Entry-Exit Block

In clinic recently, many people have shown an entry-exit block between Liver and Lung. This may be old hat to practitioners living in the US, but I’m finding this common pattern fascinating. During the first month of the Lunar New Year, we are in a Metal month, while entering a Wood season of Spring. The Liver energy is rising, yet we still face any unresolved pathologies of Metal. The urge to move, to do things, to activate, really gets us going and possibly shakes us out of the wintertime blues. Yet, at this time many people experience the pain of transition between seasons- colds and flus attack the lungs, and restlessness and irritability from the unexpressed liver can exacerbate ill-feelings. Unexpressed grief can flash into anger, and anger can melt into grief as well.

The end of the Liver meridian is the 14th point, located above the 6th rib,  on a line directly below the nipple. Its name is Qi Men, Gate of Hope. According to the esteemed J. R. Worsley, this point allows us to see our way out of darkness and into a better future.


The Liver is associated with the emotion of anger. The Spiritual Pivot states, “With anger the qi rebels upwards and accumulates in the chest.” Another text by Zhang Jing-yue states “If anger occurs during or after eating it injures the Stomach and Spleen.” Furthermore, LR14 is a meeting point of the Yin Linking Vessel, which if diseased, will cause Heart pain. Obviously this point has a lot to do with opening an outlet for the resolution of this conflict, anger, and constriction or obstruction of the entire chest/lungs/heart. The Liver is of the Wood element, whose energy is represented by the tiny seed using huge amounts of pressure to force its way through tough soil in order to sprout. If this naturally beneficial “pushing upward” energy is stuck, or assertiveness is discouraged, then the Liver can begin to create patterns of anger and frustration. This will in turn create the sour stomach after eating when emotionally frustrated or disturbed. It can create that feeling of holding in your breath for fear that if you let it out you’d punch someone. It can create a feeling of suffocation, of sharp pains in the heart, of having no urge to breathe fully as your mind runs in circles around some blockage or conflict.

In the midst of this accumulation of tension, it’s interesting that the Liver is a big reservoir of blood, a very Yin organ, and a place where the organ’s associated spirit must come to “rest.” The organ’s spirit, or the Hun, the ethereal soul, is a very Yang spirit involved in directing our actions and showing courage in the world. The Yin of the blood resting and the Yang of the soul moving represents the dichotomy of making decisions from a calm, restful, peaceful place and then using those decisions to create a powerful  utilization of resources. When we don’t have that calm basis for energetic action, we do things prematurely or erratically, creating frustration. As that happens, the balance tips toward more Yang energy, a flaring upwards of bottled emotion, and the constricted breath that is relieved by a heaving sigh of frustration. This heaving sigh is completely characteristic of Liver/Wood imbalance, and it leads us to the LUNG!

The beginning of the Lung channel is a point on the lateral edge of the pectoral muscle, in the first intercostal space. The human’s individual life begins with its first breath, outside of the amniotic sac.
Lungs allow the expression of our first scream! In a similar way, the Lung meridian begins of the flow of Qi through the whole meridian system, which loops back to the Liver meridian, seen as the “last meridian” which completes the circle by connecting with Lung once more.  The name of the 1st point of the Lung channel is “Zhong Fu”- Middle Palace or Central Treasury. It can be interpreted as the place where our internal authority resides (the god within the palace). This authority dictates what we allow into our bodies, what boundaries we must form, and to what use we will put the breath in our bodies. The Lung commands the Qi of the entire body; lungs are the bellows that stoke the fire. Lungs also act in a gentler way, as the leaves of the forest, transpiring and creating a beneficial mixture of elements in the air to allow life to flourish. The Lung is also the uppermost organ of the body; from there it serves to descend Qi down through the rest of the organs, where ultimately the Kidney grasps

this fresh Qi from the outer universe and converts it into an internal Qi that helps to power our core. It is like the mountaintop that gathers the clouds, which then rain and snow, creating the water that nourishes the plains and all life below. The Lung harvests Qi and begins this beneficial chain reaction of allowing the body to be fully nourished. It doesn’t ultimately carry out the details, but without this beginning we would not exist. It embodies the transformation of external environment (air) into internal power (life via oxygenation of blood).

Thus the Lung has a very active presence as an organ, compared to the liver. It is in direct communication with the external environment via the bronchioles; it is permeable, active, and promotes inspiration, as the human body inspires and expires. The corresponding “spirit” associated with the Lung is the Po, or Corporeal Soul. This is the part of the human that enters with the first breath and leaves with the last; it is very much connected to our presence here on earth, and it is a very solid and Yin-associated soul. Someone with strong constitution must have strong lungs, because the Corporeal Soul helps a person’s innate Essence to flourish in the body and become material strength. This strength aspect is also shown in the strength of someone’s attention span, the ability to overcome challenging work over a long period of time, patience, and the ability that is born of long hours of practice.

However, the Corporeal Soul in its healthy form embodies optimism, inspiration, the joy of connection with heavens, the essence of meaning within the mundane, and the spark of creativity rather than cold precision and logic. In order to follow through with these challenging tasks, one must have an underlying optimism or positive spirit. The balance of optimism and pessimism can control the flow of Qi in the body.

Sorrow and grief or pessimism are the emotions associated with the Lung; these emotions above all others have the power to make us want to stop breathing, to give up. Sorrow can paralyze and collapse the lungs, creating stagnation in the Heart, and often putting the Liver into disarray as well. In the control cycle, Lungs control Liver as Metal Controls Wood (an axe chops the tree). Lungs don’t only provide control in the form of preventing the Liver from becoming too angry/aggressive/powerfully moving, but they also provide control in the form of direction, encouragement, creating demands that create positive limitation and structure. If the Liver lacks the ability to form plans and structure, it will sink Impasseinto frustration. So a feedback cycle occurs with deficient Lungs (or a grief/sorrow) throwing the Liver into chaos, jumbling the planning process and creating frustrated circular patterns of thinking with occasional lashing out, which then can give way to grief again.

In a beneficial pattern, Lungs open to allow grief to flow through the body as necessary, allowing sorrow to soften anger and to actually allow deep breathing, wailing, the outpouring of sound in honor of this emotion, in order to create space for transformation to occur. Lungs can expand and open up space, so the Liver will be able to relax knowing that the path is cleared, and no moths need to beat their wings against the ribcage. Lungs must be open and healthy in order to perform a full exchange of oxygen with blood cells, and any sorrow or grief should be expressed in order to feel that optimism and hope that the steadfast Corporeal Soul represents, filling our mundane lives here on earth with meaning. Knowing and feeling this meaning creates the contentment necessary for the Ethereal Soul to rest within the Liver, gathering strength to perform correct action as needed. Gathering this life force with each breath propels our bodies through time and builds strength.

Balancing Lung and Liver can seem to be difficult without help, when one is really stuck in a rut. It’s extremely difficult to accept grief and let go, when you don’t have the hope of being able to receive inspiration after letting go. That’s why the Gate of Hope leads to the Central Palace. One’s Ethereal Soul must use its great active energy to open the door, and meet the Corporeal Soul’s steadfast strength to form this internal discipline and optimism that sets all of the following bodily and emotional processes on the correct track.

In clinic, I witnessed a great turn-around of a patient who came in with Liver-Lung disconnection/blockage. His pulse completely paused after every third beat; he came in with an affect of great sorrow kept in check, but he only spoke of feeling angry enough to punch things. He believed that being sad didn’t help anything and that being angry was more productive. Yet his pulse just stopped for an entire beat, every third beat. So my supervisor stood next to the patient and massaged Liver14 and Lung1 on the left side of the body for a minute, then the right side of the body another minute or so. This normalized the patient’s pulse to a large extent and actually created a watering in his eyes. The rest of the patient interview became more opening for the patient, and he left with an expression of underlying happiness with a more surface sorrow. It seemed like the doorway had been opened into a more hopeful outlook, and the optimism of the Metal/Lung could now nourish the positive forward energy of the Wood/Liver.


Deadman, Peter and Al-Khafaji, Mazin. 2007. A Manual of Acupuncture. Vista, CA: Eastland Press.

Ju-Yi, Wang and Robertson, Jason. 2008. Applied Channel Theory in Chinese Medicine. Seattle, WA: Eastland Press.

Worsley, J.R. and Worsley, J.B. 1998. Classical Five-Element Acupuncture Volume III: The Five Elements and the Officials. The Worsley Institute of Classical Five-Element Acupuncture.

Class with Michael Berletich, L.Ac.


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