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The ancient texts state: The Lung is like the official of a prime minister, from which governance and regulation arise. It is the source of vital Qi (vital energy), shaped with four hanging lobes, attached to the third thoracic vertebra of the spine. There are twenty-four openings distributed in rows to circulate Qi among the Zang organs. It is the chief of the Zang organs and serves as a canopy covering the Heart.

It is also said: This meridian (the Hand-Taiyin Lung Meridian) has abundant Qi and scarce Blood. It corresponds to the skin, its luster manifests in the hair, and it opens into the nose.

The *Nan Jing* (Classic of Difficult Issues) states: The Lung weighs three jin and three liang, having six lobes and two ears, totaling eight lobes. Its primary function is to store the Po (corporeal soul). The lung tissue is white and translucent, hence called the "Canopy" (Hua Gai) because it covers the other organs. Internally, it is hollow like a honeycomb, with no perforations at the bottom. Upon inhalation, it fills; upon exhalation, it empties. Each breath occurs naturally, regulating the transformation and transportation of clear and turbid substances, serving as the bellows for the human body's respiration.

It is also said: During the Yin hour (3-5 AM), Qi and Blood flow into the Lung.

[Lung Diagram]

The term "Lung" (Fei) implies a marketplace, where all meridians converge. When food and drink enter the stomach, they do not act independently; instead, Earth Qi, being lowly, ascends to converge in the Lung. Lung Qi descends like Heavenly Dao, bringing brightness.

The classics state: In Heaven, the Lung corresponds to Dryness; on Earth, to Metal; in Man, to the Lung organ; in Season, to Autumn; in Direction, to the West; and in Color, to White. It opens into the nose.

The classics state: The West belongs to Metal. All things harvest due to it.

It is also said: The True Qi of the Zang organs is highest in the Lung, circulating Ying (Nutritive) and Wei (Defensive) Qi and Yin-Yang. Spleen Earth is the Mother, Kidney Water is the Child. The Large Intestine is a Fu organ (text erroneously says Zang), controls Wood and governs Qi. Prolonged lying down injures Qi. The Lung stores the Po, corresponds to Metal, animal to Horse, trigram to Qian (Heaven), nature to Righteousness, luster to Hair, manifestation to Nose, grain to Rice, seasonal correspondence to the Tai Bai star. Disease manifests in the skin and hair. The musical note is Shang (strong), symbolizing Metal's hardness. The number is nine, odor is fishy, sound is weeping, fluid is nasal mucus, taste is pungent. Externally it corresponds to skin and hair, color white; however, it should be lustrous like white jade, not dull like chalk.

The *Ling Shu* (Spiritual Pivot) states: The Lung corresponds to the skin; thick skin indicates a thick Large Intestine. Furthermore, the Lung governs Dryness, but excessive Dryness injures the Lung, causing cough. Regarding smallpox/pox, if Heat Qi prevails, disease occurs, manifesting as pale face, sorrowful crying, hand rubbing eyes/nose/face, sneezing, rhinorrhea, vomiting, epistaxis, wheezing, alternating chills and fever, and moving Qi in the hypochondrium. Lung Deficiency causes sighing, shortness of breath, excessive nasal discharge, dry throat, fatigue, hemoptysis, and pale lips. Lung Excess causes chest oppression, restlessness, rapid breathing, cough, rebellious Qi, nasal congestion, pain in calves/thighs/shoulders, and chest fullness. Lung Exhaustion presents with sweating, moist hair, unceasing asthma, hair loss, and escaping Qi; death occurs within three days. A normal pulse in autumn (72 days) is floating and fine ("Mao"), meaning sparse and soft, light and empty resembling floating. The hostile pulse is floating, large, and firm. Red face is adverse. The critical pulse feels like hair blown by wind.

Hua Yuanhua said: The Lung is the source of generating Qi and the canopy of the five Zang organs.

The classics state: The Lung belongs to Xin Metal, is Yin within Yin (Tai Yin), connects with Autumn Qi, pairs with the Large Intestine as Interior-Exterior. Its mother is Spleen Earth, child is Kidney Water, it overcomes Liver Wood, and is overcome by Heart Fire. It stores the Po. Color white, taste pungent, odor fishy, luster in hair, manifestation in nose, nourishes skin, fluid is nasal mucus, sound is weeping. Deficiency causes sighing; excess causes asthma and cough. Normal pulse is floating and short; hostile pulse is surging. When Hand-Taiyin Qi exhausts, skin and hair become scorched; scorched skin leads to loss of fluids; damaged skin joints lead to withered skin and broken hair; broken hair indicates death of the hair first. Condition worsens on Bing day, dies on Ding day. Lung exhaustion leads to death in three days. Pulse suspension leads to death in twelve days. White as pig fat indicates survival; white as dry bone indicates death. Excess dreams of weapons and conflict; deficiency dreams of fields and plains. Sorrow injures the Lung; Joy overcomes Sorrow. Tonify with Sour, drain with Pungent, purge with Bitter.

Qibo said: Cold exposure and cold drinks injure the Lung. Cold drinks cause internal and external cold interaction, injuring both, leading to rebellious Qi ascending.

The *Jin Gui Zhen Yan Lun* states: Autumn diseases affect the shoulders and back, corresponding to the Lung.

It is also said: Changes in pulse manifest as cough.

The *Mai Lun* states: A pulse that is gentle and fluttering, like falling elm seeds mixed with coins, is a healthy Lung pulse. A pulse that is neither high nor low, feeling like touching a chicken feather, indicates Lung disease. A pulse that is light and floating, like hair blown by wind, indicates Lung death. The true Lung pulse is large and empty, like a feather touching the skin.

The classics state: Signs of Lung disease include frequent sneezing, sorrow, desire to cry, aversion to cold and fever, pain in the supraclavicular fossa, shoulder and back pain, lower abdominal pain on the right of the umbilicus, frequent urination, loose stools, skin pain and numbness, asthma with shortness of breath, and visible Qi on the cheeks.

The classics state: The Lung governs Qi.

It is also said: All Qi belongs to the Lung.

It is also said: The Lung stores Qi. Excess Qi causes asthma, cough, and rebellious Qi; deficient Qi causes easy breathing but shortness of breath.

The *Ling Shu* states: Dan Zhong is the Sea of Qi; Dan Zhong is the chamber of the Lung. Excess causes redness of chest and face; deficiency causes lack of Qi and power, and reluctance to speak.

Danxi said: Cold Qi, stagnant Qi, rebellious Qi, and ascending Qi are all caused by the Lung suffering from Fire pathogenic factors. Qi undergoes inflammatory transformation, rising without descending, steaming the clear pathways, potentially becoming severe illness. Formulary prescriptions often use acrid, aromatic, drying, and hot agents, which is adding fire to fire.

Zi He said: All diseases arise from Qi; all pains are due to Qi.

*Hui Chun* states: Wind injuring Qi causes pain; Cold injuring Qi causes shivering; Summerheat injuring Qi causes heat and oppression; Dampness injuring Qi causes swelling and fullness; Dryness injuring Qi causes constipation.

*Ru Men* states: Idleness causes Qi stagnation and knotting. Mild cases heal with movement; severe cases require Tangerine Peel One-Ingredient Decoction (Tangerine Peel 1 liang, washed, decocted in fresh water).

*Zhi Zhi* states: The Seven Qi refer to Joy, Anger, Sorrow, Thought, Worry, Fright, and Fear, or alternatively Cold, Heat, Resentment, Anger, Joy, Sorrow, and Grief; these are all interconnected.

The classics state: The Back is Yang, and within Yang is Yin, which is the Lung. The Lung is a Yin organ (Pin Zang); Pin means Yin.

It is also said: All Qi stagnation belongs to the Lung.

Humans have Seven Emotions, giving rise to Seven Qi. Qi knotting generates Phlegm; abundant Phlegm further knots Qi. Therefore, regulating Qi must first resolve Phlegm. For example, Seven Emotion Decoction uses Pinellia as the main herb, assisted by Cinnamon Bark, which is an excellent method.

Tai Yi Zhen Ren said: Speak little to nourish internal Qi.

Xiang Chuan Weng said: Essence generates Qi; Qi generates Shen (Spirit). Nourishing Ying and Wei throughout the body cannot surpass this.

Yellow Emperor asked: I know hundred diseases arise from Qi. Anger causes Qi to ascend; Joy causes Qi to slacken; Sorrow causes Qi to dissipate; Fear causes Qi to sink; Cold causes Qi to contract; Heat causes Qi to leak; Fright causes Qi to disorder; Labor causes Qi to consume; Thought causes Qi to knot. These Nine Qi differ; what diseases arise? Qibo replied: Anger causes Qi to rebel; severely, it causes vomiting blood and undigested stool diarrhea, so Qi ascends. Joy harmonizes Qi and will, making Ying and Wei smooth, so Qi slackens. Sorrow tightens the Heart connection, lifts Lung leaves, blocks Upper Jiao, prevents Ying and Wei dispersion, trapping Heat in the middle, so Qi dissipates. Fear retreats Essence; retreat blocks Upper Jiao; block returns Qi; return causes Lower Jiao distension, so Qi does not move. Cold closes pores, stops Qi movement, so Qi contracts. Heat opens pores, allows Ying and Wei flow, causes profuse sweating, so Qi leaks. Fright leaves Heart unsupported, Shen unanchored, thoughts unsettled, so Qi disorders. Labor causes panting and sweating, internal and external leakage, so Qi consumes. Thought fixes mind and Shen, causing Zheng Qi to remain stagnant, so Qi knots.

The classics state: Qi is the root of Shen and Essence. (Li Dongyuan said: Qi is the ancestor of Shen; Essence is the son of Qi; Qi is the root of Shen and Essence.)

It is also said: Prolonged lying down injures Qi.

*Xishan Ji* states: Approaching foul Qi touches True Qi; approaching Death Qi disturbs Generating Qi.

*Zheng Chuan* states: Men belong to Yang, receiving Qi easily scatters it. Women belong to Yin, encountering Qi often stagnates it. Thus, men's Qi diseases are fewer; women's Qi diseases are more common. Treatment principle: Women should regulate Blood to consume Qi; Men should regulate Qi to nourish Blood.

Qi Generated from Grain

*Ling Shu* states: Humans receive Qi from grain. Grain enters the Stomach and transmits to the Lung; all Zang and Fu organs receive Qi. The clear part becomes Ying (Nutritive); the turbid part becomes Wei (Defensive). Ying is inside the vessels; Wei is outside. They circulate endlessly, meeting every fifty cycles, Yin and Yang interconnecting like a circle without end.

It is also said: Upper Jiao opens and disseminates the flavors of grain, warming the skin, filling the body, moistening the hair, like mist and dew irrigating; this is called Qi.

It is also said: Qi acts as Wei, defending the exterior.

*Zheng Li* states: Daily consumption of dietary essence, when cooked, benefits Qi. This Qi is generated from grain, thus Qi comes from rice.

Ascending Qi

*Ling Shu* states: Pathogens in the Lung cause chills, fever, and ascending Qi. Ascending Qi means exhaling more than inhaling, with rapid and urgent breathing.

*Nei Jing* states: Excess Qi causes asthma, cough, and ascending Qi.

Descending Qi

*Gang Mu* states: Descending Qi belongs to the Heart.

The classics state: Summer pulse corresponds to the Heart. If Heart pulse is insufficient, it manifests below as Qi leakage.

It is also said: In epilepsy and consumptive diseases, if Qi leaks downward continuously, death is certain. This is exhaustion of True Qi, closure of intestines, stomach, and pores, preventing Grain Qi from circulating outside the intestines, thus leaking out from them.

Hejian said: Intestinal and gastric stagnation causes Grain Qi to emit internally but not circulate externally, leading to belching or descending Qi.

Zhongjing said: In Shaoyang Yangming disease, if there is dry feces in the Stomach, turning flatus (shifting gas) indicates success; purging then cures it. Turning flatus is downward Qi leakage.

Shortness of Breath

*Ming Li* states: Shortness of breath refers to Qi being too short to continue. If Qi rushes upward but is not truly rushing, breathing is frequent but discontinuous, resembling asthma without shoulder shaking, resembling groaning without pain, it is a difficult syndrome to distinguish. To recognize the truth, look for urgent and short breathing.

Zhongjing said: In healthy people with chills and fever, shortness of breath and inability to breathe fully indicates Excess.

It is also said: Shortness of breath with slight fluid retention should be treated by promoting urination. Ling Gui Zhu Gan Tang is indicated. Shen Qi Wan is indicated.

*Ru Men* states: Shortness of breath is discontinuous breathing. Cases include nodules/swelling, fluid retention with palpitations, Wind-Damp binding, or inherent Qi deficiency. Generally, heart and abdomen fullness/tightness indicates Excess and interior pathogens; soft fullness indicates Deficiency and exterior pathogens.

Dongyuan said: For shortness of breath with frequent urination, Si Jun Zi Tang minus Poria, plus Astragalus, is used to tonify.

*Ru Men* states: Scattered Qi causes Middle Jiao Deficiency, fatigue, weakness, shortness of breath. Tiao Zhong Yi Qi Tang or Ren Shen Yang Rong Tang are indicated.

*Mai Jing* states: Cun Kou pulse sinking indicates shortness of breath in the chest.

Scanty Qi

*Gang Mu* states: Scanty Qi means insufficient Qi to speak.

*Ling Shu* states: The Lung stores Qi; Qi deficiency causes faint breathing and scanty Qi.

It is also said: Lung Deficiency causes scanty Qi and inability to complete inhalation.

It is also said: The Kidney governs Qi; Kidney Deficiency causes scanty Qi, lack of speech, soreness of bones upon inhalation, and lethargy/inability to move.

It is also said: Dan Zhong is the Sea of Qi. Deficiency causes scanty Qi insufficient for speech.

*Nei Jing* states: Timidity and scanty Qi indicate failure of water passages and depletion of form and Qi. Speaking faintly, only speaking again after a whole day, indicates Qi robbery. Sheng Mai San is indicated.

Yi Lao said: Weak True Qi, weak pulse, reluctance to speak. Si Jun Zi Tang or Shen Qi Yi Qi Wan is indicated.

Dongyuan said: Internal injury to Spleen and Stomach causing Middle Qi deficiency. Bu Zhong Yi Qi Tang or Yi Wei Sheng Yang Tang is indicated.

*Huo Ren Xin Fa* states: Qi Deficiency Fever, shaking of hundred vessels, sensation of insects crawling, Minister Fire rising from feet, frequent heart vexation and palpitations, heavy head and brain stuffiness. Huang Qi 2 qian, Ren Shen and Gan Cao 1 qian each, Dang Gui 0.5 qian, Wu Wei Zi 9 grains, decocted. Named Huang Qi Tang, a clearing, harmonizing, and stabilizing agent.

Qi Pain

*Ru Men* states: Yuan Qi and Blood circulate in the body. When obstructed horizontally between organs, it causes pain, accumulations, and masses. When blocking upwards in the chest, it causes oppression, stabbing pain, etc. Often due to Seven Emotions and diet, condensing into Phlegm-Fluid. Early stage requires Acrid-Warm to open stagnation, move Qi, resolve Phlegm, and eliminate accumulation. Long-term requires Acrid-Cold to descend Fire and remove roots. Qi stagnation in Upper Jiao causes chest/heart oppression and pain; Zhi Ju Tang is indicated. Qi stagnation in Middle Jiao causes abdominal/hypochondriac stabbing pain; Mu Xiang Po Qi San is indicated. Qi stagnation in Lower Jiao causes lower back pain and hernia/masses; Si Mo Tang is indicated. Qi stagnation externally causes whole-body stabbing pain or edema; Mu Xiang Liu Qi Yin is indicated.

Rebellious Qi

*Ling Shu* states: Yellow Emperor asked: What causes rebellion and disorder? Qibo replied: Clear Qi is in Yin, Turbid Qi is in Yang. Ying Qi follows vessels; Wei Qi moves counter-current. Clear and Turbid interfere, disordering the chest, causing "Man" (oppression/stuffiness). Thus, Qi disordering Heart causes panting, silence, bowing head; disordering Lung causes up-and-down panting, calling while pressing hands; disordering Intestines/Stomach causes Cholera; disordering arms/legs causes Four Reversals; disordering Head causes Vertigo/Collapse.

*Ru Men* states: Rebellious Qi is Qi suddenly rushing up from the abdomen.

Danxi said: Patients saying cold air rises from below: This ascending Qi originates from Liver, carrying Minister Fire. It feels hot but patient perceives cold; it is not true cold.

It is also said: Upward rebellious Qi belongs to Yang, having no basis in Cold. Aversion to cold is Extreme Fire resembling Water.

*Ru Men* states: To scatter Fire, one must first break Qi; when Qi descends, Fire descends.

Qi Stagnation

Danxi said: Initial Qi disease is subtle. Due to Seven Emotions, Six Qi, or diet, fluids fail to move, Clear and Turbid interfere. From Qi forms Accumulation; from Accumulation forms Phlegm. Qi becomes stagnant, causing oppression or pain.

*Zheng Chuan* states: Qi stagnation with Dampness stasis leads to Heat. Thus, Qi stagnation diseases often accompany floating, swelling, and fullness.

*Ru Men* states: Stagnation means disease knotting unresolved. Jiao Gan Dan treats various Qi stagnations, emotional distress, loss of fame/fortune, depression, Seven Emotion injuries, poor appetite, sallow complexion, emaciation, chest/diaphragm oppression. It greatly regulates Water and Fire. Cyperus Rhizome 1 jin, soaked in running water for 3 days, taken with fried Poria 4 liang, pounded, honey pills, size of bullet. Chew one pill finely, swallow with Er Chen Tang.

Qi Deficiency Causing Disease

*Ling Shu* states: Where pathogens reside, there is deficiency. Upper Qi deficiency causes brain insufficiency, ear ringing, head heaviness, dizziness. Middle Qi deficiency causes urinary/fecal changes, intestinal rumbling. Lower Qi deficiency causes flaccidity/collapse and heart symptoms.

It is also said: Push and elevate Upper Qi deficiency; accumulate and follow Lower Qi deficiency. If Yin and Yang are both deficient, Fire will dominate.

*Ru Men* states: Seven Emotions originate from Heart; Seven Qi belong to Qi. Qi is Yang; movement generates Fire. Treat by descending Fire, resolving Phlegm, eliminating Accumulation. Generally: Qi Deficiency uses Si Jun Zi Tang; Qi Excess uses Xiao Wu Chen Tang; Excess Fire adds Huang Lian Jie Du Tang; Excess Phlegm adds Er Chen Tang; Excess Accumulation adds Ping Wei San.

Danxi said: For chronic Qi syndromes where Qi does not return to origin, and long-term medication fails, use Po Gu Zhi (Cibotium Rhizome) as sovereign. (Po Gu Zhi stir-fried 1 liang, Huixiang stir-fried and Ru Xiang 0.5 liang each, pounded, honey pills, size of paulownia seed. Take 50 pills on empty stomach with plain water.)

Fang Shi said: If Qi medicines fail for Qi diseases, it is because the storage of Qi lacks containment. Lung governs Qi, Kidney stores Qi. Qing Mu Xiang Yuan and Mu Xiang Shun Qi Wan both use Po Gu Zhi to make Qi ascend and descend, returning to Kidney.

*Ru Men* states: General prescription for Qi diseases is Er Chen Tang. (Upper Jiao stagnation add Zhi Ke, Jie Geng, Xiang Fu, Sha Ren. Middle Jiao stagnation add Hou Po, Zhi Shi, San Leng, Peng Ze. Lower Jiao stagnation add Qing Pi, Mu Xiang, Bing Lang. Qi pain add Zhi Ke. Qi excess add Wu Yao, Xiang Fu. Qi deficiency add Ren Shen, Bai Zhu, Mu Xiang.)

Danxi said: To treat ascending Qi, use Huang Qin, Huang Lian, Zhi Zi, Xiang Fu.

It is also said: "Qi has no tonification method" is secular talk. Consider that if Zheng Qi is deficient, it cannot transport pathogens, leading to disease. Classics say: Robust people recover as Qi moves; timid people develop disease as Qi sticks. If timid Qi is not tonified, how can Qi move?

It is also said: For Qi stagnation, use Chuan Xiong, Xiang Fu, Zhi Zi, Huang Qin, Huang Lian.

It is also said: Mu Xiang moves Middle/Lower Jiao Qi. Xiang Fu relieves stagnant Qi. Chen Pi drains rebellious Qi. Zi Su disperses Exterior Qi. Hou Po drains Wei Qi. Bing Lang drains Highest Qi. Huo Xiang ascends Stomach Qi. Chen Xiang ascends/descends True Qi. Nao She (Camphor/Musk) scatters True Qi. All these drain Qi's branch, not its root.

Blood-streaked phlegm indicates Yin Deficiency with Fire stirring, damaging Lung through consumption.

To distinguish hemoptysis, spit into water: Blood floating on water is Lung blood.

*Nei Jing* states: Lung Qi arises from San Jiao.

It is also said: Epiglottis is the gate of voice.

It is also said: Irrigates throat below, connecting to Spirit.

It is also said: Xuan Ji, Yu Heng, Se Lan Xu.

It is also said: Twelve rings in the central pavilion.

*Zhong Jing* states: Throat has twelve rings, flowing down between breasts.

*Wai Jing* states: Crimson Official has twelve levels of Heavy Tower.

*Ren Jing Jing* states: Epiglottis attaches below tongue base, corresponding above trachea. Trachea is throat. Located anteriorly, governing respiration, gate of voice.

It is also said: Inhalation Gate has twelve segments. Upper three small, lower nine larger. Fourth segment is Adam's Apple (Jie Hou). Adam's Apple contains upper three segments internally. During eating, Adam's Apple rises, covering upper three segments externally, reaching epiglottis to cover them, preventing food/water leakage. Mistaken ingestion causes choking.

It is also said: Lung is white like Metal. Lung floats in water; Metal sinks in water. Why? Lung is not pure Metal. Pungent, Shang note, Bing's softness. Greatly discussing Yin/Yang, small husband/wife. Interpreting subtly, Yin marries Fire, delighting in Fire, performing Yang Dao mostly, thus Lung floats in water. Cooked Lung sinks; Pungent returns to Geng. (Initially follows transformation, finally returns to origin.)

It is also said: Five Zang are equal, yet Heart/Lung alone are above Diaphragm. Why? Heart is Blood, Lung is Qi. Blood is Ying, Qi is Wei. Following up/down, called Ying-Wei, circulating meridians, Ying circles body, thus Heart/Lung are above Diaphragm.

*Nei Jing* states: Lung palace resembles Canopy.

It is also said: Passing under Canopy, clear and cool.

It is also said: Returning past Canopy, moves Kidney Essence.

It is also said: Lung Qi arises from San Jiao, opening hundred vessels, blood flows.

It is also said: Fluids connect to Six Fu organs.

It is also said: Lung belongs to Metal, pitch matches Huang Zhong, like sound of metal/stone.

Classics state: Metal reigns in Autumn, assists in Late Summer,废 (wastes) in Winter, trapped in Spring, dies in Summer. Reign days Geng/Xin, reign time afternoon. Trapped days Jia/Yi, trapped time dawn.