Concept of the seven emotions
The seven emotions refer to seven emotional activities including joy, anger, worry, anxiety, sadness, fear and fright. They are external manifestations of the functional activities of viscera. Normally, the seven emotions don’t cause diseases and only when the emotional stimulations are too abrupt, violent, and prolonged and beyond one's adaptability or when there is diminished adaptability due to imbalanced yin-yang, qi and blood of viscera, can they turn into pathogenic factors, thus causing diseases. This is what is called "internal injury due to seven emotions."
Interrelationship between seven emotions and essential qi of viscera
The seven emotions are the physiological responses of visceral qi, blood, yin and yang. Different visceral qi, blood, yin and yang differ from each other in moving styles, leading to different emotional responses. In Huangdi Neijing, the seven emotions are matched with the five viscera: the heart governs joy, the liver governs anger, the spleen governs contemplation, the lung governs grief, and the kidney governs fear. Terror and anxiety are also closely related to the activity of qi in the five zang-organs.
The attribution of the seven emotions to the five zang-organs is not absolute. On the one hand, the same viscus may produce different emotional responses because of different pathophysiological states. For example, excess of liver-qi causes anger while deficiency of liver-qi brings on fear; excess of heart-qi brings on joy while deficiency of heart-qi leads to grief; etc. On the other hand, the seven emotions are exclusively dominated by the heart. In fact all the emotional activities are controlled by the heart and all the emotional responses are the manifestations of heart-spirit.
The following is a brief generalization of the effect of the seven emotions on the activity of qi:
- Excessive joy relaxes the activity of qi;
- Excessive anger drives qi to move upwards;
- Excessive contemplation stagnates qi;
- Excessive grief exhausts qi;
- Fear drives qi to move downwards; excessive terror disturbs qi;
- Excessive anxiety depresses qi.
Pathogenic characteristics of internal injury due to the seven emotions
1. Directly impairing the internal organs
Since the seven emotions are endogenous, they can directly impair the internal organs. For example, excessive joy impairs the heart, excessive anger impairs the liver, excessive contemplation impairs the spleen, excessive grief impairs the lung and excessive fear impairs the kidney, etc...The relationships among the five zang-organs are complicated, so the impairment of one viscus by the seven emotions may involve several zang-organs and fu-organs.
For example, depression and rage impair the liver. But the adverse flow of liver-qi often attacks the spleen and the stomach, leading to imbalance between the liver and the spleen as well as disharmony between the liver and the stomach. Since the heart is the supreme dominator of the mental activities, the impairment caused by the seven emotions is closely related to the heart. Clinically the seven emotions often impair the heart, the liver and the spleen.
2. Affecting the visceral qi movement
Seven emotions correspond with five zang viscera. Strong emotional stimulation can affect qi movement of the viscera, resulting in various syndromes marked by disharmony of qi and blood.
(1) Rage leading to qi ascending
Rage impairs the liver, giving rise to upward adverse flow of liver qi. Clinical manifestations include reddish complexion and eyes, headache and dizziness, irriability and susceptibility to rage. Bleeding due to qi reversed flow results in hematemesis, and sudden coma, etc...Transverse dysfunction of liver qi can result in gastric and abdominal pain, vomiting and diarrhea, etc...
(2) Excessive joy leading to qi loose
Sudden joy impairs the heart and results in slackened heart qi. In a mild environment, palpitations, fearful throbbing, asthenic breathing, weakness and distraction will occur and in a serious case, collapse of heart spirit, mental disorders and mania will occur.
(3) Excessive sorrow leading to qi consumption
Excessive sorrow impairs the lungs and leads to the failure of the lungs in dispersing, purifying and descending the consumption of lung qi. And its clinical manifestations include asthenic breathing, reluctance to speak, oppression in chest, mulligrubs and dispiritedness.
(4) Fear leading to qi sinking
Sudden and excessive fear impairs the kidney. Pathological changes of collapse d qi and insecurity of kidney qi will occur. Clinical manifestations include urinal and fecal incontinence and spermatorrhea and prospermia.
(5) Fright leading to qi turbulence
Sudden fright impairs the heart and causes turbulence of the heart qi and abnormality of the heart-mind. Clinical manifestations include palpitations and restlessness, consternation, dumbness, insomnia and susceptibility to fright, and even insanity.
(6)Pensiveness leading to qi knotting
Pensiveness, or prolonged anxiety impairs the spleen, causing stagnation of spleen qi, failure of spleen in ascending, descending and inability of receiving and transforming. Clinical manifestations include: poor appetite, abdominal distention, anorexia and loose stool etc. .
(7) Worry leading to qi accumulation
Worry may lead to blockage of qi movement, manifested as oppression in chest, dysphoria, lassitude of limbs, sallow complexion, and lusterless hair.
3. Tending to cause emotional diseases
Emotional diseases refer to the diseases manifested as abnormal emotional changes and their onset is related to emotional stimulations. The diseases caused by excessive seven emotions mostly are emotional diseases. Such as depression, depressive psychosis, mania, chest discomfort, real heart pain etc., most of which are caused or precipitated by abnormal emotional stimulations and accompanied by abnormal emotional manifestations, with the pathological course varying with the changes of emotions.
4. Affecting the sequelae of diseases
The changes of seven emotions can affect the onset, development, changes and sequelae of diseases. Good spirit and optimism lead to no disease or help patients recover. Otherwise, they are apt to lead to diseases and worsen the condition of diseases. For example, chest discomfort, real heart pain can all be precipitated or aggravated by seven emotions. Malignant tumors can lead to rapid aggravation due to seven emotional stimulations. A good understanding of seven emotions which can affect diseases positively and negatively can help doctors adopt a thorough and correct treatment method.