Waking During the Yinshi Hour, Rough Temples and Malnourished Joints: A Traditional Chinese Medicine Interpretation of the Common Origin of Lung and Kidney

Three to five in the morning—the yinshi hour. The Lung Meridian is on duty, and qi and blood shift from stillness to movement. Some people wake naturally during this period and happen to touch the skin at their temples, finding it rough and coarse, with a noticeable grainy texture as the fingertip glides across; when they move the cervical spine or wrists, a faint friction sound emanates from the joints—like an unoiled wooden axle. Is this sensation of "rough temples and rough bones" merely a coincidence?

From the perspective of traditional Chinese medicine, the temple region is not only an area traversed by meridians but is also closely linked to the functions of the lung governing the skin and hair, and the kidney governing the bone marrow. The yinshi hour happens to be the period when the qi and blood of the Lung Meridian are at their most abundant. The lung and kidney—one in the upper jiao governing qi and managing the skin and hair, the other in the lower jiao governing water, storing essence, and generating marrow. The two mutually nourish each other along the chain of metal-water mutual generation. Once this connection falls out of order, the skin and bones often send out signals simultaneously.

If one observes carefully at this time, one will find that the roughness is not an isolated phenomenon. Loss of skin luster is often accompanied by increased dry lines and decreased elasticity; joint clicking or an uneven texture on the bone surface may be related to insufficient marrow fluid and malnourishment of the tendons and bones. From the perspective of TCM pattern differentiation, such manifestations are commonly seen in constitutional states of yin-fluid depletion or insufficiency of essence and blood. What needs to be distinguished is whether the roughness is caused by dry pathogens damaging the lung, or whether it reflects kidney-essence deficiency with insufficient bone marrow—the two require different directions of regulation.

I. Why the Skin and Bones Are the First to Wake When the Lung Meridian Is on Duty During the Yinshi Hour

The Huangdi Neijing · Suwen · Chapter 44 on Wei Syndrome states: "The lung governs the skin and hair of the body; the kidney governs the bone marrow of the body." These twelve characters together reveal the interconnected relationship between lung and kidney, and between skin-hair and bone marrow. The lung faces the hundred vessels and transports essence to the skin and hair; the kidney stores essence, essence generates marrow, and marrow nourishes bone. The lung belongs to metal, the kidney belongs to water; metal can generate water. When lung fluids are sufficient, they descend to irrigate kidney essence; when kidney essence is replete, it ascends to moisten lung metal.

During the yinshi hour, the Lung Meridian is on duty—it is the time when the qi and blood of the lung organ are at their most vigorous. Qi and blood converge in the Lung Meridian at this time. If lung yin is insufficient, the skin and hair lose their nourishment, and the temple region—thin-skinned and flesh-sparse—is the first to show signs of dryness and roughness. At the same time, lung metal is the mother of kidney water; when the mother is deficient, the child is weak. When lung yin is depleted, it cannot descend to generate and nourish kidney water below; kidney essence subsequently becomes insufficient, the source of marrow transformation is imperiled, and the joint and bone surfaces lose their internal moisture, producing a rough friction sensation during movement.

This is precisely the chronobiological pathogenesis underlying "rough temples and rough bones"—not two unrelated matters, but manifestations of simultaneous water deficiency at both upstream and downstream points along the same metal-water mutual generation chain.

II. The Common Origin of Lung and Kidney: A Plain-Language Interpretation of a Classical Passage

"The lung governs the skin and hair of the body; the kidney governs the bone marrow of the body" comes from the Suwen · Wei Lun. Its original intent was to discuss wei syndrome—a condition of flaccid weakness of the limbs. The classical text points out that each of the five zang organs has its corresponding bodily tissue: the lung corresponds to skin and hair, the heart to blood vessels, the liver to fascia, the spleen to muscles, and the kidney to bone marrow. If the qi of a certain organ becomes hot or its essence is depleted, the tissue it governs will lose its normal function.

How does this passage relate to the theme of this article? Between the lung and kidney lies a biochemical pathway of "metal generating water." The lung disseminates fluids to the body surface, forming a defensive barrier; the kidney stores essence and transforms it into marrow, filling the bone cavities and supporting the skeleton. The skin-hair and the bones may appear distant from each other, yet they are in fact connected by fluids and essence-marrow—a pair of "upstream and downstream water fluids." Rough skin at the temples indicates insufficient dissemination of lung fluids, while the rough sensation in the bones suggests that kidney essence is somewhat deficient in its nourishment of the bone marrow.

This also explains why merely applying moisturizing lotion cannot resolve temple roughness—the problem is not local, but lies in the lung's disseminating function and the kidney's essence reserves. Similarly, regarding calcium supplements for rough joints: if kidney essence is not replete, no matter how much material is supplemented, it will be difficult to transform into marrow fluid.

III. Meridian Pathways at the Temple Region and the Theory That "Shaoyang Governs the Bones"

In TCM meridian charts, the temple region is located near the pathways of the Foot Shaoyang Gallbladder Meridian and the Hand Shaoyang Sanjiao Meridian. The Gallbladder Meridian "arises at the outer canthus, ascends to the corner of the head, and descends behind the ear"—the corner of the head precisely encompasses the temple area. Furthermore, the Huangdi Neijing contains the statement that "shaoyang governs the bones." When shaoyang meridian qi flows freely, the joints are smooth and agile; when the shaoyang pivot mechanism is impaired, the joints often exhibit stiffness, clicking, or a rough sensation.

The shaoyang meridian belongs to wood and governs rising and generating. From the zishi hour to the yinshi hour is precisely the phase when shaoyang qi transitions from latent storage to rising and generating. During the yinshi hour, the Lung Meridian is on duty; the lung belongs to metal, and metal controls wood—if lung metal is excessively exuberant or the lung qi's disseminating and descending functions are impaired, the shaoyang wood qi becomes suppressed, meridian qi is impeded, and the joints lose their capacity for extension. The temple, as an area traversed by the shaoyang meridian and simultaneously a site where the skin is thin and the bone is superficial, both receives nourishment from lung fluids and depends on the full reach of shaoyang meridian qi.

Clinically, individuals with rough temples accompanied by joint clicking often simultaneously present with bitter taste in the mouth, distension and fullness in the hypochondriac region, or emotional suppression—all of which point to a composite state of impaired shaoyang pivot mechanism and loss of clear moistening by lung metal. At such times, it is not appropriate to solely nourish yin; one must also consider whether the pivot mechanism's transportation is smooth. From the perspective of the five phases, lung metal generates kidney water, and water can contain wood; if lung metal is not clear, the water it generates is also turbid, and wood qi naturally cannot unfold smoothly.

IV. Essence-Blood Insufficiency and Failure to Distribute Fluids: Two Common Directions of Roughness Patterns

In TCM clinical practice, roughness at the temples and joints is commonly seen in two different pattern directions. The first is lung-kidney yin deficiency with insufficiency of essence and blood. In such individuals, not only are the temples rough, but the skin over the entire body tends toward dryness, the hair is lusterless and brittle, and the joints often produce a rustling sound during movement, possibly accompanied by soreness and weakness of the lower back and knees, heat in the five centers, and night sweats. The tongue body tends to be red with little coating, and the pulse is thin and rapid. The core pathogenesis lies in depletion of yin fluids and insufficiency of essence and blood, resulting in loss of nourishment.

The second is spleen-lung qi deficiency with failure to distribute fluids. Qi is the motive force for the movement of fluids. When spleen qi is weak, transformation and transportation lack power; when lung qi is insufficient, disseminating and descending functions are impaired. Although fluids are produced in sufficient quantity, they cannot be transported to the body surface and bone marrow. In such individuals, skin roughness tends toward "dry without moisture" rather than "dry and malnourished," and is often accompanied by fatigue, shortness of breath, poor appetite, and loose stools. The tongue tends to be pale and swollen with teeth marks, and the pulse is thin and weak. The key pathogenesis is that qi fails to distribute fluids, rather than a deficiency of yin fluids per se.

These two directions—one deficient, one replete; one at the yin level, one at the qi level—require entirely different approaches to regulation. For yin deficiency, one nourishes yin to contain yang; for qi deficiency, one supplements qi to distribute fluids. If one indiscriminately nourishes yin without differentiation, those with qi deficiency may become more stagnant with supplementation; if one indiscriminately warms and dries, those with yin deficiency may be like adding fuel to fire. This is precisely where the value of TCM pattern differentiation lies—the same rough manifestation may have completely opposite qi-blood-fluid states behind it.

V. Seeking Shu and Mu Points: Meridian Nourishment Approaches for Feishu and Shenshu

In TCM theory, the qi of the five zang organs is infused into specific shu points on the back. Feishu is located 1.5 cun lateral to the lower border of the spinous process of the third thoracic vertebra, and Shenshu is located 1.5 cun lateral to the lower border of the spinous process of the second lumbar vertebra. These two points, one above and one below, precisely correspond to the sites where the essence qi of the lung and kidney—two organs—converges. From the meridian perspective, rough temples and malnourished joints involve both the lung and kidney, and the back shu points are naturally worthy regulatory links to consider.

Moxibustion is one of the commonly used external therapies in TCM; its action lies in using warm-heat qi to penetrate the acupoints and warm and free the meridians. For regulating the lung and kidney, moxibustion at Feishu and Shenshu is a relatively common approach. However, specific procedures must be determined by a licensed TCM practitioner based on individual constitution, including acupoint combinations and duration of moxibustion—these should not be generalized. More importantly, moxibustion is not suitable for all dryness patterns—for those with yin deficiency and internal heat, excessive moxibustion may instead consume and damage yin fluids.

Compared with moxibustion, a more fundamental path to regulating the lung-kidney relationship lies in breathing and posture. The lung governs qi and manages respiration. Deep, steady breathing is itself the lung's rhythmic movement. Combined with gentle daoyin movements such as chest expansion and torso rotation, it helps with the lung qi's disseminating and descending functions and the unfolding of shaoyang meridian qi. Such daoyin movements need not pursue amplitude, but rather the coordination of rhythm and breathing. Specific methods may reference traditional daoyin techniques or relevant forms in Baduanjin, practiced under professional guidance.

VI. Yinshi and Youshi: Respective Nourishment Windows for Lung and Kidney

Within a single day, the Lung Meridian is on duty during the yinshi hour (3–5 a.m.), and the Kidney Meridian is on duty during the youshi hour (5–7 p.m.). These two time periods constitute natural temporal coordinates for lung and kidney nourishment. If one wakes during the yinshi hour and notices rough skin or stiff joints, there is no need to rush to use any intervention—one may first lie quietly with steady breathing for a moment and observe the body's feedback as lung qi begins to stir. If one can fall back asleep after the yinshi hour, there is no need for alarm—the body's response to the time period is itself diagnostic information.

During the youshi hour, the Kidney Meridian is on duty—it is a time window for the storage and nourishment of kidney essence. The evening meal should be light and gently moistening; one may appropriately select ingredients that help nourish yin fluids and supplement kidney qi—such as black sesame, mulberry, and Chinese yam. Steaming and boiling are the preferred cooking methods, and the amount should follow the principles of "moderate amount" and "a small quantity." The commonality of such ingredients lies not in any single component, but in their balanced nature—neither biased nor extreme—providing a silent, nourishing supplement to kidney essence in the daily diet. They may be incorporated as part of the daily diet without deliberately increasing the amount.

The rough sensation at the temples and joints belongs, in holistic pattern differentiation, to a "body surface signal" rather than an independent disease name. What it reminds us of is whether there is a gap in the coordinating relationship between the lung and kidney—this water-metal mother-child pair. Every awakening during the yinshi hour and every dietary habit during the youshi hour participate in their own ways in maintaining this relationship. When you touch roughness, perhaps pause to consider: are the body's fluids and essence-marrow reminding you to adjust some rhythm, rather than relying solely on a bottle of moisturizer to solve everything?

References:

1. The original text of the Huangdi Neijing · Suwen can be consulted in the TCM ancient texts database: https://tcmdata.cintcm.com/

2. World Health Organization strategy documents on traditional medicine: https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine

3. Official website of the National Administration of Traditional Chinese Medicine: https://www.satcm.gov.cn/

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