A friend recently asked me to copy the passage on sadness and grief from my book, Chinese Medicine from the Classics: A Beginner’s Guide, as he felt that it might be useful to a patient in their recent state of bereavement. Since that request, a friend of mine also died.
At these times the classics of Chinese medicine can help to remind us of the ever changing nature of reality and within our personal suffering, bring us closer to the timeless and universal.
The passage is reproduced below:
Several characters may be translated as sadness and grief. In the character bei (悲) the heart is below (心) and above is fei (非) which is a negation, a denial, a negative prefix. It is literally a negation of the heart. It is usually translated as sadness, and suggests a movement of repression and restriction which is often associated with the metal element and the lungs. But in Suwen chapter 5 the expression of will associated with the metal element is you (憂), which may be translated as oppression or sometimes oppressive grief. The character ai (哀) is also often paired with bei and both characters are then translated as grief or mourning.
Different characters are used in different contexts to express the emotions of sadness, grief and oppression, but it is the same movement of constriction and pressure which is common to the metal element and to the qi in the autumn time. The relationship of sadness and oppression to the autumn is found in many cultures which share the seasons of the temperate northern hemisphere. In Europe, autumn is traditionally associated with the melancholic temperament – poetic, withdrawn and introspective. In Japan, the autumn is favoured as a time of particular beauty – the traditional society venerating its soft colours, obscuring mists, its sense of loss and things that are not quite seen.
In the medical texts, sadness and grief affect the lungs. Pressure and constriction cause the chest to collapse, the breath to become short – it is no longer possible to take a deep breath and the kidneys and lungs begin to lose their proper exchange and interrelationship.
In Lingshu chapter 8, sadness and grief, sorrow and oppression, are seen to have a slightly different effect on the qi:
‘In sadness and grief (bei ai 悲 哀) one is moved at the very centre, used up and exhausted, and the generation of life is lost… In sorrow and oppression (chou you 愁 憂), the qi is closed and blocked, and there is no circulation.’
Both suggest a closing in and a closing down – bei ai giving a more acute vision of grief and mourning. Chou, translated above as sorrow, is made with the character for the autumn (秋) placed over the heart (心). Literally, autumn in the heart. Autumn is the time for letting go – grief and sadness the natural reaction to this loss.
In modern life, we often do not give ourselves the time to grieve. We no longer have rites and rituals that help us through times of loss – and society expects us just to carry on. Not so long ago we wore black arm bands when someone in the family died, so that everyone would know to treat us with special care. There would be a prescribed time when this was necessary, followed by stages of return to normality. In Eastern cultures, there are special days for tending the family graves, but we no longer seem to visit the graves of our ancestors. These simple rituals allow a space for grief. They give it shape and form. To light a candle on a death day is a small act which gives our sadness a place.
The autumn reminds us that life is constant change and transformation, and that it is not possible to hold on to the past. As the trees shed leaves and plants die back, we are reminded that to allow new growth, the old must go. The scales, which appear as a symbol for the autumn in both China and the West (as in the scales of the zodiac sign Libra) allow us to judge and weigh up what we should keep and what we should let go of in order to move forward. The virtue associated with metal and the autumn is justice, which again is symbolized by the scales. Grief that is repressed often surfaces later in life in lung problems. In Suwen chapter 39 it simply says: ‘When there is sadness (bei 悲), the qi disappears.’
In Suwen chapter 5 oppression (you 憂) is related specifically to the lungs, where it follows the movement of the metal element in its contraction and constriction, but it may also be seen affecting other zang and is sometimes coupled with other emotions. Its effect on the qi is one of blocking by pressure and restriction, and this can be seen very clearly, for example, where it is linked to the spleen in a later section of Lingshu chapter 8:
‘When the spleen is prey to sorrow and oppression (chou you) and is not able to free itself, there is injury to the intent (yi 意). The intent being injured, one is in a state of complete disorder, the four limbs can no longer be raised…’
Intent (yi 意) is related to the earth element, and here we can see both the mental and physical effects of oppression on the spleen. Oppression affects the ability of the spleen to transport and transform. This manifests in an inability to nourish the body, and particularly the muscles. There is a kind of wastage, and the strength of the four limbs is diminished.