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The Body’s Defenses: Lungs, Skin and the Metal Element

Lungs, Skin and the Metal Element:   What is the Connection?

Are you surprised to hear that lung health is connected to the skin?  It may not seem obvious, yet modern studies of allergy, immune response and respiratory illness confirm a connection with the skin that Five Element acupuncture theory has recognized for centuries. For example, it is well-established that childhood asthma and eczema often occur together, and are mediated by the immune system.  Lungs, skin and the Metal Element in Five Element acupuncture are seen as a key part of the body-mind system of defenses, especially our connection to the outside air. 

Lungs and skin function in regulating boundaries, creating a protective container, and mediating exchange of nutrients and toxins.  As a system, they encompass far more than simply physical health and respiration. Through touch and breath, the lungs and skin link conscious awareness to the unconscious mind and to the bodily responses of the autonomic nervous system.  Emotional states, mental alertness and sensory perception are all mediated in part by the functions of lung and skin.  

Autumn and the Metal Element: Elimination and Respiration

The ancient Chinese physicians looked to nature and the seasons to understand the workings of the human body, mind and spirit.  The Five Elements are organizing principles that relate the cycles of nature to the body systems within us.  The systems of the body and the acupuncture meridians are viewed as energetic entities, called the “officials.”  These “officials” are like members of a team who each have a job to do.  (To distinguish the Chinese “officials” from their counterpart organs in Western medicine, we capitalize the name – e.g., Lung, Colon.)

The qualities of Autumn are expressed in the Metal Element.  One essential quality of the Metal Element that is easy to feel in Autumn is the letting go and dying back of life.  All around us, trees lose their leaves, plants wither and the world begins to turn cold.  Nature lets go of whatever has served its purpose, preparing for the cold months to come.  Without letting go, we can’t survive.  We have to get rid of the rubbish.  (To learn more in depth about the Metal Element, read this earlier blog post, or watch the video.)

Within the body, letting go means elimination of toxins and waste.  The body’s great eliminator of waste and toxins is, of course, the Colon official.  Nonetheless, the Lungs and skin also serve in elimination.   Respiration serves elimination via the exchange of gases, and skin serves elimination via perspiration through the pores.  The skin is sometimes called the “third lung” in Five Element acupuncture theory.  If our body is overwhelmed by toxins and waste, it may show up in skin problems, pimples and rashes, as our body attempts to eliminate via the skin.

Lungs, Skin and the Outside Air:  Boundaries and Protection

There’s a flip side to letting go of toxins and waste:  the ability to take in, inhale and inspire.

Inspiration is primarily a function of the Lungs, and by extension the skin.  Lungs, skin and the respiratory tract form our direct connection to the outside air.  

The outside air is vital to life.  If we can’t breathe, we can only survive for a few minutes.  At the same time, that connection has to be regulated, allowing us to take in only what is of value.  As much as possible, we need to keep out pathogens, toxins and anything that might do us harm.  That means we need good boundaries and a strong protective container.

The Lungs, nose and skin are a combined unit for the body’s boundaries and defenses.  In ancient Chinese medical theory, the nose is called the “protector” of the Lung.  The nasal membranes and passages are the first line of defense in filtering out airborne pathogens and pollutants, to keep them from going deeper into the respiratory tract and causing more serious illness.  If you come down with an ordinary head cold and are able to get rid of it, be glad that your Metal element energy is robust!

Lungs, Breath and Consciousness

A special quality of the Metal Element officials, Lung and Colon, is that they are close to our consciousness.  We have at least a small degree of voluntary control over their functions.  People are usually quite aware of how well elimination and respiration are working.  

By contrast, most of our other vital functions are controlled entirely by the autonomic nervous system and are far below the level of conscious control.  For example, if the Liver and Gall Bladder officials are doing their job, we are thankfully unaware!

A unique characteristic of the breath is that it is both voluntary and involuntary.  Breathing serves as a gateway between the conscious mind and the autonomic nervous system (unconscious).  Breath practices used in meditation, chanting and yoga can alter our state of consciousness.  The breath has the power to invoke a healing state by shifting the autonomic nervous system, allowing the person to move from sympathetic (fight-or-flight) to parasympathetic (rest-and-digest).  Healthy breathing supports all other systems – heart, digestion, brain – in functioning fully.

Through respiration and breathing, the Lungs give us a capacity for awareness and mental alertness.  When the Metal Element is robust, our boundaries are healthy and we are able to regulate our defenses appropriately.  We are alert in response to danger, and equally able to relax in safety.  

Skin Deep:  Boundaries and Touch

The skin covers the entire body, creating a protective container.  It is often said to be the largest organ in the body.  In Chinese medicine and Five Element acupuncture theory, there is a special kind of Qi (vital energy) associated with the skin, called the Wei Qi or “defensive energy.”  The skin, including the Wei Qi, is the fundamental barrier between outside and inside.  It forms a porous membrane that regulates what is allowed in and what is kept out.  

Skin is also the organ of touch.  As such, it is how we know where “self” ends and “other” begins.  The skin differentiates “me” from “not-me.”  As infants, touch is the primary mode of pre-verbal communication.  Experiencing safe touch is key to healthy development, and to the ability to differentiate safety from danger.  Touch also mediates the experience of pain and pleasure.  Through touch, the skin allows us to regulate our defensive responses, invoking both alertness to threat and relaxation in safety.

Touch can communicate a wide range of emotions, setting off a cascade of biochemical reactions.  Because of the deep physiological response invoked by touch, it can be a powerful tool for healing.  Many healing modalities, including Zero Balancing and Five Element acupuncture, access the body through the skin and touch.

Lungs, Skin and the Metal Element: Key Points

Autumn, season of the Metal Element, is the time of year we associate with the arrival of colds, flu and respiratory illness.  It’s a season when we feel more challenged both physically and emotionally, with cooler weather and fewer hours of daylight.  We are more in need of protection, comfort and safety.  One aspect of the Metal Element is the function of Lungs, skin and respiratory system as protective boundaries with the outside air.  To sum up:

  • Five Element acupuncture views the skin as the “third Lung,” and recognizes a connection of lung and skin health that has been confirmed by modern research.
  • Skin, lungs and respiratory tract regulate our connection to the outside air.  They allow us to take in what is needed, keep out what is not needed, and get rid of waste and toxins.
  • Lungs, via the breath, are a gateway between the conscious mind and the unconscious, autonomic nervous system.  Via the breath, the Lungs help regulate our emotional and physical defenses, allowing us to be alert in response to threat, and relax in safety and comfort.
  • The skin, as the organ of touch, is the primary sense organ of pre-verbal communication.  Touch mediates our experience of pain and pleasure, communicates a wide range of emotions, and regulates our responses to safety and danger.


Alaine D. Duncan.  The Tao of Trauma.  North Atlantic Books, 2019.

Claude Larre and Elisabeth Rochat de la Vallee.  The Lung.  Monkey Press, 1989.

J.R Worsley.  Classical Five Element Acupuncture, Vol. III:  The Five Element and the Officials.  1998.

Inner Works Acupuncture is a Five Element acupuncture clinic in northwest Portland, Oregon.  For more information or to schedule an appointment, call 503-227-2127.

Inner Works Acupuncture

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