The Twenty-Four-Character Formula for Nourishing the Stomach
Eating with measure, living with routine; outwardly active, inwardly still; a cheerful mood, balanced work and rest; guarding against harm from medication.
These twenty-four characters were summarized by the late Ningbo TCM physician Wei Changchun. When I read them in his work I deeply agreed, so I copied them down and offer a rough explanation.
Eating with measure means eating in moderation, without bingeing. Today it is fashionable to take pride in being a foodie, which is very bad for the stomach. Overeating, or eating the wrong things, both damage the stomach. Alcohol harms the stomach most; ancient TCM works have whole treatises on the wine drinker's illness, because wine drinkers' stomachs are long since injured, so they have many medication contraindications (the Guizhi Tang line in Shanghan Lun even warns that wine drinkers will be harmed by Guizhi Tang), and therapeutic effects are hard to achieve. Overeating also harms the stomach greatly; greedy eaters who habitually stuff themselves not only distend the stomach but easily develop accumulations (juji)—ancient accumulations mostly correspond to today's digestive-tract tumors.
Living with routine is also very important for stomach care. Once the body's biological clock is fixed, it should not be frequently changed. People who habitually stay up late easily develop stomach illness. Long-lived elders are almost all people whose daily routines have long been unchanged. When to eat, when to defecate, when to exercise—these may vary slightly but should not vary greatly or often. Once gastric acid secretion has formed a rhythm, it is fixed; if at a mealtime one does not eat, the secreted acid burns the stomach tissue, and over time gastritis or gastric ulcer inevitably develops.
Outwardly active, inwardly still means the body should move while the mind stays calm. Exercise is the best medicine for promoting gastric emptying and intestinal peristalsis; life lies in movement, and a person who dislikes exercise easily suffers indigestion. That is why many veteran TCM physicians, when prescribing, add a few words of advice about taking morning and evening walks. Regrettably, most patients think that taking medicine alone cures disease and ignore such advice, to the detriment of efficacy.
A cheerful mood is also important for stomach care. Modern medicine recognizes the stomach as an organ of emotion; ancient TCM held that once the liver, which governs emotion, is diseased, it will surely damage the spleen and stomach—what is called wood overacting on earth. Clinically, common gastric diseases such as gastritis and gastric ulcer occur more often in patients prone to depression.
Balanced work and rest stresses that one should neither over-indulge in ease nor over-strain; the optimal state is what ancient health scholars called small exertion—exertion that stops at the right point. Patients over-indulging in ease easily develop accumulation-type diseases.
Guarding against harm from medication reminds both patients and doctors. Patients with pre-existing stomach disease or weak spleen and stomach need special care in treatment: medications should be light and gentle. Overly heavy formulas that injure the patient's spleen and stomach will inevitably impair nutrient absorption. TCM emphasizes that the spleen and stomach are the acquired foundation; if one wishes to remain healthy and long-lived, one depends on the spleen and stomach to absorb the essence of food and replenish the body's original qi, spirit, and essence. Once stomach qi fails, the day of departure is not far off.