脾胃为水谷之海，得后天之气也。何也？盖人之始生本乎精血之原，人之既生，由乎水
谷之养，非精血无以立形体之基，非水谷无以成形体之壮。精血之司在命门，水谷之司在脾
胃，故命门得先天之气，脾胃得后天之气也。是以水谷之海，本赖先天为之主，而精血之海
，又必赖后天为之资。故人之自生至老，凡先天之有不足者，但得后天培养之力，则补天之
功亦可居其强半，此脾胃之气所关于人生者不小。且先天如朝廷，后天如司道，执政在先天
，布政在后天，故人自有生以后，无非后天为之用，而形色动定，一无胃气之不可。故经曰
∶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。又曰∶人以水谷为本，
人绝水谷则死，脉无胃气亦死。正以人之胃气即土气也，万物无土皆不可，故土居五行之中
而主于四季，即此义也。
由此推之，则凡胃气之关于人者，无所不至，即脏腑、声色、脉候、形体，无不皆有胃
气，胃气若失，便是凶候。如五脏胃气之病，则凡气短气夺而声哑喘急者，此肺之胃败也。
神魂失守，昏昧日甚，而畏寒异常者，此心之胃败也。躁扰烦剧，囊缩痉强，而恐惧无已者
，此肝胆之胃败也；胀满不能运，饮食不能入，肉脱痰壅而服药不应者，此脾之胃败也。关
门不能禁，水泉不能化，热蒸不能退，骨痛之极不能解者，此肾之胃败也。又如五色之有胃
气者，无论青红黑白，皆宜兼苍黄明润，若色赤如赭，或如 血；色青如蓝，或如草滋
；色白如盐，或如枯骨；色黄如枳实，或如黄土；色黑如 ，或如地苍，而加之沉晦，
是皆五色之胃败也。又如脉象之有胃气者，经曰∶脉弱以滑，是有胃气；脉实以坚，谓之益
甚；脉逆四时，为不可治。故无论浮、沉、迟、数，皆宜兼见缓滑，方是脉中之胃气。若见
但弦、但钩、但毛、但石、但代，或弦搏之极而全无和气，或微渺之极而全无神气，总云
真脏之见，是皆五脉之胃败也。不独此也，即如情性气质，亦无不关于胃气，盖土性浓重，
而轻薄者少胃气，土色苍固，而夭嫩者少胃气，是可知土气为万物之源，胃气为养生之主，
胃强则强，胃弱则衰，有胃则生，无胃则死。
是以养生家必当以脾胃为先，而凡脾胃受伤之处，所不可不察也。盖脾胃之伤于外者，
惟劳倦最能伤脾，脾伤则表里相通，而胃受其困者为甚。脾胃之伤于内者，惟思忧忿怒最为
伤心，心伤则母子相关，而化源隔绝者为甚，此脾胃之伤于劳倦情志者，较之饮食寒暑为更
多也。故经曰∶二阳之病发于脾，有不得隐曲，女子不月，其传为风消，其传为息贲者，死
不治。再此之外，则脾胃属土，惟火能生，故其本性则常恶寒喜暖，使非真有邪火，则寒凉
之物最宜慎用，实所以防其微也。若待受伤，救之能无晚乎？此脾胃之伤于寒凉生冷者，又
饮食嗜好之最易最多者也。故昔有柳公度者，善于摄生，或问其致寿之术，则曰∶我无他也
，但不以气海熟生物，暖冷物，亦不以元气佐喜怒耳。此得善养脾胃之道，所以便能致寿。
故凡欲察病者，必须先察胃气，凡欲治病者，必须常顾胃气，胃气无损，诸可无虑。奈
何今之医家习矣不察，初不知元气胃气为何物，动辄止知攻病，开口便云有火，以致败人胃
气，绝人谷气者，不可胜纪。殊不知病之与命，孰为重轻？正之与邪，孰为缓急？矧此中的确
之用，孰者宜先，孰者宜后，自有标本一定之理，原非可以意凑猜摸者也。世有庸流，每借
窃一二成语，东扯西拽，以似为是，偏执惑乱，欺人误人，倘不幸遇之而不能烛其真伪，其
亦命之使然乎，悲乎！悲乎！
脾胃是受纳和腐熟水谷的枢纽，依靠后天获得的精气来维持功能。为什么呢？因为人生命的起源根本在于精血这一本源，而人出生后生存，则依赖于水谷精微的滋养。没有精血就无法建立形体的基础，没有水谷精微就无法使形体强壮。精血的调控在于命门，水谷的运化在于脾胃，所以命门禀受先天的精气，脾胃禀受后天的精气。因此，作为水谷之海的脾胃，本来依赖先天之气作为主宰；而作为精血之海的命门，又必须依赖后天之气作为资助。所以人从出生到衰老，凡是先天禀赋不足的，只要得到后天脾胃培养的助力，那么补益先天之功也可以占据一半以上，这说明脾胃之气对人生的影响是非常大的。况且先天如同朝廷，后天如同地方行政机构，执政权在先天，施政在后天，所以人自从出生以后，无非是依靠后天之气发挥作用，而身体的形态、色泽、动作、静止，无一不是没有胃气就不能够进行的。所以《内经》说：健康人的常气禀受于胃，胃就是健康人的常气，人如果没有胃气就称为逆证，逆证者死。又说：人以水谷为本，人断绝了水谷就会死亡，脉象中如果没有胃气也会死亡。正因为人的胃气即土气，万物没有土都不能生存，所以土居于五行之中而主司四季，就是这个道理。
由此推论，凡是胃气对人的影响，无处不在，即使是脏腑、面色声音、脉象候诊、形体状态，无不都有胃气的存在，如果失去了胃气，就是凶险的征候。例如五脏出现胃气败坏的病症，那么凡是气息短促、气力夺失而声音嘶哑、喘息急促的，这是肺的胃气败坏。神魂不能守舍，神志昏昧日益加重，并且异常畏寒的，这是心的胃气败坏。烦躁扰乱病情严重，阴囊收缩、筋脉拘挛强直，并且恐惧不止的，这是肝胆的胃气败坏。腹部胀满不能运化，饮食不能入口，肌肉消瘦、痰液壅盛且服药无效的，这是脾的胃气败坏。二便关门不能禁固，小便不能正常化生排泄，发热蒸腾不能退去，骨痛至极无法缓解的，这是肾的胃气败坏。再比如五色中带有胃气的表现，无论青、红、黑、白，都应当兼有苍黄之色且明润光泽，如果面色赤红如赭石，或如凝血；青色如靛蓝，或如枯草；白色如盐粒，或如枯骨；黄色如枳实，或如黄土；黑色如煤炭，或如地苍色，并且加上沉滞晦暗，这些都是五色中胃气败坏的表现。再比如脉象中有胃气的表现，《内经》说：脉象软弱而滑利，这是有胃气；脉象坚实而强硬，称为病势加重；脉象违背四时变化规律，为不可治疗。所以无论浮、沉、迟、数哪种脉象，都应当兼见缓滑之象，这才是脉中的胃气。如果只见单纯的弦脉、钩脉、毛脉、石脉、代脉，或者弦急搏指到了极点而完全没有和缓之气，或者微弱渺小到了极点而完全没有神气，总称为真脏脉的出现，这都是五脉中胃气败坏的表现。不只是这些，即使是性情气质，也无不与胃气相关，大概土性浓重，而性格轻薄的人少胃气；土色苍固，而面容夭折娇嫩的人少胃气，这就可以知道土气是万物的源头，胃气是养生的主宰，胃气强则身体强，胃气弱则身体衰，有胃气则生，无胃气则死。
因此，养生家必定应当以调理脾胃为先务，而对于脾胃受伤的各种情况，是不可不仔细考察的。大概脾胃受到外邪伤害的，只有劳倦最能伤脾，脾受伤则表里相通，而胃受到牵连困顿最为严重。脾胃受到内伤（情志）的，只有思虑、忧愁、愤怒最伤心，心受伤则母子相生关系受影响，而气血化源隔绝最为严重，这种因劳倦和情志导致的脾胃损伤，比因饮食、寒暑导致的更多。所以《内经》说：阳明经的病发源于脾，有难以启齿的隐曲之事，女子月经不行，其传变为风消（形容消瘦），其传变为息贲（形容喘促）的，属于死证不可治。除此之外，脾胃属土，只有火能生土，所以它的本性常常厌恶寒冷而喜欢温暖，如果不是真正的邪火，那么寒凉性质的食物和药物最应该谨慎使用，这实际上是为了预防微小的损伤。如果等到已经受伤，再去救治，难道不晚了吗？这是脾胃因寒凉生冷而受伤的情况，这也是饮食嗜好中最容易、最多见的损伤。所以过去有位柳公度，善于养生，有人问他长寿的方法，他说：我没有什么别的秘诀，只是不用丹田之气去加热熟食或温热冷食，也不用元气去助长喜怒情绪罢了。这就是善于调养脾胃的方法，所以能够长寿。所以凡是想要诊断疾病的人，必须先察辨胃气；凡是想要治疗疾病的人，必须时刻顾护胃气，只要胃气不受损，其他都可以不必担忧。奈何现在的医家习以为常而不加考察，起初不知道元气和胃气是什么东西，动不动只知道攻伐病邪，开口就说有火，以致败坏人的胃气，断绝人的谷气，这种情况不可胜数。却不知道疾病与生命，哪个更重要？正气与邪气，哪个更紧迫？况且这里确切的治疗用法，哪些应该先做，哪些应该后做，自有标本先后一定的道理，原本不是可以随意凑合猜测的。世间有些庸医，常常窃取一两句成语，东拉西扯，以似是而非的东西当作真理，偏执惑乱，欺骗他人误导他人，如果不幸遇到他们而不能洞察其真伪，那也只能说是命运使然吧，可悲啊！可悲啊！
The Spleen and Stomach are the sea of water and grain, relying on acquired Qi for their function. Why is this? The origin of human life lies fundamentally in the source of Essence and Blood (Jingxue), while survival after birth depends on nourishment from water and grain. Without Essence and Blood, there can be no foundation for the physical form; without water and grain, the physical form cannot become robust. The regulation of Essence and Blood resides in the Gate of Vitality (Mingmen), while the transformation of water and grain resides in the Spleen and Stomach. Thus, the Gate of Vitality receives congenital Qi, and the Spleen and Stomach receive acquired Qi. Therefore, the Sea of Water and Grain (Spleen and Stomach) originally relies on congenital Qi as its master, while the Sea of Essence and Blood (Gate of Vitality) must rely on acquired Qi as its resource. Hence, from birth to old age, if one has congenital insufficiency, obtaining the strengthening power of acquired nourishment can achieve half of the merit in supplementing heaven. This indicates that the Qi of the Spleen and Stomach has a significant impact on human life. Moreover, congenital Qi is like the imperial court, while acquired Qi is like local administration; governance lies in the congenital, while policy implementation lies in the acquired. Thus, since birth, humans rely entirely on acquired Qi for function, and the body's form, color, movement, and stillness are all impossible without Stomach Qi (Wei Qi). As stated in the classics: "The normal Qi of a healthy person is derived from the Stomach; the Stomach is the normal Qi of a healthy person. If a person lacks Stomach Qi, it is called 'Ni' (reversal), and those with 'Ni' die." It also states: "Humans take water and grain as their root; if humans cut off water and grain, they die. If the pulse lacks Stomach Qi, death occurs." Precisely because human Stomach Qi is Earth Qi, and nothing can survive without Earth, Earth occupies the center of the Five Elements and governs the four seasons, which is the meaning here.
From this, we can deduce that wherever Stomach Qi affects humans, it is omnipresent. Even within the Zang-Fu organs, voice and complexion, pulse diagnosis, and physical form, Stomach Qi is present everywhere. If Stomach Qi is lost, it indicates an ominous prognosis. For example, in diseases of Stomach Qi failure in the five Zang organs: shortness of breath, loss of vitality, hoarseness, and rapid panting indicate the failure of Stomach Qi in the Lung. Loss of spirit and soul retention, increasing confusion, and extreme aversion to cold indicate the failure of Stomach Qi in the Heart. Restlessness, severe agitation, retraction of the scrotum, spastic rigidity, and endless fear indicate the failure of Stomach Qi in the Liver and Gallbladder. Abdominal distension and inability to transport, inability to eat, emaciation, phlegm obstruction, and ineffectiveness of medication indicate the failure of Stomach Qi in the Spleen. Inability to control the orifices, inability to transform urine, unresolvable steaming heat, and unbearable bone pain indicate the failure of Stomach Qi in the Kidney. Regarding the five colors, those with Stomach Qi should, regardless of being green, red, black, or white, exhibit a pale yellow brightness and luster. If the complexion is red like hematite or coagulated blood; green like indigo or dead grass; white like salt or dry bones; yellow like immature orange or yellow earth; black like coal or dark earth, especially when accompanied by dullness and obscurity, these are signs of Stomach Qi failure in the five colors. Regarding pulse qualities, the classics state: "A weak and slippery pulse indicates the presence of Stomach Qi; a solid and hard pulse indicates worsening condition; a pulse contrary to the four seasons is untreatable." Thus, whether floating, deep, slow, or rapid, the pulse should ideally show slowness and slipperiness to possess Stomach Qi. If only a pure wiry, hook, hair, stone, or choppy pulse is seen, or if the wiry pulse is extremely forceful without any harmonious Qi, or if the pulse is extremely faint without any spiritual Qi, these are collectively referred to as the appearance of True Viscera Pulses, indicating Stomach Qi failure in the five pulses. Furthermore, even temperament and constitution are related to Stomach Qi. Earth nature is heavy and substantial, so those who are frivolous lack Stomach Qi; Earth color is firm and solid, so those who appear prematurely aged or delicate lack Stomach Qi. This shows that Earth Qi is the source of all things, and Stomach Qi is the master of health preservation. Strong Stomach Qi leads to strength, weak Stomach Qi leads to decline; with Stomach Qi there is life, without Stomach Qi there is death.
Therefore, health preservers must prioritize the Spleen and Stomach, and carefully examine how the Spleen and Stomach are injured. Externally, fatigue and overwork most easily injure the Spleen; once the Spleen is injured, the interior and exterior communicate, causing severe distress to the Stomach. Internally, excessive thinking, worry, anger, and resentment most easily injure the Heart; once the Heart is injured, the mother-child relationship is affected, severing the source of transformation. Such injuries to the Spleen and Stomach due to fatigue and emotional factors are more common than those due to diet, cold, or heat. As the classics say: "Diseases of the Yangming channel originate in the Spleen, manifesting as hidden grievances and amenorrhea in women. If it transmits to Feng Xiao (wasting away) or Xi Ben (accumulation in the chest), it is incurable and fatal." Additionally, the Spleen and Stomach belong to Earth, which is generated by Fire. Thus, their nature dislikes cold and prefers warmth. Unless there is genuine pathogenic fire, cold-natured substances should be used with extreme caution to prevent minor injuries. If treatment is delayed until injury occurs, will it not be too late? This refers to injuries caused by cold, raw, and uncooked foods, which are the most common dietary habits. In the past, Liu Gongdu was skilled in health preservation. When asked about his longevity secret, he said: "I have no other method; I simply do not use my Qi Hai (lower Dantian) to warm cooked food or hot cold food, nor do I use my Yuan Qi (Original Qi) to fuel anger or joy." This is the way to properly nourish the Spleen and Stomach, allowing him to achieve longevity. Therefore, anyone wishing to diagnose illness must first observe Stomach Qi; anyone wishing to treat illness must always protect Stomach Qi. If Stomach Qi remains undamaged, there is little to worry about. However, modern physicians are accustomed to neglecting this, unaware of what Original Qi and Stomach Qi are. They often focus solely on attacking pathogens, claiming there is always "Fire," thereby damaging patients' Stomach Qi and cutting off their grain intake, a phenomenon too numerous to count. They fail to realize: which is heavier, disease or life? Which is more urgent, righteous Qi or pathogenic Qi? Moreover, regarding the precise application of treatment, what should be done first and what later follows the fixed principles of root and branch. It is certainly not something that can be guessed or improvised. There are mediocre practitioners in the world who steal a few idioms, drag them together arbitrarily, pass off semblance as truth, act with bias and confusion, deceiving and misleading others. If one不幸 encounters them and cannot discern their authenticity, it may be considered fate. How sad! How sad!