The Mechanism of Anger
The Transformation of Emotions, Part 2
In the last post, we took a look at sorrow or sadness, quoting from Zhèng Zhì Zhǔn Shéng [證治準繩·雜病 Level-line for Patterns and Treatments, 1602] by Wáng Kěntáng [王肯堂], and Líng Shū [Spiritual Pivot] chapter 8, entitled Běn Shén [Root of the Spirit], among other sources. We noted that sorrow can affect the liver, but what of anger, the emotion connected with the liver? Today we’ll take a brief look at anger, its pathogenesis, transformations, and treatments. All translations and misunderstandings are my own.
Anger: Etiology and Pathomechanism
In Zhèng Zhì Zhǔn Shéng, Wáng Kěntáng writes:
怒
怒在陰陽，為陰閉遏其陽，而陽不得伸也。經云：陰出之陽則怒。又云：血並於上，氣並於下，心煩冤善怒。東垣云：多怒者，風熱陷下於地是也。怒屬肝膽。經云：在臟為肝，在志為怒。又云：肝臟血，血有餘則怒。又云：膽為怒是也。丹溪治怒方，香附末（六兩）、甘草末（一兩），上和勻，白湯調服五錢。
Anger
Anger is in yīn and yáng, it causes yīn to block and suppress its yáng so that the yáng cannot expand. The classic says: yīn leaving yáng results in anger. It also says: when blood rises while qì sinks simultaneously, [there will be] heart vexation, grievance, irascibility and anger. Dōng Yuán said: In many cases of anger, it is surely wind and heat sinking down into earth. Anger pertains to the liver and gallbladder. The classic says: Among the viscera it is the liver, among the minds it is anger. It also says: Liver is the viscera of blood, surplus blood results in anger. It also says: Truly the gallbladder governs anger. Dān Xī treated anger with a formula of ground Xiāng Fù [Rz Cyperi] (6 liǎng), and Gān Cǎo [Rx Glycyrrhizae] (1 liǎng), combine the above evenly, stir 5 qián into plain boiled water and take.
Mulch comments: Dōng Yuán is Lǐ Dōngyuán, author of Pí Wèi Lùn [Treatise on the Spleen and Stomach, 脾胃論]; I take the quote here to indicate something like liver heat oppressing the spleen. “Surplus blood” strikes me as a possible indication for bloodletting, including wet cupping. Dān Xī is Zhū Dānxī, an influential scholar-physician from the Yuán era, most associated nowadays with the school of yīn supplementation.
Wáng continues:
運氣怒，皆屬木太過。經云：木太過曰發生，發生之紀，其病怒。又云：歲木太過，風氣流行，甚則善怒。又云：歲土不及，風反大行，民病善怒是也。怒在禁忌多生厥逆。經云：陽氣者，大怒則形氣絕，而血菀於上，使人薄厥。又云：暴怒傷陽。又云：怒則氣逆，甚則嘔血及餐泄是也。大法以悲勝之，或用藥益肺金以平肝木。
The movement [yùn] and qì of anger always pertains to wood major excess. The classic says: When wood major excess days occur, the illness of the period they occur in is anger. It also says: In years of wood major excess, wind qì spreads and moves, resulting in susceptibility to anger. It also says: In years when earth cannot reach, there is a major movement of wind opposition, and the illness of the masses is surely susceptibility to anger. Anger is to be avoided as it often engenders reversal counterflow. The classic says: Yáng qì, great anger results in the qì becoming cut off, as well as the blood gathering in the upper, which causes one to suddenly collapse. It also says: Sudden anger injures yáng. It also says: Anger results in qì counterflow, which surely results in retching of blood as well as diarrhea after meals. The larger principle is on the basis that sorrow prevails [over anger], perhaps use medicinals to boost lung metal to balance liver wood.
Mulch comments: Much like we saw in the sorrow post, Wáng takes into account the movements and qì (yùn qì), the great cosmological cycles outlined in Sù Wèn 69-71. Anger can be a mass movement – much like sadness, and much in evidence in the world today. Use of the controlling cycle of the five phases is posited to help calm the liver.
Anger and its Transformations
As we noted with sorrow, anger can affect organs other than the liver. As alluded to above, it may oppress spleen-earth, or insult lung-metal. A commentary on Líng Shū 8 shows that anger can also transfer backward through the engendering cycle from wood to water:
腎盛怒而不止則傷志。志傷則喜忘其前言。腰脊不可以俯仰屈伸。毛悴色夭。死於季夏(怒。本肝志。而亦傷腎者。肝腎為子母。氣相通也)
Kidney: Rage and anger that do not cease result in damage to the will. Damage to the will results in forgetting what one said previously. The lumbar spine cannot flex or extend. The hair is withered and its color fades prematurely. [There may be] death in the final month of summer. (Anger, its root is the mind of the liver, yet it also can damage the kidney. The liver and kidney act as the child and its mother, their qì is interlinked.)
Mulch comments: The Líng Shū excerpt and parenthetical comment above is from Zhēn Jiǔ Féng Yuán (針灸逢源, Encountering the Origins of Acumoxa) by Lǐ Xuéchuān (1815). A possible schematic of anger transformations can look something like this:
Acupuncture Points for Anger
Some of the points listed in Zhēn Jiǔ Dà Chéng [Great Compendium of Acupuncture and Moxibustion, 針灸大成] which came up in a search for the 怒 [nù] character include:
肝俞 Gān Shū (UB18)： 多怒 [frequent anger]
復溜 Fù Liū (KD7)：善怒多言 [susceptibility to anger and frequent talking]
築賓 Zhú Bīn (KD9)： 妄言怒罵 [raving and angry cursing]
勞宮 Láo Gōng (PC8)： 善怒 [susceptibility to anger]
行間Xíng Jiān (LR2)： 善怒 [susceptibility to anger]
身柱Shēn Zhù (DU12)： 怒欲殺人 [homicidal anger]
Mulch comments: Some interesting points.
UB18 and LR2 are the back transport and fire points of the liver respectively, so not surprising.
KD7 is the metal and mother point of the kidney, and may reflect the treatment strategy of strengthening metal to restrain wood as well as supplementing the kidney to prevent damage to the will.
KD9 is the cleft point for the yīn linking vessel.
PC8 with LR2 is a combination to drain the liver in five-phase acupuncture.
DU12 I remember from my studies with Japanese teachers as being a Fukaya-style moxibustion point for calming the nervous system, as well as a frequently-used point in pediatrics, especially in the treatment of kanmushi, a sort of cranky-child syndrome.
Herbal Medicine for Anger
Some of the medicinals for 怒 [nù] found in Běn Jīng Shū Zhèng [Explanation of the Materia Medica Classic, 1832] by Zōu Shù [鄒澍] include:
茯神 Fú Shén [Poria Pararadicis]:多恚怒、善忘，開心益智，安魂魄，養精神。[frequent anger and rage, forgetfulness, opens the heart and sharpens the wits, calms hún and pò, nourishes the essence-spirit.]
龍骨 Lóng Gǔ [Os Draconis]: 恚怒 [rage and anger]
牡蠣 Mǔ Lì [Concha Ostreae]: 驚恚，怒氣 [fright and rage, anger qì]
萆薢 Bì Xiè [Rz Dioscoreae Hypoglauca]: 傷中恚怒 [injury to the center, rage and anger]
松蘿 Sōng Luó [Usnea]: 瞋怒 [angry staring]
Mulch comments:
The first three listed medicinals are well-known and commonly used to calm, anchor and settle the spirit.
Bì Xiè is an interesting choice; it is generally known for its function of separating clear from turbid. On a spirit level, perhaps it serves to introduce some clarity that may defuse one’s anger.
Sōng Luó (“pine creeper”) is a lichen that hangs off dead pine branches. I found an interesting article about it from ITM (click the hyperlink).
Shén Nóng Běn Cǎo Jīng Shū (Clarification of the Divine Farmer’s Materia Medica Classic, 1625) by Miào Xīyōng (1546-1627) offers some treatment principles, contraindications and recommended medicinals for treating those prone to anger:
善怒 怒則氣上逆，甚則嘔血及飧泄。
【忌】補，升，熱燥，閉氣。
諸藥俱見前。
【宜】降氣，清熱，甘寒，酸寒，鹹寒，佐以辛散。
蘇子 鬱金 番降香 生甘草 青黛 麥冬 生地黃 赤芍藥 橘皮 蒲黃 當歸 延胡索 砂仁 香附 童便
Susceptibility to Anger: Anger results in qì rising counterflow, which then results in vomiting blood and food diarrhea.
[Contraindicated] Supplementing, upbearing, hot and dry, blocking qì.
All medicinals previously seen.
[Indicated] Downbearing qì, clearing heat, sweet cold, sour cold, salty cold, assisted by acrid scattering.
Sū Zi [Fr Perillae], Yù Jīn [Rz Curcumae], Fān Jiàng Xiāng [Lignum Dalbergiae Guangdongensis], Shēng Gān Cǎo [Rx Glycyrrhizae Cruda], Qīng Dài [Indigo Naturalis], Mài Dōng [Tuber Ophiopogonis], Shēng Dì Huáng [Rx Rehmanniae] Chì Sháo Yào [Rx Paeoniae Rubra], Jú Pí [Pc Citri Reticulatae], Pú Huáng [Pollen Typhi], Dāng Guī [Rx Angelicae Sinensis], Yán Hú Suǒ [Rx Corydalis], Shā Rén [Fr Amomi Villosi], Xiāng Fù, Tóng Biàn [Urina Infantis/ child's urine]
Mulch comments: Contraindicated medicinal categories here are what one might expect: supplementing as in Rén Shēn [Rx Ginseng] and Huáng Qí [Rx Astragali]; upbearing as in Shēng Má [Rz Cimicifugae] and Chái Hú [Rx Bupleuri]; hot and dry as in Gān Jiāng [Rz Zingiberis] and Wú Zhū Yú [Fr Evodiae]. The medicinals listed in the text under 閉氣 ‘blocking qì’ include
銀杏 米麵食 豬脂油 二術 黃耆
Yín Xìng [Sm Gingko], Mǐ Miàn Shí [rice flour foodstuffs], Zhū Zhī Yóu [Adeps Suis/pork lard], Èr Shù [Rz Atractylodis Et Atractylodis Macrocephalae], Huáng Qí.
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. Retrieved December 16, 2022.
Miào, X. (1625). Shén Nóng běn cǎo jīng shū. https://jicheng.tw/tcm/book/%E7%A5%9E%E8%BE%B2%E6%9C%AC%E8%8D%89%E7%B6%93%E7%96%8F/index.html. Retrieved November 5, 2023.
Wáng, K. (1602). Zhèng zhì zhǔn shéng 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. Retrieved March 3, 2024.
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.
Zōu, S. (1832). Běn jīng shū zhèng. https://jicheng.tw/tcm/book/%E6%9C%AC%E7%B6%93%E7%96%8F%E8%AD%89/index.html. Retrieved February 25, 2024