头肿、喉痹、斑黄、狂乱、谵妄、潮热。登高而呼。弃衣而走。骂詈不避亲疏。凡其在经在络在腑。无不以气实血
热显症。此仲景所谓胃家实也。然亦有虚与寒者。则必以相火之虚。故胃怯而不支。为病洒洒振寒。善申数欠。颜黑。
病至则恶人与火。闻木声则惕。然而惊心欲动。独闭户牖而处。身以前皆寒栗。胃中寒胀。此则阳明之虚。不可不察也。
要之胃家为营卫之大主。五脏之宗主。其气腾而上盛。则脉倍见于人迎。其精充以下输。则脉涌盛于趺阳。仲景察病必
先诊两夹喉动脉之人迎。及两足趺之冲阳。以知人之死生间甚。盖以足阳明及足少阴为先后天之根本故也。故胃虽与腑
为阳明。胃土也。而当相火居止之地。其地为两阳合明。合明者。太阳少阳二部之地分。相合于此而明之也。凡三焦少
阳胆之所游部。手心主胞络之所总督。皆与阳明为腐热水谷之用。故本经曰。阳明者午也。午为夏令之中气。而相火之
本职。又三阳合之气也。其腑气旺。血多热盛。故能应夏令而主相火。凡心胞络之代心而主相火者。其建功致用。皆以
阳明也。仲景曰。阳明之为病。胃家实也。夫胃家之实。非谓大便之硬。与中下焦之燥。阳坚实。盖谓其腑为两阳合明
之盛。得病必为气血两实之症耳。是以凡胃病之来。其病气无有不实。而其热甚则为狂。疟、湿淫、汗出、鼽衄、口
唇胗。而其脉能大见于寸口。而立一阳藏于五阴之间。凡以此也。
头部肿胀、咽喉痹阻、皮肤发黄发斑、神志狂乱、胡言乱语、潮热。登高呼喊，脱衣奔跑，骂人不分亲疏。凡是病邪在经、在络、在腑的，无不以气实血热的症状表现出来。这就是张仲景所说的“胃家实”。然而也有虚证和寒证的情况，这必定是因为相火虚弱，导致胃气怯弱而不能支撑，出现战栗恶寒、频繁伸腰打哈欠、面色发黑等症状。发病时厌恶人和火光，听到木器敲击的声音就会惊恐心动，独自关上门窗独处，身体前部皆寒冷战栗，胃中因寒而胀满。这是阳明经的虚证，不可不仔细辨别。
总之，胃是营卫的主要主宰，也是五脏的宗主。如果胃气升腾而上盛，那么人迎脉就会格外明显；如果精气充盈而下输，那么趺阳脉就会涌盛有力。张仲景诊察疾病，必定先诊察喉结两侧动脉的人迎穴，以及足背部的冲阳穴，以此来判断病人的生死轻重。这是因为足阳明胃经和足少阴肾经分别是后天和先天的根本缘故。所以，虽然胃属于六腑中的阳明，五行属土，但它处于相火居止的地方，这个部位被称为“两阳合明”。“合明”是指太阳经和少阳经两个部位在此相合而明亮。凡三焦、少阳、胆所游历的部位，以及手厥阴心包络所统率的部位，都与阳明胃一起发挥腐熟水谷的作用。所以《内经》本经说：“阳明对应午时。”午时是夏令的中气，也是相火的本职，又是三阳合并之气。胃腑之气旺盛，血多热盛，所以能顺应夏令而主司相火。凡是心包络代替心脏主司相火的功能，其建功致用，都依赖于阳明胃。张仲景说：“阳明病的特征，就是胃家实。”所谓胃家之实，并不是指大便干硬，也不是指中下焦的燥热或阳气的坚实，而是指胃腑处于两阳合明的盛大状态，得病后必然是气血两实的病症。因此，凡是胃病发作，其病气没有不实的，如果热势严重就会导致发狂、疟疾、湿邪泛滥、出汗、鼻出血、口唇生疮等症，而且脉象能在寸口显著变大，形成一阳藏于五阴之间的格局。这都是因为上述原因。
Swelling of the head, Bi syndrome (obstruction) of the throat, yellow discoloration and macules on the skin, mania and confusion, delirium, tidal fever. Climbing high to shout, discarding clothes and running about, cursing without distinguishing between relatives and strangers. Whether the pathogen is in the meridians, collaterals, or the fu organs, all manifest with symptoms of excess Qi and heat in the blood. This is what Zhang Zhongjing referred to as "Shi (Excess) of the Stomach Family" (Wei Jia Shi). However, there are also cases of deficiency and cold. These must be due to the deficiency of Ministerial Fire (Xiang Huo), causing the Stomach to be timid and unable to support itself, resulting in symptoms such as shivering aversion to cold, frequent stretching and yawning, darkening of the face. Upon onset of the disease, the patient dislikes people and fire; hearing the sound of wood causes palpitations and fright; they prefer to stay alone with doors and windows closed; the anterior part of the body feels cold and trembling; there is abdominal distension due to cold in the Stomach. This is a deficiency pattern of the Yangming channel, which must not be overlooked.
In essence, the Stomach is the great master of Ying (Nutritive) and Wei (Defensive) Qi, and the patriarch of the five Zang organs. When its Qi ascends and becomes abundant, the Renying (Human Welcome) pulse at the neck becomes particularly visible; when its Essence fills and descends to nourish the lower parts, the Duyang (Foot-Yang) pulse on the dorsum of the foot becomes surging and vigorous. Zhang Zhongjing, when examining diseases, always first palpates the Renying artery located on both sides of the larynx, and the Chongyang (Surging Yang) point on the dorsum of the feet, to discern the severity and prognosis of life and death. This is because the Foot-Yangming Stomach Channel and the Foot-Shaoyin Kidney Channel are the foundations of Post-Heaven and Pre-Heaven, respectively. Therefore, although the Stomach belongs to the Yangming Fu organs and corresponds to Earth, it resides in the location where Ministerial Fire dwells. This location is called "Liang Yang He Ming" (The Brightness of Two Yangs). "He Ming" refers to the convergence of the Taiyang (Greater Yang) and Shaoyang (Lesser Yang) regions, combining here to create brightness. All areas traversed by the Sanjiao (Triple Burner), Shaoyang Gallbladder, and those governed by the Pericardium (Hand-Jueyin) serve the function of rotting and ripening food and water together with the Yangming Stomach. Thus, the Classic states: "Yangming corresponds to Wu (noon)." Wu is the central Qi of summer, the proper duty of Ministerial Fire, and also the combined Qi of the three Yang channels. The Fu organ's Qi is prosperous, with abundant blood and intense heat, thus responding to summer and governing Ministerial Fire. Whatever functions the Pericardium performs on behalf of the Heart to govern Ministerial Fire, its efficacy relies entirely on the Yangming Stomach. Zhang Zhongjing stated: "The manifestation of Yangming disease is Shi (Excess) of the Stomach Family." The "Shi" of the Stomach Family does not merely refer to hard stool or dryness in the Middle and Lower Jiao, nor simply to solid Yang. Rather, it signifies that the Fu organ is in a state of abundance due to the convergence of two Yangs, so that upon contracting disease, it inevitably presents as a condition of dual excess in both Qi and Blood. Therefore, whenever Stomach disease arises, its pathogenic Qi is invariably excessive. If the heat is severe, it leads to mania, malaria, dampness overflowing, sweating, epistaxis (nosebleed), and herpes labialis (lip lesions). The pulse can become significantly enlarged at the Cunkou (Inch Position), establishing a configuration where one Yang is hidden among five Yin pulses. All these phenomena occur for the reasons described above.