Whence Cometh Sad Tears?

Elsewhere, however, Qibo offers a different account. In this version, sad qi in the heart causes the heart straps (xinxi 心系) to tighten, which in turn causes the lungs to rise and ye 液 fluids to ascend.{{⁴}}{{{Lingshu, 36.283. Most historical exegetes have taken xinxi to refer to a physical link binding the heart and the lungs. For a summary, see Shen Xueyong, ‘“Xinxi” shi xi’, Zhenjiu linchuang zazhi 4, no. 13 (1997): 1.}}} Since neither the heart nor the lungs can hold steady in their elevated positions, they waver up and down, causing the person to cough and tear up.

To start with, sadness was conceived as a bodily change. That is to say, a crucial—perhaps the most crucial—part of experiencing an emotion in classical Chinese medicine was the experience of the physical changes that accompanied it. The Inner Canon identified sadness with the series of bodily experiences: a lurching of the heart, the trembling of the vessels and fluid pathways, a contraction of the heart straps, the wobbling of the lungs, an unsettled spirit, a faltering will.{{¹⁴}}{{{On the understanding of emotions as bodily experiences in Chinese medicine, see Shigehisa Kuriyama, The Expressiveness of the Body and the Divergence of Greek and Chinese Medicine (New York: Zone Books, 2002), 103; Angelika C. Messner, ‘Aspects of Emotion in Late Imperial China: Editor’s Introduction to the Thematic Section’, Asiatische Studien 66, no. 4 (2012): 899–902.}}}

Second, tears emerged from imbalance. The tear-generating processes described in the Inner Canon consistently feature disequilibrium. Qibo’s first explanation identifies the immediate trigger of tears as the opening of fluid pathways, which habitually, in the absence of external disruptions, remain closed. In his second account, a state of dynamic equilibrium exists among the heart, the heart straps and the lungs. A tightening of the heart straps, however, throws everything out of kilter and forces the lungs upward. The resultant irregular oscillation of the lungs and heart acts like a pump, pushing tears out. The third account, too, presents two aspects of the self thrown off balance; the will and the spirit are both caught off guard, and their consequent failure to watch over spiritual essences leads to the inadvertent release of watery tears.

For the most part, such perturbations are fleeting, and the Inner Canon does not portray them as affecting lasting harm. Emotions become damaging only in excess.{{¹⁵}}{{{The Inner Canon assigns specific terminology to discuss excessive emotions as pathologies. For instance, it addresses excessive anger as ‘anger and craziness’ (nükuang 怒狂) and explicitly calls it a disease (bing 病). See Suwen, 46.594. The text also qualifies emotions as immoderate (bujie 不節) when they provoked changes needing medical attention—for example, ‘immoderate joy or anger’ (xi nü bu jie 喜怒不節). See Suwen, 5.80, 62.795. For a comprehensive discussion of emotions as medical problems, see Unschuld’s analysis under the rubric ‘somatopsychic diseases’. Unschuld and Tessenow, Huang di nei jing su wen, 227–34.}}} But there is a deeper reason for the neutral nature of sadness. Sad qi was, like qi more generally, neither essentially good nor bad in itself.{{¹⁶}}{{{Hsü, The Transmission of Chinese Medicine, 235.}}} In this respect, it was quite different from the so-called deviant qi (xieqi 邪氣) that invaded the body from without and was intrinsically harmful.{{¹⁷}}{{{Technically, qi was generally in constant flux, moving in and out of the body. Deviant qi was different in the sense that it was primarily associated with the external environment, from which it exerted an intense illness-inducing influence. According to Unschuld, deviant qi became conflated with pathogenic wind, which was explicitly an external force. See Paul Unschuld, Medicine in China: A History of Ideas (Berkeley, CA: University of California Press, 2010), 67–73. For a discussion of deviant qi in practical contexts, see Hsü, The Transmission of Chinese Medicine, 69.}}}  A surge of sadness, by contrast, was just one out of many possible ‘endpoints’ in the general fluctuations of qi, an irregularity in the body’s inner circulation.{{¹⁸}}{{{Unschuld and Tessenow, Huang di nei jing su wen, 161.}}} Therefore, even if the emotion became excessive and required medical intervention, healers focused on regulating disrupted flows and re-establishing smooth and easy circulation around the body, rather than confronting the emotion itself as a discrete and specific enemy.{{¹⁹}}{{{Unschuld and Tessenow, Huang di nei jing su wen, 231.}}}

Lastly, a tear was more than just a tear. The liquid in tears was not unique to them and was the same as found in many other bodily fluids.

The third account above traces tears to ‘accumulated water’ and thus roots them in the general pool of fluids flowing through the body. Similarly, in the chapter containing the second account, the Lingshu distinguishes five different types of fluids, but they all originate in the end from the same liquid (ye) and are part of a common circulation. Water and grains (shuigu 水穀), the chapter explains, are received in the stomach and intestines (changwei  腸胃) and generate ye fluid, which then becomes differentiated into urine (ni 溺), breath (qi), sweat (han 汗), tears (qi 泣) and saliva (tuo 唾).{{²⁰}}{{{Lingshu, 36.282. Scholars have different views about how to interpret qi in this statement. Some read it as referring to the omnipresent qi, and others treat it as the antecedent of urine rather than as a separate, independent fluid. See Unschuld, Huang di nei jing ling shu, 383. This reading, however, leaves the current passage with four instead of five bodily fluids. I follow He Xiaohui’s reading to translate it as ‘breath’, which stands on its own as one of the five fluids. Breath suits the context as the text mentions the circumstances of ‘cold weather and thin clothing’, in which a person reasonably exhales visible vapour. See He Xiaohui, ‘“Tian han yi bo ze wei ni yu qi” zhi wo jian’, Shanghai zhongyiyao zazhi 10 (1985): 46. Also, the Suwen presents a different scheme of five fluids, including sweat, mucus, tears, saliva (xian 涎) and spittle (tuo 唾). See Suwen, 23.337. For an analysis of this version of the five fluids, see Unschuld and Tessenow, Huang di nei jing su wen, 121.}}} The same fluid can thus become urine or nervous sweat—or, when sad qi arises, tears.