Loading...
Chapter 78 of 78
黄帝内经·素问
Overall Paraphrase
The Yellow Emperor was in the Mingtang (the ancient hall where emperors proclaimed governance and discussed medicine) listening to Lei Gong's inquiries. Lei Gong said: I have studied medicine and transmitted its applications, relying on classical texts, physical examination methods, yin-yang acupuncture and moxibustion, and herbal decoctions for nourishment. Yet clinical outcomes vary—some succeed, some fail, and I cannot achieve perfection in every case. If we first discuss pathogenic factors such as grief and joy, anger and sorrow, dryness and dampness, cold and heat, yin and yang, male and female, I wish to understand the principles therein. Regardless of differences between noble and humble, or variations in physique, how to skillfully apply the Way and its techniques in clinical practice—this I have already been taught. Now I wish to raise a question that is foolish and shallow, not explicitly recorded in the classics, and I would like to hear its details. The Yellow Emperor said: This question is of great import.
Lei Gong asked: When a person weeps, tears do not flow out, or tears come forth but nasal discharge is scarce—what is the reason? The Yellow Emperor said: This is already recorded in the classics. Lei Gong further asked: I do not know whence tears arise, nor whence nasal discharge emerges. The Yellow Emperor said: Asking these things may not directly aid treatment, but a physician ought to understand them, for this is the fundamental root from which the medical Way arises.
The Heart is the reservoir where the essential qi of the Five Viscera (five yin-organs) gathers; the eyes are the external orifice of the heart; facial complexion is the flourishing manifestation of the heart. Therefore, when a person possesses virtue, qi flows harmoniously and is revealed in the eyes; when one experiences disappointment, worry and sorrow manifest in the countenance. Hence grief and sorrow bring forth tears, and tears are born from this. The root of water is accumulated fluid, which pertains to extreme yin (the most exuberant yin), and extreme yin is transformed from kidney essence. Normally the water governed by kidney essence does not flow out, because essence secures and restraintes it; auxiliary qi wraps about it, and so fluids do not disperse recklessly.
The essence of water transforms into zhi (the spirit stored in the kidneys), and the essence of fire transforms into shen (the spirit stored in the heart). Water and fire mutually respond; when shen and zhi are both grieved, the watery fluid in the eyes is thus produced. Therefore the proverb says: Sorrow of the heart is also called sorrow of the zhi, for zhi and heart-essence jointly converge upon the eyes. When spirit qi transmits to the heart, essence does not rise to the zhi, and the zhi alone grieves—hence tears emerge. Nasal discharge and tears both relate to the brain; the brain pertains to yin, and marrow nourishes the bones. Thus brain qi descending and seeping becomes nasal discharge. Zhi is the master of the bones, so when water-fluid flows out, nasal discharge follows—their mode of movement is that of like responding to like. The relation of nasal discharge and tears is like that of brothers: in urgency they die together, in tranquility they live together; when shen and zhi are stirred by grief, nasal discharge and tears flow out together, even streaming across the face. The reason weeping brings both tears and nasal discharge forth together is that they belong to the same category.
Lei Gong said: How great is this principle! I venture to ask: when some people weep but no tears come, or tears come forth but very scantily, and nasal discharge does not follow—why is this? The Yellow Emperor said: Weeping without producing tears is because the weeping lacks true grief; the absence of tears is because the shen is not moved to compassion. When shen is not compassionate, zhi is not grieved; yin and yang hold each other in check—how could tears come forth alone? When zhi is grieved, there is lamentation and sighing; lamentation causes qi to rush counterflow into the yin sphere (the lower, yin position). Rushing against yin causes the zhi to depart from the eyes; when zhi departs, shen cannot guard the essence, and both spirit and essence leave the eyes—then nasal discharge and tears come forth together.
Moreover, have you not recited and contemplated the words of the classics? In jue (rebellious counterflow of qi), the eyes see nothing. When a person experiences jue, yang qi converges above and yin qi converges below. When yang converges above, fire pathogen alone flourishes; when yin converges below, the feet become cold; cold feet lead to abdominal or bodily distension. One water cannot overcome five fires; therefore the eyes fail to see clearly. Thus when facing wind, tears flow incessantly. When wind pathogen invades the eyes, yang qi secures and dwells within the essence, and fire qi scorches the eyes—hence seeing wind brings forth tears. This may be illustrated by an analogy: only when fire blazes fiercely and wind rises simultaneously can rain be formed—this is likewise a matter of like kind.
Mutual Response of Spirit and Zhi; Mutual Support of Water and Fire: This text attributes the production of tears to the resonance between heart fire and kidney water. The heart stores shen, and the kidney stores zhi; when grief arises, both shen and zhi stir, water and fire interact, and fluid emerges from the eyes. This embodies the consistent zangxiang–emotion holistic view of the Neijing: emotions are not isolated psychological activities but reflections of the movement of essential qi in the five viscera.
Tears and Nasal Discharge Share a Common Source; Brain and Kidney Are Connected: The text proposes that "weeping and nasal discharge pertain to the brain," "brain seepage becomes nasal discharge," and "zhi is the master of the bones," threading tears, nasal discharge, brain, marrow, bones, and kidney essence into a single fluid system. Tears are formed by water-fluid governed by kidney essence gathering upward in the eyes; nasal discharge is formed by brain marrow seeping downward into the nose. Both belong to the same category and respond accordingly. This is an early, unsophisticated model of head-and-face fluid metabolism.
Yin-Yang Stalemate and Counterflow of Qi Dynamics: In explaining "weeping without tears," the text emphasizes that "when shen is not compassionate, zhi is not grieved; yin and yang hold each other in check—how could tears come alone?"—that is, when emotion is not deep and yin-yang have not been stirred, tear secretion cannot be elicited. In jue conditions, yang qi becomes solely hyperactive above while yin qi sinks below, and fire-heat scorches the eyes, resulting in impaired vision and tearing when facing wind. The text here uses ascending and descending of yin and yang to explain emotional and orificial pathologies.
Emotional Tearing Has Neurophysiological Basis: Modern medicine holds that emotions such as sadness activate the limbic system and hypothalamus, influencing lacrimal gland secretion through the autonomic nervous system. This aligns at a macro level with the classical descriptions of "grief and sorrow bring down tears" and "shen and zhi both grieve," though the ancients employed a heart–kidney–shen–zhi model.
Common Origin of Tears and Nasal Discharge Has Anatomical Basis: The nasolacrimal duct connects the eye and nasal cavity; when weeping increases tear production, excess tears can drain through the nasolacrimal duct into the nasal cavity as "nasal discharge." The ancient saying that "nasal discharge and tears are like brothers" matches observed experience; however, "brain seepage becomes nasal discharge" was speculation, as the ancients did not know the nasolacrimal duct structure.
Modern Explanation of Tearing in Wind: Wind and cold air stimulate the ocular surface, triggering reflex lacrimal secretion, which may also relate to tear film instability or meibomian gland dysfunction. The ancients explained it with "wind and fire fanning each other" and "fire qi scorching the eyes"—a theoretical analogy rather than precise pathology.
"One Water Cannot Overcome Five Fires" and "In Jue, the Eyes See Nothing": These are inferences of yin-yang and five-phase theory. In modern terms, one should not treat "five fires" as five material fires, nor should "blindness" be naively equated with any single modern disease. The texts suggest that upper–lower yin-yang disharmony may affect orificial function, but specific mechanisms require contemporary medical assessment.
Keep Emotions Balanced; Grieve Without Excess: Tears are a natural channel for emotional release and need not be forcibly suppressed; yet prolonged immersion in grief may disturb the spirit and essential qi. Daily practices such as confiding in others, physical exercise, and conscious breathing can restore emotional equilibrium.
Protect the Eyes from Wind; Reduce Stimuli: In windy, sandy, cold, or dry conditions, the eyes readily become reflexively tearful or dry and uncomfortable. Wearing protective eyewear or otherwise shielding the face when going out can reduce wind-pathogen irritation of the ocular surface.
Keep Head and Feet Warm; Harmonize Qi and Blood: The statement that "when yin converges below, the feet become cold" suggests that a hot head with cold feet may reflect disharmony in upward-and-downward qi-blood circulation. Pay attention to avoiding excess heat in the head and excess cold in the feet, avoid prolonged sitting or standing, and support overall patency of qi and blood throughout the body.
This content is based on classical Chinese medical classics and is provided solely for traditional cultural learning and study. It does not constitute any medical diagnosis, prescription, or treatment advice; if you are unwell, please seek timely medical care.