《素问》六节脏象论曰∶肺者气之本,魄之处也。阴阳应象大论曰∶心之变动为忧。《
灵枢
》口问篇曰∶思忧则心系急,心系急则气道约,约则不利,故太息。本脏篇曰∶心小则易伤
以忧。盖忧则伤神,故伤心也。宣明五气篇曰∶精气并于肝则忧,肝胜而侮脾也。《灵枢
》
本神篇曰∶脾忧愁而不解,则伤意。脾主中气,中气受抑,则生意不伸,故郁而为忧。是心
肺脾肝四脏,皆能病忧也。戴复庵云∶七气致病,虽本一气,而所以为气者,随症而变。如
忧伤肝,肝属木,忧则气并于肝,而脾土受邪。忧伤心,心属火,忧则气并于心,而肺金受
邪。忧伤肺,肺属金,忧则气并于肺,而肝木受邪。凡人忧多则气机不利,胸胁痛。忧多则
水湿凝滞,周身走痛,或关节痛,遇阴寒则发。忧多则热蓄不散,目瞀,小便赤。忧多则气
虚不能摄涎,动则喘。忧多则血脉蹇滞,四肢无力,能食便红。忧多则食物不化,嗳酸腹满
不能食。目之白睛属于肺,肺忧郁太过,则肺气不舒,结成翳障,视物模糊。复有忧极而悲
者,伤及心胞之相火。有忧极而恐者,伤及肾中之真水,火不足则光华不能发越于外,水不
足则膏液不能充满于中,轻则昏 羞涩,重则鱼胞鹘眼,补肺安神,最为要法,再令素所亲
信之人,好言慰劝,使心阳转动,即喜胜忧之意也。
《素问·六节脏象论》说:肺是气的根本,也是魄所在的地方。《素问·阴阳应象大论》说:心的变动表现为忧。《灵枢·口问》篇说:思虑和忧愁会使心脉拘急,心脉拘急则气道约束,气道约束则不通利,所以会长叹气(太息)。《灵枢·本脏》篇说:心脏较小的人容易因忧愁而受伤。大概是因为忧愁会损伤神志,所以伤害心脏。《素问·宣明五气》篇说:精气汇聚于肝就会产生忧的情绪,这是因为肝气偏胜而克制脾土。《灵枢·本神》篇说:脾脏忧愁而不能解脱,就会损伤“意”(思维意念)。脾主司中焦之气,中焦之气受到抑制,那么“意”就不能舒展,所以郁结而产生忧愁。因此,心、肺、脾、肝四脏都能导致产生忧愁的病症。戴复庵说:七情致病,虽然本源都是气机失调,但具体表现为何种气机变化,则随症状不同而改变。例如,忧愁伤肝,肝属木,忧愁导致气机汇聚于肝,从而脾土受邪;忧愁伤心,心属火,忧愁导致气机汇聚于心,从而肺金受邪;忧愁伤肺,肺属金,忧愁导致气机汇聚于肺,从而肝木受邪。凡人如果忧愁过多,就会导致气机不利,出现胸胁疼痛。忧愁过多会导致水湿凝滞,全身游走性疼痛,或者关节痛,遇到阴寒天气就会发作。忧愁过多会导致热邪蓄积不散,出现视物昏花,小便颜色深红。忧愁过多会导致气虚不能固摄唾液,活动后气喘。忧愁过多会导致血脉运行不畅,四肢无力,食欲旺盛但大便带血。忧愁过多会导致食物不消化,嗳气泛酸,腹部胀满,无法进食。眼睛的白色部分属于肺,如果肺气因忧郁过度而不舒展,就会结成翳障,导致视物模糊。还有因为极度忧愁而转为悲伤的,这会损伤心包络中的相火。有因为极度忧愁而转为恐惧的,这会损伤肾脏中的真阴(真水)。相火不足则眼部的光华不能发散于外,真阴不足则眼内的膏液不能充满于内,轻则视力昏暗、羞明畏光,重则出现鱼胞眼(眼睑浮肿如鱼腹)或鹘眼(眼球突出如鹘鸟之眼)。治疗上,补益肺气、安神定志是最为重要的方法,再让患者平时亲近信任的人,用温和的话语安慰劝导,使心阳得以转动,这就是以喜胜忧的意思。
The *Suwen* (Basic Questions), Chapter 6 "Zangxiang Lun" (Treatise on Zang-Fu Manifestations) states: The Lung is the root of Qi and the residence of Po (Corporeal Soul). The *Suwen*, Chapter 4 "Yinyang Yingxiang Dalun" (Great Treatise on Yin-Yang Correspondences to Phenomena) states: The transformational manifestation of the Heart is sorrow/worry. The *Lingxu* (Spiritual Pivot), Chapter 12 "Kouwen" (Inquiry from the Mouth) states: Thinking and worry cause the Heart vessels to become tense; when the Heart vessels are tense, the Qi pathways are constricted; when constricted, they are not smooth, thus leading to deep sighing (Tai Xi). The *Lingxu*, Chapter 13 "Benzang" (Original Zang-Fu) states: A small Heart is easily injured by worry. Generally, worry injures the Shen (Spirit), thereby damaging the Heart. The *Suwen*, Chapter 8 "Xuanming Wuqi" (Clear Exposition of the Five Qi) states: When Jing-Qi (Essence-Qi) converges in the Liver, worry arises; this occurs because Liver Wood overacts upon Spleen Earth. The *Lingxu*, Chapter 10 "Benshen" (Original Spirit) states: If the Spleen is worried and cannot resolve it, the Yi (Intellect/Intent) is injured. The Spleen governs Middle Qi; if Middle Qi is suppressed, the Yi cannot extend, thus becoming depressed and giving rise to worry. Therefore, the Heart, Lung, Spleen, and Liver can all give rise to disorders of worry. Dai Fu'an stated: Although diseases caused by the Seven Emotions originate from Qi, the specific nature of the Qi disturbance varies with the symptoms. For instance, if worry injures the Liver, which belongs to Wood, the Qi converges in the Liver, and Spleen Earth suffers evil. If worry injures the Heart, which belongs to Fire, the Qi converges in the Heart, and Lung Metal suffers evil. If worry injures the Lung, which belongs to Metal, the Qi converges in the Lung, and Liver Wood suffers evil. In ordinary people, excessive worry leads to stagnant Qi mechanism, resulting in chest and hypochondriac pain. Excessive worry causes water-dampness to coagulate and stagnate, leading to wandering pain throughout the body or joint pain, which flares up upon exposure to yin-cold. Excessive worry causes heat to accumulate and fail to dissipate, resulting in blurred vision and dark red urine. Excessive worry leads to Qi deficiency failing to control saliva, causing panting upon movement. Excessive worry causes blood vessels to be sluggish, resulting in weakness of the four limbs, good appetite but bloody stools. Excessive worry leads to indigestion, belching with acid regurgitation, abdominal fullness, and inability to eat. The white part of the eye belongs to the Lung; if Lung Qi fails to diffuse due to excessive depression, membranes and obstructions may form, causing blurred vision. Furthermore, extreme worry turning into grief injures the Ministerial Fire of the Pericardium. Extreme worry turning into fear injures the True Water (Kidney Yin) within the Kidney. If Ministerial Fire is insufficient, the brilliance of the eyes cannot radiate outward; if True Water is insufficient, the nourishing fluids cannot fill the interior. Mild cases present with dim vision and photophobia; severe cases present with fish-belly eyelids (edematous eyelids resembling a fish's belly) or hawk-eyes (protruding eyeballs resembling a hawk's eyes). Tonifying the Lung and calming the Spirit are the most crucial methods. Additionally, having persons close and trusted by the patient offer gentle words of comfort and persuasion to stimulate the movement of Heart Yang constitutes the principle of using Joy to overcome Worry.