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Stomach
胃 〔胃〕wèi
Abbreviation: ST. The organ in which food first collects after it enters the body before it passes to the intestines, and where it is broken down to enable its essence
(nutrients) to be absorbed into the body; one of the six bowels. The stomach stands in exterior-interior relationship with the spleen. Like the spleen, it belongs to earth among the five phases. Its associated channel is the foot yáng brightness (yáng míng) stomach channel.
NB: In some contexts, stomach
means stomach stomach qì, the vitality of the digestive system in general. See also stomach duct.
the sea of grain and water(水谷之海 shuǐ gǔ zhī hǎi) and
the great granary(大仓 dà cāng). The functions of the spleen are traditionally described in terms of
governing intake,
rotting and ripening,and
free downbearing.All of these functions are dependent on a healthy spleen and are easily disturbed by morbidity of not only the stomach but also the spleen.
The spleen and stomach are often referred to as the center
(中 zhōng), reflecting, on the one hand, their association with earth and the central position in the five phases and, on the other, their occupancy of the center burner (see The Triple Burner).
Stomach Functions
The Stomach Governs Intake (胃主受纳 wèi zhǔ shòu nà)
The significance of the stomach governing intake is that it controls the appetite. Hunger is felt when the stomach is empty but not when it is full. When, in morbid conditions of the stomach or spleen, food fails to pass out of the stomach as normal, there will be reduced eating.
When reduced eating is associated with a feeling that previously ingested food has not been fully digested, it is often referred to as torpid intake.
The Stomach Governs Rotting and Ripening of Grain and Water (胃主腐熟水谷 wèi zhǔ fǔ shú shuǐ gǔ)
Food and drink collecting in the stomach undergo
(腐熟 fǔ shú, i.e., preliminary digestion). Since the spleen moves the fluids of the stomach, the rotting and ripening process is understood to be controlled by the spleen.
Disturbance of rotting and ripening can stem from different causes. Intense stomach heat can speed up the process, giving rise to swift digestion with rapid hungering.
Conversely, insufficiency of the yáng qì of the stomach or spleen can slow down the process, causing torpid intake. In any event, the downbearing action of stomach qì is usually affected (see below).
The Stomach Governs Free Downbearing (胃主通降 wèi zhǔ tōng jiàng)
Stomach qì bears downward, carrying food into the small intestine. This function is mutually complementary with the stomach’s rotting and ripening function.
The
(胃以通降为顺 wèi yǐ jiàng wéi shùn). When stomach qì bears downward as normal, the stomach is said to be in harmony (和 hé).
Disharmony of stomach qì: When the stomach’s free downbearing function is impaired, this is called disharmony of stomach qì
or impaired harmony and downbearing of the stomach,
which is marked by torpid intake, distension and fullness, or even pain in the stomach duct, and nausea, or fetid mouth odor (bad breath, or halitosis). If intense stomach heat is the cause, there may also be scorching pain in the stomach duct
and clamoring stomach
(a feeling like hunger but not hunger, like pain but not pain).
Disharmony of stomach qì can occur in any stomach pattern, whether rotting and ripening slows down or speeds up. Fullness and pain provide clues for differentiation. When discomfort is relieved by pressure, it is attributed to vacuity; when exacerbated by pressure, it is attributed to repletion; when relieved by warmth, the cause is cold; and when exacerbated by warmth, the cause is heat.
Note that disharmony of stomach qì can cause insomnia: When the stomach is in disharmony, there is unquiet sleep
(胃不和则卧不安 wèi bù hé zé wò bù ān).
Stomach qì ascending counterflow: When severe, disharmony of stomach qì gives way to stomach qì ascending counterflow,
that is, the upward movement of qì, which is marked by nausea, vomiting, belching, and hiccup. This can occur in any stomach pattern, and the signs vary according to cause. When intense stomach heat is the cause, there may be immediate vomiting of ingested food.
When intense stomach heat or food stagnating in the stomach duct is the cause, there may also be acid upwelling,
and in severe cases acid swallowing,
which is the welling up of sour fluid into the mouth that is swallowed before it can be spat out. When stomach cold is the cause, there may be upwelling and vomiting of clear water.
| Stomach Downbearing vs. Spleen Upbearing |
|---|
| The spleen is a viscus and hence yīn, while the stomach is a bowel and hence yáng. This is the opposite of the yīn-yáng categorization of the movements of the qì of the two organs. Splenic upbearing is upward movement, which is yáng, while stomach downbearing is downward movement, which is yīn. As the Nèi Jīng suggests, this is analogous to the movements of heaven and earth. The qì of heaven descends to produce rain, while the qì of earth rises to produce clouds. |
The stomach as representing the entire digestive tract: The downbearing of stomach qì in fact represents the downbearing along the whole of the digestive tract. Free downbearing is a prerequisite for the intake function, since when food fails to move downward along the digestive tract, the hunger sensation diminishes. If food fails to move from the stomach to the small intestine, movement in the large intestine is also affected, and there may be rumbling intestines, passing of flatus, diarrhea, or constipation. For these reasons, the term stomach
means not just the stomach itself, but in some contexts the whole of the digestive tract. In the Shāng Hán Lùn, the term stomach domain
(胃家 wèi jiā) is often used to represent this broader concept. More about this under Stomach Qì below.
Stomach downbearing and spleen upbearing The downbearing action of stomach qì stands in complementary opposition to the upbearing movement of spleen qì, which carries the essence of grain and water upward and outward. These movements constitute yīn-yáng complementary opposites. These complementary opposites are often described in terms of
(降浊 jiàng zhuó) and
(升清 shēng qīng) the notions of turbid
(waste) and clear
(nutrients) again forming a yīn-yáng pair.
When the spleen’s function of movement and transformation is impaired, stomach downbearing is also affected. This similarly manifests in reduced eating, distension, fullness, and pain. Feelings of discomfort arising from a spleen problem tends to be more generalized and hence referred to as distension and fullness in the stomach duct and abdomen,
while when stemming from a stomach problem they are more localized and hence referred to as distension and fullness in the stomach duct.
Stomach Qì (胃气 wèi qì)
| Stomach Qì, Not Spleen Qì, as the Root of Human Life? |
|---|
Given the preeminence of the viscera over the bowels, the spleen is understood to dominate the stomach. Why stomach qì, rather than spleen qì, is the root of human life is explained by the fact that before the theory of the organs incorporated the systems of correspondence, the stomach was understood to be the main organ of digestion. The spleen only gained ascendancy when the yīn-yáng distinction between storing and discharging organs required that the stomach, identified as a discharging organ ( In this context, note that modern Chinese all but ignores the role of the small intestine is virtually in digestion. Although the small intestine is said to have the functions of |
As previously stated, stomach qì is the agent that ensures the downward flow of food along the digestive tract in general. Accordingly, the term stomach qì
is often used in the sense of the vitality of the digestive function of the spleen, stomach, and intestines in general. In this sense, stomach qì is of great importance to health. Chinese medicine holds that
(人以胃气为本 rén yǐ wèi qì wéi běn). The Sù Wèn (Chapter 19) states,
(胃者五脏之本也 wèi zhě wǔ zàng zhī běn yě). It is also said,
(有胃气则生, 无胃气则死 yǒu wèi qì zé shēng, wú wèi qì zé sǐ). This means that the digestive function is vital to life activity and survival.
In medicinal therapy, it is important to maintain the functions of the stomach and under certain circumstances provide special support for stomach qì.
(勿伤胃气 wù shāng wèi qì) and
(保胃气 bǎo wèi qì) are key mottos for clinicians, because if the digestive function is impaired, it is hard for ingested medicinals to produce any effect.
The term stomach qì
has a special meaning in the context of the pulse: it is the reflection of spleen and stomach function in a calm and leisurely, harmonious and moderate pulse. The spleen and stomach are responsible for the digestion of food and absorption of nutrients. Disturbance of these functions is often detectable in the pulse. The stomach qì pulse is moderate and forceful; it is neither rapid nor slow. Any deviation from this may be a sign that stomach qì is ailing.
The Stomach Channel (胃经 wèi jīng)
The channel associated with the stomach is the
The Stomach Likes Moistness and Is Averse to Dryness (胃喜润恶燥 wèi xǐ rùn wù zào)
The stomach’s function of rotting and ripening and its downbearing action are performed by the stomach’s yáng qì. However, they require that the yīn humor of the stomach be sufficient. Stomach humor easily becomes insufficient, giving rise to dryness and heat. Such conditions must be treated with cold bitter medicinals, but if not used with care these can cause more damage to stomach yīn.
The stomach’s liking moistness and being averse to dryness is contrasted with the spleen’s opposite tendency of liking dryness and being averse to moistness.
Stomach Signs and Patterns
For fuller information than is given below, follow the pattern links. See stomach pattern identification.
Stomach patterns include qì vacuity, repletion and vacuity cold, repletion and vacuity heat, and accumulation of food or phlegm-rheum. In general, they are characterized by signs of stomach disharmony such as fullness and pain in the stomach duct and by signs of stomach qì ascending counterflow such as nausea,
Stomach cold (胃寒 wèi hán): Stomach cold takes the form of vacuity cold or repletion cold, which are often poorly distinguishable because vacuity-repletion complexes are common. The causes are excessive consumption of raw and cold foodstuffs or catching cold in the abdomen (repletion cold) and spleen qì vacuity or enduring illness weakening the stomach (vacuity cold). It is characterized by torpid intake, upwelling and vomiting of clear water, and vomiting of undigested food. Vacuity cold is marked by pain in the stomach duct and abdomen relieved by warmth, pressure, and eating, by mild cold signs, and by a sunken slow forceless pulse. Repletion cold is characterized by severe cold pain in the stomach duct and abdomen exacerbated by cold and relieved by warmth and a pulse that is sunken and either tight or stringlike.
Stomach yīn vacuity (胃阴虚 wèi yīn xū): Dull pain in the stomach duct, dry stool, glomus in the stomach duct, dry retching, hiccup, hunger with no desire to eat, dry throat, and dry mouth. The tongue is red with scant liquid. The pulse is fine and rapid.
Intense stomach heat (胃热炽盛 wèi rè chì shèng): Caused by various factors such as predilection for hot foods, liver fire invading the stomach, or external evils, intense stomach heat manifests in scorching pain in the stomach duct that refuses pressure, thirst with desire for cold drinks, swift digestion with rapid hungering, clamoring stomach, fetid mouth odor, acid swallowing, painful swollen gums, ulcerated gums, bleeding gums, short voidings of yellow urine, and dry bound stool. The tongue is red with a yellow fur. The pulse is slippery and rapid.
Cold rheum collecting in the stomach (寒饮停胃 hán yǐn tíng wèi): Arising from spleen yáng vacuity, cold rheum collecting in the stomach is marked by glomus and distension in the stomach duct, sound of water moving in the stomach duct, vomiting of clear water and phlegm-drool, bland taste in the mouth, absence of thirst, and dizziness. The tongue fur is white and glossy. The pulse is sunken and stringlike.
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