着议处方已详矣，然恐或者不知其源，而无所考据，复以《黄帝内经》、仲景所说脾胃
者列于下。
《太阴阳明论》云∶太阴阳明为表里，脾胃脉也，生病而异者何也？岐伯曰∶阴阳异位
，更虚更实，更逆更从，或从内，或从外，所从不同，故病异名也。帝曰∶愿闻其异状也？
岐伯曰∶阳者，天气也，主外；阴者，地气也，主内。故阳道实，阴道虚。故犯贼风虚邪者
，阳受之，食饮不节，起居不时者，阴受之。阳受之则入六腑，阴受之则入五脏。入六腑，
则身热不得卧，上为喘呼；入五脏，则腹满闭塞，下为飧泄，久为肠 。故喉主天气
，咽主地气。故阳受风气，阴受湿气。阴气从足上行至头，而下行循臂至指端；阳气从手上
行至头，而下行至足。故曰∶阳病者，上行极而下，阴病者，下行极而上。故伤于风者，上
先受之，伤于湿者，下先受之。
帝曰∶脾病而四肢不用，何也？岐伯曰∶四肢皆禀气于胃，而不得至经，必因于脾，乃
得禀也。今脾病不能为胃行其津液，四肢不得禀水谷气，气日以衰，脉道不利，筋骨肌肉，
皆无气以生，故不用焉。
帝曰∶脾不主时何也？岐伯曰∶脾者，土也，治中央，常以四时长四脏各十八日寄治，
不得独主于时也。脾脏者，常着胃土之精也。土者，生万物而法天地，故上下至头足，不得
主时也。
《阴阳应象论》曰∶人有五脏，化五气，以生喜怒悲忧恐。故喜怒伤气，寒暑伤形，暴
怒伤阴，暴喜伤阳。厥气上行，满脉去形。喜怒不节，寒暑过度，生乃不固。《玉机真脏论
》曰∶脾大过，则令人四肢不举，其不及，则令人九窍不通，名曰重强。又《通评虚实论》
曰∶头痛耳鸣，九窍不利，肠胃之所生也。《调经论》曰∶形有余，则腹胀，经溲不利，不
足，则四肢不用。
又《气交变论》曰∶岁土太过，雨湿流行，肾水受邪，民病腹痛，清厥意不乐，体重烦
冤；甚则肌肉萎，足萎不收，行善 ，脚下痛，饮发，中满食减，四肢不举。又云∶岁土不
及，风乃大行。霍乱，体重腹痛，筋骨繇复，肌肉润酸，善怒。又云∶咸病寒中，复则
收政严峻，胸胁暴痛，下引少腹，善太息，虫食甘黄，气客于脾，民食少失味。又云∶土不
及，四维有埃云，润泽之化不行，则春有鸣条鼓拆之政；四维发振拉飘胜之变，则秋有肃杀
霖淫之复。其眚四维，其脏脾，其病内舍心腹，外在肌肉四肢。
《五常政大论》∶土平曰备化，不及曰卑监。又云∶其动疡涌分溃痈肿，其发濡滞，其
病留满痞塞，从木化也。其病飧泄。又云∶土太过曰敦阜，其味甘咸酸，其象长夏，其经足
太阴阳明。又曰∶其病腹满，四肢不举，邪伤脾也。
《经脉别论》云∶太阴藏搏者，用心省真，五脉气少，胃气不平，三阴也，宜治其下俞
，补阳泻阴。《脏气法时论》云∶脾主长夏，足太阴阳明主治，其日戊己。脾苦湿，急食苦
以燥之。又云∶病在脾，愈在秋，秋不愈，甚于春，春不死，持于夏，起于长夏。禁温食饱
食，湿地濡衣。脾病者，愈在庚辛，庚辛不愈，加于甲乙，甲乙不死，持于丙丁，起于戊己
。脾病者，日 慧，日出甚，下晡静。脾欲缓，急食甘以缓之，用苦泻之，甘补之。又
云∶脾病者，身重，善饥，足痿，足不能行，行善 ，脚下痛。虚则腹满肠鸣，飧泄食不化
血者。《经脉别论》∶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
。气归于权衡，权衡以平，气口成寸，以决死生。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。
《五常政大论》∶有太过不及，太过者，薄所不胜，乘所胜也。不及者，至而不至，是
为不及，所胜妄行，所生受病，所不胜者乘之也。
仲景云∶人受气于水谷以养神，水谷尽而神去，故云安谷则昌，绝谷则亡。水去则营散
，谷消则卫亡，营散卫亡，神无所根据。又云∶水入于经，其血乃成，谷入于胃，脉道乃行。
故血不可不养，卫不可不温，血温卫和，营卫乃行，得尽天年。
已经详细论述了辨证和处方，然而担心有些人不知道这些理论的源头，缺乏考证依据，因此再次将《黄帝内经》和张仲景关于脾胃的论述列在下面。
《太阴阳明论》说：太阴经和阳明经互为表里，属于脾胃的经脉，它们生病表现不同，为什么呢？岐伯回答说：阴阳所处的位置不同，虚实交替变化，逆顺关系不同，有的病从内生，有的病从外受，来源不同，所以疾病名称也不同。黄帝说：我想听听它们不同的症状表现。岐伯说：阳，代表天气，主司外部；阴，代表地气，主司内部。所以阳道常实，阴道常虚。因此，遭受贼风虚邪侵袭的，阳经受之；饮食不节制、起居无规律的，阴经受之。阳经受邪则传入六腑（如胃、大肠、小肠等），阴经受邪则传入五脏（如心、肝、脾、肺、肾）。邪入六腑，则出现身体发热、不能安卧，向上表现为喘息呼叫；邪入五脏，则出现腹部胀满、大便闭塞，向下表现为完谷不化的泄泻，日久发展为肠澼（痢疾或便脓血）。所以喉主纳天气，咽主纳地气。因此，阳经受风气侵袭，阴经受湿气侵袭。阴气从足部上行至头部，再下行沿手臂到达手指末端；阳气从手部上行至头部，再下行至足部。所以说：阳病者，病势向上发展到极点则向下传变，阴病者，病势向下发展到极点则向上逆行。因此，被风邪所伤的，上部先受邪；被湿邪所伤的，下部先受邪。
黄帝说：脾脏生病导致四肢不能运动，为什么呢？岐伯说：四肢都禀受胃气的滋养，但胃气不能直接到达四肢的经脉，必须依靠脾脏的转输，才能布散到四肢。现在脾脏生病，不能为胃传输津液，四肢得不到水谷精气的滋养，正气日益衰败，脉道运行不畅，筋骨肌肉都因为没有精气滋生而失去功能，所以四肢不能运动。
黄帝说：脾脏不单独主宰某个季节，为什么呢？岐伯说：脾脏属土，治理中央，常在四季之中各十八日寄旺于四脏，不能单独主宰某一个季节。脾脏的作用，是常常彰显胃中土精的化生。土能生化万物并效法天地，所以其气上下贯通头足，不能单独主宰一时。
《阴阳应象大论》说：人有五脏，化生五气，从而产生喜、怒、悲、忧、恐五种情志。所以喜怒过度会伤气，寒暑过度会伤形体，暴怒伤阴，暴喜伤阳。厥逆之气上行，会使血脉充满而神形分离。喜怒没有节制，寒暑调节过度，生命根基就不稳固。《玉机真脏论》说：脾气太过，就会使人四肢不能抬举；脾气不及，就会使人九窍不通利，名叫“重强”（身体沉重僵硬）。又《通评虚实论》说：头痛耳鸣、九窍不利，是由肠胃病变引起的。《调经论》说：形体有余，则出现腹胀、大小便不利；形体不足，则四肢不能运动。
又《气交变大论》说：岁运土气太过，雨湿流行，肾水受到邪气侵犯，百姓容易患腹痛、四肢厥冷、心情抑郁不乐、身体沉重烦闷；严重的会出现肌肉萎缩、足痿无力不收、行走困难、脚下疼痛、饮停发肿、脘腹痞满、食欲减退、四肢不能抬举。又说：岁运土气不及，风气就会大行。出现霍乱、身体沉重、腹痛、筋骨动摇不定、肌肉酸软、易怒。又说：咸味致病多在中焦寒证，复气来时收敛政令严峻，胸胁突然疼痛，向下牵引少腹，喜欢叹气，虫蚀甘黄色食物，气客于脾，百姓食欲不振、味觉丧失。又说：土气不及，四维（四季之交）有埃云，润泽的化育不行，则春季会有鸣条鼓拆的风政；四维发生振拉飘胜的变化，则秋季会有肃杀霖淫的雨复。其灾害在四维，其内脏对应脾，其病在内涉及心腹，在外涉及肌肉四肢。
《五常政大论》说：土气平和叫做“备化”，土气不及叫做“卑监”。又说：其变动表现为疮疡涌出、分溃痈肿，其发作表现为濡滞，其病症表现为留满痞塞，这是从木气转化所致。其病症还有完谷不化的泄泻。又说：土气太过叫做“敦阜”，其味兼甘、咸、酸，其象对应长夏，其经脉对应足太阴脾经和足阳明胃经。又说：其病症是腹部胀满、四肢不能抬举，这是邪气伤害脾脏所致。
《经脉别论》说：太阴脏脉搏动有力，要用心审视真气，如果五脉气少，胃气不平，属于三阴病，适宜治疗其下部的俞穴，采用补阳泻阴的方法。《脏气法时论》说：脾主长夏，由足太阴脾经和足阳明胃经主治，对应的日子是戊日和己日。脾脏怕湿，应当急切食用苦味食物来燥湿。又说：脾脏生病，痊愈在秋季，秋季不愈，则在春季加重，春季不死，则在夏季维持稳定，在长夏开始好转。禁忌温食和饱食，避免潮湿的地面和湿润的衣服。脾脏生病，痊愈在庚辛日，庚辛日不愈，则在甲乙日加重，甲乙日不死，则在丙丁日维持稳定，在戊己日开始好转。脾脏生病的人，白天精神清爽，日出时病情加重，下午傍晚时安静。脾脏想要舒缓，应当急切食用甘味食物来缓和它，用苦味药泻它，用甘味药补它。又说：脾脏生病的人，身体沉重，容易饥饿，足部痿弱，足不能行走，行走时容易跌倒，脚下疼痛。虚证则腹部胀满、肠鸣、完谷不化的泄泻、食物不消化。《经脉别论》说：食物进入胃，精微物质散布到肝脏，滋养筋脉。食物进入胃，浊气归于心，精微物质注入脉道。脉气归于权衡，权衡平衡，气口形成寸脉，以此判断生死。饮水进入胃，游溢精气，向上输送给脾，脾气散布精微，向上归还于肺，通调水道，向下输送到膀胱。水精四布，五条经脉并行，符合四时五脏阴阳规律，揣度测量作为常规。
《五常政大论》说：有太过和不及两种情况，太过者，会克制它所不胜的五行，乘袭它所胜的五行。不及者，时令到了但气未至，这就是不及，此时它所胜的五行妄行，它所生的五行受病，它所不胜的五行会乘虚而入。
张仲景说：人依靠水谷之气来养育神气，水谷耗尽则神气离去，所以说“安谷则昌，绝谷则亡”。津液流失则营气散失，谷物消亡则卫气灭亡，营气散失、卫气灭亡，神气就无所依托。又说：水进入经脉，血液才能生成；谷物进入胃，脉道才能通行。所以血不可不滋养，卫气不可不温煦，血温卫和，营卫才能正常运行，得以享尽天年。
The discussion on syndrome differentiation and prescription has been detailed. However, fearing that some may not know the source of these theories and lack evidence for verification, I hereby list below the discussions on the Spleen and Stomach as stated in the *Huangdi Neijing* (Yellow Emperor's Inner Canon) and Zhang Zhongjing.
The *Taiyin Yangming Lun* (Treatise on Taiyin and Yangming) states: Taiyin and Yangming are interior and exterior to each other, belonging to the meridians of the Spleen and Stomach. Why do diseases manifest differently? Qibo answered: The positions of Yin and Yang are different; they alternate between deficiency and excess, and between reversal and compliance. Some diseases originate internally, while others are contracted externally. Since the origins differ, the disease names also differ. The Yellow Emperor said: I wish to hear about their different symptoms. Qibo said: Yang represents the Qi of Heaven and governs the exterior; Yin represents the Qi of Earth and governs the interior. Therefore, the Path of Yang is often solid (excess), and the Path of Yin is often hollow (deficient). Thus, those who suffer from treacherous winds and empty pathogens contract them in the Yang meridians; those whose diet and drinking are irregular and whose daily routine is untimely contract them in the Yin meridians. Contraction in the Yang meridians leads to transmission into the Six Fu Organs (e.g., Stomach, Large Intestine, Small Intestine); contraction in the Yin meridians leads to transmission into the Five Zang Organs (e.g., Heart, Liver, Spleen, Lung, Kidney). When pathogenic factors enter the Six Fu Organs, the body becomes feverish with inability to lie down, and upwardly manifests as panting and calling out. When they enter the Five Zang Organs, abdominal fullness and constipation occur, and downwardly manifests as undigested stool diarrhea (Sun Xie); if prolonged, it develops into Chang Pi (dysentery or bloody stools). Therefore, the throat governs the intake of Heavenly Qi, and the pharynx governs the intake of Earthly Qi. Consequently, the Yang meridians are susceptible to Wind pathogen, and the Yin meridians are susceptible to Dampness pathogen. Yin Qi ascends from the feet to the head and then descends along the arms to the fingertips; Yang Qi ascends from the hands to the head and then descends to the feet. Hence it is said: In Yang diseases, when the upward progression reaches its extreme, it turns downward; in Yin diseases, when the downward progression reaches its extreme, it turns upward. Therefore, those injured by Wind pathogen are first affected at the upper part; those injured by Dampness pathogen are first affected at the lower part.
The Yellow Emperor asked: Why does Spleen disease lead to immobility of the four limbs? Qibo answered: The four limbs all receive nourishment from the Stomach Qi, but Stomach Qi cannot reach the meridians directly; it must rely on the Spleen's transportation to be distributed to the limbs. Now, due to Spleen disease, it cannot transport fluids and essence for the Stomach. The four limbs do not receive the Qi of water and grain. The vital Qi declines day by day, the meridian pathways become obstructed, and the sinews, bones, muscles, and flesh have no Qi to sustain life, hence they do not function.
The Yellow Emperor asked: Why does the Spleen not govern a specific season? Qibo answered: The Spleen belongs to Earth, governs the center, and commonly supports the Four Zang Organs for eighteen days each throughout the four seasons; it cannot exclusively govern one season. The function of the Spleen organ is to constantly manifest the refined essence of Stomach Earth. Earth generates all things and models itself after Heaven and Earth; thus, its Qi extends from head to feet and cannot govern a single time.
The *Yinyang Yingxiang Dalun* (Great Treatise on Yin-Yang Correspondence to Phenomena) states: Humans have five Zang organs that transform five Qi, thereby generating the emotions of joy, anger, sorrow, worry, and fear. Therefore, excessive joy and anger injure Qi; excessive cold and heat injure the form. Violent anger injures Yin; violent joy injures Yang. Rebellious Qi ascending causes vessels to fill and spirit to separate from form. If joy and anger are unregulated, and exposure to cold and heat is excessive, the foundation of life becomes unstable. The *Yuji Zhenzang Lun* (Treatise on the True Viscera and Pulse Mechanisms) states: If Spleen Qi is excessive, it causes the four limbs to be unable to lift; if Spleen Qi is deficient, it causes the nine orifices to be obstructed, a condition named "Zhong Qiang" (heavy stiffness). Furthermore, the *Tongping Xushi Lun* (Treatise on Uniform Evaluation of Deficiency and Excess) states: Headache, tinnitus, and obstruction of the nine orifices arise from disorders of the intestines and stomach. The *Tiaojing Lun* (Treatise on Regulating the Meridians) states: If the form is in excess, there is abdominal distension and difficulty in urination and defecation; if the form is deficient, the four limbs are immobile.
Additionally, the *Jiaobian Dalun* (Great Treatise on Changes in Qi Interaction) states: When the annual Earth Qi is excessive, rain and dampness prevail, and Kidney Water suffers evil. The people suffer from abdominal pain, cold extremities, depression, heavy body, and vexation. Severe cases present with muscle atrophy, foot flaccidity and inability to grasp, difficulty walking, pain under the feet, fluid retention edema, epigastric fullness, reduced appetite, and immobility of the four limbs. It also states: When annual Earth Qi is deficient, Wind prevails greatly. Cholera, heavy body, abdominal pain, wavering sinews and bones, sore muscles, and irritability occur. It further states: Salty flavors causing disease often involve Cold in the middle. When the restoring Qi arrives, the policy of contraction is severe, causing sudden chest and hypochondriac pain radiating to the lower abdomen, frequent sighing, insects eating sweet yellow foods, Qi lodging in the Spleen, resulting in poor appetite and loss of taste. It also states: When Earth Qi is deficient, there are dusty clouds at the four corners (transitional periods of seasons), and the transformation of moistening fails. Then spring brings policies like rustling branches and breaking drums; if the four corners exhibit changes like shaking, pulling, and drifting, autumn brings retribution policies of solemn killing and excessive rain. The disaster occurs at the four corners, the corresponding viscera is the Spleen, and the disease involves the interior heart and abdomen, and the exterior muscles and four limbs.
The *Wuchang Zheng Dalun* (Great Treatise on the Five Constant Policies) states: Balanced Earth is called "Beihua" (Complete Transformation); deficient Earth is called "Beijian" (Low Supervision). It also states: Its movements manifest as ulcers, swelling, rupture, and carbuncles; its onset is sluggish; its diseases include lingering fullness and blockage, transforming from Wood. Its diseases also include undigested stool diarrhea. It further states: Excessive Earth is called "Dunfu"; its flavors include sweet, salty, and sour; its image corresponds to Late Summer; its meridians are the Foot-Taiyin Spleen and Foot-Yangming Stomach. It also says: Its diseases are abdominal fullness and immobility of the four limbs, caused by pathogenic invasion of the Spleen.
The *Jingmai Bielun* (Extraordinary Discourse on the Meridians) states: When the Taiyin visceral pulse is forceful, one must carefully examine the true Qi. If the Qi of the five pulses is scant and Stomach Qi is uneven, it is a Three-Yin disease. One should treat the lower Shu points, tonifying Yang and draining Yin. The *Zangqi Fashi Lun* (Treatise on Visceral Qi and Time Laws) states: The Spleen governs Late Summer, controlled by the Foot-Taiyin Spleen and Foot-Yangming Stomach meridians, corresponding to Wu and Ji days. The Spleen dislikes Dampness; urgently consume bitter substances to dry it. It also states: For Spleen disease, recovery occurs in Autumn; if not recovered in Autumn, it worsens in Spring; if not fatal in Spring, it stabilizes in Summer and begins to improve in Late Summer. Avoid warm food, overeating, damp ground, and wet clothing. For Spleen disease, recovery occurs on Geng and Xin days; if not recovered on Geng and Xin days, it worsens on Jia and Yi days; if not fatal on Jia and Yi days, it stabilizes on Bing and Ding days and begins to improve on Wu and Ji days. Patients with Spleen disease feel clear-headed during the day, worse at sunrise, and quiet in the late afternoon. The Spleen desires relaxation; urgently consume sweet substances to relax it, use bitter substances to drain it, and sweet substances to tonify it. It also states: Patients with Spleen disease have a heavy body, frequent hunger, foot flaccidity, inability to walk, tendency to fall while walking, and pain under the feet. In deficiency, there is abdominal fullness, borborygmus, undigested stool diarrhea, and indigestion. The *Jingmai Bielun* states: Food Qi enters the Stomach, disperses essence to the Liver, and nourishes the sinews. Food Qi enters the Stomach, turbid Qi returns to the Heart, and refined essence enters the vessels. Vessel Qi returns to balance; when balanced, the Cun Kou pulse forms, determining life and death. Drinks enter the Stomach, overflow with essence and Qi, ascend to the Spleen. The Spleen disperses essence, sending it up to the Lung, which regulates water passages and transports it down to the Bladder. Water essence distributes everywhere, the five meridians run together, conforming to the Yin-Yang of the four seasons and five viscera, measured as the norm.
The *Wuchang Zheng Dalun* states: There are conditions of excess and deficiency. Excess invades what it cannot overcome and overcomes what it can. Deficiency means the time arrives but the Qi does not; this is deficiency. What it overcomes acts recklessly, what it generates suffers disease, and what overcomes it takes advantage.
Zhang Zhongjing said: Humans receive Qi from water and grain to nourish Shen (Spirit). When water and grain are exhausted, Shen departs. Thus, it is said: "If one can digest grain, prosperity ensues; if grain is cut off, demise follows." Loss of fluids causes Ying (Nutrient) Qi to scatter; consumption of grain causes Wei (Defensive) Qi to perish. With scattered Ying Qi and perished Wei Qi, Shen has no basis. He also said: When water enters the meridians, blood is formed; when grain enters the Stomach, the meridian pathways flow. Therefore, blood must not fail to be nourished, and Wei Qi must not fail to be warmed. When blood is warm and Wei Qi is harmonious, Ying and Wei Qi circulate properly, allowing one to fulfill their natural lifespan.