The Dynamics of Sorrow
On the Transformation of Emotions
On the recommendation of a friend, I was looking through a well-regarded Ming-era text, Zhèng Zhì Zhǔn Shéng [證治準繩·雜病 Level-line for Patterns and Treatments] by Wáng Kěntáng [王肯堂] published in 1602. The discussions of pathology in the book can be quite weighty but I came across a short piece which was of interest as it was relevant to something that I have been seeing a growing amount of in the clinic as well as the world at large: sadness. I thought I would post my working translation (note that there are bound to be mistakes) and a few idle musings on the subject.
Sorrow Pertains to the Lung
Sadness, or sorrow in the Wiseman term set, is the emotion most commonly associated with the lung. Wáng writes:
悲
悲屬肺。經云：在臟為肺，在志為悲。又云：精氣並於肺則悲。仲景云：婦人臟躁，喜悲傷欲哭，象如神靈所作，數欠伸，甘麥大棗湯主之。甘草三兩，小麥一升，大棗十枚。水六升，煮三升，溫分三服。
Bēi [Sorrow]
Sorrow pertains to the lung. The classic says: Among the viscera it is the lung, among the minds it is sorrow. It also says: Essence qì alongside the lung conforms to sorrow. Zhòngjǐng says: Women with visceral agitation [zàng zào] are inclined to sorrow with a desire to weep, which appears as if it were the work of a spirit, with frequent yawning and stretching. It is governed by Gān Mài Dà Zǎo Tāng [Licorice, Wheat, and Jujube Decoction]. Gān Cǎo [Rx Glycyrrhizae] 3 liǎng, Xiǎo Mài [Sm Tritici] 1 shēng, Dà Zǎo [Fr Jujubae] 10 pieces. Use 6 shēng of water and boil down to 3 shēng, take warm divided into 3 doses.
In Chinese medicine, however, transformation is the rule, and while the lung governs sorrow, sorrow doesn’t always just stay with the lung. Its pathogenesis, furthermore, isn’t always limited to the inner landscape. Wáng continues:
運氣悲，皆屬寒水攻心。經云：火不及曰伏明，伏明之紀，其病昏惑悲忘，從水化也。又云：太陽司天，寒氣下臨，心氣上從，喜悲數欠。又云：太陽司天，寒淫所勝，善悲，時眩僕。又云：太陽之復，甚則入心，善忘善悲，治以諸熱是也。
The yùn [movement] and qì of sorrow all belong to cold and water which attack the heart. The classic says: fire which does not reach is called hidden brilliance [fú míng], the illnesses of the period of hidden brilliance are clouding, confusion, sorrow, and forgetfulness, after water transforms it. It also says: When Tàiyáng controls heaven, cold qì descends, and heart qì ascends following, there is a tendency to sorrow and frequent yawning. It also says: When Tàiyáng controls heaven, cold yín [untimely seasonal qi] dominates, one is susceptible to sorrow, and at times there is dizziness or collapse. It also says: Tàiyáng's revenge, in severe cases it enters the heart, there is forgetfulness and susceptibility to sorrow, treat using all hot [medicinals] to correct.
Wang’s explanation of the yùn qì [運氣], the great cosmological cycles outlined in Sù Wèn 69-71, are a reminder that sadness is not necessarily tied to a particular cause, that it may not be anyone’s fault, but may descend unbidden as a consequence of larger environmental phenomena.
Wáng goes on:
針灸悲有二：其一取心。經云：邪在心則病心痛善悲，時眩僕，視有餘不足而調其輸也。其二取厥陰。經云：厥陰根於大敦，結於玉英，絡於膻中，厥陰為闔，闔折即氣絕而喜悲，悲者取之厥陰，視有餘不足，虛、實、寒、熱、陷下而取之也。
For acumoxa [treatment of] sorrow, there are two. Number one, select the heart. The classic says: Evil in the heart results in illnesses [such as] heart pain and susceptibility to sorrow, at times there is dizziness or collapse. Look for surplus or insufficiency and regulate it with the transport [points]. Number two, select juéyīn. The classic says: The root of juéyīn is Dà Dūn [LR1], it binds at Yù Yīng [CV18], it networks at Shān Zhōng [CV17], if juéyīn becomes closed, it closes turning back on itself, meaning the qì is cut off and there is a tendency to sorrow, [thus] in cases of sorrow, juéyīn is chosen, then look for surplus or insufficiency, vacuity, repletion, cold, heat, or sinking, and choose [the appropriate points].
Zhēn Jiǔ Féng Yuán (針灸逢源, Encountering the Origins of Acumoxa) by Lǐ Xuéchuān (1815), elaborates on the closing of juéyīn:
厥陰為闔。（居陰分之裡也。）闔折即氣絕而喜悲。（肝傷。則肺氣乘之也。）
Juéyīn becomes closed (its residence is the interior of the yīn aspect). It closes turning back on itself, meaning the qì is cut off and there is a tendency to sorrow (liver damage, resulting from lung qì overwhelming).
Some possible transformations might be illustrated thus:
This transfer of sorrow to the liver is something I have noticed in clinic from time to time. It brings to mind the passage from Líng Shū chapter 8, entitled Běn Shén [本神] or the Root of the Spirit:
肝悲哀動中則傷魂。魂傷則狂妄不精。不精則不正。
Liver: Sorrow and grief moving within damages the hún [ethereal soul]. Hún damage results in wild arrogance and lack of essence. Lack of essence results in lack of rectitude [zhèng].
An arrogant façade may crack during the course of treatment to reveal a deep well of underlying sadness. A patient stricken with sadness may erupt into bouts of anger and frustration. Prolonged sorrow can lead to lack of essence, with a consequence of lack of rectitude. The rectitude here may be physical in nature: it may manifest as a lack of zhèng qì, with a deterioration of immunity to seasonal illnesses; the lack of essence may lead to spinal degeneration, with inability to walk fully upright; or it may lead to sexual dysfunction, as the passage goes on to mention:
當人陰縮而攣筋。
At that point the person’s genitals will shrink and there will be hypertonicity of the sinews.
Thus a chronic degenerative condition, even one that on the surface might appear purely mechanical, could have sorrow and grief as an etiological factor.
Acupoints for Sorrow
Here is a brief selection of acupoints with Bēi/悲 listed among their indications, from the Great Compendium of Acupuncture and Moxibustion [Zhēn Jiǔ Dà Chéng 針灸大成] by Yáng Jìzhōu [楊繼洲], published in 1601.
· 尺澤 Chǐ Zé (LU5)：悲哭 , sorrowful crying
· 解谿 Jiě Xī (ST41)：煩心悲泣, heart vexation, weeping with grief
· 商丘 Shāng Qiū (SP5)：心悲, sorrowful heart
· 漏谷 Lòu Gǔ (SP7): 心悲, sorrowful heart
· 大橫 Dà Héng (SP15)： 善悲, inclination to sorrow
· 極泉 Jí Quán (HT1)：悲愁不樂, sorrow, anxiety, unhappiness
· 靈道 Líng Dào (HT4):： 悲恐 , sorrow and fear
· 通里 Tōng Lǐ (HT5)：數欠頻呻悲, frequent yawning, frequent groaning, sorrow
· 神門 Shén Mén (HT7):: 狂悲狂笑, mad sorrow, mad laughter
· 少府 Shǎo Fǔ (HT8):：悲恐畏人, sorrow, fear, dread of people
· 少衝 Shǎo Chōng (HT9): 悲驚寒熱, sorrow and fright with cold and heat
· 支正 Zhī Zhèng (SI7):：驚恐悲愁, fright, fear, sorrow and worry
· 心俞 Xīn Shù (UB15):：語悲泣, speech sorrowful and weeping
· 湧泉 Yǒng Quán (KD1):：善悲欠, inclined to sorrow and yawning
· 照海 Zhào Hǎi (KD6):：心悲不樂, sorrowful heart and unhappiness
· 大陵 Dà Líng (PC7):： 喜悲泣驚恐, tendency to sorrow, weeping and fright
· 勞宮 Láo Gōng (PC8):：悲笑不休, compulsive sorrow and laughter
· 天井 Tiān Jǐng (GB21)：悲傷不樂, sorrow damage, unhappiness
· 輒筋 Zhé Jīn (GB23) : 太息善悲 , deep sighing, tendency to sorrow
· 日月 Rì Yuè (GB24)：太息善悲, deep sighing, tendency to sorrow
· 神道 Shén Dào (GV11)：悲愁健忘 , grief, anxiety, absentmindedness
And a couple of point combinations from the same source
· 心痹悲恐 [Heart impediment with sorrow and fear]：神門 大陵 魚際 [HT7, PC7, LU10]
· 心性呆癡，悲泣不已 [Dull and withdrawn temperament, sorrow and weeping without end]：通里 後谿 神門 大鐘 [HT5, SI3, HT7, KD4]
Okay, that’s all I have for now. Thanks, as always, for reading.
Note: this publication is for information purposes only and is not intended as medical advice. Please seek the opinion of a health care professional for any specific medical issues you may have.
References
Lǐ, X. (1815). Zhēn jiǔ féng yuán. https://jicheng.tw/tcm/book/%E9%87%9D%E7%81%B8%E9%80%A2%E6%BA%90/index.html
Wáng, K. (1602). Zhèng zhì zhǔnshéng·zá bìng. https://jicheng.tw/tcm/book/%E8%AD%89%E6%B2%BB%E6%BA%96%E7%B9%A9/%E9%9B%9C%E7%97%85/index.html
Yáng, J. (1601). Zhēn jiǔ dà chéng. https://jicheng.tw/tcm/book/%E9%87%9D%E7%81%B8%E5%A4%A7%E6%88%90/index.html . Retrieved December 26, 2023.