It says in chapter 39: "Sadness makes the Heart cramped and agitated; this pushes towards the
lungs' lobes, the Upper Burner becomes obstructed, Nutritive and Defensive Qi cannot circulate
freely, Heat accumulates and dissolves Qi".58(225) According to this passage then, sadness
primarily affects the Heart and the Lungs suffer in consequence since they are both situated in
the Upper Burner. The Lungs govern Qi and sadness and grief deplete Qi. This is often
manifested on the pulse as a Weak quality on both left and right Front positions (Heart and
Lungs). In particular, the pulse on both Front positions is Short and has no wave, i.e. it does not
flow smoothly towards the thumb. Other manifestations deriving from sadness and grief include
a weak voice, tiredness, pale complexion, slight breathlessness, weeping and a feeling of
oppression in the chest. In women, deficiency of Lung-Qi from sadness or grief often leads to
Blood deficiency and amenorrhoea.
Although sadness and grief deplete Qi and therefore lead to deficiency of Qi, they may also, after
a long time, lead to stagnation of Qi, because the deficient Lung- and Heart-Qi fail to circulate
properly in the chest.
As mentioned before, each emotion can affect other organs apart from its "specific" one. For
example, the "Spiritual Axis" in chapter 8 mentions injury of the Liver from sadness rather than
anger: "When sadness affects the Liver it injures the Ethereal Soul; this causes mental confusion
... the Yin is damaged, the tendons contract and there is hypochondrial discomfort".59(226) This
shows how organs can be affected by emotions other than their "specific" one. In this case,
sadness can naturally affect the Ethereal Soul and therefore Liver-Yin. Sadness has a depleting
effect on Qi and it therefore, in some cases, depletes Liver-Yin leading to mental confusion,
depression, lack of a sense of direction in life and inability to plan one's life.
Case History 9.1
Mental-Emotional Problems: Sadness Affecting the Liver-Female, Age 40
A 40-year-old woman was under a great deal of stress due to her divorce which caused her great
sadness. She felt often weepy. She felt aimless and questioned her role in her relationships with
men; she was at a turning point in her life and did not know what direction to take. She slept
badly and her pulse was Choppy.
This is a clear example of sadness affecting the Liver and therefore the Ethereal Soul. She was
treated, improving tremendously, with the Yin Linking Vessel points (P-6 Neiguan on the right
and SP-4 Gongsun on the left) and BL-23 Shenshu, BL-52 Zhishi and BL-47 Hunmen (see
below).
Finally, some doctors consider that grief which is unexpressed and borne without tears affects
the Kidneys. According to them, when grief is held in without weeping, the fluids cannot come
out (in the form of tears) and they upset the fluid metabolism within the Kidneys. This would
happen only in situations when grief had been felt for many years.