Stomach Disease Patterns Summary

Stomach (TCM) - General Location

Located in the middle Jiao (middle burner), directly below the diaphragm, connected to the Spleen.

Stomach (TCM) - Overall Importance

In TCM, the Stomach is a pivotal Fu organ, serving as the primary digestive organ for receiving and processing food.

• It is the "Sea of Food and Fluids," initiating the transformation of food into usable essences.

• It plays a central role, along with the Spleen, in the production of post-natal Qi and Blood, which are essential for overall body function and vitality.

Stomach Main Functions (Summary)

The primary roles of the Stomach in TCM include:

• Governing Receipt and Ripening of Food: Receiving ingested food and beginning its breakdown.

• Governing Descending of Qi: Ensuring the proper downward movement of digested food and Stomach Qi.

• Origin of Fluids: Producing and influencing the body's fluids necessary for digestion and nourishment.

Stomach Function: Governing Receipt and Ripening of Food

The Stomach receives food and drink and performs the initial stage of digestion, called 'rotting and ripening.'

• Receipt: Takes in all food and liquids ingested.

• Ripening: Chemically and physically breaks down food into a more manageable form (chyme), preparing it for further transformation by the Spleen.

• Imbalance: Impaired receipt can lead to poor appetite or rejection of food, while improper ripening leads to indigestion and accumulation.

Stomach Function: Governing Descending of Qi

The Stomach's Qi naturally moves downwards (descends), pushing the 'rotted and ripened' food into the Small Intestine for further separation.

• Crucial for digestion: The smooth descending action is vital for the continuous movement of the digestive process.

• Prevents rebellion: If Stomach Qi moves upwards instead of downwards, it causes symptoms like nausea, vomiting, belching, and hiccups.

• Harmony with Spleen: Works in opposition but harmony with the Spleen's ascending Qi function (Spleen ascends pure, Stomach descends impure).

Stomach Function: Origin of Fluids

The Stomach is often referred to as the 'Sea of Food and Fluids' because it is critical for hydrating the body and generating digestive fluids.

• Moistening: The Stomach requires adequate fluids (Yin) to perform its rotting and ripening function and prevent dryness.

• Fluid Balance: Contributes to the overall fluid metabolism, influencing the moistness of the mouth, throat, and intestines.

• Imbalance: Deficiency of Stomach fluids (Yin deficiency) can lead to thirst, dry mouth, and constipation.

Stomach - Opens to the Mouth/Pharynx

The Stomach channel circulates around the mouth and lips, and imbalances can manifest in this area.

• Taste Perception: Healthy Stomach Qi allows for normal and accurate taste. Imbalances can cause a bland, bitter, or absent taste sensation.

• Oral Health: Strong Stomach fire can lead to symptoms like swollen, painful, or bleeding gums and bad breath.

• Pharynx: Dryness or discomfort in the throat can be linked to Stomach Yin deficiency.

Stomach Basic Nature (Summary)

The Stomach has specific functional preferences and dislikes:

• Preferences: Likes moistness and descending motion.

• Dislikes: Dryness and ascending (rebellious) motion.

• Implications: It needs sufficient fluids to function properly and for its Qi to move downwards; any deviation from these preferences indicates an imbalance.

Common Stomach Disease Signs

Common external signs reflecting the health of the Stomach include:

• Complexion: Sallow, pale, or yellowish-tinged (deficiency); bright red (heat).

• Lips: Dry, pale, or lacking luster (deficiency); red and dry (heat).

• Mouth and Gums: Swelling, pain, or bleeding of gums (heat); bad breath.

• Taste: Altered taste sensations (e.g., bland, bitter, sweetish).

Stomach Element

Earth

• Characteristics: Nurturing, stability, transformation, and rootedness.

• Connection: Reflects the Stomach's role as the central hub of digestion and the source of post-natal nourishment, providing a foundation for the entire body.

Stomach Season

Late Summer

• Characteristics: A transitional period between seasons, representing abundance, ripening, and harvest.

• Connection: Aligns with the Earth element and the Spleen/Stomach's function of transforming and transporting the essence of food.

Stomach Climate - dislikes __?

DRYNESS - The Stomach requires a moist environment to properly 'rot and ripen' food and maintain its descending function.

• Impact: Dryness, whether caused by internal heat, external dry climate, or insufficient fluid intake, can impair Stomach function.

• Symptoms: Manifests as thirst, dry mouth and throat, dry stools, or constipation.

Stomach Direction

Center

• Characteristics: Represents stability, balance, and the core from which all other directions emanate.

• Connection: The Stomach is the central pivot of digestion, providing nourishment to all other organs and body parts.

Stomach Color

Yellow

• Characteristics: The color of earth, harvest, and nourishment.

• Clinical significance: A sallow or yellowish tinge in complexion can indicate Spleen/Stomach Qi deficiency or Dampness affecting these organs.

Stomach Sound

Singing

• Connection: Healthy and joyful expression, reflecting a well-nourished and balanced Earth element. Usually associated more with Spleen, but Stomach contributes to this underlying vitality.

Stomach Taste - Beneficial

Sweet (in moderation, from natural sources)

• Functions: Harmonizes the middle Jiao, replenishes Qi and Blood, and aids in the building and transformation processes of the Spleen and Stomach.

• Benefits: Can alleviate acute pain, relax tension, and provide energy. Examples include grains, fruits, and certain vegetables.

Stomach Taste - Harmful (Excess)

Sweet (in excess), Pungent, or Spicy

• Excess Sweet/Rich: Over-consumption of refined sugars, fatty, or rich foods can overwhelm the Stomach and Spleen, leading to the accumulation of Dampness and Heat, impairing digestion.

• Excess Pungent/Spicy: Can generate Stomach Fire, consume Stomach Yin, and cause symptoms like burning pain, acid reflux, or thirst.

Stomach Paired ZANG Organ

Spleen

• Relationship: The Stomach and Spleen are the central Zang-Fu pair of the Earth element, forming the core of post-natal Qi and Blood production.

• Functions:

  • Stomach: Receives and 'rots and ripens' food, descends the impure essences.

  • Spleen: Transforms and transports the pure essence of food upwards to the Lungs and Heart.

• Interdependence: They are mutually dependent; the Stomach needs the Spleen's transformative power, and the Spleen depends on the Stomach's receipt and ripening function. Their Qi movements (Stomach descends, Spleen ascends) must be harmonious.

Stomach Government Role

The "Official of Granaries and Storehouses"

• Functions: Responsible for receiving, holding, and beginning the processing of food, much like a granary stores and prepares grains for distribution. It is the initial gateway for nourishment.

• Imbalance: A dysfunctional Stomach fails to receive and process food effectively, leading to issues with appetite and digestion, affecting the entire body's energy supply.

Stomach Spirit / Affect Mind and Emotions

The Stomach indirectly influences the mind and emotions, primarily through its role in producing abundant Qi and Blood.

• Yi (Intellect/Thought): While the Yi resides in the Spleen, a healthy Stomach ensures sufficient post-natal Qi and Blood, which nourish the brain and support mental clarity, focus, and memory.

• Imbalance: Poor Stomach function (e.g., from indigestion, deficiency, or heat) can lead to symptoms like fatigue, brain fog, poor concentration, anxiety, or an inability to relax and think clearly. Discomfort can also cause irritation.

Stomach Associated Emotions

While the Spleen is more directly associated with worry and pensiveness, the Stomach is significantly affected by these emotions and can contribute to agitation.

• Connection: Prolonged worry or anxiety can lead to Stomach Qi stagnation or rebellious Qi, causing indigestion, nausea, or acid reflux.

• Impact: Emotional distress can easily disrupt the Stomach's smooth descending function, creating discomfort that intensifies emotional unease (e.g., irritability from chronic indigestion). Conversely, a calm and balanced emotional state supports healthy Stomach function.

Common Etiologies of Stomach Diseases

The main causes of Stomach imbalances include:

• Dietary Factors:

  • Irregular Eating Habits: Skipping meals, overeating, eating too quickly, eating late at night.

  • Improper Food Choices: Excessive consumption of cold/raw foods (injures Yang/Qi), greasy/spicy/fried foods (generates Heat/Damp-Heat), alcohol (generates Heat, damages Yin).

• Emotional Factors: Worry, pensiveness, anxiety, and even anger (via Liver Qi invading Stomach) can disrupt the smooth flow of Stomach Qi.

• External Pathogens: Invasion of external Cold (e.g., from cold drinks, exposure) can directly affect the Stomach.

• Constitutional Weakness: Inherited weakness in digestive capacity.

• Chronic Illness: Prolonged illness can deplete Stomach Qi or Yin.

• Medication Side Effects: Certain medications can injure Stomach Qi or Yin.

Key Signs of Stomach Imbalance

Common symptoms indicating a Stomach pattern in TCM:

• Digestive: Epigastric pain or discomfort, bloating, poor appetite, nausea, vomiting, belching, hiccups, acid regurgitation, indigestion, difficult swallowing.

• Oral: Dry mouth, thirst, bad breath, swollen/bleeding gums, abnormal taste (e.g., bitter, bland, sweetish).

• Abdominal: Abdominal distension, constipation or loose stools (often linked to Spleen).

• General: Fatigue, sallow complexion, weight loss (in chronic deficiency), aversion to certain foods.

Stomach-Spleen Relationship

The Stomach and Spleen are the most fundamental Zang-Fu pair, forming the core of digestion and post-natal Qi production (Earth element).

• Functions:

  • Stomach: Receives and 'rots and ripens' food, descends impure essences.

  • Spleen: Transforms and transports the pure essence of food; governs ascending Qi.

• Interdependence:

  • Qi: Stomach's descending Qi and Spleen's ascending Qi must work in harmony for proper digestion and nutrient distribution. The Stomach provides the raw material, the Spleen processes it.

  • Fluids: Stomach needs fluids for functioning; Spleen prevents dampness. Imbalances can lead to dryness (Stomach Yin Def) or dampness (Spleen Def).

  • Post-Natal Essence: Together they produce Qi and Blood, vital for nourishing all other organs and tissues.

• Imbalance: Very common and intertwined; Stomach problems (e.g., heat, rebellious Qi) often lead to Spleen dysfunction (e.g., dampness, Qi deficiency), and vice-versa. This is why they are often treated together.

Stomach-Heart Relationship

An indirect but significant relationship, primarily through the production of Qi and Blood and the influence of heat.

• Blood & Qi: The Stomach (with Spleen) is the source of post-natal Qi and Blood. Abundant Qi and Blood nourish the Heart, ensuring its strong function and providing the material basis for the Shen (Mind).

• Hot/Cold Influence:

  • Stomach Heat: Can rise and disturb the Heart Shen, leading to symptoms like restlessness, anxiety, insomnia, agitation, or even delirium.

  • Heart Fire: Can also extend downwards to the Stomach, exacerbating Stomach heat symptoms or causing digestive upset due to emotional distress.

Stomach-Lung Relationship

An indirect relationship, primarily concerning the descending function of Qi and the regulation of fluids.

• Qi Movement:

  • Lung Qi: Governs descending and ensures smooth circulation of Qi throughout the body.

  • Stomach Qi: Also needs to descend smoothly for proper digestion.

  • Interaction: If Stomach Qi rebels upwards (e.g., vomiting, hiccups), it can interfere with the Lung's descending function, leading to symptoms like cough, asthma, or chest oppression.

• Fluid Metabolism: The Stomach is the origin of fluids, and the Lungs help distribute these fluids throughout the body. Stomach Yin deficiency can affect Lung Yin, causing dry cough.

Stomach-Gallbladder Relationship

An indirect relationship existing through their connection to the Liver and their roles in digestion.

• Qi Flow: The Gallbladder's function of storing and excreting bile relies on the smooth flow of Liver Qi. A healthy Liver/Gallbladder ensures smooth Qi flow, which aids the Stomach's descending function.

• Bile Production: Bile flow into the Small Intestine (facilitated by Gallbladder) is crucial for digestion, especially of fats. Dysfunction can back up and affect the Stomach.

• Imbalance: Damp-Heat in the Gallbladder/Liver channel often affects the Stomach, causing a bitter taste in the mouth, nausea, vomiting, dark urine, and epigastric pain or discomfort. Rebellious Stomach Qi can also affect the Gallbladder, contributing to these symptoms.

Stomach Yin Deficiency

Pathomechanism: Insufficient fluids (Yin) in the Stomach, often caused by chronic Stomach Heat, prolonged illness, irregular eating, excessive pungent/hot foods, or Spleen/Kidney Yin deficiency. Lack of Yin fails to nourish the Stomach, leading to dryness and impaired 'rotting and ripening' and descending functions.

• Key Signs:

  • Epigastric discomfort or dull burning pain, hunger with no desire to eat or only for small amounts, dry mouth and throat (especially in the afternoon/night).

  • Thirst with desire for small sips of liquids, dry stools/constipation, slight nausea, hiccups.

  • Emaciation over time, slight fever or feeling of heat in palms/soles (five-palm heat).

• Other Possible Signs:

  • Heartburn (mild).

  • Poor digestion of roughage.

  • Slight dizziness.

• Tongue: Red (especially in the center) with little or no coating, possibly peeled and dry.

• Pulse: Thready (細, Xi), rapid.

Stomach Deficiency Cold

Pathomechanism: Deficiency of Stomach Yang/Qi, leading to internal cold. Often caused by prolonged Spleen Yang deficiency affecting the Stomach, chronic illness, excessive consumption of cold foods/drinks over time, or overuse of cold-nature medications. Cold impairs the Stomach's rotting & ripening and descending, leading to hypoactive function.

• Key Signs:

  • Dull epigastric pain (milder than acute cold invasion), better with warmth/pressure, aversion to cold foods, preference for warm drinks, poor appetite, cold sensation in epigastrium, fatigue.

  • Lack of thirst (or desire for warm liquids).

• Other Possible Signs:

  • Borborygmi (rumbling sounds in the intestines).

  • Loose stools.

  • Pale complexion.

• Tongue: Pale, wet with a thin white coating.

• Pulse: Deep, slow, weak.

Cold Invading the Stomach

Pathomechanism: Caused by an invasion of external cold (e.g., cold weather, cold food/drinks). Cold constricts Qi and impairs the Stomach's 'rotting and ripening' and descending functions.

• Key Signs:

  • Sudden epigastric pain (worse with cold, better with warmth), feeling of coldness in the epigastrium.

  • Nausea, vomiting of clear fluid, poor appetite, aversion to cold food/drink.

  • Lack of thirst, cold limbs, preference for warm covering over the abdomen.

• Other Possible Signs:

  • Borborygmi (rumbling sounds in the intestines).

  • Diarrhea if cold extends to the Intestines.

  • Pale complexion.

• Tongue: Pale, wet with a thick, white coating.

• Pulse: Deep, slow, tight.

Stomach Fire

Pathomechanism: An excess heat pattern arising from excessive consumption of hot/spicy/fried foods, alcohol, Liver Fire 'invading' the Stomach, or extreme emotional stress generating heat. Fire consumes Stomach Yin and causes Stomach Qi to become rebellious and rush upwards.

• Key Signs:

  • Burning epigastric pain, intense thirst with desire for cold drinks, acid reflux, sour regurgitation.

  • Bad breath, swollen and painful, often bleeding gums, mouth ulcers.

  • Nausea/vomiting (especially soon after eating), excessive hunger.

  • Red face, constipation with dry stools, mental restlessness or agitation, dark, scanty urine.

• Other Possible Signs:

  • Headache.

  • Feeling of heat in the body.

  • Heavy bleeding during menstruation (due to heat forcing Blood out).

• Tongue: Red with a dry yellow or thick yellow coating (especially in the center).

• Pulse: Rapid, full, often slippery (滑, Hua).

Food Stagnation in the Stomach

Pathomechanism: Overeating, irregular eating habits, eating difficult-to-digest foods, or Spleen/Stomach weakness leading to impaired digestion and accumulation of undigested food in the Stomach. This obstructs the normal descending flow of Stomach Qi and its 'rotting and ripening' function.

• Key Signs:

  • Epigastric fullness, distension, and pain (worse after eating).

  • Sour regurgitation, foul-smelling belching, nausea, vomiting (often relieved by vomiting).

  • Poor appetite, indigestion, aversion to food.

• Other Possible Signs:

  • Abdominal distension.

  • Feeling of heaviness.

  • Restless sleep (especially if severe).

  • Loose stools or constipation with a foul smell.

• Tongue: Has a thick, greasy coating (can be white or yellow depending on underlying heat/cold).

• Pulse: Slippery (滑, Hua) or Full, particularly in the Stomach position.

Blood Stagnation in the Stomach

Pathomechanism: Severe or prolonged emotional stagnation (e.g., Liver Qi stagnation), chronic Stomach heat or cold leading to damage of vessels, trauma, or surgery. The obstruction of Blood flow causes severe pain and disrupts the Stomach's functions.

• Key Signs:

  • Stabbing, fixed, or severe epigastric pain (worse at night, often not relieved by food/pressure).

  • Vomiting dark blood or coffee-ground material.

  • Black tarry stools (melena).

• Other Possible Signs:

  • Palpable mass in the epigastrium (in severe chronic cases).

  • Dark complexion.

  • Dry skin.

  • Emaciation.

• Tongue: Dark purple or with static spots on the body, especially under the tongue (sublingual veins distended).

• Pulse: Choppy (澀, Se), Wiry (弦, Xian) and tight, or Deep and Fine.