I. Traditional Chinese Medicine’s Understanding of Gastric Ptosis

I. Traditional Chinese Medicine’s Understanding of Gastric Ptosis

In Traditional Chinese Medicine, gastric ptosis is called “stomach descent” or “stomach sluggishness.” These terms were already recorded in the “Yellow Emperor’s Classic of Internal Medicine,” demonstrating the extraordinary wisdom of our ancestors. The “Spiritual Pivot: On the Essence of the Body” states: “The spleen corresponds to flesh; firm, large flesh indicates a thick stomach; flimsy, small flesh indicates a thin stomach. Small, flimsy flesh indicates a non-firm stomach; if the flesh doesn’t match the body, the stomach descends, and when the stomach descends, the lower conduit is not well controlled. If the flesh isn’t firm, the stomach is sluggish.” This shows that people with strong, robust muscles have thick stomachs, while those with thin muscles have thin stomachs; if the muscle is thin and doesn’t match the body, the stomach position is lower, and if the muscle isn’t firm enough, the stomach is sluggish. At the same time, it explains that those with stomach sluggishness inevitably have stomach descent. Since the “Yellow Emperor’s Classic of Internal Medicine” first mentioned this disease, no subsequent medical texts have dedicated a special chapter to discussing it. The descriptions in “Jin Gui Yao Lue” such as “the person was originally robust but now thin, fluid flows between the intestines, making a dripping sound—this is called phlegm-dampness” and “a hard mass under the heart, as big as a plate, with edges like a hanging plate” actually refer to gastric ptosis.

The location of gastric ptosis is in the middle jiao, the spleen and stomach; moreover, the cause of this disease is weak, flabby muscles, and since muscles are governed by the spleen and stomach, overall the pathogenesis of this disease is key: spleen deficiency and qi sinking. The reasons for spleen deficiency and qi sinking are mainly dietary indiscretion, emotional distress, and excessive labor. As stated in “On the Spleen and Stomach”: “Dietary indiscretion and improper temperature lead to spleen and stomach damage”; “Joy, anger, sorrow, fear deplete original qi, nourish heart fire, and fire and original qi cannot coexist—when fire prevails, it takes over the earth element, hence the illness”; “Physical labor leads to spleen disease.” The spleen’s function of lifting and raising is to lift and fix the internal organs, entirely relying on this function of the spleen. If the spleen lacks strength, qi sinks, and the internal organs lose the power to be lifted and fixed, resulting in organ ptosis. Here we can see that the so-called “qi-lifting function” is actually the tension (pulling force) of the muscles and ligaments surrounding the organs. Since the spleen governs the middle jiao, when the spleen qi sinks, it is often referred to as qi sinking. Clinically, patients may also exhibit symptoms of yang deficiency, such as cold limbs, indicating further development of spleen deficiency; some patients may also have both spleen yin deficiency and stomach yin deficiency, forming a pattern of qi-yin dual deficiency—this is precisely the pathological reaction when the spleen’s function of lifting and the stomach’s preference for moisture and aversion to dryness are both out of balance. In addition, due to spleen and stomach weakness and insufficient transformation, water, dampness, and phlegm-dampness will linger, so accompanying dampness and phlegm are often seen; when prescribing formulas, one should consider both deficiency and excess, and address both root and branch. For patients with congenital deficiencies, don’t forget to also tonify the kidneys.