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Also metal and water are mutually engendering; lung and kidney are of the same source. The lung and kidney have a beneficial effect on each other. In water metabolism, the kidney governs water (i.e., urine production), whereas the lung is the upper source of water and the lung governs regulation of the waterways (i.e., downward movement of water to the kidney). Vacuity of either the lung or kidney can cause water swelling. In respiration, the lung governs qì, whereas the kidney governs qì absorption. Although breathing is a function of the lung, it can be affected by kidney vacuity. Kidney vacuity preventing qì absorption gives rise to shortness of breath and panting. In the five phases, the lung is ascribed to metal, and the kidney is ascribed to water. Metal and water are mutually engendering. In the engendering sequence, metal engenders water, and according to the principle of disease in the mother (engendering phase) can affect the child (engendered phase), lung qì vacuity can give rise to kidney qì vacuity. Furthermore, according to the principle that disease in the child affects the mother, kidney qì vacuity can give rise to lung vacuity.

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