Lungs
The Lungs are one of the five Zang (yin) organs in TCM, belonging to the Metal element. They govern Qi and respiration, control the skin and body hair, regulate water passages, and are known as the 'tender organ' due to their direct contact with the external environment.
Five Element Correspondences
Season
Autumn
Climate
Dryness (Zào 燥)
Emotion
Sadness and grief (Bēi 悲, Yōu 忧)
Color
White (Bái 白)
Taste
Pungent/Acrid (Xīn 辛)
Sound
Weeping (Kū 哭)
Direction
West
Sense Organ
Nose (Bí 鼻)
Body Tissue
Skin and body hair (Pí Máo 皮毛)
Body Fluid
Nasal mucus (Tì 涕)
Peak Hours
03-05
Meridian
Lung Meridian
Educational content · Consult qualified TCM practitioners for diagnosis and treatment
Overview
In Traditional Chinese Medicine (TCM), the Lungs (Fèi 肺) are one of the five Zang organs, occupying the highest position in the torso among the internal organs. This elevated position gives them the poetic name "canopy" (Huá Gài 华盖), likening them to an umbrella that protects all the organs below. The Lungs belong to the Metal element and work closely with their paired Fu organ, the Large Intestine.
Unlike the Western anatomical understanding, the TCM concept of the Lungs encompasses a much broader functional system. The Lungs are considered the "tender organ" (Jiāo Zàng 娇脏) because they are the only major organ in direct contact with the external environment through the nose and throat, making them particularly vulnerable to external pathogenic factors like wind, cold, and dryness. They govern the body's Qi (vital energy) and respiration, control the skin and body hair, regulate water metabolism, and house the Corporeal Soul (Pò 魄).
The Lungs are crucial for maintaining immune function through their control of Defensive Qi (Wèi Qì 卫气), which circulates at the body's surface to protect against invasion by pathogens. When Lung function is strong, a person has healthy skin, a clear voice, and strong resistance to colds and infections.
Historical Context
The concept of the Lungs in Chinese medicine has been documented for over two thousand years, with foundational descriptions appearing in the Huang Di Nei Jing (Yellow Emperor's Classic of Internal Medicine) compiled around 200 BCE to 200 CE. This classical text established the Lungs as the 'Prime Minister' (Xiàng Fù) that assists the Heart in governing the body, and introduced concepts still used today—such as the Lungs governing Qi, controlling the skin, and opening to the nose.
During the Jin-Yuan dynasties (1115-1368 CE), physicians like Li Dong-Yuan further developed understanding of the Lung's relationship with other organs, particularly its connection to the Spleen in Qi production. The Ming dynasty physician Zhang Jie-Bin (1563-1640) elaborated on the Lung's role in water metabolism and its relationship with the Kidneys in breathing. The Qing dynasty warm disease (Wen Bing) school greatly expanded understanding of how external pathogens affect the Lungs, developing treatments for febrile diseases that remain influential today.
Physiological Functions
Governs Qi and Respiration
主气，司呼吸 (Zhǔ Qì, Sī Hū Xī)The Lungs are the primary organ of respiration, taking in clean air (Qīng Qì) from the environment and expelling turbid air (Zhuó Qì). This process of breathing is called 'exhaling the old, inhaling the new' (Tǔ Gù Nà Xīn). Beyond respiratory function, the Lungs govern the Qi of the entire body, helping to form Gathering Qi (Zōng Qì) by combining inhaled air with nutrients from the Spleen. This vital energy then circulates throughout the body to support all physiological activities.
Controls Dispersing and Descending
主宣发肃降 (Zhǔ Xuān Fā Sù Jiàng)The Lungs have two complementary movements: dispersing (Xuān Fā) and descending (Sù Jiàng). Dispersing sends Qi, fluids, and Defensive Qi outward to the skin and upward to the head, nourishing tissues and protecting against pathogens. Descending sends Qi and fluids downward to the Kidneys and Bladder for excretion. These two functions work together like a balanced see-saw—if one is impaired, the other is affected, leading to symptoms like cough, wheezing, or fluid retention.
Regulates Water Passages
通调水道 (Tōng Tiáo Shuǐ Dào)The Lungs play a key role in water metabolism by distributing fluids throughout the body and downward to the Kidneys and Bladder. This is why the Lungs are called 'the upper source of water' (Shuǐ Zhī Shàng Yuán). Through their dispersing function, they send moisture to the skin (enabling sweating) and through their descending function, they send water down for urination. When this function is impaired, symptoms like edema, urinary problems, or phlegm accumulation may occur.
Controls Skin and Body Hair
主皮毛 (Zhǔ Pí Máo)The Lungs nourish and moisten the skin and body hair through their dispersing function. When Lung function is healthy, the skin is smooth, well-moisturized, and the body hair is lustrous. The Lungs also control the opening and closing of the pores (Còu Lǐ), regulating sweating and protecting against external pathogens. This is why skin problems like dryness, eczema, or susceptibility to colds often indicate Lung weakness in TCM.
Connects to All Blood Vessels
朝百脉 (Cháo Bǎi Mài)All blood vessels converge at the Lungs, where blood is 'oxygenated' with fresh Qi before being circulated throughout the body. This function assists the Heart in moving blood through the vessels. The saying 'Qi is the commander of Blood' reflects how the Lungs' governance of Qi supports healthy blood circulation. When Lung Qi is deficient, blood circulation may be impaired, leading to symptoms like cold extremities or a purple tinge to the lips.
Governs Regulation
主治节 (Zhǔ Zhì Jié)The Lungs are called the 'Prime Minister' (Xiàng Fù Zhī Guān) that assists the Heart (the 'Emperor') in regulating the body's functions. This regulatory role includes maintaining rhythmic breathing, coordinating the movement of Qi throughout the body, assisting blood circulation, and managing water metabolism. The Lungs ensure that all these functions operate smoothly and in proper rhythm.
Houses the Corporeal Soul
藏魄 (Cáng Pò)The Lungs house the Pò, often translated as the Corporeal Soul. The Pò is the most physical and instinctual aspect of the soul, governing automatic body functions, sensory perception, and basic physical responses. It enters the body at birth with the first breath and is closely tied to the physical body. When Lung Qi is weak, a person may feel low vitality, detachment from their body, or difficulty 'letting go' of grief.
Relationships with Other Organs
Other
The Lungs and Large Intestine form an interior-exterior pair within the Metal element. They share a close functional relationship: the Lungs' descending function helps the Large Intestine eliminate waste, while the Large Intestine's proper elimination supports clear Lung Qi. When there is Heat in the Lungs, purging the Large Intestine can relieve Lung symptoms. Conversely, constipation due to dryness in the Large Intestine can be treated by moistening the Lungs.
Generating
According to Five Element theory, Earth (Spleen) generates Metal (Lungs). The Spleen extracts Grain Qi from food and sends it upward to the Lungs, where it combines with inhaled air to form Gathering Qi. This mother-child relationship means that chronic Spleen deficiency can weaken Lung Qi. The saying 'the Spleen is the source of Phlegm, the Lungs are the container' reflects how Spleen dysfunction creates Phlegm that accumulates in the Lungs.
Controlling
The Lungs and Kidneys share a special relationship in governing respiration. While the Lungs control inhalation and send Qi downward, the Kidneys 'grasp' or receive this Qi (Shèn Zhǔ Nà Qì). When the Kidneys are weak and cannot grasp Qi, breathing difficulties—particularly difficulty inhaling—may occur. The Lungs also send fluids down to the Kidneys, while the Kidneys vaporize fluids back up to moisten the Lungs.
Other
Both the Heart and Lungs reside in the Upper Burner, with the Heart governing Blood and the Lungs governing Qi. Since 'Qi is the commander of Blood,' the Lungs assist the Heart in circulating blood throughout the body. The Gathering Qi formed in the chest supports both heart rhythm and blood circulation. This close relationship means that Lung Qi Deficiency can affect Heart function, and Heart problems can manifest with respiratory symptoms.
Controlling
According to Five Element theory, Metal (Lungs) controls Wood (Liver). The Lungs' descending Qi helps to counterbalance the Liver's ascending nature, maintaining proper Qi circulation throughout the body. When this controlling relationship is disrupted—such as when Liver Fire rises excessively—it can 'insult' the Lungs, causing symptoms like coughing blood or chest tightness with emotional upset.
Common Pathological Patterns
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Key Manifestations
Tongue Manifestations
Lung patterns manifest in several distinct ways on the tongue. A pale tongue with thin white coating suggests Lung Qi Deficiency. A red tongue with little or no coating, possibly with cracks, indicates Lung Yin Deficiency with Empty Heat. A red tongue with yellow coating suggests Lung Heat or Phlegm-Heat. A swollen tongue with thick greasy white coating points to Phlegm-Damp obstruction. The front third of the tongue (the tip area) particularly reflects the condition of the Lungs and Heart—redness here may indicate Heat in the Upper Burner affecting the Lungs.
Pulse Manifestations
The Lung pulse is felt at the right cun (inch) position on the wrist. In healthy individuals, this pulse should be soft and flowing. Various pathological changes indicate different Lung conditions: a weak or empty pulse indicates Lung Qi Deficiency; a floating pulse suggests external pathogenic invasion affecting the Lungs; a rapid pulse indicates Heat; a slippery pulse suggests Phlegm accumulation; a thin or thready pulse may indicate Lung Yin Deficiency with depleted fluids. A floating and tight pulse together typically indicates Wind-Cold invasion, while floating and rapid suggests Wind-Heat.
Clinical Relevance
In clinical practice, the Lungs are a focal point for treating respiratory conditions, skin disorders, and immune deficiency. Common presentations include colds, flu, allergies, asthma, bronchitis, and chronic cough—all conditions where TCM offers effective treatments by addressing the underlying Lung patterns. The Lung's control of the skin means that eczema, psoriasis, and other skin conditions are often treated through the Lungs, particularly when accompanied by dryness or respiratory symptoms.
Modern TCM practitioners frequently treat Lung Qi Deficiency in patients with chronic fatigue, weak immunity, or those recovering from prolonged illness. The Lung's sensitivity to dryness makes Lung Yin Deficiency patterns common in dry climates, among smokers, and in people who use their voice extensively. The Lung-Spleen relationship is clinically important in chronic conditions involving phlegm production, where treating both organs together yields better results. Acupuncture points along the Lung and Large Intestine channels, combined with herbal formulas, provide effective treatment for both acute and chronic Lung conditions.
Classical Sources
Huang Di Nei Jing - Su Wen
Chapter 8 - Ling Lan Mi Dian Lun肺者，相傅之官，治节出焉
The Lungs are the minister official from which regulation and governance emerge.
Huang Di Nei Jing - Su Wen
Chapter 5 - Yin Yang Ying Xiang Da Lun天气通于肺
The Qi of Heaven communicates with the Lungs.
Huang Di Nei Jing - Su Wen
Chapter 10 - Wu Zang Sheng Cheng诸气者，皆属于肺
All Qi belongs to the Lungs.
Nan Jing (Classic of Difficulties)
Chapter 32肺主皮毛
The Lungs govern the skin and body hair.
Modern References
The Foundations of Chinese Medicine
Comprehensive textbook covering Lung physiology, pathology, and treatment from a TCM perspective, widely used in acupuncture schools worldwide.
Chinese Acupuncture and Moxibustion
Authoritative reference on the Lung meridian, acupoints, and clinical applications, published by the Foreign Languages Press, Beijing.
The Web That Has No Weaver
Accessible introduction to TCM concepts including the Lung organ system, written for Western readers without medical background.
Chinese Medical Herbology and Pharmacology
Comprehensive herbal reference including herbs that treat Lung patterns, with modern pharmacological research.