I have noticed that many of my colleagues rely only a little on their patients' descriptions of their feelings, preferring to look for more obvious signs and symptoms. It is hardly surprising, considering this is how we were taught at acupuncture school.
While it always is nice to have signs and symptoms that paint a clear picture of the patient's condition, their emotions can be much more helpful in establishing a diagnosis than they are given credit for. Numerous classical sources including Nei Jing point out a strong relationship between the zang organs and emotions, and yet when patients describe what they feel, many acupuncturists place such descriptions into the "subjective" category in their notes. Can it be possible, however, to get more reliable information from the patient's descriptions of their experiences? Let us consider several observations that help to rediscover zang organs, and then you be the judge of their value.
Imagine a young man who is walking down a street slouching, heavily stepping and periodically sighing. Even though you do not know this man and do not know what happened to him, you would doubtlessly know he is feeling sad. But what makes you so sure? You are so sure because when you, just like all other people, feel sad, you always feel this emotion in your chest. Notice, too, that if you experience an emotion in any other place in your body, that feeling would never be sadness. But let us look at sadness more closely.
Recall any situation that made you feel sad. Pay attention to the emotion it triggered, recalling the situation again only if your feeling starts to fade. You would immediately feel how the sensation of heaviness is filling up two specific pockets on both sides of your lateral chest. If the situation you chose makes you experience intense sadness, then these pockets would fill to their brims, expanding bilaterally in your chest.
What you are feeling in this case is, presumably, the lung organ described by ancient Chinese physicians. What is interesting about the heaviness you feel when you are sad is that this feeling is how lungs interpret the sensation that penetrates it. The actual sensation, however, that initiates your experiencing an emotion is the same for any feeling--the qi sensation.
You can feel your heart (or, rather, pericardium), if you observe how you experience joy. Just as you did with sadness, you would not confuse joy with any other emotion. You would easily recognize people who are feeling joyous by their forward-arched chests, spring in their steps and, of course, by their laughter. If you think of a situation that triggered joy in you and observe this emotion instead of observing the situation that brought it about, you would feel the pocket that contains your joy. What is curious about this emotion is that it never enters the heart. It tries to squeeze its way in, but your heart repels it, causing that well-known tickling sensation in the center of your chest that makes you laugh.
We recognize when someone is angry by their directness or harshness in movement and breathing. It is difficult to pinpoint anger's location, unless you observe how you yourself experience anger. Say you are walking toward your car and you see someone breaking a window and reaching for your GPS. If you feel anger, then you would feel it as a sensation that fills up two fist-sized containers, located bilaterally in your lower anterior rib cage.
Anger always starts in those places and then spreads deeper into your body, right below the diaphragm when it is intense. If you compare many situations that trigger the appearance of your anger, you will notice each situation makes you feel the pockets that contain your anger fill up to a different degree. These pockets probably are your liver, the way ancient Chinese physicians identified it, but only intense anger will make you feel the entire organ.
Worry is noticeable because you fidget, trying to get comfortable by pressing down your rib cage with your upper torso. You do so because you experience worry as a sensation, as if your upper abdomen becomes less dense and does not support your upper body as well as it usually does. According to the classics, the organ you are feeling is spleen. To actually feel your spleen, however, you would have to spend some time re-teaching yourself to observe your worry like an outsider, as opposed to someone who is actually feeling worried, because you would have to identify its location by observing your sensations in the area that surrounds your spleen. (The actual organ, just like your upper abdomen, feels less dense while you are worried, making it more difficult to identify.) Once you do it, you would feel either your entire spleen or a part of it, depending on the intensity of the emotion.
Desires and Dreams
Before we discuss the kidneys, let us look at where our desires come from in our bodies, and let us do it by using an example. Peter has dreamed of a yacht ever since he could remember. An article in a magazine reminds him of his dream. He imagines his yacht with its tall, white sail and a wide deck, and Peter could find and use any sailing gear whenever he needed it. He feels his yacht gently sway side to side, rocked by waves that melodically splash against the yacht's white frame.
Peter does not notice when he stops reading the article and lifts his head. As he sinks deeper into his daydream, Peter gradually leans back in his chair as if something is pushing him in the lower rib cage, where his kidneys are -- arching forward his upper abdomen.
Peter is not an exception; we all move this way when we daydream. This happens because our dreams seem to be tied up with a push from our backs, and we relax our bodies so they do not stand in the way of our dreams.
But let us return to Peter. He continues to daydream until he hears his colleagues talking in the next cubicle and realizes he needs to get back to work. Peter sighs and leans forward, curbing his dream by placing his body in the way of that push from his back -- the way we all do.
If you recall any time when you wanted something, you would be able to observe how your desire originates in your back and spreads forward, pushing you to move toward your goal.
What is curious about daydreaming is that observing it, you can see and feel the pure push of your desire. In real life, your body disperses the force of that push to different areas, depending on your body type and your personality.
Let us now look at the last of the five zang organs -- the kidneys. And let us do so, again, by means of an example. Picture yourself crossing a road and not seeing any cars until you hear a loud screech of brakes and a car suddenly stops, very nearly striking your leg. If you feel scared, you would feel this emotion in your back, right where your kidneys are. In fact, you would feel your kidneys, either somewhat or fully. Just like with the other organs, the intensity depends on the fear's intensity. Unlike the heart, kidneys do not seem to mind when fear squeezes them. This squeezing is one of the reasons you might feel numb or even paralyzed with fear. The other reason for your feeling noticeably numb is the kidney's proximity to the initial push, which starts all your dreams and desires. (Perhaps that place where the initial push takes place is what ancient Chinese physicians called the ming meng.)
When a child sees a new toy and runs to or simply reaches for it, the very beginning of the child's movement and the desire to get that toy come from their back, immediately posterior to the kidneys. Every step you take, a mere moment before you transfer your body weight from the heel to the ball of your foot, starts at exactly the same place. The pockets of the kidneys that contain your fear are located anterior to the ming meng and hinder the distribution of the initial push, causing the sensation of paralysis.
I have observed many of my simple and compound emotions and they have always involved one or more of the five zang organs. I have found these observations useful in practice; when I hear patients telling me what and how they feel, I remember those sensations from my own experiences, and that makes the task of establishing a diagnosis a little bit easier.
Vladislav Korostyshevskiy holds a private practice in New York. He is author of "Pulse Diagnosis: A Self-Study Approach" appeared in the 2008 summer issue of The American Acupuncturist.