By Richard Gold

The physiological importance of the organs of the abdomen for maintaining and restoring health is unquestioned by health care providers of all backgrounds and perspectives. Certainly in traditional East Asian medicine, the abdominal organs are considered to be of the utmost importance in physical and mental health. The abdominal region can play an important role in the diagnosis and evaluation of patients. In addition, the abdominal region affords a variety of treatment strategy options.

Most people, including many health care professionals, have no idea what the Omentum is, where it is located or what physiological role it plays in the human body. For those who are aware of the Omentum's existence, most think it plays a very minor role in bodily health or practically no role at all.

In the East Asian medical community, the Omentum has a startling anonymity.

Where we acknowledge its existence or not, as practitioners, every time we touch, needle or cup an abdomen, we are in an energetic exchange with the Omentum. The more we understand the Omentum in both Western physiological and in energetic potentiality terms, the more benefit we can derive from our work.

There are actually two Omentums, the Greater Omentum and the Lesser Omentum. Both function in similar manners, the distinction is location and attachments. The Greater Omentum is a highly vascularized fatty tissue that is approximately 14 inches long and 10 inches wide. It hangs like an apron over the intestines and lower abdominal region. The combined Omentums have attachments to the stomach, small intestine, colon, spleen, diaphragm, liver, portal vein, bile duct and hepatic artery.

The smaller and more delicate Lesser Omentum is stretched with attachments only between the stomach and the liver.

The Omentum is described as a thin, membranous bag that is "quilted" into little pockets. These pockets can be filled as a storage reservoir with superfluous fatter materials and other nutritional elements that are circulating in the blood and not immediately needed by the body. The fat deposits are received from the lacteals of the small intestines, the mesentery and the lymphatics of the liver, pancreas and spleen. During times of physiological need, these nutritional elements and fats can be readily reabsorbed back into the bloodstream.

The Omentum functions structurally as a "shock absorber" that surrounds and protects the abdominal viscera from physical injury. In addition, the Omentum distills an oily vapor that lubricates the surfaces of the abdominal viscera and facilitates the perpetual motion of these organs over each other. The Omentum also functions to protect the organs from temperature changes.

The Omentum has bactericidal properties and is able to contain and ward off infection and inflammatory processes in the abdomen, thereby protecting the viscera.

The Omentum has been described as the "brain" of the gut, containing numerous nerves that help control the varied viscera of the gut. The Omentum is rich in fibroblast growth factors that provoke the growth of new nerve tissues. The Omentum is an abundant source of neuro/transmitters, including serotonin and nerve growth factors that support central nervous system axon regeneration. The Omentum allows and supports normal bioelectrical activity and metabolism or nerve cells and tissues. Omental areas designated as "milky spots" are capable of generating macrophages that are specialized immune cells that facilitate healing. Even stem cells are contained in Omental tissues.

The lymphatics of the Omentum have an enormous capacity to absorb edematous fluids. The lymphatics of the Omentum are able to remove metabolic wastes, destroy toxic substances and fight infections. The Omentum is rich in angiogentic factors that stimulate the growth of new blood vessels and re-vascularize ischemic tissues. Also, the Omentum contains biological factors that prevent fibrosis and lessen adhesion formation.

Clearly, the Omentum is not inert tissue bereft of significant biological functions, as it has mostly been perceived. Indeed, the Omentum is a dynamic, vital and multi-dimensional aspect of our physiology.

How can the Omentum be viewed from an East Asian Medical perspective? .Does the Omentum provide functional aspects that are identified with the Spleen in TCM and with the Liver?... The Omentum has numerous attachments to the vital organs of the middle and lower jiaos. There is a direct attachment through the Lesser Omentum between the stomach and Liver. Taking into account the neurological capacities of the Omentum, can it possibly be facilitating communication between these organs?...Might the Omentum be functioning as an energetic information facilitator; a type of synergistic networking hub?

The Omentum allows for all these vital organs to share a physical connection as well as a physiological commonality that is not so readily apparent. In addition, as a source of stored nutrients, the Omentum is able to recognize nutritional deficiencies and direct energy and nutrients to an area of need and deficiency. Can we view this activity as a part of the spleen's transportation function?

Can the Omentum's role in neurological communication of the organs be seen as an aspect of the liver's role in maintaining a smooth and even flow of energy in the abdomen?

The Omentum functions as a storage area of fats. Fats area vital source material of hormone creation. The Omentum's role in fat absorption and fat storage point to crucial physiological importance for the endocrine system.

The primary white marrow of our bones is constituted of 98% fat. Considering the Omentum's role in fat absorption, fat storage and fat distribution, can we speculate that the Omentum functions, indirectly as a source of marrow?...The Omentum has been described as the brain of the gut, and in TCM we consider the brain as the sea of marrow. Might the Omentum be viewed as a "sea of marrow" located in the gut?

The Omentum is a vital, yet largely ignored organ in our bodies. It functions in numerous and diverse ways to help maintain and restore health. Clinicians of East Asian medicine would be well advised to become aware of the Omentum and seek to purposely focus attention on the Omentum in evaluation, treatment, and with herbal and nutritional strategies.