寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Stomach

Wibu

한글 위부  ·  Pinyin Wei Fu

The great granary — a cheok and six chon of tube that holds three mal five seung, the sea of water and grain from which every organ takes its qi, and the reason a person who does not eat for seven days dies

胃腑

The second bowel chapter, and the one the Internal Damage chapter rests on. The stomach is measured — one cheok six chon long, two cheok six chon if straightened, a capacity of three mal five seung, of which two mal is grain and one mal five seung water — and it is the granary, the market where the five flavours arrive, the sea from which the viscera and bowels all draw their qi. The Lingshu's arithmetic follows: a person passes two seung five hop twice a day, five seung a day, and in seven days the three mal five seung are gone, which is why seven days without food is death. The stomach is read from the flesh of the thighs and the length of the sternum; its injury is eating twice one's fill; its disease is a distended belly and pain under the heart with food that will not go down, and its heat and cold are read on the veins at the base of the thumb. The treatment section is Dongwon's — regulate the food, suit the cold and warmth, still the mind and wait for the true qi to return — with Pyeongwi-san for the full stomach and two supplements for the empty, and Danxi's warning that Pyeongwi-san flattens the earth and must not be taken for long. The signs of its end are the mouth and eyes twitching and wild speech, and the twenty- seven simples are almost all food.

8.1 The Form of the Stomach 胃形象

8.1.1
Source원문

胃長一尺六寸, 胃紆曲屈伸之長二尺六寸, 大一尺五寸, 徑五寸, 受水穀三斗五升, 其中之穀常留二斗, 水一斗五升. 《靈樞》

Translation영역
The stomach is one cheok six chon long; with its bends straightened out, two cheok six chon; one cheok five chon around and five chon across; it receives three mal five seung of water and grain, and of that two mal of grain is always held and one mal five seung of water.
Clinical note임상 주석
The Lingshu's measurements from its anatomy chapter, and the Ojangyukbu chapter's 1.10 gave the total for the whole gut. A capacity of three mal five seung is some six litres by the Han measure, which is about what a stomach can be distended to.

Yeongchu 靈樞

8.1.2
Source원문

胃重二斤十四兩. 《難經》

Translation영역
The stomach weighs two geun fourteen nyang.

Nangyeong 難經

8.1.3
Source원문

胃爲之市. 註曰, 水穀所歸, 五味皆入, 如市雜, 故爲市也. 《內經》

Translation영역
The stomach is the market. The commentary says: water and grain return to it and the five flavours all enter it, mixed like a market, and so it is the market.

Naegyeong 內經

8.1.4
Source원문

胃號太倉, 俗呼爲肚. 受水穀三斗五升, 平人日再圊, 一行二升半, 一日五升, 七日則三斗五升而水穀盡矣. 故平人不飮食七日而死者, 胃中水穀津液俱盡也. 《入門》

Translation영역
The stomach is called the great granary, and commonly the belly. It receives three mal five seung of water and grain; a healthy person goes to the privy twice a day, passing two seung five hop each time, five seung a day, so that in seven days the three mal five seung are exhausted. This is why a healthy person who does not eat or drink for seven days dies: the water, grain and fluids in the stomach are all gone.
Clinical note임상 주석
The arithmetic of starvation — capacity divided by daily output equals seven days. The figure is wrong (a person survives weeks without food) but the reasoning is the tradition's: the stomach is a reservoir, and life is what is left in it.

Immun 入門

8.2 The Position of the Stomach 胃部位

8.2.1
Source원문

咽門至胃長一尺六寸. 胃居心蔽骨與臍之中, 上下各四寸. 《難經》

Translation영역
From the throat's gate to the stomach is one cheok six chon. The stomach sits midway between the bone that shields the heart and the navel, four chon from each.

Nangyeong 難經

8.2.2
Source원문

中脘一穴, 胃之募也. 在心蔽骨與臍之中, 上下各四寸. 在背則胃兪, 在脊第十二顀下兩傍, 胃之部位也. 《銅人》

Translation영역
The point Jungwan (中脘, CV12) is the stomach's alarm point, midway between the bone that shields the heart and the navel, four chon from each; on the back, Wisu (胃兪, BL21) is on either side below the twelfth vertebra. These are the stomach's territory.
Clinical note임상 주석
Jungwan, halfway between xiphoid and navel — the point the Spleen chapter's 4.2.1 called the upper mouth of the granary, and the most-needled point in the book for the belly.

Dongin 銅人

8.3 The Stomach Is the Sea of Water and Grain 胃爲水穀之海

8.3.1
Source원문

人之所受氣者, 穀也. 穀之所注者, 胃也. 胃者, 水穀氣血之海也. 海之所行雲氣者, 天下也. 胃之所出氣血者, 經隧也. 經隧者, 五藏六府之大絡也.

Translation영역
What a person receives qi from is grain; what grain pours into is the stomach; the stomach is the sea of water and grain, of qi and blood. What the sea sends out as cloud and vapour goes over all under heaven; what the stomach sends out as qi and blood goes into the channel-tunnels, and the channel-tunnels are the great network vessels of the five viscera and six bowels.
Clinical note임상 주석
The sea that makes the clouds that water the land — the Lingshu's image for the stomach feeding the channels. The Qi chapter's 4.3 gave grain as the source of the qi; this is the organ that receives it.

Yeongchu 靈樞

8.3.2
Source원문

胃者, 五藏六府之海也. 水穀皆入於胃, 藏府皆稟氣於胃. 五味各走其所喜, 酸先走肝, 苦先走心, 甘先走脾, 辛先走肺, 鹹先走腎. 穀氣津液已行, 榮衛大通, 乃化糟粕, 以次傳下. 《靈樞》

Translation영역
The stomach is the sea of the five viscera and six bowels. Water and grain all enter the stomach, and the viscera and bowels all receive their qi from the stomach. The five flavours each go to what they favour: sour goes first to the liver, bitter to the heart, sweet to the spleen, acrid to the lung, salty to the kidney. When the grain's qi and fluids have moved and the construction and defence are fully open, the dregs are transformed and passed down in order.
Clinical note임상 주석
Each flavour to its organ — the five-phase table read as digestion, and the reason every organ chapter's treatment section gave foods by flavour.

Yeongchu 靈樞

8.3.3
Source원문

胃爲水穀之海, 脾爲消化之器. 水入於經, 其血乃成. 穀入於胃, 脈道乃行. 血不可不養, 衛不可不溫. 血溫衛和, 得盡天年. 《入門》

Translation영역
The stomach is the sea of water and grain and the spleen the vessel of digestion. When water enters the channels the blood is formed; when grain enters the stomach the vessel-paths move. The blood must be nourished and the defence must be warm; with the blood warm and the defence harmonious, one lives out the heaven-given years.

Immun 入門

8.3.4
Source원문

飮食入胃, 則胃實而腸虛. 食下, 則腸實而胃虛. 胃滿則腸虛, 腸滿則胃虛, 更虛更實, 故氣得上下而無病矣. 《靈樞》

Translation영역
When food and drink enter the stomach, the stomach is replete and the intestines empty; when the food goes down, the intestines are replete and the stomach empty. When the stomach is full the intestines are empty and when the intestines are full the stomach is empty — now empty, now replete, and so the qi can go up and down and there is no disease.
Clinical note임상 주석
The Ojangyukbu chapter's 1.3.2 in full: the stomach and gut are never both full, and health is the alternation. 更虛更實 — the bowel's health is emptiness taking turns.

Yeongchu 靈樞

8.4 The Size of the Stomach 胃腑大小

8.4.1
Source원문

𩩲骬以下至天樞, 長八寸, 過則胃大, 不及則胃小. 《靈樞》

Translation영역
From the xiphoid down to Cheonchu is eight chon; longer means a large stomach, shorter a small one.
Clinical note임상 주석
The stomach measured from outside: xiphoid to the navel-level point Cheonchu (天樞, ST25), eight chon on a standard body. A long trunk has a big stomach, and the Lingshu makes the rule from the proportion.

Yeongchu 靈樞

8.5 The Outer Signs of the Stomach 胃外候

8.5.1
Source원문

胃爲之海, 廣骸大頸張胸, 五穀乃容.

Translation영역
The stomach is the sea; where the frame is broad, the neck thick and the chest open, the five grains find room.

Yeongchu 靈樞

8.5.2
Source원문

脾應肉. 肉䐃堅大者胃厚, 肉䐃麼者胃薄. 肉䐃小而麼者胃不堅. 肉䐃不稱身者胃下, 胃下者, 下脘約不利也. 肉䐃不堅者胃緩. 肉䐃無小裹累者胃急. 肉䐃多少裹累者胃結, 胃結者, 上脘約不利也. 《靈樞》

Translation영역
The spleen answers to the flesh. Where the muscle-masses are firm and large the stomach is thick; where they are slight, thin. Where they are small and slight the stomach is not firm. Where they are out of proportion to the body the stomach is low, and a low stomach means the lower cavity is constricted and does not pass. Where they are not firm the stomach is slack. Where they have no small knots the stomach is tense. Where they have many or few small knots the stomach is knotted, and a knotted stomach means the upper cavity is constricted and does not pass.
Clinical note임상 주석
The stomach read from the muscle of the thighs, which the spleen rules — as the liver was read from the ribs and the heart from the xiphoid. 上脘·下脘, the upper and lower cavities, are the two points above and below Jungwan, and the Lingshu makes them the stomach's two gates.

Yeongchu 靈樞

8.5.3
Source원문

䐃, 謂肘膝後肉如塊者.

Translation영역
䐃 means the flesh behind the elbows and knees that lies in masses.

Donguibogam · Wibu

8.6 The Patterns of Stomach Injury 胃傷證

8.6.1
Source원문

飮食自倍, 腸胃乃傷. 《內經》

Translation영역
When food and drink are doubled, the intestines and stomach are injured.
Clinical note임상 주석
Six graphs — eating twice as much hurts the gut — and the Internal Damage chapter's whole first half is this line worked out. The stomach's injury is not the wrong food but too much.

Naegyeong 內經

8.6.2
Source원문

胃傷之證, 不思飮食, 胸腹脹痛, 嘔噦惡心, 噫氣呑酸, 面黃肌瘦, 怠惰嗜臥, 常多自利. 《東垣》

Translation영역
The pattern of stomach injury: no thought of food or drink, distension and pain of chest and abdomen, retching and nausea, belching and acid swallowing, a yellow face and wasted flesh, sluggishness and a love of lying down, and frequent spontaneous diarrhoea.
Clinical note임상 주석
Dongwon's list, and it is the indication of Pyeongwi-san at 8.9.5 word for word. The Spleen chapter's 4.7.2 gave the same picture from the Nanjing.

Dongwon 東垣

8.7 The Patterns of Stomach Disease 胃病證

8.7.1
Source원문

胃病者, 腹䐜脹, 胃脘當心而痛, 上支兩脇, 膈咽不通, 飮食不下.

Translation영역
In stomach disease the abdomen is distended and full, the stomach cavity pains at the level of the heart, there is propping up into both flanks, the diaphragm and throat do not pass, and food and drink will not go down.
Clinical note임상 주석
胃脘當心而痛 — pain in the stomach cavity at the heart's level. The tradition's 心痛 is usually this, epigastric rather than cardiac, and the Chest chapter sorts the two.

Yeongchu 靈樞

8.7.2
Source원문

飮食不下, 膈塞不通, 邪在胃脘也.

Translation영역
Where food and drink will not go down and the diaphragm is blocked and does not pass, the evil is in the stomach cavity.

Yeongchu 靈樞

8.7.3
Source원문

胃中寒, 則手魚際之絡脈多靑. 胃中熱, 則手魚際之絡脈多赤.

Translation영역
Where the stomach is cold, the network vessels at the fish's belly of the hand are mostly green; where the stomach is hot, they are mostly red.
Clinical note임상 주석
The thenar eminence — 魚際, the fish's belly — as a window on the stomach. The veins at the base of the thumb blue for cold and red for heat, and the Lingshu's diagnostic chapter gives the rule; it is the one place the stomach shows on the hand.

Yeongchu 靈樞

8.7.4
Source원문

面熱者, 足陽明病. 兩跗之上脈竪堅者, 足陽明病. 此胃脈也. 《靈樞》

Translation영역
A hot face is a disease of the foot yang brightness; a pulse standing hard on the top of both feet is a disease of the foot yang brightness. This is the stomach's pulse.
Clinical note임상 주석
The pulse on the top of the foot — 趺陽, the dorsalis pedis — which Zhongjing read for the stomach in the Cold Damage treatise. The Pulse Diagnosis chapter's 4.9 gave it as one of the three pulses the ancients took.

Yeongchu 靈樞

8.8 Vacuity and Repletion in Stomach Disease 胃病虛實

8.8.1
Source원문

胃脈實則脹, 虛則泄. 《內經》

Translation영역
Where the stomach's pulse is replete there is distension; where it is vacuous, diarrhoea.

Naegyeong 內經

8.8.2
Source원문

胃中元氣盛, 則能食而不傷, 過時而不飢. 脾胃俱旺, 則能食而肥. 脾胃俱虛, 則不能食而瘦, 或少食而肥, 雖肥而四肢不擧. 《東垣》

Translation영역
Where the stomach's origin qi is exuberant, one can eat without harm and go past mealtime without hunger. Where spleen and stomach are both flourishing, one can eat and is stout. Where both are vacuous, one cannot eat and is thin — or eats little and is stout, but stout without the four limbs being able to lift.
Clinical note임상 주석
Four bodies: the one who eats and is well, the one who eats and is fat, the one who cannot eat and is thin, and the one who eats little and is fat but weak. The last is Dongwon's contribution — fat is not always fullness — and the Body chapter's 1.7.2 said the same with 穀氣勝元氣.

Dongwon 東垣

8.9 The Treatment of Stomach Disease 胃病治法

8.9.1
Source원문

人無根本, 水食爲命. 盖脾胃屬土, 主納水穀, 人之根本也. 《丹心》

Translation영역
A person has no root of their own; water and food are their life. The spleen and stomach belong to earth and govern the taking in of water and grain, and are the root of a person.

Dansim 丹心

8.9.2
Source원문

五味淡薄, 令人神爽氣淸. 《回春》

Translation영역
Where the five flavours are plain and light, the spirit is bright and the qi clear.

Hoechun 回春

8.9.3
Source원문

胃病治法, 調其飮食, 適其寒溫, 澄心息慮, 從容以待眞氣之復常也. 《東垣》

Translation영역
The method of treating stomach disease: regulate the food and drink, suit the cold and warmth, still the mind and rest the thoughts, and wait at ease for the true qi to return to its norm.
Clinical note임상 주석
No medicine in the sentence. Dongwon's treatment of the stomach is diet, temperature, calm and patience, and the Body chapter's 1.15 said the same for every organ. The formulas come after, for when this has not been enough.

Dongwon 東垣

8.9.4
Source원문

胃實, 宜平胃散. 胃虛, 宜異功散ㆍ補中益氣湯方見內傷. 不進飮食, 宜養胃進食湯.

Translation영역
For stomach repletion, Level the Stomach Powder is appropriate; for stomach vacuity, Different Achievement Powder and Supplement the Centre and Boost the Qi Decoction formula in the Internal Damage chapter; where food and drink do not advance, Nourish the Stomach and Advance Food Decoction.
Clinical note임상 주석
Four formulas, all registered. Pyeongwi-san is the most-cited formula in the book after Sagunja-tang, and this is its home chapter; 8.9.5 gives its full indication and 8.9.6 Danxi's warning about it.

Donguibogam · Wibu

8.9.5
Source원문

平胃散, 治脾胃不和, 不思飮食, 心腹脹痛, 嘔噦惡心, 噫氣呑酸, 面黃肌瘦, 怠惰嗜臥, 常多自利, 或發霍亂, 及五噎八痞, 膈氣反胃等證. 《入門》

Translation영역
Level the Stomach Powder treats the spleen and stomach in disharmony: no thought of food, distension and pain of heart and abdomen, retching and nausea, belching and acid swallowing, a yellow face and wasted flesh, sluggishness and a love of lying down, frequent spontaneous diarrhoea, and perhaps sudden turmoil, the five dysphagias and eight glomi, diaphragm qi and stomach reflux.
Clinical note임상 주석
The indication in full — 8.6.2's list plus the digestive emergencies. Atractylodes, magnolia bark, tangerine peel and licorice: four medicinals that dry, move and relax the stomach, and the Ojangyukbu chapter sent here for them.

Immun 入門

8.9.6
Source원문

平胃散, 決烈耗散之劑, 實非補胃之藥. 能瀉土氣之敦阜, 使之平耳. 用之而胃氣和平, 則便止, 不可常用也. 《丹心》

Translation영역
Level the Stomach Powder is a sharp, dispersing preparation, and truly not a medicine that supplements the stomach. It can drain the earth qi's heaping-up and make it level, no more. Use it until the stomach's qi is level and harmonious, then stop; it must not be taken for long.
Clinical note임상 주석
平, level — Danxi reads the name literally: the formula flattens a stomach that has piled up, and a flat stomach is not a fed one. 不可常用也, must not be taken for long — the warning the Medicine Use chapter's 5.33 gave for every dispersing formula, attached to the one most likely to be over-used.

Dansim 丹心

8.10 The Signs of the Stomach Expiring 胃絶候

8.10.1
Source원문

胃爲足陽明, 其終者, 口目動作, 善驚, 妄言, 色黃, 其上下經盛不仁, 則終矣. 《內經》

Translation영역
The stomach is the foot yang brightness. Where it ends, the mouth and eyes twitch, there is much fright and wild speech, the colour is yellow, and when the upper and lower channels are full and without feeling, it ends.
Clinical note임상 주석
Twitching of mouth and eyes, delirium, and a yellow face — the yang brightness's end from the Suwen's 診要經終論. The Cold Damage chapter's yang brightness delirium is this stage short of the end.

Naegyeong 內經

8.10.2
Source원문

胃絶五日死, 何以知之. 脊痛, 腰中重, 不可反覆. 《脈經》

Translation영역
The stomach expiring, death in five days — how is it known? The spine aches, the lumbus is heavy, and one cannot turn over.

Maekgyeong 脉經

8.11 Simple Medicinals 單方

8.11.1
Source원문

凡二十七種.

Translation영역
Twenty-seven kinds in all.
Clinical note임상 주석
Twenty-seven simples for the stomach — gypsum, pueraria, ginseng, cardamom, the two atractylodes, soybean and its sprout, clove, amomum, dry and fresh ginger, barley and its sprout, rice, two millets, ox tripe and fermented milk, mutton and sheep tripe, dog, hen, carp, mullet, croaker, taro, tangerine peel, jujube, dried persimmon, and one vegetable whose name the transcription loses. Two medicines at the head to cool and open, and twenty-five things to eat: the stomach's materia medica is dinner.

Donguibogam · Wibu

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 3, The Stomach chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.