Stomach
The Stomach (Wèi) is a Fu (Yang) organ belonging to the Earth element, responsible for receiving food and drink and performing the initial "rotting and ripening" of digestion. Together with its paired organ the Spleen, it forms the "Root of Post-Heaven Qi" – the body's ongoing source of energy and nourishment after birth.
Five Element Correspondences
Season
Late Summer
Climate
Dampness
Emotion
Worry/Pensiveness (shared with Spleen; excessive thinking affects digestion)
Color
Yellow
Taste
Sweet
Sound
Singing/Humming (shared with Earth element)
Direction
Center
Sense Organ
Mouth (opens to the mouth, together with the Spleen)
Body Tissue
Flesh/Muscles (shared with Spleen; the Earth element governs muscles and flesh)
Body Fluid
Saliva (thin fluid - jin)
Peak Hours
07-09
Meridian
Stomach Meridian
Educational content · Consult qualified TCM practitioners for diagnosis and treatment
Overview
The Stomach (Wèi) is one of the six Fu (hollow/Yang) organs in Traditional Chinese Medicine, considered the most important of all Fu organs. Located in the middle of the body, it connects to the esophagus above and the small intestine below. Together with the Spleen, the Stomach forms what TCM calls the "Root of Post-Heaven Qi" (后天之本, Hòutiān zhī Běn) – the foundation of all energy and nourishment the body produces after birth.
Unlike Western anatomy's view of the stomach as simply a digestive organ, TCM's Stomach represents a broader functional system responsible for receiving food and drink, initially breaking them down (called "rotting and ripening"), and sending the processed material downward for further refinement. This downward movement is a key characteristic: in health, Stomach Qi always descends. When this natural flow is disrupted, symptoms like nausea, vomiting, belching, and hiccups arise.
The Stomach belongs to the Earth element and shares a vital interior-exterior relationship with the Spleen. While the Spleen prefers dryness and sends pure substances upward, the Stomach prefers moisture and sends impure substances downward. This complementary partnership – described as "The Spleen governs transformation, the Stomach governs reception" – makes them the central pivot of all digestive and nutritive functions in the body.
Historical Context
The Stomach's importance in Chinese medicine dates back over 2,000 years to the foundational texts. The Huangdi Neijing (Yellow Emperor's Classic of Internal Medicine) established the Stomach as the "Sea of Grain and Water" and emphasized its role as the source of post-natal nourishment. The classic concept was that without Stomach Qi, life cannot be sustained – hence the saying "those who can eat will live; those who cannot eat will die."
A pivotal development came in the Jin-Yuan dynasties (12th-14th centuries) when physician Li Dong-yuan wrote the Pi Wei Lun (Discussion of the Spleen and Stomach), elevating Spleen-Stomach theory to central importance. Li argued that many diseases originate from Spleen-Stomach weakness, and his school became known as the "Earth School" of medicine. His work established treatment principles still used today for digestive disorders.
In the 1920s, Yun Tieqiao introduced the concept of Zangxiang (organ manifestation theory), which clarified that TCM organs like the Stomach are functional systems rather than purely anatomical structures. This helped reconcile traditional theory with modern Western anatomy by acknowledging that the TCM Stomach encompasses broader physiological processes than the Western anatomical stomach alone.
Physiological Functions
Receiving and Containing Food
胃主受纳 (Wèi Zhǔ Shòunà)The Stomach's primary role is to receive and hold food and drink after it's swallowed. Think of it as the body's "granary" or warehouse where all nourishment first arrives. This receiving function is why the Stomach is called the "Sea of Grain and Water" (水谷之海) and "The Great Granary" (太仓). A healthy Stomach has good appetite; when this function is impaired, appetite decreases and eating becomes uncomfortable.
Rotting and Ripening
腐熟水谷 (Fǔshú Shuǐgǔ)After receiving food, the Stomach "rots and ripens" it – an old term describing initial digestion and breakdown. Through the warming action of Stomach Qi, food is churned and transformed into a semi-liquid mass (food mush or chyme). This prepares the nutrients to be extracted by the Spleen and transported throughout the body. The Stomach requires adequate fluids to perform this macerating function properly.
Descending Turbid Substances
胃主通降 (Wèi Zhǔ Tōngjiàng)A fundamental characteristic of healthy Stomach function is that its Qi naturally descends. After rotting and ripening food, the Stomach sends the processed material downward to the Small Intestine for further separation of pure from impure. This downward movement is essential – when Stomach Qi fails to descend or rebels upward, symptoms like nausea, vomiting, belching, hiccups, and acid reflux appear. TCM says "The Stomach prefers descent and harmony."
Origin of Body Fluids
胃为水谷气血之海 (Wèi Wéi Shuǐgǔ Qìxuè zhī Hǎi)The Stomach, together with the Spleen, is the source of all Qi and Blood produced after birth. The nutrients extracted from food form the raw material for making Qi, Blood, and Body Fluids. This is why the Spleen-Stomach pair is called the "Root of Post-Heaven Qi" – our ongoing source of vitality that sustains life after the original prenatal essence we're born with.
Relationships with Other Organs
Other
The Spleen and Stomach share the most intimate relationship of any organ pair in TCM. As interior-exterior partners, they complement each other perfectly: the Stomach receives and breaks down food (a descending, Yang function), while the Spleen transforms and transports the nutrients (an ascending, Yin function). The Stomach is Yang (likes moisture, sends downward) while the Spleen is Yin (likes dryness, sends upward). Together they form the "Root of Post-Heaven" – the body's ongoing source of Qi and Blood after birth. Their balance is essential; dysfunction in one inevitably affects the other.
Controlling
The Liver ensures the smooth flow of Qi throughout the body, which directly supports proper Stomach function. When Liver Qi flows freely, the Stomach can descend properly. However, when emotions like anger, frustration, or stress cause Liver Qi to stagnate, it commonly "invades" the Stomach, disrupting its descending function. This pattern (Liver Qi invading the Stomach) is one of the most common digestive disorders, causing symptoms like epigastric pain, distension, nausea, and acid reflux.
Other
The Small Intestine receives the "rotted and ripened" food material from the Stomach and continues the digestive process by separating pure from impure. The Stomach's descending function must work properly for the Small Intestine to receive material; if Stomach Qi fails to descend, the entire digestive chain is disrupted.
Generating
While the Spleen-Stomach represents Post-Heaven (acquired) Qi, the Kidneys store Pre-Heaven (inherited) Essence. These two sources support each other: Kidney Yang provides warmth to help the Stomach's rotting and ripening function, while proper Stomach function ensures continued nourishment that supplements Kidney Essence over time.
Common Pathological Patterns
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Food Stagnation in the Stomach
ExcessKey Manifestations
Stomach Qi Rebellion (Rebellious Stomach Qi)
ExcessKey Manifestations
Key Manifestations
Tongue Manifestations
The tongue coating (fur) is primarily a reflection of Stomach function. A thin white coating indicates normal Stomach Qi and proper rotting/ripening function. This coating forms from a small amount of "turbid dampness" that rises from the Stomach's digestive activity – it's actually a sign of health.
Key tongue signs for Stomach disorders include: No coating or peeled coating (especially in the center) indicates Stomach Yin deficiency or severely weakened Stomach Qi – the Stomach lacks fluids to perform its functions. Thick greasy coating suggests food stagnation or dampness accumulation. Yellow coating indicates heat in the Stomach. White wet coating suggests cold or dampness affecting the Stomach. The center of the tongue specifically reflects Stomach and Spleen conditions.
Pulse Manifestations
The Stomach is assessed at the right middle (Guan) position of the pulse, sharing this location with the Spleen. This reflects their intimate functional relationship. In TCM pulse diagnosis, "Stomach Qi" also refers to the overall quality of the pulse – a healthy pulse should feel smooth and harmonious, which indicates adequate Stomach Qi nourishing the vessels.
Specific pulse findings include: Weak pulse at the right Guan position indicates Stomach Qi deficiency. Thin, rapid pulse suggests Stomach Yin deficiency. Slippery, rapid, forceful pulse indicates Stomach Fire or heat. Slippery pulse may indicate food stagnation or phlegm-dampness. Wiry pulse affecting the middle position can indicate Liver Qi invading the Stomach. The presence or absence of "Stomach Qi" in the overall pulse quality is considered a vital prognostic sign.
Clinical Relevance
The Stomach is central to clinical practice because it's involved in such a wide range of disorders. Digestive complaints – including poor appetite, nausea, vomiting, acid reflux, epigastric pain, and bloating – directly involve Stomach dysfunction. But the Stomach's importance extends further: since it's the source of post-natal Qi and Blood, chronic Stomach weakness can lead to fatigue, weakness, anemia, and susceptibility to illness throughout the body.
In diagnosis, practitioners pay close attention to tongue coating (reflecting Stomach function), appetite, and the quality of the middle pulse position. Treatment commonly involves harmonizing the Stomach, which may mean tonifying Stomach Qi in deficiency patterns, clearing heat in excess patterns, descending rebellious Qi when there's nausea/vomiting, or nourishing Yin when fluids are depleted. Dietary therapy is especially important for Stomach conditions, as eating habits directly impact this organ's health.
Classical Sources
Huangdi Neijing Lingshu
Chapter 30: Jue Qi (Counterflow Qi)人之所受气者，谷也，谷之所注者，胃也。胃者水谷之海也。
What gives people their Qi is grain; where grain goes is the Stomach. The Stomach is the Sea of Grain and Water.
Huangdi Neijing Suwen
Chapter 11: Discussion on the Five Organs水谷入口，则胃实而肠虚；食下，则肠实而胃虚。
When food and drink enter the mouth, the Stomach is full and the intestines are empty; when food descends, the intestines are full and the Stomach is empty.
Nanjing (Classic of Difficulties)
Thirty-First Difficulty三焦者，原气之别使也。
The Triple Burner is the messenger of the Original Qi (explaining how Stomach Qi relates to the body's overall energy distribution).
Pi Wei Lun (Discussion of the Spleen and Stomach)
Li Dong-yuan's treatise脾胃虚则九窍不通
When the Spleen and Stomach are deficient, the nine orifices do not function properly.
Modern References
The Foundations of Chinese Medicine: A Comprehensive Text
Comprehensive coverage of Stomach physiology, pathology, and patterns from both classical and modern perspectives
The Practice of Chinese Medicine: The Treatment of Diseases with Acupuncture and Chinese Herbs
Clinical applications of Stomach pattern treatment with detailed case studies
Pi Wei Lun (Treatise on the Spleen and Stomach)
Classical text translation essential for understanding Earth School theories of digestive disorders
Chinese Acupuncture and Moxibustion
Standard textbook covering Stomach meridian points and their clinical applications