25), Wailing (ST29), Daju (ST30) exist; Shuidao (ST28), Guilai (ST29), Qichong (ST30) follow sequentially; Biguan (ST31), Futu (ST32) lead to Yinshi (ST33); Liangqiu (ST34), Djubi (ST35), Zusanli (ST36); Shangjuxu (ST37) connects to Tiaokou (ST38); Xiajuxu (ST39) jumps up to Fenglong (ST40); Jiexi (ST41), Chongyang (ST42), Xiangu (ST43); Neiting (ST44), Lidui (ST45) mark the end of the meridian's acupoints (ninety acupoints on both sides).
This meridian starts at Touwei (ST8) and ends at Lidui (ST45). Select Lidui (ST45), Neiting (ST44), Xiangu (ST43), Chongyang (ST42), Jiexi (ST41), and Zusanli (ST36). The meridian originates beside the nose, crosses at the nasal root, binds laterally with the Bladder Meridian of Foot-Taiyang, descends along the lateral side of the nose, enters the upper teeth, emerges to encircle the lips, intersects below at Chengjiang (CV24), follows the posterior mandible downwards, emerges at Daying (ST5), ascends along Jiache (ST6), passes anterior to the ear at Kongzhu (GB13), follows the hairline to the forehead. A branch descends from the front of Daying (ST5) to Renying (ST9), follows the throat into Quepen (ST12), penetrates the diaphragm, belongs to the Stomach, and connects with the Spleen; its main trunk descends from Quepen (ST12) along the medial aspect of the breast, flanks the umbilicus, and enters Qichong (ST30); another branch originates from the lower opening of the Stomach, runs within the abdomen, descends to merge at Qichong (ST30), then passes through Biguan (ST31), reaches Futu (ST32), descends into the knee patella, follows the lateral aspect of the leg down to the dorsum of the foot, and enters the space between the second and third toes; another branch separates three cun below the knee, descending into the space between the second and third toes; yet another branch separates from the dorsum of the foot, enters the space between the big toe and second toe, emerges at the tip, and connects with the Foot-Taiyin Spleen Meridian. This meridian has abundant blood and Qi, receiving Qi and Blood injection during the Chen hour (7-9 AM).
The Stomach is the Fu Organ of Wu Earth, with its pulse located at the right Guan position. When Stomach Qi is balanced and harmonious, the Five Zang Organs are secure. In excess patterns, the pulse is excess, manifesting as dry lips and mouth, and swelling and pain in the axilla; draining Stomach Earth is appropriate. In deficiency patterns, the pulse is deficient, manifesting as abdominal pain with borborygmus, and puffy face and eyes; warming and tonifying herbs should be used. To verify excess heat, there must be internal oral congestion and dryness; Xiehuang San (Drain Yellow Powder) yields results. To examine deficiency cold, bone and joint pain throughout are required; Renshen San (Ginseng Powder) is most miraculous. Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) treats heat-thirst with frequent vomiting and hiccups; Wuyao Chenxiang San (Lindera and Amber Powder) treats cold-pain with Xiangfu combined with Wuyao and Chenxiang. Cold Stomach generating phlegm is treated with Banxia and fresh Ginger decocted with raw Fuzi; Cold in the Middle Jiao retaining water is treated with Shenqu Wan combined with Cangzhu and aged Chenpi. Yuanhua eliminates mass accumulations, made into pills with Zhusha; Huanglian treats Xiao Ke (Wasting-Thirst), decocted with Gancao. Liu Huang and Mercury结成 Sandan (Cinnabar-like compound), stopping vomiting immediately; Renshen and Wuzhuyu decocted with Zao and Jiang, relieving sour regurgitation. Huoluan with tendon spasms and cold limbs are treated with Mugua salt-fried with Wuzhuyu; Shi Xia and Jiu Pi causing hypochondriac and chest pain are treated with Ezhu and Yanling boiled with vinegar. Stomach deficiency with cough and rebellion uses Renshen and Gancao doubled with Chenpi; Stomach excess with phlegm-wheezing adds Huoye and Dingpi to Banxia. Tonifying deficiency and descending fire uses Zhuru, Gancao, Chenpi, and Hongshen, or adding Zhishi and Baizhu; Supporting weakness and dispelling cold uses Chenpi, Liangjiang, Ding, and Banxia, plus Renshen, Gancao, Jiang, and Ling. It is heard that having a pulse above but not below indicates food-cold stagnation; probing vomit with salt soup brings relief. If all three positions have rapid pulses and the Renying pulse is surging, it is called internal congestion; taking Ling Wan for purgation is convenient. Medicines to regulate the Spleen and assist the Stomach are hardest to master; heat consumes muscles, requiring Zhonghe Yinzi; methods of variation and addition are difficult; cold reduces dietary intake, requiring Renyi Dantou. If the mind is absent, eating without tasting flavor, Zhengxin is the prescription; if the mouth is not cautious, drinking without moderation, Jiankou is the good formula. Know that taking medicine after illness is inferior to self-prevention before illness.