Chinese Medicine
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Earth Element: The Nurturing Spleen and Stomach & their Functions

The Earth time of year is with us. And it is strong.

The Earth element in Chinese medicine is associated with the season of late summer, the time when summer fades away and the turning inward of fall has yet to happen. Earth is also associated with the time between all seasons, between all climactic and celestial transitions (the equinoxes and solstices). These two manifestations of Earth blend right now because the autumn equinox is upon us, and it is late summer (in the Northern hemisphere).

This time of year is ripe to contemplate what it means to be centered, grounded and connected.
The carefree days of summer are over. School starts. The harvest time, dying back of plant life and hiding of the animals are around the corner. The end of the year (a time of completion) and the holidays (a time of sharing material and spiritual wealth) are approaching. We think about what we are worth and how our garden will reap (or not) what we sowed earlier this year.

The Earth element is like a pivot. It’s a standstill, the eye of a hurricane. In the seasons, it’s where the expansiveness of summer turns and pauses before it retreats inward for fall. For a plant, the Earth element is what holds it in place; it’s not the stem and leaves and flowers, nor is it the roots, but the place where they come together.


It’s the middle road, not quite holding back and not quite full expression. It’s unity, harmony, agreement, symmetry. At this time of year, it’s good to follow a path of moderation and regularity. In fact, it is helpful to cultivate harmony in all areas of your life anytime you want to work on strengthening the Earth element and it’s associated organs, the Spleen or the Stomach.

With each element of Chinese medicine, there are physical, emotional, spiritual and environmental manifestations. Here’s a post about eating for the Spleen and Stomach, and in the future I’ll write about what we can do in our daily life to bring out the best of the Earth element.

By it’s nature the Earth element is quite physical, so I will start this series with a review of the Earth element in the body. This will be a simple overview of the potentially complex subject of Chinese medicine theory.

I wish I knew the perfect way to talk about Chinese medicine without using the completely confusing terms like Qi and Blood, Yin and Yang, and Organs with a capital “O”. But I am not that savvy – yet. So please bear with me and use your imagination. I hope that it paints a picture of the grounding and nurturing capacities of the Earth element in the body.

earth element infographicThe Spleen & Stomach

The organ systems associated with Earth are the Spleen and the Stomach. They are capitalized because they represent organ systems, functions and relationships within the body, not the actual organs of the spleen and stomach (although there is much overlap).

As one could guess, the Spleen and Stomach have a lot to do with digestion. They accept nourishment, break it down and distribute building blocks derived from our diet to the rest of the body. Here’s a summary of each of their actions:

The Spleen

Governs digestion and absorption The Spleen transforms what we eat and drink so that it can form the basis of energy and nutrients in the body with the help of other organ systems in the body. When this process is working well, we have good appetite and digestion, and easy and regular elimination.

Governs Fluid Metabolism Just as the soil holds water in ways that can be used by plants and animals, the Earth organs do the same in the body. It’s common for Chinese medicine practitioners to say that there is “Spleen dampness” or just plain “dampness” in the body.

Dampness can occur when the normal movement of water in the body is off, often stemming from impaired digestion. Or Dampness can occur because it is coming from the outside in, like living in a damp environment, or eating cold and mucus forming foods. Edema, puffiness, watery or loose stool, phlegm, nodules, or being bothered by damp weather are a few potential signs of dampness.

Has an Ascending Quality and Controls the Blood Because of it’s Earth element association, the Spleen holds and contains parts of the body. Thus the Spleen holds the organs, structures and materials of the body in their rightful places. Bleeding, flaccidity, leakage and prolapse may result from a deficient Spleen. As Gail Reichstein’s says in Wood Becomes Water,

“Dysfunctions in this aspect of the Spleen can lead to phlegm, diarrhea, or asthma, or to organ prolapses, varicose veins and hemorrhoids.”

The Spleen’s relationship to blood is more than just holding it in place; it also helps to form the blood because of it’s ability to digest food into the base building blocks which form blood itself. When treating anemia, nutrient deficiencies, or working with the Chinese medicine concept of tonifying blood, the Spleen is always treated.

Working with women during the postpartum period, I have seen how treating the Spleen (along with other organs and meridians) can help the restore the pelvic floor to it’s rightful function holding, lifting and yet buoyant and weight-bearing. The pelvic floor is like a pivot itself!

Controls the Limbs and Muscles One of my instructors at Chinese medical school would say, “the muscles of the body need TLC, in the form of ample Qi and Blood”. As eager acupuncture students, we would want to put needles right in an achy or weak low back and call it a day, but our teachers would encourage us to treat the reason why the back didn’t have the vitality it could have, which could be because the energy and nutrients from the Spleen and Stomach were lacking. This is especially the case with general fatigue or chronically achy muscles and heavy limbs.

The Spleen is Associated with Saliva, the Lips and the Mouth The mouth is the start of the digestive system, so it’s no wonder that the Spleen manifests here. Pale, dry, cracked, or overly red lips are a signal that the Spleen needs some support, (and related cracks in the corner of the mouth are sign of Stomach imbalance).

A dry or sticky mouth, food not tasting right or appealing while chewing or lack of appetite are also signs of imbalance. The Spleen has many functions which overlap with the pancreas, which produces digestive enzymes. Some of these enzymes are present in saliva and start the digestive process of carbohydrates right in the mouth. That’s why starchy foods like crackers can dissolve right in your mouth, all those enzymes!

The Spleen Houses the Intellect  Our bodies can only digest so much – physically and mentally. Each organ has a related area of the human psyche, and for the Spleen it is our mental capacity. On one end of the spectrum, feeling spacey, the inability to concentrate or ungroundedness can be a sign on Spleen imbalance; while on the other end one tends to over-thinking, worry and obsessive.

Students or anybody who does more mental work and memorization then their body can tolerate (especially under pressure) can often feel the Spleen being taxed. Poor digestion, bloating, feeling tired after eating, loose stool, lack of appetite can occur when being overworked mentally.

The Stomach

In Chinese medicine theory, the Stomach and the Spleen are very much related. In fact, they are the most interrelated of the Yin and Yang organ pairs (others being Liver and Gallbladder, Heart and Small Intestine, Pericardium and Triple Burner, Lung and Large Intestine, and Kidney and Bladder), and are more like two aspects of of one organ system, rather than two semi-related organs which are paired together, like the other pairs.

The Stomach:

  • Receives food and fluids literally, and ‘invites’ food to itself through its relationship to producing an appetite
  • Breaks down food and fluids through the fermentation process
  • Transports essences and fluids derived from food throughout the body

foot-treeThe Importance of Digestion There is a saying in natural medicine that goes something like this:

“We are what we eat, digest, assimilate, absorb and fail to eliminate”

The Earth organs are pivotal to our health and vitality for this very reason. We derive Qi and make Blood from what we eat, which is dependent on a vibrant Spleen and Stomach to extract and build it from the basic building blocks of food.

But it’s more complicated than just food in equals our available vitality; so many other organs systems, genetic, microbiomic, emotional and environmental factors influence how well that digestive (and assimilation, absorption and elimination) process happens. Add in the all the factors which surround food politics in our modern world, and you can see that the Earth organs often don’t have the nourishment they could have, and we can feel the effects.

The Spleen and Stomach Imbalanced

Symptoms that we consider par for the course as a side effect of modern life are taken seriously in Chinese medicine. Nausea, bloating, acid reflux, loose stools or constipation, poor appetite, wanting to lay down after eating, weight gain or loss are signs that the Spleen and Stomach’s functionality have been compromised. The person may be treated with any combination of diet, herbs, acupuncture and bodywork, Qi Gong or movement or Feng Shui.

I agree that these symptoms should be treated. It seems that I give some sort of formula for these digestive complaints to just about all the patients I treat with herbs.

Remember that the Earth organs extract the vital nutrients to provide energy for the entire body? Symptoms of Spleen deficiency can include signs other than obvious digestive complaints, like chronic tiredness or being tired after eating, weakness, pale complexion and feeling down, depressed or in a creative funk.

This is just the beginning of these Earth organs and how they play out in the body. As a practitioner, I utilize palpation and tongue and pulse diagnosis to help verify any signs of symptoms I suspect may be due to a Spleen imbalance. But regardless of your depth of understanding of Chinese medicine specifics, one can benefit from reflecting on the Earth element in your life.

In the next post, I’ll talk about some Earthy foods to support our center.


Reichstein, Gail. Wood Becomes Water: Chinese Medicine in Everyday Life.

Maciocia, Giovanni. The Foundations of Chinese Medicine.

Pitchford, Paul. Healing with Whole Foods.


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