《灵枢》本神篇曰∶心有所忆谓之意，意之所存谓之志，因志而存变谓之思。阴阳应象
大论
曰∶中央生湿，在志为思。举痛论曰∶思则气结。又曰∶思则心有所存，神有所归，正气留
而不行，故气结矣。本神篇曰∶怵惕思虑则伤神。本病篇曰∶忧愁思虑则伤心。盖心为脾之
母，母气不行，则病及其子，所以心脾皆病于思也。张会卿曰∶思郁者，气结于心而伤于脾
也。及其既甚，则上连肺胃，而为咳喘，为失血，为噎膈，为呕血。下连肝肾，则为带浊，
为崩淋，为不月，为劳损。李东垣曰∶五脏六腑之精气，皆禀受于脾，上贯于目。脾者，诸
阴之首也。目者，血脉之宗也。思虑伤脾，则五脏之精气皆失所司，不能归明于目，而有视
物羞明，眼皮宽纵，倒睫拳毛等症。或生偷针，或生眼瘅，治宜扶脾补土兼清心阳。若初病
而气结凝滞者，宜顺宜开，久病而损及中气者，宜修宜补。然以情病者，必得愿遂而后可释
，或以怒胜思，亦可暂解。如朱丹溪治一思想气结之女，先激之使怒，然后与药，复念病虽
愈，必得喜方已。乃 以夫回，病遂不举。予尝用此治太湖李姓之妇，目竟获痊，即此法也
。
痿论曰∶悲哀太甚，则胞络绝。胞络绝，则阳气内动，发则心下崩。宣明五气篇曰∶精
气并
于肺则悲。本神篇曰∶悲哀动中者，竭绝而失生。又曰∶肝悲哀动中则伤魂。又曰∶心气虚
则悲。调经论曰∶神不足则悲，是肺肝心三脏亦病于悲也。又运气∶悲皆属寒水攻心。五常
政大论曰∶火不及曰伏明，伏明之纪，其病昏惑悲忘，从水化也。又曰∶太阳司天，寒气下
临，心气上从，喜悲数欠。至真要大论曰∶太阳司天，寒淫所胜，民病善悲，时眩仆。又曰
∶太阳之复，甚则入心，善忘善悲。夫悲之为情，与忧思大异，忧思则默然不语，如呆如痴
，悲则哀恸迫切，号呼痛哭，渐至泪枯眼肿，视物无形。且悲则心系急，肺布叶举，而上焦
不通，营卫不散，热气在中，熏蒸清道，伤及五轮，遂有黑花蝇翅鱼鳞白陷诸症。治宜补其
肝脾。盖木为火之母，子虚则补母之义也。土为火之子，补子令母实之义也。然必释其悲，
则治得其效。若妇女性执，终岁戚戚，虽日用芜芎香附以升提，参术归苓以培本，是亦扬汤
止沸之计而已。
《灵枢·本神》篇说：心中有所回忆称为“意”，意念所存留的称为“志”，依据志向而进行变化思考称为“思”。《素问·阴阳应象大论》说：中央方位产生湿气，在情志方面对应为“思”。《素问·举痛论》说：思虑过度会导致气机郁结。又说：思虑会使心神专注于某处，神气归附于内，导致正气停留而不能运行，所以气机就会郁结。《灵枢·本神》篇说：恐惧和思虑会损伤神气。《素问·本病论》说：忧愁和思虑会损伤心脏。因为心是脾的母亲（五行中心属火，脾属土，火生土），母脏之气运行不畅，就会波及子脏，所以心和脾都会因思虑而生病。张会卿说：思虑导致的郁结，是气机郁结在心并损伤了脾。如果病情严重，向上牵连肺和胃，就会出现咳嗽气喘、失血、噎膈（吞咽困难）、呕血等症状；向下牵连肝和肾，就会出现白带浑浊、崩漏淋证、月经闭止、虚劳损亏等症状。李东垣说：五脏六腑的精气，都禀受于脾，向上贯通于眼睛。脾是诸阴经的首领。眼睛是血脉汇聚的根本。思虑损伤脾脏，那么五脏的精气都失去主宰，不能使目光清明，从而出现视物畏光、眼睑松弛下垂、倒睫拳毛等症状。或者发生偷针眼（麦粒肿），或者发生眼丹（眼睑红肿热痛），治疗应当健脾补土兼清心阳。如果是初病且气机郁结凝滞的，适宜疏通开散；久病且损伤中气的，适宜修养滋补。然而因为是情志致病，必须心愿达成才能解除，或者用怒来克制思虑，也可以暂时缓解。比如朱丹溪治疗一位因思想导致气结的女子，先激怒她使其发怒，然后给药，又告诉她虽然病愈，但必须得到喜悦（丈夫归来）才能彻底痊愈。于是让丈夫回来，病随即痊愈。我曾经用这种方法治疗太湖李姓的妇女，眼睛竟然痊愈，就是用的这个方法。
《素问·痿论》说：悲哀太甚，会导致胞络断绝。胞络断绝，阳气在内妄动，发作时会出现心下出血。《素问·宣明五气篇》说：精气合并于肺则表现为悲。《灵枢·本神》篇说：悲哀触动内脏，会导致精气竭绝而丧失生机。又说：肝受悲哀触动内脏则损伤魂。又说：心气虚弱则易悲。《素问·调经论》说：神气不足则易悲，这说明肺、肝、心三脏也会因悲伤而生病。另外从五运六气角度分析：悲伤都属于寒水之气攻心的表现。《素问·五常政大论》说：火气不及称为“伏明”，伏明的纪年，其病症表现为昏乱迷惑、悲伤健忘，这是从水化生的结果。又说：当太阳寒水司天时，寒气下行临袭，心气上从于寒，患者喜欢悲伤且频繁打哈欠。《素问·至真要大论》说：太阳司天，寒气过胜，民众容易患病表现为善于悲伤，时常眩晕仆倒。又说：太阳复气严重时侵入心脏，表现为善忘和善悲。悲伤这种情志，与忧思有很大不同，忧思使人沉默不语，像痴呆一样；悲伤则哀痛迫切，号呼痛哭，逐渐导致泪干眼肿，视物模糊无形。而且悲伤会使心系拘急，肺叶布展举起，导致上焦不通畅，营卫之气不能散布，热气郁结在中焦，熏蒸清窍，损伤五轮（眼科五轮学说中的肉轮、血轮、气轮、风轮、水轮），于是出现黑花、蝇翅、鱼鳞、白陷等各种眼症。治疗应当补益肝脾。因为木（肝）是火（心）的母亲，子虚则补母的道理。土（脾）是火（心）的儿子，补子令母实的道理。然而必须消除悲伤的情绪，治疗才能见效。如果妇人性格执拗，整年忧伤抑郁，即使每天使用川芎、香附来升提气机，人参、白术、当归、茯苓来培补根本，这也只是扬汤止沸的权宜之计罢了。
According to the *Ben Shen* chapter of the *Ling Shu* (Spiritual Pivot): "What the heart remembers is called Yi (Intent); what is retained by Yi is called Zhi (Will); based on Zhi, changes are stored and considered, which is called Si (Reflection/Overthinking)." The *Yin Yang Ying Xiang Da Lun* (Great Treatise on Yin-Yang Correspondence in Images) states: "In the Central region, Dampness arises; in emotional activities, it corresponds to Si (Reflection/Overthinking)." The *Ju Tong Lun* (Treatise on Pain) states: "Si (Reflection/Overthinking) causes Qi stagnation." It further says: "Si (Reflection/Overthinking) causes the mind to focus on something specific, and the Shen (Spirit) to return inward; thus, Zheng Qi (Upright Qi) remains stagnant and does not flow, resulting in Qi stagnation." The *Ben Shen* chapter states: "Fear and Si (Reflection/Overthinking) injure the Shen (Spirit)." The *Ben Bing Lun* (Treatise on Root Diseases) states: "Worry and Si (Reflection/Overthinking) injure the Heart." Since the Heart is the Mother of the Spleen (Fire generates Earth), if the Qi of the Mother organ fails to circulate, it will affect the Child organ; therefore, both the Heart and the Spleen can be diseased by Si (Reflection/Overthinking). Zhang Huiqing stated: "Si Yu (Stagnation due to Overthinking) involves Qi stagnating in the Heart and injuring the Spleen." When the condition becomes severe, it connects upward to the Lung and Stomach, causing cough and asthma, hemoptysis (blood vomiting), ye ge (dysphagia/choking sensation), and vomiting blood. It connects downward to the Liver and Kidney, causing leukorrhea and turbidity, beng lin (metrorrhagia and stranguria), amenorrhea, and lao sun (consumptive disease). Li Dongyuan stated: "The essence and Qi of the five zang and six fu organs all receive their nourishment from the Spleen and ascend to penetrate the eyes. The Spleen is the head of all yin meridians. The eyes are the congregation of blood vessels." Si (Reflection/Overthinking) injures the Spleen, causing the essence and Qi of the five zang organs to lose their governance, unable to bring clarity to the vision, leading to symptoms such as photophobia (aversion to light), laxity of the eyelids, trichiasis (in-turned eyelashes), and entropion with curled lashes. One may develop hordeolum (stye) or yan dan (eyelid inflammation/redness). Treatment should involve supporting the Spleen and tonifying Earth, combined with clearing Heart Yang. If the disease is recent and characterized by Qi stagnation and condensation, appropriate methods are smoothing and opening; if the disease is chronic and has damaged Middle Qi, appropriate methods are repairing and tonifying. However, for diseases caused by emotions, resolution is only possible when wishes are fulfilled, or anger can overcome Si (Reflection/Overthinking), providing temporary relief. For instance, Zhu Danxi treated a young woman whose Qi was knotted due to overthinking by first provoking her anger, then administering medicine, and telling her that although the illness would heal, it would only be completely resolved upon feeling joy (her husband's return). Consequently, her husband returned, and the illness vanished. I once used this method to treat a woman surnamed Li from Taihu Lake, whose eye condition was completely cured; this is precisely that method.
The *Wei Lun* (Treatise on Flaccidity Syndromes) states: "Excessive sorrow leads to the severance of the Bao Luo (Pericardium Collaterals). When the Bao Luo is severed, Yang Qi moves internally, and upon manifestation, it causes bleeding from below the heart (hematemesis/hematochezia)." The *Xuan Ming Wu Qi Pian* (Chapter on Manifesting the Five Qi) states: "When Essence and Qi combine in the Lung, it manifests as Bei (Sorrow)." The *Ben Shen* chapter states: "Those who are moved internally by sorrow and grief exhaust their vitality and lose life force." It further states: "If the Liver is moved internally by sorrow, Hun (Ethereal Soul) is injured." It also states: "Heart Qi deficiency leads to sorrow." The *Tiao Jing Lun* (Treatise on Regulating the Channels) states: "Shen (Spirit) insufficiency leads to sorrow." Thus, the Lung, Liver, and Heart are also diseased by Bei (Sorrow). Furthermore, regarding the Six Qi transformations: Sorrow belongs to Cold Water attacking the Heart. The *Wu Chang Zheng Da Lun* (Great Treatise on the Five Constant Policies) states: "When Fire is deficient, it is called Fu Ming (Hidden Brightness). In the pattern of Fu Ming, the diseases include confusion, dizziness, sorrow, and forgetfulness, transforming according to Water." It further states: "When Tai Yang (Solar Cold) governs the year, Cold Qi descends and临 (approaches), Heart Qi follows upwards; patients tend to feel sorrowful and frequently yawn." The *Zhi Yao Yao Da Lun* (Great Treatise on the Most Essential Requirements) states: "When Tai Yang (Solar Cold) governs, and Cold excess prevails, the people suffer from frequent sorrow and occasional dizziness and fainting." It also states: "When Tai Yang returns excessively, if it severely enters the Heart, it manifests as forgetfulness and frequent sorrow." The emotion of Bei (Sorrow) differs greatly from You Si (Worry and Overthinking). You Si makes one silent and mute, appearing dull and foolish; Bei (Sorrow) involves urgent and profound grief, wailing and crying bitterly, gradually leading to dried tears and swollen eyes, and blurred vision where objects appear formless. Moreover, Bei (Sorrow) causes the Xin Mai (Heart Vessel/Mind connection) to contract urgently, and the Fei Ye (Lung Lobes) to spread and rise, obstructing the Upper Jiao (Upper Burner), preventing the dispersion of Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi). Heat accumulates in the center, steaming the clear orifices, and damaging the Wu Lun (Five Wheels of the Eye). This results in various ocular symptoms such as floaters (black flowers), muscae volitantes (fly wings), fish-scale patterns, and white depressions. Treatment should tonify the Liver and Spleen. Because Wood (Liver) is the Mother of Fire (Heart), the principle applies: when the Child is deficient, tonify the Mother. Earth (Spleen) is the Child of Fire (Heart), applying the principle: tonify the Child to make the Mother full. However, the emotion of sorrow must be alleviated for treatment to be effective. If a woman is stubborn and perpetually melancholic throughout the year, even if one daily uses Chuanxiong Rhizome (Chuanxiong) and Cyperus Rhizome (Xiangfu) to lift and raise Qi, and Ginseng Radix (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Angelica Sinensis Radix (Danggui), and Poria (Fuling) to cultivate the root, this is merely a strategy of stirring the boiling water to stop the boil (a temporary palliative measure).