The Lung and Large Intestine according to Traditional Chinese Medicine (TCM)

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According to Traditional Chinese Medicine (TCM), the Lung and Large Intestine are related to the Season of Fall. 

TCM, the Five Elements and the Lung

The Five Elements (Water, Fire, Wood, Metal, Earth) are qualities of nature that are foundational to the theory of TCM. The theory of the Five Elements is systematically applied to symptomatology, diagnosis, and treatment.  Some may argue that, together with the theory of Yin-Yang, it constitutes the foundation of TCM theory.

Each season is associated with an element, organ system, taste, etc. Each of these correspondences are then utilized in identifying patterns (TCM diagnosis), and treatment options. For example: Herbs that are recommended for phlegm in the sinuses are generally pungent (acrid).

A partial list of the Five-Elements correspondences for Fall includes:

• Season — Fall
• Element — Metal
• Yin Organ system — Lung
• Yang Organ system — Large Intestines
• Developments — Harvest
• Color — White
• Sounds — Weeping
• Emotions — Sadness
• Taste — Pungent
• Tissue — Skin
• Sense organ — Nose
• Climate — Dryness

The Lung governs regulation of the waterways, and the Large Intestine governs liquid. They are closely related with respect to “water metabolism” – a term for how the body processes, transports, and utilizes fluids. The Spleen, Lung, Kidney, Intestines, and Bladder work together to “regulate the water pathways.” Within TCM, the term “fluids” encompasses all normal fluid substances of the human body. These include sweat, saliva, stomach juices, urine, and other fluids secreted or discharged from the body.

Autumn and the Lung

One of the functions of the Lung is to receive the qi of the air and mix it with the qi extracted from food. This combination of qi is then distributed throughout the body, where it is important in preventing invasion from viruses, bacteria, and other invading pathogens. This function is called “protecting the exterior.”

During the Fall, the fluctuation of hot/cold and presence of wind creates an atmosphere ripe for “external invasions” such as the common cold or flu. The Lungs are an integral part of Wei Qi, your immune system, and are frequently affected by the common cold. That is why during Fall it makes sense to focus on keeping your Lungs and your immune system strong.

Sadness and the Lung

The emotion related to the Lung is sadness. The Lung opens up into the nose. That is why when you are crying you frequently have a drippy nose. It is also common to have a respiratory illness during/after grieving.

The skin and the Lung

Skin disorders are also considered pathologies of the Lung in TCM, because the Lung controls the skin. It is common for those that suffer from asthma to also suffer from acne.

There are other factors and systems that are taken into consideration when assessing the skin. For example: are parts of the skin dry, red, flat/raised, itchy, purulent (pus filled), and/or oozing? The presence of some of these may indicate that other systems are contributing to the symptoms.

In TCM it is rare that only one system is being affected because of how everything is connected. Also, when there is disharmony in one system it doesn’t take long for a “cascading effect” to take place and affect other systems.

The Lung and Large Intestine

The Lung is considered to be the internal, yin organ system. It forms a pair with the Large Intestine, which is considered to be the external, yang organ system.

Asthma and allergy sufferers frequently find that they have issues with constipation, due to the “internal-external relationship” between the Lung and Large Intestine.

You can also find the relationship between the Lung (Lu) and Large Intestine (LI) in how the energy flows through the meridians or channels. Note the internal connection between the meridians, and where the last point of the Lung meridian begins to where the Large Intestine Meridian begins. For a more detailed description please read pp. 73-96 of A Manual of Acupuncture. [4]

Note: “cun” is a TCM form of measurement. One cun is equivalent with the width of the interphalangeal joint (the top part of your thumb). A cun is based on your client’s body measurement.

The Lung Channel of Hand Taiyin

• The Lung meridian originates in the middle jiao (in the region of the stomach).
• It descends and connects with the large intestines (creating the internal connection between the Lu and LI), and then it returns upwards past the diaphragm and penetrates the lung.
• It continues to ascend the throat and passes obliquely downwards towards Lu1- where the channel emerges to form acupuncture points. Lu 1 is level in the first intercostal space, 6 cun from the midline of the chest.
• The channel continues to rise to the next rib space.
• Then, it moves up and past the armpit (antero-lateral aspect of upper arm), lateral to the Heart and Pericardium channels.
• The Lung meridian descends the arm, to the cubital fossa of the elbow at Lu5.
• It continues on its antero-lateral path as it descends towards the wrist.
• It moves through the thenar eminence (the meaty part of the thumb).
• The Lung meridian terminates at the radial (outside) of the thumbnail at Lu 11.
• A branch of the Lung meridian separates from the main channel at Lu 7 (at the styloid process) and travels to the radial side (outside) of the tip of the index finger, where it links with the Large Intestines channel at LI 1.

From: A Manual of Acupuncture, pg. 73 (4)

The Large Intestine Channel of Hand YangMing

• The Large Intestine channel begins at LI 1.
• It runs up the radial side of the index finger and passes through the web between the first and second metacarpal bones at LI 4.
• It then ascends to the depression between the tendons of extensor pollicis longus and brevis (the anatomical snuff box)- where LI 5 is located.
• It continues a path up to the elbow to LI 11.
• It ascends the lateral aspect of the arm up to the shoulder joint to LI 15.
• From there it crosses behind the shoulder to the depression between the scapular spine and lateral extremity of the clavicle to LI 16.
• Then, it travels medially, passing through Small Intestines 12 (SI 12), the center of the suprascapular spine to Governing Vessel 14 (Du14), just below the spinous process of C7. At C7 it meets the five yang channels of the hand and foot.
• From Du14, it enters the supraclavicular fossa in the region of Stomach 12 (ST 12); then it connects with the lung before descending through the diaphragm to join with the large intestines.
• Another branch ascends from the supraclavicular fossa along the lateral aspect of the neck, and passes through the cheek, and enters the lower gums.
• From the gums the channel passes through ST 4, curves around the upper lip and crosses to the opposite side of the body at Du 26 (at the philtrum below the nose).
• From Du 26, the left channel travels to the right and the right channel travels to the left to terminate either side of the nose at LI 20.
• At LI 20 the Large Intestine channel joins with the Stomach channel.
• According to some texts this is where the primary channel of the Large Intestine descends to ST 37 (on the leg). ST 37 is the “Lower He-Sea point of the Large Intestines.”

From: A Manual of Acupuncture, pp. 95-96 (4)

Lung function and the Kidneys

The Lungs, like in Western medicine, are where there is an exchange between gasses within and outside of the body. They take in clear, natural qi and expel turbid qi. This function is referred to as “diffusion” and “depurative downbearing.” Diffusion is the upward movement of Lung qi that carries nourishment to the skin, controls sweating, and keeps the nose free. Depurative downbearing is the downward movement of Lung qi that helps to prevent accumulation of water accumulation (ex. fluid in the lungs) or severe panting.

Together with the Kidneys, which TCM considers to be the root of qi, Lung qi and Kidney qi combine to form “true qi.” The Lung qi descends, but it is the Kidney qi that rises up and essentially latches on to the Lung qi to create a full fluid breath. Deficiency of either can lead to shortness of breath and rapid breathing with slight exertion.

Common symptoms of Lung disorders

• Respiratory disorders such as asthma, wheezing, coughing, dyspnoea (labored breathing), shortness of breath
• Nasal disorders such as nosebleed, nasal obstruction
• Disorders of the throat such as dryness, soreness, congestion, swelling and pain

For more information on how TCM approaches these symptoms, see The Common Cold.

Additional Information

• Eating for the Season: TCM and Fall
• Dietary Recommendations for Lung Disorders
• The Common Cold
• Your Immune System and Traditional Chinese Medicine
• TCM Dietary Recommendations for Kidney Deficiency

References

1. Kastner, J. (2004). Chinese Nutritional Therapy. Jeorg Thieme Verlag.
2. Pitchford, P (2002). Healing with Whole Foods 3rd edition. Berkeley, CA: North Atlantic Books
3. Hyunbae,K. (2007). Handbook of Oriental Medicine 3rd edition. Harmony & Balance Press.
4. Deadman, P., Al-Khafaji, M., Baker. K. (2005). A Manual of Acupuncture. East Sussex: Journal of Chinese Medicine Publications
5. Maciocia, G. Xin Ming, S. (2005). The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. London: Churchill Livingstone.
6. Wiseman, N. [editor, translator], and Ellis, A. [translator] (1996). Fundamentals of Chinese Medicine. [Rev. ed] Brookline, MA: Paradigm Publications