As you might have noticed from being alive on the planet, which generally requires breathing, the Lung is located in the chest. The location of the Lung is reflected more on the right side than on the left (something that you’ll encounter again in Diagnostics when we talk about pulses). If you look at a diagram of the lung you will see that there are three lobes in the right lung and only two in the left (so that there is room for the heart).
As far as position in the body goes it is the highest Yin/Zang organ in the body. The Lungs are called the “Imperial Carriage Roof” for this reason in many texts because it sits above the Emperor, the Heart. The Lung is also one of your bigger interfaces with the world since you draw in air (the world) all day and all night every moment you are alive, so if there is an external pathogenic invasion of the body the Lung (which in TCM includes the throat, tonsils, bronchials, etc) is generally the first to be affected by these pathogens.
The Lung channel, which is called The Lung Meridian of the Hand Taiyin, originates in the Middle Jiao at about the Ren 12 point (draw a line from your umbilicus to the sternal costal angle – you’ll find Ren 12 in the middle of this line). From here the meridian pathway goes downward to connect to the Large Intestine and then does a U-turn, going up through the Stomach and diaphragm before going to the Lung itself. It ascends through the throat with a branch off of the channel going to the lateral chest and then down to the upper extremities.
Five Element Connection
Per the Five Elements, the element of Earth generates Metal, which is the elemental association for Lung. To tonify the Lung Qi, you can tonify the Stomach and the Spleen which will then pass on the good juju to the Lung system.
Physiological Functions of the Lung
The Lung Governs Qi and Respiration
Lung is the origin for the exchange of Qi between you and the universe through the mechanism of inhaling and exhaling. Lungs filter the air, while the Liver filters blood and the Kidney filters water. You exhale exhausted Qi through both your Lungs and through your skin in the form of sweat.
A baby’s first action as an independent being is to take a great gulp of air, taking in Qi from the atmosphere and descending it downward into the Lungs. Lung Qi’s natural direction of movement, which is outward and downward, then disperses Qi through the system. You can witness this outward and downward motion of the Lungs by watching yourself take a long slow deep breath in the mirror. Your chest expands outward demonstrating the outward movement. Your belly expands too, reflecting the downward motion.
When this movement is impaired, like when the Lung Qi ascends too much, there is the possibility of asthma, shortness of breath, wheezing, coughing, etc. All of these reflect a failure in the Lung’s natural directions of movement.
Transformation of Qi occurs through the control of respiration.
You get three sources of Qi when you come here to this planet. The Neijing says the universe feeds human beings from heaven (air) and earth (food). The third type of Qi (which is really the first type you get) is the Primary Qi you get from your parents when you are conceived and then carried in your mother’s womb. This is kind of a starter pack or trust fund, a happy birthday from mom and dad.
Da Qi or Big Qi – fresh air.
Food Qi or Gu Qi – vital qi you get from your food and drink.
Primary Qi – that’s the starter pack you get at birth from your parents.
Transportation of Qi
This is the movement of Qi. This includes the ascending and descending of qi. When you inhale, Qi descends. When you exhale, Qi ascends.
When the Lung Qi is weak, this is called Lung Qi deficiency which shows as symptoms such as a pale face, shortness of breath, soft/small/weak voice, and fatigue. Disorders in the transportation of Lung Qi include tightness in the chest, dyspnea (difficult breathing), wheezing and cough.
The Lung Controls Channels and Blood Vessels
Let’s talk about how the Lung controls the Blood vessels first because this has a direct biomedical connection that you might be able to relate to. You might remember from anatomy and physiology classes that the heart and the lung make up the pulmonary circulation. If the heart is impaired it will also affect the lung and (often but not always) vice versa. This is why congestive heart failure patients have shortness of breath and/or a lot of phlegm production. COPD (Chronic Obstructive Pulmonary/Lung Disease) also has heart complications along with it.
In TCM the same is true. The Heart and Lung work together intricately. Chinese culture views the body as a kind of ‘homunculus,’ a microsystem of the rest of the Earth. Not only is the body subject to seasons, to dampness, dryness, etc., but it is also governed in the same way the Chinese government historically functioned. Each of the primary yin/zang organs has a governmental role to make the ‘country’ that is your body function properly. The Lung is referred to as the Prime Minister, the Heart is the Emperor, the Liver is the General, and so forth. While the Heart/Emperor is the supreme commander of the body, it is the Prime Minister (the Lung) that shields the heart from harm and works closely with it to make the government of the body function properly. The two are interrelated and cannot be separated. If you happen to live in a country with a constitutional monarchy, you’ll get this association right away. We Yanks will have to work a little harder to get this concept!
Moral to this tale: The Lung controls the Blood vessels.
Now let’s talk about how the Lung controls the channels or meridians. The Neijing says “the Lung meets with all channels and collaterals.” Another quote from the Neijing: “Lung controls the Hundred Channels.” You will note as you study TCM that all vertical meridians pass through the Lung. You can see the significance of this in TCM in at least three ways:
The Lung channel runs down the radial/medial side of the lower arm. When you take a pulse as an Asian medicine practitioner you will place your fingers in 3 positions along the path of the Lung channel just proximal to the crease of the wrist.How can three positions on the lung channel reflect the health of the five main Yin organs? They can do that because the Lung controls the channels and because all channels run through the lungs. You can feel excesses and deficiencies in each of the organs in this way.
Lung is beneficial for energy and blood flow.
Blood flow is related to the breath. You will notice later in clinic that when you are taking someone’s pulse it will often change if they start speaking. You will also learn to count the number of breaths compared to the number of beats of the pulse to determine if the pulse is fast or slow (4 beats per inhale is good, 6 or more per inhale and it is considered fast).
Blood flow will come like waves corresponding with the breath.
Lung sends blood to the peripheral areas of the body along with the energy of the Heart. (And because of this you can sometimes sense what feels like an irregularity in the pulse that is really the breath affecting the pulse as mentioned above.)
Governs dispersing and descending
Lung Qi disperses outward and descends downward.
Three major things are dispersed by the Lung:
Wei Qi is generated and dispatched to the exterior of the body by the Lung for purposes of defense against pathogens (bacteria, viruses, parasites, but also TCM pathogens like wind, cold, etc.).The skin is the first layer of defense. When the Wei Qi, or protective Qi of the body, is deficient, the immunity is lowered rendering you more vulnerable to sickness.
Sent to the skin to keep it moist.
Wastes are sent out of the body through the sweating pores. This processes out toxins and also helps maintain the water metabolism balance of the body. The sweat pores (all 36,000 or so of them) open when you inhale so they can release wastes. That’s why someone who gets a serious drunk on the night before often smells like alcohol despite brushing their teeth and taking a shower.The Qi of the Lung sends vital substances out to the surface of the body using this dispersing energy, so when you exhale the pores shut, holding the Lung Qi in.
Qi in the Lung disperses in all directions, but it is responsible specifically and especially for the descending motion.
Descends fresh air downward to the dantian (the lower center of gravity in the body located about three finger widths below the umbilicus and in the center of the body). At the lower dantian the inhaled air meets with Gu Qi (Qi generated from food).Bonus info: Another name for the dantian is the Red Elixir Field or the Cinnabar Fields.
Read In Search of the Medicine Buddha on your next break if you want to know more about that.
Asthma patients are often shallow breathers, breathing into the chest only and unable to get the breath to descend to the Dantian or red elixir field.
Descends body fluids to the Urinary Bladder
Look at the diagram to the right. Food and drink are ingested and then descend to the Stomach. From here they move downward to the Small Intestine where they are separated into 1) pure, which goes directly to the Spleen, 2) pure in impure which goes to the Urinary Bladder, and 3) impure in impure, which goes to the Large Intestine.Absorbed Qi can go directly from the Stomach to the Spleen, from the Small Intestine to the Spleen, and even from the Large Intestine to the Spleen in the form of water that is reabsorbed while the stool is being processed in the Large Intestine.The Spleen can then send body fluids and Wei Qi up to the Lung and also direct the reabsorbed fluids from the Large Intestine up to the Lung.
Descends wastes to the Lower Jiao
Finally, the Lung descends waste products down to the Large Intestine and Urinary Bladder which are part of the Lower Jiao. This is one of the Lower Jiao’s jobs: to channel out wastes. In order for the Lung to maintain good condition it cannot tolerate foreign bodies. Excreting this waste helps the Lung maintain health.
The Lung regulates water passage
The Lung is the upper source of water in the body. Think of it like a holding pond with sluices that release water. The San Jiao is the route for water passage through the body. The San Jiao (Triple Burner, Triple Warmer, Triple Heater) is a channel, true, but the term “Jiao” also refers to the areas of the body through which water moves. The Upper Jiao as an area of water refers to the Lung. The Middle Jiao through which water is passed refers to the Spleen and Stomach and the Lower Jiao refers to the Urinary Bladder and Kidney. Water passage is regulated between these three jiao through the dispersing and descending functions of the Lung. This maintains proper water balance in all parts of the body.
Upon exhaling, waste in the form of carbon dioxide exits the body through the nose and mouth (as do extra body fluids) in the form of vapor. Wastes also exit the body in the form of water through the Bladder. This is regulated by the body in response to the seasons. In the summer the body sweats more, releasing more body fluids out through the sweating pores and less through the bladder. In the winter when the universal energy is down less fluid is dispersed through the skin and more to the urinary bladder.
The Lungs are sensitive to the season and to temperature changes. We communicate (both verbally and non-verbally) with the outside world through the Lungs. The Lungs also regulate water balance through the dispersal and descending function. While fluid is generated by the Spleen, Stomach, Small and Large Intestines, the Lung remains the upper source of water in the body. This does not refer to the generation of fluid, but through the lung’s ability to disperse and descend fluids. If this function is not working properly there can be water retention in the Lung (pulmonary edema), puffy eyes, and facial edema.
Lung opens to the nose
The color of the nose, quality and quantity of nasal discharge, nosebleeds, and more all reflect the condition of the Lung. Symptoms of the nose are very important for diagnosis of Lung problems. Here are some examples:
Watery loose discharge from the nose: can indicate invasion of wind and cold
Sticky, yellow/green discharge from the nose: can indicate heat in the Lung, infection or inflammation.
Nasal bleeding or bloody sputum: can indicate toxic heat
(Note: nose bleeds when one is not sick can indicate a very strong Yang constitution rather than a Lung symptom.)
Stuffy nose with no discharge and impaired sense of smell: can reflect stagnant Lung qi.
Lung controls the skin and hair growing in the skin
The skin-to-Lung relationship revolves around the dispersing function. There is a form of asthma often triggered by allergies which is associated with dermatitis and eczema. This condition reflects heat in the body either natively or heat that has invaded. When this form of asthma is worse, the skin is often better – when the asthma is less problematic the dermatitis is often worse. This is because the Lung must disperse the heat somehow, either through the Lungs or through the skin.
Dry skin is also often associated with Lung. The Wei qi, which is part of the Lung qi, opens and closes sweat pores. When the Wei qi is weak, it cannot close those pores again upon the exhale as it is supposed to. This releases more fluids and can dry the skin. Dry skin can also be but can also be associated with Heart, which provides the material foundation of sweat. Anxiety, which is closely associated with Heart imbalance, can make dermatitis and dry skin worse.
The Lung houses the Corporeal Soul or the Po
There are three parts to the soul in Chinese philosophy. Two parts of the soul live on after physical death. The third part, the Po, is the spirit of the body, the corporeal soul. It dies with the body at death. Po in Chinese can be translated as “White Ghost.” It is said when the Lung Qi is weak one often dreams of white objects. The Po can be damaged by trauma, emotional shock or grief. Asthma, especially adult onset asthma, is often due to childhood abuse and/or a bad diet during childhood.
You can sometimes diagnose Lung problems through dreams. In general, if you dream you get a gift, then the body is in a weakened condition. If you dream of white objects, bloody dreams, or killing, the Lungs are deficient. If you dream you give a gift, this may indicate an excess condition. When the lungs are in excess you may dream of weeping. If you have a repeat dream, you are in need of whatever that is.
Four sayings regarding Lung
The Lungs control the 100 (blood) vessels
This is due to the connection between Lung and Heart. Lung 9, for instance is the influential point for blood vessels. Bronchitis goes from acute to chronic to emphysema to pulmonary heart disease.
Lung loathes Cold
The Lung is sensitive to weather changes and any temperature changes. When the weather turns cold you feel it in your lungs and get goosebumps on your skin.
Lung controls the voice
Zhong qi is the “gathering qi” or the collective qi of the chest encompassing the heart and Lung qi. Its’ health or lack thereof controls the voice when Zhong qi is transformed into voice.
Lungs are located on the right or descending side
OK, really they’re located on both sides, but you can detect Lung qi most easily on the right. The right hand pulse is where you feel Lung health or dysfunction, for example.
The Qi of the body ascends on the left (controlled by the Liver) and descends on the right (controlled by the Lungs).
Functions of the Large Intestine
- Receive digested food from the Stomach and Small Intestine
- Reabsorb body fluids and send them to the Spleen
- Move the bowels (descending qi again) and get rid of the stool.
When the stool is loose, not enough has been absorbed; when there is constipation it might be that too much has been absorbed.
Relationship between Lung and Large Intestine
The descending function of the Lung Qi helps bowel movements. The Large Intestine resorbs bodily fluids to help moisten the Lung.
You can sometimes treat asthma and lung function by promoting bowel movements. Xuan Bai Chen Qi Tang is a formula which promotes the descending Lung Qi function and assists with this problem within 2-3 weeks.
- Source: Wu, Qianzhi. “Foundations of Chinese Medicine.” AOMA Graduate School of Integrative Medicine, Austin Texas. Fall 2007. Lecture Series.
- Maciocia, Giovanni. Foundations of Chinese Medicine. London: Elsevier Ltd, 2006. Print
- Ni, Maoshing. The Yellow Emperor’s Classic of Medicine. Boston MA: Shambhala Publications, 1995. Print.