The Four Earth Organs of Chinese Medicine

Whole Systems Healthcare


  • One model of the Chinese organ systems posits that there are four Earth organs: the Stomach, the Small Intestine, and Pericardium, and the Liver.
  • All of these function in the creation and maintenance of boundaries, a key attribute of Earth.
  • With any imbalance aspects of boundaries are compromised, resulting in either an excessively porous boundary, or an excessively closed one.

In Traditional Chinese Medicine (TCM) there are generally only two Earth organs, the Spleen and the Stomach. However, there are several ways to assign phase-elements to the organ systems, and one of the models uses the organ clock, or calendar, rather than the five-phase model. This calendrical model is older than the five-phase model and offers some wonderful insights into the function of the organs beyond their traditional physiology as explained in TCM.

As with the organ clock each month of the year is associated with a particular organ system. There are two organs for each  of the four seasons: spring, summer, fall, and winter, represented respectively by Wood, Fire, Metal, and Water. The Earth phase, however, is spread throughout the year, occurring as the third month of every season. Therefore, in this model, there are four Earth organs, instead of just two. Note that in the image below the Earth organs each have three associated constellations.

Note that the Earth organs are associated with three constellations, instead of just two.

Heiner Fruehauf’s Organ Holomap

According to Dragon Rises, Red Bird Flies, by Dr. Leon Hammer, the Earth phase is responsible for bonds and boundaries at a psychological level. I’ve put together the basic attributes of the Earth phase in the table below.

Earth PhysiologyEarth YangEarth Yin
The substance of bonds between peopleIngestion, digestion, absorption, metabolism of food and thoughtBonding, with oneself and the human race
The template that informs a person’s self-worthProper boundary formation and developmentIdentity as human, identifying with humanity
The center of the self, the sense of selfTransformation of bondsEvenness, easiness, a sense of quiet, peace, calm, and compassion
Feeling safe being vulnerableProper separation between inside and outsideTrust and self-worth, ability to receive nourishment
Ability to trust Ability to give and receive minimally egocentric unconditional love
Ability to give and receive nurture and nourishment The substance of the bond with another person

As you’ll see, these attributes also apply in some form to the Earth organs according to the calendrical model. Let’s explore them, and what could happen if they get out of balance.


As an Earth organ in both the five-phase model as well as the calendrical model, the Stomach is the epitome of Earth. I’ve written extensively about the role of the Stomach in my series on digestion, and the table above summarizes the psychological aspects of the Stomach quite well. In terms of boundaries, the Stomach is responsible for holding in the self, and thereby creating a distinction between what is outside and what is inside.

If the Stomach is excess or deficient certain emotional issues tend to arise. I’ve discussed the Stomach’s role in the suppression of emotion, but I’ll include a summary from Dragon Rises, Red Bird Flies for the sake of completeness.

Stomach DeficiencyStomach Excess
Deficiency of separationRuthlessness, hardened heart; excessive boundaries
Inadequacy resulting from lack of experienceTough, intense drive for personal power
Symbiotic relationships, boundaries mergeHarden or perish, pushed into the world early
Lack of boundaries in relationshipsInability to give and accept tenderness or affection
Lack of confidence to explore the worldLoyalty only to family and tribe members
 Relationships are contracts, business-like
 Inability to be vulnerable and trusting


Opposite the Stomach, six months or six hours away, is the Pericardium. The Pericardium is a Fire organ in the five-phase model, but is considered an Earth organ in the calendrical model. The Pericardium yin plays some very Earth-like roles within the realm of Fire, as the summary below from Dragon Rises, Red Bird Flies shows.

Pericardium Yin PsychologyPericardium Yin DeficiencyPericardium Yin Excess
Maintain integrity of intimate threads with othersEasily exploited due to eagerness to pleaseRepressed heart energies: Heart Closed
Receives the heart’s sustenance: contactUnable to stand up to others, craves acceptanceDifficulty opening their hearts to give or receive
Contains and safeguards the heart’s desire to connectInability to control heart feelings and delay surges of emotionDifficulty opening their minds to new ideas
Discrimination over who to trust and share withImpulsively falls in love and forms clinging attachmentsDo not share themselves with others, leading to lack of intimacy
Joining romance and eroticism, the spirit and the bodyLack of self-grounding, overly concerned and focused on othersKeeping everyone at arm’s length
Maintain interpersonal defenses with integrity“Heart on the sleeve”Lonely, bitter, isolated, depressed
Ability to be safely vulnerableIdentity is dependent on receiving romantic love from others 
Ability to take criticismEtiology is often from lack of parental validation 

The yin of the Pericardium is the protector of intimate contact with the Heart, just as the Spleen (Earth yin) is the protector and substance of bonds with people and with humanity as a whole. Its role as the protector of the Heart necessarily involves being able to create boundaries, an Earth-type function. In a word, it “contains” the Heart.

As detailed above, with a deficiency of yin the Pericardium is unable to contain the desires of the Heart, and inappropriately seeks and allows Heart connection. With an excess, the opposite is true, and the Pericardium doesn’t allow anything in or out. The boundary is either too permeable, or too closed.

Small Intestine

The third Earth organ of the calendar, the Small Intestine is another Fire organ in the five-phase model. The Small Intestine is the sorter, the categorizer, that separates pure from impure. It helps decide what is important and not important, separates thought from emotion, separate and structures thoughts and ideas, and helps to focus the fire of awareness. This separating function is the aspect of Earth within the Small Intestine, as separation by definition requires a boundary of some sort. This boundary is fundamentally between what is important and what is not.

If the Small Intestine is deficient this can lead to a certain amount of distractibility. Stimuli from both inside and outside begin to overwhelm the mind as the Small Intestine is unable to sort through what is important to pay attention to. Dr. Hammer categorizes this state as Heart yin excess, which is another way of saying that the yang of the Small Intestine is insufficient to deal with the overflow of perception that is coming into the mind.

If the Small Intestine is in excess there is rigidity in thought processes and too much attention to detail. Things are overly separated, leading to black and white thinking and excessive analysis.

As the other aspects of the Small Intestine are not relevant to the current discussion I’ll leave them aside for now.


The last Earth organ of the calendar is the Liver, a Wood organ in the five-phase model. The Wood nature of the Liver is well-known, due to an emphasis in TCM on the movement of Liver Qi and its subsequent obstruction or stagnation. The Earth nature of the Liver is less known, and involves the containment of emotion.

Dr. Leon Hammer has written at length about the function of the Liver in containing the emotions by holding them in the Blood. Just as the Blood provides the medium for the Pericardium to contain the Heart, Blood provides this for the Liver in order to contain all the stresses of daily life. Without this containment any little thing that interfered with our desires would trigger an outpouring of feelings, such as what happens with small children. This is generally considered to be unacceptable as an adult living in society, and those of us who cannot manage our emotions get labeled with mental disorders.

Thus, the Liver also has to do with boundaries. The boundaries enacted by the Liver are between our inner emotions and the outer expression of them. This container is also what keeps the Qi flowing in a smooth, orderly fashion. And, the Liver, by containing the Blood and the emotions, also contains an aspect of our bonds with others, since the nature of a bond is always an emotional one.

When the boundaries of the Liver fail the Qi begins to escape, leading to labile emotions. I discuss this in my article on PMS; the moodiness and irritability that often occurs with PMS is a perfect example of this dynamic.


Five-Phase Dynamics

Interestingly, all of these Earth organs are related to each other when examining them from the five-phase model. The Liver, as a Wood organ, nourishes the two Fire organs, the Pericardium and Small Intestine. The Small Intestine then nourishes the Stomach. This is according to the generating cycle, where Wood nourishes Fire, and Fire nourishes Earth.

There is also the control cycle, which exists primarily between the Stomach and the Liver, as Wood is considered to control Earth. If the Earth is too soft experiences will enter undigested and effect the Liver. The Liver will have more to contain, leading to signs and symptoms of Liver Qi stagnation. If the Earth is too hard it’s actually a similar situation, as the suppressed emotion creates obstructions that invite Liver Qi to try and move. This will also lead to symptoms of Liver Qi stagnation.

Clock-Pair Dynamics

There is a reciprocal relationship between the Liver and the Small Intestine. A weak Small Intestine doesn’t sort or separate well, which allows all kinds of thoughts and emotions to arise and enter the mind and Blood. This provides more work for the Liver as it needs to contain what may not be important or necessary. A weak Liver is also less able to nourish the Fire of the Small Intestine. No matter which organ is the root, weakness in one will directly influence the other.

The other clock-pair is the Stomach and Pericardium. This relationship is already known through the actions of certain acupuncture points, especially Pericardium 6, which is a Pericardium point known for its effect on Stomach counterflow. The Stomach is responsible for bringing in, containing, and digesting sensory experience of all kind. The Pericardium is also responsible for ingesting, but it’s sphere is more focused on the contact that nourishes the Heart, as explained by Dr. Hammer. Both organ systems are responsible for containment: the Stomach contains experience as it is incorporated into the self, and the Pericardium contains the Heart as it attempts to reach out for contact.

Conformation Dynamics

The Liver and Pericardium are the two Jueyin organs, giving them a special relationship. As the Jueyin conformation is about Blood, we can see that Blood has an Earth quality to it in its function of containing the shen and the emotions. The Pericardium is related more to the intimate connections that sustain the Heart, whereas the Liver is related more to the stresses and emotions of daily interaction.