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Skin and Boundaries

Skin – W.+20°/E.-20°
Images from 1918 Gray's Anatomy of the Human Body from

Interior Boundaries – N.-20°/S.+20° V.0° (LU(KD))

Exterior Boundaries – W.+20°/ E.+20 V.0° (LI(KD))


All tissues have boundaries. This is what makes a tissue a tissue, rather than one big glob of cells. Our skin is the most notable boundary, as it differentiates our physical bodies from other things in the environment. Every organ of the body essentially has its own form of skin (albeit without the multiple layers). There are interior boundaries and exterior boundaries. Take for instance the lungs. There is an internal boundary separating the lungs from the other tissues in the chest cavity. There is also an external boundary between the lungs and the air we breathe. This is common for all tissues. Arteries have an external boundary touching the blood and an internal one touching the tissues in which the artery resides. Interior and exterior is relative, in that way. Think about it this way: external touches the surface that is more expansive and open while internal touches more dense cell structures. In the digestive tract, the external boundary touches the food and stool while the internal one touches the interior cells.

The boundaries are common locations for diseases, especially diseases that have the capacity to move around (Fire controls Metal). If a disease can move from one location to another, say an infection, it clearly needs a way to insert itself in the new location. It must break through the boundaries. Healthy boundaries repel anything that is not supposed to enter. Imbalanced boundaries, however, are more permeable.

Trauma can also compromise boundaries. Falling and scraping your knee breaks down the external boundary of the skin. That is emblematic of internal trauma as well, except that it is much more dangerous when an internal tissue is compromised in this way as bleeding can occur without anyone knowing it.


Skin: Metal

Internal Boundaries: Metal + Water

External Boundaries: Metal + Water

Tissue Treatment


Basic Perfusion: Advanced Perfusion:

Heaven: Fire + Metal Heaven: Up.Fire or Down.Water + Metal

Man: Earth + Metal Man: Metal + E.Wood

Earth: Water + Metal Earth: Metal + Water

Internal Boundaries

Basic Perfusion: Advanced Perfusion:

Images from 1918 Gray's Anatomy of the Human Body from
Fire + Water Heaven: Water + Earth

Man: Earth + Metal + Water Man: Water + Metal

Earth: Water + Metal Earth: Metal + N.Water or S.Fire

External Boundaries

Basic Perfusion: Advanced Perfusion:

Heaven: Fire + Water Heaven: Water + Earth

Man: Earth + Metal + Water Man: Water + Metal + E.Wood

Earth: Water + Metal Earth: Metal


Skin: Integrity/Protection in Judgment/Expectation

Interior boundaries: Confidence in Integrity/Protection

Exterior boundaries: Confidence in Judgment/Expectation

Closely Interrelated Tissues

Boundaries are intricately related to the tissues they protect. The external structures are also intricately related to the external boundaries and the internal structures are intricately related to the internal boundaries.

Boundaries are associated with Metal. Metal is generated by Earth and is controlled by Fire. So, boundaries that are weak and permeable can be strengthened by strengthening the spleen and flesh. Boundaries that are excessive, such as callouses, can be controlled via the blood vessels and/or heat.

Notes From Ethan's Clinic

Oftentimes people present in the clinic with rashes. It is important to note that the skin is often not the root for a rash. The root is more likely from the blood vessels or even the flesh below the skin if the root of the rash is internally derived rather than from external sources. The goal with rashes is to help push them out of their deepest root towards the skin and out of the body, so that they can completely vent. The method for this is to find the lines of forces, the boxes, and/or the tissues that are one level deeper than the location of the imbalance and then use Fire Qi to push the imbalance towards the surface in Heaven/Man/Earth levels. In the case of Fire rashes, another methodology is to cool the excessive heat, for instance with cold microbursts. But even with Fire rashes, it may be helpful to use Fire to push it externally. The surface of Heaven is SI/HT. The surface of Earth is SI/HT. And the surface in Man is BL/KD. So, when I say you need to push towards the external, I mean to push towards these directions of each plane.

Chronic rashes tend to be caused by cold stuck in the skin with heat stuck below it. Acute rashes, such as poison ivy, tend to be heat in the blood vessels that can be transferred both to the flesh and the skin. If the heat is pushed into the flesh, it can become a chronic rash with deep sores. If the flesh is protected, the rash can only move out.

Hair may be considered the skin of the flesh. I know that sounds weird, but hair follicles tend to exist deeper than the dermis. Whether this is the subcutaneous level of the skin or whether it is the tissue level of the flesh, I do not truly know as of this writing. So, to regrow hair, you need to look at the well-being of the skin tissue inside the flesh tissue. I once grew a hundred small white hairs out of the balding areas of my scalp by balancing the “skin” of the flesh level and increasing heat in the capillaries that feed it. I believe the hair would have turned black with continued focus, but my attention moved on to other vanities, oh, I mean things.

Many people who read this section will likely be thinking about cosmetic issues, such as regrowing hair, getting rid of stretch lines, or removing moles. The hair is a good example about how surface issues tend to materialize much deeper. The skin does not have much in the way of structure, so structural issues must have a deeper root than the skin level. Burns, for instance, don't usually leave a scar if the burn is superficial. However, they will scar if the flesh beneath the skin is singed. A first degree burn is superficial, while second and third damage deeper tissue levels. Use Water microbursts immediately after a burn to avoid skin damage or deeper damage. You may even want to focus the microburst at the level of the skin
Images from 1918 Gray's Anatomy of the Human Body from
LU(KD), at the capillary level SI(KD), and at the flesh level SP(KD).

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