In Neijing, the functions of small intestine and large intestine are sometimes included in the stomach. For example, The Book of Lingshu says: "The large intestine and small intestine belong to the stomach." Treatise on Febrile Diseases sometimes refers to the large intestine and small intestine as the stomach, such as "there is dry feces in the stomach", and this "stomach" is the intestine.
The stomach has meridians (Foot Yangming Meridian) and the spleen has meridians, forming an exterior-interior relationship. Therefore, Lingshu said in this book: "Spleen meets stomach."
The main physiological function of the stomach is to receive and decompose Shui Gu. The movement of the stomach is characterized by controlling the flow, and the stomach is characterized by being moist and tired of dryness.
1. Shui Gu, his stomach is in charge of acceptance and decay.
Ling Shu Ren Ping Juegu said: The stomach is "influenced by Shui Gu" and Thirty-one Difficult Classics said: "Those with moderate coke will have a bloated belly, and they will not be able to get up, which will mainly rot Shui Gu."
Acceptance is acceptance and accommodation. Shui Gu, that is, food and drink. Stomach governs reception, which means that the stomach has the function of receiving and containing food and drinks in the digestive tract. Food and drink intake, first through the mouth, through chewing teeth and stirring the tongue, epiglottis swallowing, from the esophagus into the stomach. The absorption of the stomach is not only inclusive, but also active, also called "absorption". The reason why the stomach can take the initiative depends on the function of stomach qi, which controls the flow and health and makes the diet go on. After a meal, the stomach is empty and can be influenced by the diet, so people have an appetite. The diet population passes through the esophagus and is contained in the stomach, so it is called "the sea of water valley", "Taicang" and "the official of granary" The capacity of Shui Gu's stomach is recorded in Lingshu Ren Ping's Unique Ancient Book. The stomach is "affected by Shui Gu's three buckets and five liters, of which two buckets often stay in the valley, and one bucket is full of five liters".
Rot refers to the process that the stomach initially digests food and drink and forms chyme. "Lingshu Business Club" said that "the focus is like retting", which more vividly described the rotting shape of Shui Gu in the stomach, just like soaking and retting. After Shui Gu was accepted by the stomach, it was digested by the stomach, making Shui Gu into chyme, which was easier to transport and absorb. After chyme is introduced into the small intestine, fine substances are absorbed under the transport of the spleen, producing qi and blood and nourishing the whole body. Therefore, the stomach is called "the sea of qi and blood in Shui Gu".
The absorption and putrefaction of the stomach are abnormal. First, the absorption of putrefaction is not mature enough, such as weak stomach qi, or the stomach qi does not drop, even if the stomach is empty, there is no appetite, or the stomach cavity is painful and rancid after eating, or vomiting after eating; First, it's too bad to eat, such as stomach fire, rapid decline of grain, and hunger soon after eating.
Although it is the beginning of the digestive process, the function of stomach acceptance and decomposition is very important, because the acceptance and decomposition of stomach is the premise of small intestine receiving nutrition and spleen transportation and transformation. The production of human essence, qi, blood and body fluid comes directly from diet, and the stomach, as the sea of water and grain, becomes the source of qi and blood biochemistry. Therefore, the Jade Edition of Lingshu said: "It is Gu Ye who suffers from it. What was injected in the valley is also in the stomach. Stomach, the blood sea of Shui Gu. " Su Wen Wu Zang Lun said: "The stomach is the sea of water and the source of six fu organs. The five flavors are hidden in the stomach and nourish the five internal organs ... It is the smell of the five internal organs, all from the stomach. " It shows that the hot water valley of the stomach is the source of nutrition for the body. Therefore, the stomach has a strong function of receiving and decomposing, and the source of qi and blood in the body is sufficient; On the contrary, sources are scarce. Therefore, "Five flavors of Lingshu" said: "If you don't go into the valley, you will be out of breath for a long time, and you will be out of breath after eating."
The function of stomach to receive and decompose Shui Gu must be coordinated with the function of spleen to transport and transform, so as to refine Shui Gu and produce qi, blood and body fluid to support the whole body and maintain the life activities of the body. For example, "Jingyue Quanshu Diet Door" said: "Stomach absorption, spleen transport, one entry and one transport, into essence." Therefore, the spleen and stomach are called "the acquired foundation" and "the source of qi and blood biochemistry".
2. The stomach controls the flow and descent.
Close, it is unobstructed. To fall is to fall. Food and drinks enter the stomach through the esophagus, are absorbed and decomposed by the stomach, and then pass down to the small intestine. In this process, the stomach must be kept open to allow food and drinks to run unimpeded. Maintaining the state of "communication" depends on the improvement of stomach qi. The movement characteristic of stomach qi is "health", which enables the food to be decomposed and transmitted downward to the small intestine. Although the meanings of "Chuan" and "Sheng" are different, they are closely related. Over, you can fall; Only when you are healthy can you keep in touch. If not, it is impossible to be healthy; On the other hand, if you don't fall, you can't get through. In other words, transmission and descent are mutually conditional and mutually causal. Therefore, the function of the stomach is normal, and it is often explained by "descending is dredging" and "harmony is calming", which is referred to as "stomach governing descending" for short.
The stomach dominates the descending, which is turbid compared with the ascending of the spleen. Turbidity refers to Shui Gu's diet. For example, Ling's Turbidity says, "Those who receive grain are turbid" and "those who are turbid travel in the stomach". The stomach governs turbidity, mainly refers to chyme digested in the stomach, which descends into the intestine under the impetus of stomach qi.
Gastric dysfunction is a pathological state. If the stomach qi is weak, the conduction is weak, which leads to food stagnation in the stomach, resulting in symptoms such as epigastric pain and anorexia; Stomach qi does not fall, and even goes up, leading to symptoms such as fullness, belching, hiccups, vomiting and so on.
In the theory of visceral manifestation, the function of the whole digestive system is often summarized by spleen ascending stomach descending. The ascending and descending function of stomach qi not only affects the stomach itself, but also has an important influence on the digestive function of the whole six fu-organs system, so that all six fu-organs show the characteristics of ascending and descending. The stomach and other internal organs are connected in a general rule, and when they fall, they all fall. In traditional Chinese medicine, the small intestine transmits food residues to the large intestine, and the functional activities of the large intestine transmitting dregs to the large intestine can also be summarized by the passage of the stomach. Constipation is also included in diseases in which the stomach cannot transmit downwards. Therefore, the rise and fall of the stomach summarizes the physiological process that the stomach qi transports chyme and residues downward to the small intestine and large intestine and promotes fecal excretion.
3. The stomach likes to be wet, but hates to be dry.
"Clinical Guide to Spleen and Stomach in Medical Records" says: "If the soil is too wet, you will get good luck; Yangming yang (dry) soil, yin and self-security. When the spleen is just dry, the stomach is soft and moist. " It is pointed out that "the stomach likes moistening dryness and hates dryness".
The physiological function of stomach governing Shui Gu is not only the promotion and warming effect of stomach qi, but also the moistening and nourishing of gastric juice (yin), so its function can be normal. "Lingshu Nutrition Health Association" said: "The focus is like a sigh." If you soak for a long time, you soak for a long time. Diet enters the stomach by gastric juice impregnation and decomposition; If the gastric juice is insufficient, it is difficult to rot, which leads to indigestion.
Judging from the clinical manifestations of the dysfunction of stomach acceptance and decomposition, it is often easy to see those caused by stomach yin deficiency, especially chronic atrophic gastritis. Because the stomach belongs to dry soil, there is no water without retting. There are many reasons for stomach yin deficiency, which can be summarized in two aspects: external causes and internal injuries. The external causes are summer heat, heat and dryness. Summer heat hurts the body, and excessive sweating can rob the stomach yin; Epidemic febrile disease can directly smoke and burn stomach yin; As soon as the heat burns, the gastric juice dries up. Internal injuries, or factors such as body yin deficiency and body fluid deficiency; Or Yangming excess heat injures gastric juice; Or because of liver depression, stomach injury yin; Or due to long-term illness, postpartum, old age, great loss of yin; And sweating, vomiting, improper diarrhea, damage to stomach yin. For all the above reasons, robbing yin and damaging body fluid lead to the disappearance of stomach yin.
Clinical manifestations of stomach yin deficiency: dry throat, dry tongue, thirst, loss of appetite, or insufficient epigastrium, or no appetite at all, pale mouth, dysphagia, vomiting, retching, hiccup, dull pain in the upper abdomen, noisy discomfort, dry stool, emaciation, listlessness, red tongue, or dry red tongue with cracks and thready pulse. Clinical Guide to Medical Records says: "Hunger leads to stomach yin injury" and "Hunger leads to insufficient stomach yin." The pathological characteristics of epigastric pain caused by insufficient stomach yin were summarized.
According to the characteristics of soft and moist stomach, Clinical Guide to Spleen and Stomach in Medical Records points out: "The so-called stomach should be depressed, harmonious but not depressed, bitter but not taken away, so as to damage stomach qi. However, if it is sweet, cool and nourishing yin, the body fluid will be recovered and handed down to the world. " This method is based on sweet, cold, soft, wet or sweet and cold drugs to promote the production of body fluids. In addition, if the liver qi stagnates and the stomach is rebellious, it is advisable to soothe the liver and nourish the stomach, and reuse the white peony root, which is soft, sweet and sour. Liver depression turns into fire, hurting stomach and robbing yin. It is not appropriate to be too sarcastic. Using Radix Adenophorae and Radix Ophiopogonis has the functions of purging fire, softening liver and nourishing stomach. Zhang Zhongjing's Treatise on Febrile Diseases, Theory of Sweet Taste and Nourishing Yin, Ye's Clinical Guide to Medical Records and Spleen and Stomach, etc., all reflect the characteristics of the stomach that it likes moistening and hates dryness.
4. People are based on stomach qi
Since Neijing, doctors in past dynasties have attached great importance to stomach qi. Gao put forward that "people take stomach qi as the foundation" (spleen and stomach theory, dietary strain begins with fever), emphasizing the important role of stomach qi in human life activities.
(1) Basic Concept of Stomach Qi In traditional Chinese medicine, there are many views on the understanding and application of the meaning of "Stomach Qi": First, it refers to the physiological functions and characteristics of the stomach. For example, the textbook "Basic Theory of Traditional Chinese Medicine" (correspondence course) says: The stomach "has the function of accepting and decomposing Shui Gu, and has the characteristics of smooth transformation and common use. These functions and characteristics are collectively referred to as stomach qi. " The second refers to the digestive function of the spleen and stomach. "People's stomach gas is also rustic." Spleen and stomach belong to soil and play a major role in the physiological processes of food intake, digestion, absorption and distribution, and this role is the role of stomach qi. Therefore, "stomach qi" is a summary of the physiological functions of the spleen and stomach. Third, it refers to the reflection of spleen and stomach function on pulse condition, that is, the pulse condition is calm and gentle. "Weak slippery pulse has stomach qi" ("Yu Su's Collection on Zhen Zang"), and "The so-called person who has no stomach qi but really hides pulse cannot have stomach qi" ("Su Wenping's Theory on Meteorology") means this. Fourthly, it refers to the yang in the stomach. For example, Qingcheng Xing Xuan's "Medical Records-Medical Tracing to Zangfu Organs" said: "If the stomach has yang, why are you angry?" Yang Qi and stomach qi are one and two, and the other is one ... Yang Qi is the inherent property of the stomach, and the cloud of fire is also hot. Fifthly, it is another name for "vitality", "valley spirit", "glory spirit", "clearing spirit", "defending spirit" and "giving birth to Yang Qi". For example, Gao said in Treatise on Febrile Diseases, Differentiation of Internal Injuries, Volume I, Diet Fatigue: "Knowing people is based on stomach qi, and people are born with it. The so-called qingqi, rongqi, weiqi and chunqi are all nicknames for stomach qi. " He also said, "Vitality, Valley Qi, Rong Qi, Qing Qi, Wei Qi and Yang Qi are all different names for stomach qi. "
The above statements are different, but they are all called "stomach qi", which simply emphasizes the importance of the spleen and stomach to Shui Gu's digestion and absorption. "China Medical Dictionary Stomach" says: "Stomach qi, the essence of Shui Gu, is transported in the stomach." From the exterior to the interior of the spleen and stomach, one is dirty and the other is fu-organs, and one is transported and entered, and the other is ascending and descending, which are coordinated with each other, and * * * completes the digestion of diet and the absorption of fine substances. Therefore, "Su Wen Ling Lan Mi Dian Lun" said: "The spleen and stomach are the officials of granaries, and the five flavors come out." Spleen transports stomach and stomach, and the two cooperate with each other. Both are indispensable. Without stomach, there would be no spleen transport. If there is no healthy exercise of the spleen, the stomach will be difficult to accept. Therefore, the "stomach-qi-based" refers to the qi of the spleen and stomach, and Shui Gu's essence is digested and absorbed by the spleen and stomach, which is the physiological basis of both. As "Medical Records-Tracing the Source of Zangfu Organs" said: "If the stomach is inexhaustible and healthy, it will not turn, so it will be summarized and tempered."
(2) The importance of stomach qi in physiology and pathology "Su Wenping's Theory of Meteorology" said: "People are based on Shui Gu." Only when the stomach controls the precipitation valley, the spleen controls the transportation and transformation of Shui Gu, and the spleen and stomach cooperate closely, can the Shui Gu be refined, the qi and blood flow and the whole body be nourished. Therefore, it is called "stomach is the sea of qi and blood in Shui Gu", "spleen is the source of qi and blood biochemistry" and "spleen and stomach are the foundation of the day after tomorrow". "Lingshu Nutrition Society" said: "People suffer from qi in the valley, the valley enters the stomach, and it spreads to the lungs and five internal organs." Su Wen's theory of five zang-organs says: "The stomach is the sea of water valley and the source of six hospitals. The five flavors are hidden in the stomach and nourish the five internal organs ... so the smell of the five internal organs comes from the stomach. " "Yu Su Wen Ji Zhen Zang Lun" said: "The five internal organs are full of qi in the stomach. The stomach is the foundation of the five internal organs. " China's Tibetan Scripture "Syndrome of Stomach Deficiency, Cold and Heat, Life and Death Against Pulse" also says: "The stomach is the foundation of human beings, while the stomach is strong, the five internal organs are strong." Both of them emphasize the important role of stomach qi in human life activities. Regarding the relationship between heaven and earth's qi, Volume 17 of Jingyue's Complete Book Spleen and Stomach says: "Spleen and Stomach are the sea of water and valleys, and they get the acquired qi. What is this? Covering a person's life depends on the origin of Xue Jing; Man is born of Shuigu. Without jingxie, there is no basis for three-dimensional body; Without Shui Gu, there would be no strong body. ..... is based on the sea of Shui Gu, which depends on nature, and the sea of Xue Jing will depend on the day after tomorrow. An old friend, from birth to old age, has congenital deficiency, but with the power of cultivation, he can make up for the merits of heaven and occupy a powerful half. This spleen and stomach qi is not small for the human body. " The digestive function of the spleen and stomach and the nutrition of diet are very important to people's life and health, so there is a saying that "people take stomach qi as the foundation"
Deficiency of stomach qi will affect the occurrence, development and change of diseases. "Five flavors of Lingshu" said: "When Shui Gu enters the stomach, all the five internal organs are full of qi in the stomach. ..... so I don't go into the valley, I am weak for a long time, and there is less weather. " Li Zhongzi made a metaphor in "Intensive Reading of Doctors, Kidney as the Foundation of Innate and Spleen as the Foundation of Acquired", saying that Shui Gu and Stomach Qi "are in their proper places, paid to the army and scattered by the people." "Spleen and Stomach Theory, Spleen and Stomach Deficiency Transmission and Change Theory" said: "Sufficient vitality can nourish vitality if it is not harmed by spleen and stomach qi; If the stomach qi is weak and the diet doubles, the qi of the spleen and stomach will be hurt and the vitality will not be filled. These diseases are also caused by it. " Put forward the theory that all diseases are caused by internal injury to the spleen and stomach. Therefore, the rise and fall of stomach qi is one of the important factors in the occurrence of diseases. Stomach qi deficiency, stomach can't accept it, spleen can't transport and transform, and digestion and absorption function is impaired. Then qi and blood become passive, the body becomes emaciated, the viscera are all exhausted, the vital qi is insufficient, and it is easy to get sick. As Wang Yi's Medical Records said: Deficiency of stomach-qi causes all diseases. "Jing Yue Quan Shu On Spleen and Stomach" said: "Stomach qi is related to people, and it is ubiquitous, that is, the viscera, rhythm, pulse condition and body all have stomach qi. Loss of stomach qi is fierce. " "Wu lecture" said: "hurting the spleen and stomach will cause the cashier to be abnormal, but the acquired qi has ceased, and those who have fewer people have already." The above discussion shows that the rise and fall of stomach qi is closely related to the occurrence, development and change of diseases.
(3) The Significance of Stomach Qi in the Diagnosis and Treatment of Diseases "Su Wenping's Theory of Meteorology" said: "The normal qi of ordinary people belongs to the stomach, and the stomach is also the normal qi of ordinary people. People who have no stomach gas say that they are rebellious, and rebellious people will die. " Excess of stomach qi leads to excess of five zang-organs, while deficiency of stomach qi leads to deficiency of five zang-organs. It shows that observing the rise and fall of stomach qi is the key to diagnosis, which is helpful to judge the severity and prognosis of the disease. Looking at the stomach qi, "God is the essence of Shui Gu" ("Lingshu Renping Juegu"), the stomach qi is full of essence, with both form and spirit, and the eyes are shining. Although the disease is mostly mild, the prognosis is also good; On the other hand, the failure of stomach qi leads to deficiency of essence, weakness, listlessness and illness. Another example is to look at the tongue coating to investigate the retention or abolition of stomach qi, fumigation of stomach qi and the presence or absence of tongue coating. Thin, white and moist tongue coating is a manifestation of vigorous stomach qi; Pale tongue without coating is the manifestation of deficiency of stomach qi or damage of stomach yin. For another example, in the course of the disease, the change of patients' diet is a direct reflection of the rise and fall of stomach qi. If the appetite is not reduced and the qi and blood are active, it indicates that the condition is mild and the stomach qi has not been damaged; The food intake changed from less to more, indicating that the stomach qi gradually recovered, the condition tended to improve and the prognosis was better; If the appetite decreases, the food intake decreases gradually, indicating that the stomach qi decreases, the condition worsens and the prognosis becomes worse; If the patient does not enter the water slurry, it means that the stomach qi drops and the prognosis is more dangerous. Therefore, there is a saying that "those who gain from the valley will prosper, and those who lose from the valley will die." Ye Shi Tian said in Clinical Guide to Medical Records: Don't Eat: "If you have stomach qi, you will live, but if you don't have stomach qi, you will die. So is the outline of all these diseases. Therefore, if the disease can be eaten, the situation is heavy and can be saved; Those who can't eat, although the situation is light, will definitely delay the play. This truth is also easy to let people know. " Whether you can eat or not reflects the retention or abolition of stomach qi and has a direct impact on the prognosis of the disease, so you can infer the quality of the disease.
The strength of stomach qi affects the treatment of diseases. For example, "Shenzhai suicide note, Volume II, Syndrome Differentiation and Treatment" says: "If a disease is not cured, it will be found in the spleen and stomach, and nothing will be lost. Why is there still a long way to go? The spleen and stomach are injured, and the four viscera are lifeless, so there are more and more diseases. Everything comes from the soil and returns from the soil. Also called tonifying the kidney without strengthening the spleen. There are many people who can't cure diseases and look for the spleen and stomach. " The theory that "the kidney is the foundation of nature and the spleen is the foundation of the day after tomorrow" says: "The failure of stomach qi makes it difficult to apply a hundred drugs." "The Seventeen Volumes of Spleen and Stomach in Jingyue Quanshu" said: "Anyone who wants to examine the disease must first examine the stomach qi; Anyone who wants to treat diseases must always take care of stomach qi. The stomach is intact and everything is safe. " Therefore, we must also pay attention to protecting stomach qi when using drugs to treat diseases. Stomach in China Medical Dictionary says: Stomach qi, "No matter what disease you treat, you should take care of it first, especially deficiency syndrome. Therefore, nourishing yin should be far away from bitter cold, Yiyang should be sparse, expelling wind should not be too dry, relieving summer heat should not be mild, diarrhea should not be dissipated, and other internal and external diseases should be treated with drugs. Anyone who violates stomach qi should use it with caution. " "Protecting stomach qi" is often regarded as an important therapeutic principle in clinic. First of all, eat regularly. Some people can't control their diet. When they meet delicious food, they will have a meal, and they will be hungry if they don't taste it. This can easily cause gastric peristalsis, lead to excessive activity of vagus nerve and nerve plexus in the gastric wall, and promote gastric juice secretion. Over time, gastritis or gastric ulcer will occur. Therefore, the diet should be regular and quantitative, and never overeat.
Pay more attention to the stomach disease that has already appeared. Try to eat regularly, 5-6 times a day, and eat less, which can reduce the burden on the stomach and avoid excessive expansion of the stomach; Eating more can keep a small amount of food in the stomach and neutralize too much gastric acid in the stomach. Seriously ill patients had better eat some nutritious and digestible soft foods, such as noodles, rice porridge, milk and so on. If conditions permit, you can also eat more honey, because honey can inhibit gastric acid secretion and promote ulcer healing.
In addition, patients with gastric diseases can't eat snacks at ordinary times, otherwise it will increase gastric peristalsis, promote gastric acid secretion and aggravate gastric ulcer.
Secondly, pay attention to food hygiene. Be sure to chew slowly when eating, so that the food can be fully ground in the mouth and mixed with saliva, which can reduce the burden on the stomach and make the food easier to digest. In addition, try to eat less irritating food, don't drink, don't smoke. Alcohol and tobacco do great harm to the stomach. Nicotine in tobacco stimulates the stomach, which will delay the discharge of gastric contents, and then cause the increase of gastric acid secretion, leading to gastritis and gastric ulcer aggravation. Drinking alcohol, especially on an empty stomach, is more harmful to patients with gastric diseases, because alcohol in wine has a great stimulating effect on gastric mucosa, and the stomach will contract and expand strongly after being stimulated, which is likely to cause gastric bleeding or perforation of gastric ulcer, thus endangering life.
Third, eat less drugs that are irritating to the stomach. Long-term use of drugs irritating to gastric mucosa, such as erythromycin and prednisone, can cause gastric mucosal damage and inflammation or ulcer. Therefore, do not take drugs that are irritating to the stomach for a long time. If you want to take these medicines occasionally, you should also take them after meals. If conditions permit, it is best to switch to Chinese herbal medicines with the same effect.
Fourth, keep cheerful. Whether the stomach is healthy or not has a lot to do with mental factors. Excessive mental stimulation, such as long-term tension, fear, sadness, depression, etc., will cause dysfunction of cerebral cortex, promote dysfunction of vagus nerve, lead to spasmodic contraction of gastric wall blood vessels, and then induce gastritis and gastric ulcer. So we should be cheerful, cheerful, strong-willed, and be good at extricating ourselves from difficulties.
Nine kinds of indigestible food
1. Fried food
2. Spicy food
3. Chocolate
4. Citrus juice
5. Mashed potatoes
6. Raw onions
7.ice cream
8. Broccoli and cabbage
9. beans