One of the key fundamental similarities of Western and Chinese medical systems, is that they both recognisethat the Lung’s primary importance is to allow oxygen/air into the body.
In Chinese medicine, one half of the acquisition of post-natal Qi, is ‘Air Qi’ and it is stated the Lungs Govern Qi and respiration by inhaling ‘clean Qi’ and exhaling ‘dirty Qi’.
In Western medicine it is seen that the Lungs supply oxygen to the blood and all cells within the body and then expel carbon dioxide, which is a fundamental necessity to the continuation of human life.
The respiratory system in its western sense, comprises of the nasal cavity, pharynx, larynx, trachea, bronchi and finally the lungs.
The nasal cavity filters air passing through it, this is achieved by the presence of mucus in the nose, in which contaminated particles stick to. This constant presence of mucus is achieved by tiny hair like structures called cilia beating in a whipping action moving fluid towards the nostrils. Another action it conducts, is to warm and moisten the air before it moves through to the next phase of respiration.
Occupying the majority of the upper chest, the Lungs are divided into 2 sections called lobes, connected to the Heart via the pulmonary artery and veins, from which the Lungs are supplied with Blood, which it then oxygenates.
The Lungs primary function is to maintain the normal level of oxygen and carbon dioxide ratio within the blood, this process is achieved via the Alveoli which are microscopic air sacs within the lobes. A gas exchange is facilitated by the process of blood flowing through capillaries in the walls of the alveoli allowing oxygenation and the carbon dioxide transfer to occur.
The mechanics of the Lungs and their ability to perform inhalation and exhalation, works on a mechanism of differing pressures between the airways and atmospheric pressure. By the process of breathing in, the volume increases within the chest creating a lower pressure than the atmospheric pressure; Air is now able to enter the Lungs and then the opposite occurs within exhalation.
The Chinese perspective of Lung function does have key, obvious similarities but several additional functions are also noted:
1. It Governs Qi and respiration giving the lung its ability to inhale and exhale and bringing clean Qi into the body and moving dirty Qi out.
2. It Controls the channels and blood vessels.The Chinese obviously knew through basic dissection of human anatomy that the heart connected directly to the Lungs, giving life to the theory of ‘Qi is the commander of blood’ & ‘blood is the mother of Qi’.
Yes, the Heart controls the blood vessels but the Lungs play an important role in the health and condition of the blood vessels by giving oxygen to the cell walls. If Lung Qi is abundant, circulation of Qi and Blood will be sufficient to nourish and energise the body.
3. Lungs control the diffusing and descending of Qi and body fluids. A primary function is that of dispersal of Qi and fluid around the body, giving its link to the skin and the ‘defensive Wei Qi’ and its protection from pathogenic influences entering via the pores of Skin. Also if accumulation of fluid in the body fails to descend, oedema may result often in the face and is known (within Chinese Medicine) as ‘moon face’.
4. Lungs descend Qi and fluids. The Lungs are often referred to as the ‘up source of water’ because they are the highest organ in the body, Qi must descend so it can communicate with the lowest source of water; the Kidneys. These two must communicate with each other to achieve a holding or grasping function of Qi and without the holding of Qi, breathlessness can occur and is a key symptom.
5. Lungs regulate all physiological activities, the Heart may be the ’emperor organ’ and in charge of the Shen, but it’s the Lungs acting like a ‘prime minister’ that are in charge of regulation of the organs; and thus the further link of the intertwined nature of Qi and Blood once again is made but now from a spiritual angle.
The Qi of the Lungs, known as Zong Qi or gathering Qi, plays a fundamental role in the circulation of blood, by assisting the Heart in the circulation of blood hence the widely used term (Qi is the commander of blood, blood is the mother of Qi). I would further suggest that the regulatory function that Lung Qi has on the organ system from our knowledge on a cellular level in the western model, oxygen depletion to the cells results in death. Without the Lungs ability to administer oxygen to the blood cells and then circulate around the body to every organ all cell life would cease to exist.
6. Lungs regulate the passage of water. From the fluids we eat and drink, the Spleen sends the pure fluid up to the Lung from which the lung sprays this fluid as a fine mist between the skin and the muscle. This control over the area of the skin, also controls the opening and closing of the pores, failure of Lung Qi to descend results in fluid not being sent down to the Kidneys and urinary retention may now occur as it has a key role in the Bladder’s normal functioning process. Through the opening and closing of the pores, the Lungs have a responsibility in the excretion of body fluid through sweat. Failure to sweat or to uncontrollably perspire is seen as deficiency of the Lung Qi.
7. Lungs control the skin and the space between muscle and skin, as the Lungs spread the fluid from the Spleen under the skin bringing nourishment and moisture to it, failure to perform this process will lead to rough dry skin. If this space is properly regulated and the opening and closing of the pores occurs as they should, defensive Wei Qi will be strong and the Lungs will be able to resist attack by external pathogenic factors. If they are weak the pores will be open, spontaneous sweating occurs and the patient will now be more prone to attack by EPF’s.
8. Lungs manifest in the body hair, the Lungs diffuse Qi and fluid to the skin giving body hair its lustre, any deficiency of the Lungs and the hair will be dry, withered and brittle.
9. Lungs open in the nose, as in the Western model the respiratory system begins in the nose, the same is true of the Chinese model as both recognise that respiration occurs through it. Deficiency of Lung Qi effects the nose and if Lung Qi is weak, the sense of smell may be reduced. If a smell of rotting can be sensed, this may indicate a chest infection from Lung or ‘phlegm-heat’ patterns. If the Lungs have been invaded by damp EPF, the nose will be blocked and if heat has invaded, loss of smell and bleeding may occur.
10. Lungs control nasal mucus, if the normal function of diffusing or spreading of fluids are achieved, normal mucus content is received by the nose. Failure to complete this, results either in blockage or a profuse discharge of nasal fluid.
11. Lungs house the Po or corporeal soul, one of the five Shen which all affect the personality and how we react to the emotions life throws at us. The emotions have a massive effect on the organs and their function and the Lung is predominately affected by worry, sadness and grief.
As we can see, the Lungs are a massively important organ and without their correct function, it considerably effects the body and the rest of the organs to function correctly. Insufficient supply of air Qi and the entire system fails.
We will now discuss the following diseases and illness typically seen within clinic.
It’s important at this stage to highlight that in Chinese medicine, all Lung diseases are seen as energetic imbalances within the body; but in Western medicine, they are seen as infections, usually viral or bacterial based.
COMMON RESPIRATORY TRACT DISEASES
The Common Cold
Probably the most frequent respiratory disease in clinic, associated with a viral invasion with an incubation period of 1 to 5 days and having symptoms of:
Symptoms: runny nose, sneezing, aches and pains stuffy head and possible sore throat.
No known cure is recognised but many symptomatic relief agents such as paracetamol, decongestants etc. are often administered.
Chinese Medicine sees this as a ‘wind cold/heat invasion’, affecting the ‘Wei Qi’ level of the body with exterior symptoms and initially, little to no disruption of the Zang Fu.
Treatment principle is to tonify the Wei Qi and expel wind.
Wind cold/heat enters via the Tai yang Chanel which runs up the back of the body, hence why many cold conditions start with a stiff neck.
Treatment: An effective treatment protocol at this stage of invasion is to spread Wei Qi over the back of the body, using the extraordinary channels with points Si3 & Bl62.
Flash cupping on the upper back and needle Gb20, Lu7, Li4, Bl11, 12, 13, 20.
Then plenty of rest, eat energetically hot foods to encourage sweating, even exercise at this stage if the patients Qi is strong will force the pores to open and release the pathogen.
If the pathogen has gone deeper into the body and overcome the Wei Qi, sweating will be profuse as the Lungs now fail to regulate the pores, breathing will be affected and phlegm levels will have increased with tightness in the chest.
If progression moves further & deeper, all aspects of Lung’s function will be impaired and the pathogen will move into the large intestine, the paired organ of the Lung, resulting in bowel related issues.
Treatment principle: descend lung Qi/expel phlegm, tonify stomach and spleen.
Regarding treatment protocols, when a pathogen has invaded the body and symptoms show an organ system is significantly compromised, it is important to remember not to tonify the organ which the pathogen resides in, as the pathogen could be strengthened; the pulse is a good medium to identify this. This is often referred to as ‘clear the excess before tonifying the deficiency’.
The Six Levels
As discussed by Zhang Zhong Jing in the Shang Han Lung, is the order in which disease passes through the body. Starting at the Lung, referred to as the delicate organ, traveling through the levels until finally reaching foot Jue Yin of the Liver.
Stages of diseases begin at the exterior.
The 1st is called a ‘Tai Yang syndrome‘.
This typically presents as a sensation of cold or fever but with…
Syndromes: no sweating, an aching body especially in the neck, occipital headaches, cough and runny nose.
Tongue is normal/white coating.
Pulse is Floating-tight.
Treatment Principle: is to disperse cold and descend Lung Qi (see above points).
The next level is called a ‘Yang Ming syndrome‘
This presents with more heat signs
Syndromes: sweating, fever, constipation, thirsty.
Tongue is red with yellow coating.
Pulse is full and rapid.
Treatment principle: to Clear Yang Ming heat.
Points prescription: Li4, 11, St 41, 44, 25.
The final exterior level is the ‘Shao Yang Syndrome’
This presents with alternating sensation of heat and cold
Syndromes: nausea, no appetite, chest fullness, Rib pain, dizziness.
Tongue is Red on the sides.
Pulse is wiry.
Treatment principle is to harmonise the Shao Yang.
Points prescription: Yang Wei Mai extraordinary channel Sj5-GB 41 is effective for alternating chills and fever. Other points to consider are Gb 20, Bl19, Lv14
It is however, good practice to tonify the unaffected organs deeper in the body, especially the digestive system as 80% of our immunity resides in the gut. This will help combat and prevent the pathogen driving deeper into the system from the first initial sign an EPF attack has taken place.
A possible acupuncture prescription could be Lu7, Ren 17, 12, St 36, 40, Sp3.
If the virus does progress and a clear syndrome can be identified, I would suggest tonifying the organs in that level, almost like a firewall to help protect the body from deeper invasion.
In the next article we will discuss various respiratory conditions that you may see in clinic.