I have discussed the emotions in Chinese medicine quite a bit on the site recently. This betrays my deep interest in the function of the emotions in health and disease, but also the interest of readers and the general public. You can read more about the emotions in my article about the Yin and Yang emotions in Chinese medicine as well as the popular article about Chapter 5 of the Neijing.
I’d like to follow up on that article in particular by visiting, in two parts, Chapter 39 of the Neijing as it represents one of the more extensive treatments of emotional health and disease that I can find in the text. Today I will cover Huang Di’s question to his favorite teacher, Qi Bo. Soon after, I will discuss Qi Bo’s reply.
I’d wager that the question phrased by Huang Di, in this situation the student, contains more pertinent information than most graduate theses in Chinese medicine! I guess it goes to show that someday the student can become the master. In Chinese, the question reads:
帝 曰 ： 善 。 余 知 百 病 生 於 氣 也 ， 怒 則 氣 上 ， 喜 則氣 緩 ， 悲 則 氣 消 ， 恐 則 氣 下 ， 寒 則 氣 收 ， 炅 則 氣 泄 ， 驚則 氣 亂 ， 勞 則 氣 耗 ， 思 則 氣 結 。 九 氣 不 同 ， 何 病 之 生 ？
A rough translation:
Huang Di said: Good. I know that the hundred disease (many diseases/all diseases) are born from Qi. Anger makes the Qi go up. Joy makes the Qi leisurely. Sadness makes the Qi vanish/perish. Fear makes the Qi descend. Cold makes the Qi consolidate. Heat makes the Qi drain out. Being startled makes the Qi chaotic. Hard labor consumes the Qi. Worry makes the Qi stagnant. These nine different Qi lead to what diseases?
Several of these Qi are mostly external in nature – Cold, Heat, being startled are all clearly reliant on some external stimulus. Hard labor is more internal, but not in the same sense that Anger, Joy, Sadness, Fear and Worry are internal. I would like to look at those five and their Qi altering behavior a little more closely. I want to put out a hypothesis that all of the qi alterations that Huang Di mentions are actually excess conditions of their respective elements, as opposed to deficiencies. I think you will see what I mean as you read on…
Anger makes the Qi go up
Anger is an emotional state associated with the Wood phase element, and thus the Liver and Gallbladder. The aim of Wood is to grow up and out at a quick rate, it is the motivating force in the body. The Liver, especially, desires open and free flowing access in all directions. So it makes sense that Anger, the Yang Wood emotion, would flow up. We’ve probably all experienced the headaches that can come along with an intense fit of anger – this is a prime example of the Qi going up.
Wood is controlled by Metal – the cutting energy of Metal keeps the Wood from spreading too much and too quickly upward, as it would like to do. In this case, the intense anger has caused an abrupt excess of the Wood element that the Metal is unable to control – resulting in an upward surge of Qi.
Joy makes the Qi leisurely
We meet the same problem here as we do in many discussions about the emotions in Chinese medicine – Joy, the Yang Fire emotion, is piled in with all the Yin emotions. The character 緩, which I translated above as leisurely can also be translated as slow, to recuperate or to slacken. So while we could translate it negatively – to say that it makes the Qi slow (or, rather, too slow) that would be out of line with our idea of Joy. Even if we were to insert the more Yin emotion associated with Fire – Mania – it doesn’t really make much sense to say that it makes the Qi slow. So, I guess we can just see this as further evidence that living in a state of Joy will do good things for us. It allows our Qi to go about its business in an unhurried manner, as it prefers. Thinking about it myself, Joy definitely does make everything move more easily. I don’t get so easily stuck on little things, my body easily resists whatever pathogens are out there and I even seem to get injured less often. My thoughts come easily and all is generally free flowing.
Sadness/Grief makes the Qi perish
Sadness is the Yin emotional state associated with the Lung. The character 消 which I translated as perish can also be translated as to vanish, to eliminate or to extinguish. The left-hand radical is water, and I think this is significant for us to understand what it is that sadness does to the Lung. The Lung is the upper source of water and is responsible for delivering nourishing and animating substance to the whole body after receiving it from the Spleen (food/drink) and the breath. As a TaiYin organ, the Lung is exquisitely sensitive to water balance. So it would make sense that the Yin emotion of the Lung would cause damage to the water of the body – indicated by the use of the water radical in the character for perish. Thinking about it myself – Grief does make me feel withered, dry, used up and generally without life.
In the control cycle of the five elemental phases, Metal is controlled by Fire. Fire softens metal’s edge, preventing it from cutting through everything around it. Now the idea of “perishing” as well as my discussion of dryness seems to point more to a deficiency situation in the metal phase as opposed to excess as I am finding in the other phases. However, Metal does have a profound drying effect and one of its excess characteristics could be an overdrying of the body. In the case of grief, perhaps this particular aspect of Lung is exaggerated. However, it is a little difficult to understand how Fire would be able to rectify that in the first place. So as usual with the Fire element, my theory breaks down a bit.
Fear makes the Qi descend
As the Yin emotional state of Water, and thus the Kidney and Bladder – Fear should inherit some of the qualities of water. One of the characteristics of water, at least in Earth’s gravity, is to go to the lowest place. This Yin descending quality can be physiological, but in this case – fear has caused a pathological descent of the body’s Qi. Some people validate this finding when they say that a scary situation made their stomachs drop. Some people even experience great fear as making them need to go to the bathroom. Both of these are strong representatives of downward rushing Qi.
Water, in the control cycle, is controlled by Earth. If you think about Earth and Water in the human world – it is often the Earth embankment of a dam that prevents the water from heading to the lowest place where it might not be as useful. So in this case, the Earth is unable to prevent the excess Earth from flooding the lower reaches of the body.
Worry makes the Qi stagnate
Worry is the Yin emotional state of Earth – resonating with the Spleen and Stomach. The character 結 can also be translated as to knot, to join and to congeal. All of these words describe my guts when I’m worried about something or just thinking something to death. When we are concerned about the outcome of a particular situation, pacing the floor at night, we’ll often proclaim, “My stomach is in knots!” But these words also describe Earth that is packed down too much – think about garden soil that has been repeatedly trampled. There is no space through which water, worms or even a stoutly driven spade can travel.
Because Earth is coursed by Wood in the control cycle of the five phase elements, when Earth is in excess we will find an inability of Wood to course Earth. This results in sogginess in the Earth element – and inevitably, stagnation.