The Experience Of National Chinese Medicine Master Xuan Guowei in Regulating The Five Organs To Nourish The Skin

The skin, as the outermost layer of the body, is an important indicator of health and beauty. Skin care and beauty treatments are increasingly valued. Traditional Chinese medicine (TCM) employs herbal medicine and traditional therapies to achieve beauty, which are widely praised for their efficacy and safety. According to TCM, "internal disorders manifest externally," meaning that internal organ dysfunction can reflect on the skin, thereby affecting aesthetics. Skin disorders are often external manifestations of imbalances in the internal organs, as the human body functions as an organic whole. When the organs are in harmony, the blood and qi flow smoothly throughout the body, resulting in healthy and beautiful skin. Hence, TCM beauty treatments emphasize holistic regulation to enhance qi and blood circulation and harmonize the organs.

Professor Xuan Guowei, a National Chinese Medicine Master and recipient of the National TCM Outstanding Contribution Award, is renowned as the "Skin Specialist." His clinical approach to treating skin conditions is rooted in the principles of balance and harmony, forming the academic ideology of "balancing yin and yang as the foundation of treatment, and using harmony as a guiding principle." He emphasizes the importance of physical and mental harmony, dietary balance, and the equilibrium of yin and yang to prevent diseases. As his student and assistant, I have had the honor of closely observing his clinical practices. Below, I summarize his experience in regulating the five organs to nourish the skin.

TCM Herbal Cistanche Supplements for Skin Care

1. Nourishing the Skin by Regulating the Lungs

The "Suwen · Formation of the Five Organs" states, "The lungs govern the skin and are manifested in body hair." This highlights that the lungs, through their dispersing function, distribute qi, blood, and body fluids to the skin and body hair, nourishing and moisturizing the body's skin and muscles. The skin, including sweat glands and hair, constitutes the body's outermost layer, which is increasingly valued in modern beauty standards.

Qi and blood are fundamental substances in the human body, playing crucial roles in physiological activities. As stated in the "Suwen · Regulation of Qi," "Humans consist of nothing but blood and qi." Qi is the driving force for the production and circulation of blood, while blood serves as the foundation and carrier of qi. Hence, "Qi is the commander of blood, and blood is the mother of qi." The lungs govern qi, enabling the inhalation of oxygen from the environment and the exhalation of carbon dioxide, thereby facilitating metabolic gas exchange. Healthy lungs promote the circulation of qi and blood, which nourishes the skin, making it supple and elastic. Conversely, poor circulation of qi and blood may lead to dull, pale, or yellowish skin. Prolonged stagnation of qi and blood may generate heat, resulting in conditions such as hyperpigmentation, melasma, and acne.

In treating melasma, for instance, Master Xuan often addresses the liver, spleen, and kidneys. However, he also considers the lungs' role in respiration (governed by the lungs) and the kidneys' role in gas exchange (governed by the kidneys). In TCM, the lungs and kidneys are interdependent, as "metal generates water." The lungs govern qi, and the spleen supplements qi; the spleen (earth) supports the lungs (metal). Therefore, Master Xuan frequently incorporates lung-nourishing and lung-tonifying herbs such as Chinese yam (Dioscorea opposita), adenophora root (Radix Adenophorae), winter melon seeds (Semen Benincasae), and platycodon root (Radix Platycodi). This aligns with the TCM theory that the skin is associated with the lungs as the "canopy" of the body and the governor of skin and body hair. By emphasizing lung health, treatment outcomes are often significantly enhanced.

Modern Medical Interpretation

From the perspective of modern medicine, the lungs play a critical role in oxygenating the blood and expelling carbon dioxide, thereby maintaining the body's metabolic balance. Oxygen and nutrients delivered through the bloodstream are essential for skin cell repair and regeneration. Impaired lung function can lead to inadequate oxygenation and hinder skin repair processes, resulting in dull or unhealthy skin. Furthermore, the link between the lungs and skin can also be observed in conditions like eczema and psoriasis, where respiratory health often correlates with symptom severity. Xuan Guowei's approach to nourishing the lungs to improve skin conditions reflects this physiological understanding and provides a comprehensive strategy that integrates TCM principles with modern medical insights.

Regulating the Five Organs to Nourish the Skin: Xuan Guowei's Approach Explained in Modern Medical Terms

The lungs, kidneys, and intestines:
According to Traditional Chinese Medicine (TCM), the lungs are closely linked to metabolic waste management by aiding in the excretion of turbid fluids through the kidneys and bladder, which form urine. Life depends on two essentials: air and food. The lungs are responsible for processing air, while the large intestine handles the conduction of food. "The lungs and large intestine are internally-externally related"; thus, lung dysfunction can disrupt the excretion of waste by the intestines. When the lungs fail to function properly, the body's metabolic waste accumulates, emitting turbid heat, which can darken and dull the skin.

Modern research has identified a connection between gut microbiota imbalance and various skin conditions, such as rosacea, atopic dermatitis, and psoriasis. This aligns with TCM's understanding of the interdependence between the lungs and the intestines. Optimal lung function helps maintain skin moisture and vitality. Xuan Guowei advocates for a diet rich in lung-nourishing foods, including lily bulbs, polygonatum (Solomon's seal), radishes, honey, pears, and sugarcane, which promote hydration and reduce inflammation.

From a modern perspective, the lungs play a vital role in oxygenating blood and eliminating carbon dioxide. By ensuring efficient oxygen exchange and circulation, the skin receives the nutrients and oxygen it needs for repair and regeneration. Poor lung function may result in hypoxia, leading to dull, dry, or inflamed skin. Additionally, the gut-lung axis, a concept explored in modern medicine, highlights the interplay between respiratory and gastrointestinal health, where gut dysbiosis can exacerbate systemic inflammation, directly affecting skin health.

Lung and immunity:
The lungs are considered the "canopy" of the five organs in TCM, responsible for dispersing protective qi (a concept akin to immune function) to the body's surface. This reinforces the skin barrier, making it resilient against external pathogens. Weak lung qi and compromised immunity can lead to skin conditions like urticaria (hives) and excessive sweating. For chronic urticaria, Xuan often uses the Yu Ping Feng San formula, which strengthens lung qi and fortifies the skin barrier. If the patient cannot tolerate warming agents like Astragalus, he substitutes it with Ficus hirta (five-fingered fig), which tonifies the lungs gently. For severe itching or dryness, he incorporates adenophora root for its lung-moisturizing and anti-itch properties, supported by modern research showing its anti-inflammatory benefits.

Modern medicine correlates such practices with the importance of maintaining a healthy skin barrier, hydration, and immunity. Chronic urticaria, for example, is linked to immune dysregulation and histamine-mediated reactions, which can benefit from dietary and lifestyle adjustments aimed at reducing systemic inflammation.

The spleen and skin health:
In TCM, the spleen is central to digestion, nutrient absorption, and the production of qi and blood that nourish the skin. The spleen processes food and fluids, transforming them into nutrients that are transported to the lungs and distributed throughout the body. "The spleen governs transportation and transformation," and its health directly influences skin conditions such as purpura, vitiligo, or a pale complexion. If spleen function is impaired, the skin loses its vitality due to insufficient nourishment.

Modern medical interpretations align with this view by recognizing the role of the gastrointestinal system in nutrient absorption and its impact on skin health. For example, malabsorption syndromes or gut dysbiosis can lead to micronutrient deficiencies (e.g., iron or zinc), manifesting as brittle nails, dry skin, or delayed wound healing.

For conditions like eczema, which TCM attributes to spleen deficiency and dampness, Xuan prescribes herbs like white atractylodes, poria, and coix seed to strengthen the spleen and reduce systemic dampness. Modern research supports this by demonstrating that these herbs possess anti-inflammatory and gut-modulating effects, which can alleviate eczema symptoms. In pediatric eczema, Xuan emphasizes regulating the spleen through gentle tonics like Ficus hirta, which is palatable for children and supports digestion.

The heart and emotional well-being:
In TCM, the heart "governs the blood and vessels" and "manifests in the complexion." Robust heart function ensures smooth blood circulation, delivering oxygen and nutrients to the skin, resulting in a rosy, radiant complexion. Conversely, insufficient heart qi or blood stagnation can lead to pale or ashen skin tones. Emotional health is also closely tied to the heart, as excessive sadness or anxiety can disrupt qi flow, dulling the complexion.

Modern medicine concurs with this by recognizing the link between cardiovascular health and skin health. Poor circulation or stress-related vasoconstriction can hinder blood flow to the face, leading to pallor or dullness. Moreover, chronic stress increases cortisol levels, which can impair skin barrier function, exacerbate acne, and accelerate aging.

Xuan emphasizes emotional regulation to nourish the heart and improve skin health. He advises patients to practice mindfulness and cultivate optimism, as positive emotions promote better blood flow and overall health. For conditions like alopecia areata, often associated with stress, he uses the Tian Wang Bu Xin Dan formula to calm the mind and nourish the heart. Ingredients like asparagus root and ophiopogon root have been shown to reduce stress-induced inflammation and improve sleep, facilitating hair regrowth.

In modern terms, this approach aligns with the psychodermatology field, which explores how mental health interventions like stress reduction and emotional well-being can improve skin conditions.

Conclusion

Xuan Guowei's TCM methodology of regulating the lungs, spleen, and heart to enhance skin health is supported by modern medical insights. His holistic approach integrates dietary therapy, emotional well-being, and targeted herbal treatments to address the root causes of skin conditions. By emphasizing the interdependence of organ systems, Xuan's practices align with modern understanding of systemic health and its impact on dermatology.