Kidney and Psyche

Introduction

1. The trigram Kan and its implications

2. Psychic aspects of the kidney
2.1 Depression a psychic aspect of t he kidney

3. The kidneys psychic aspects seen from the point of view of western
medicine
3.1 The triple burner, the kidney and the peripheral sympathetic
nervous system

3.2 The thyroid gland and its relation to the kidney

4. Conclusions

Introduction
The kidney is the most interesting organ in the human body. Since the very
beginning of medical theories this organ has been mystified and mostly because
of anatomic findings: there are two kidneys, one on the left and one on the right
side of the spine, which are nevertheless one entity. As a Yin-Yang organ in
itself it has always been regarded as being responsible for reproduction and this
means the kidney has been regarded as the organ which enables man to
correspond to heaven and earth, the father and mother of all things. Suwen (5)
gives a summary of all correspondences of the kidney. It states:

The north brings about the cold

Cold produces water
Water is salty
The salty produces the kidneys
The kidneys produce the bones and the medulla
()
The kidneys govern the ears
In heaven it is the cold
On earth it is water
In the body it is the bones
Among the organ it is the kidneys
Among the colors it is black
()
Among the orientations of the heart it is anxiety
Anxiety may harm the kidneys
Contemplation overcomes anxiety (..)1

Suwen (5); Yang Weijie (1990): 52

When we have a closer look especially at the psychic aspects associated with the
kidney we may find more than those which are traditionally known and we find
from the point of view of western medicine a lot of implications on the
neuroendocrine level.

1 The trigram Kan and its implications

First of all we have to refer to the text which is the origin of all Chinese medical
theories, the Yijing. This work, which came into existence during the Shangdynasty (1600 1066) is the main source for medical theory in later times; and
before all the commentaries to this work written during the period of the Spring
and Autumn (770 - 476) and the Warring States (475 - 221) had great impact on
medical thought throughout the times. As for the inner organs and the
relationships between them the shuogua commentary which deals with the
symbolism of the trigrams and the great appendix (xici dazhuan) are very
instructive.
We have a correlation between the 8 trigrams and the inner organs. The shuogua
commentary gives the following correspondences:

Heaven

Lung

Qian
Earth

Stomach

Kun
Thunder

Gallbladder

Zhen
Wind

Liver

Xun
Water
Kan

Kidney

Fire

Heart

Li
Mountain

Spleen

Gen
Sea

Small intestine

Dui
Table 1: The trigrams and their corresponding inner organs

Among these trigrams the most outstanding and the most important one in our
context is the Kan trigram. The fundamental relevance of this trigram can first
be seen in the fact that in the Luoshu map, which is the map of the later heaven,
the trigram Kan takes over the position of the trigram Kun in the Hetu, which is
the map of the former heaven.

Figure 1: Heinz4

This means Kun

, the earth, and Kan
, the water, have a close
relationship, and in the human body the Kan takes over the tasks of Kun, the
earth. This means that Kan has to do with reproduction and motherhood. This
fact can be also seen in the shuogua commentary which states: Kan means

water. It is the trigram exactly in the north, it is the trigram of trouble, all things
have their origin in it. 2 From this commentary one may draw the further
conclusion that kan-kidney stands for the beginning and the end of life, birth and
death and for the development of the organism as a life process. Moreover the
trouble mentioned in the commentary is an allusion to the fact that the kidney is
mainly responsible for the bodys health.
As for the character of Kan the shuogua commentary states:
Kan is water, it is a linking channel, it is hidden, curved, its movement is
straight-lined, in man trouble brings about danger, it means heart disease, ear
pain, it is the blood trigram, it is purple red. In the horse it represents the
marvelous back, palpitations of the heart, the head bent down, a weak leg,
slow movement, as a carriage it has many defects, it is a ditch, it represents the
moon and a fleeing robber. In a tree it is the stable heart. 3

This statement is very symbolic and allusive. First we have the metaphor
water. Water connects all structures, as groundwater it is hidden in the earth,
its course is curved and in streams it is like an arrow leaving the bow. Water
symbolizes the blood in the human body. Blood nourishes the body as the water
nourishes the earth and it brings about danger in case of deficiency and
stagnation.
The second symbol is weakness, exhaustion and exhaustability traced in the
statements the head bent down, weak leg, slow movement, palpitation
and chariot with many defects.
The third symbol is the stability and beauty. The Yang line between two Yin
lines symbolizes the stable spine of a horse that means it is the symbol for the
physical stability. The hart of a tree symbolizes the inner stability. This means
that in the body the kidney is responsible for outer and inner stability.

2 Psychic aspects of the kidney

2
3

Zhouyi zhezhong (2003): 1012

Zhouyi zhezhong (2003): 1024

Let us now have a look at the psychic aspects of the kidney:

First the Huangdi neijing makes some statements on the emotional aspects of the
kidney:
So Lingshu (8) states that the kidney stores the will zhi and defines what zhi
means It states: () what the heart recalls into memory is intention, the
direction of intention is zhi , the will.4 The will is the psychic force of man to
direct his intention it is the goal-directedness of human consciousness. The
kidneys psychic aspect zhi, the will, is the immediate correspondence to the
kidneys responsibility for inner, that is, the mental stability of man. The mental
stability of man manifests itself in his will zhi. Zhi is stored in the essence and
depends on the free flow of Qi. It is a function of kidney Yang as Leon Hammer
states:
Kidney Yang is the energy which gives the impulse to all organ systems and
for the blood and Qi circulation. () On the mental level this impulse manifests
itself in motivation and will. (). The kidney-fire provides us with the
metabolic heat which makes an inactive organism a dynamic and goal orientated
being. From the very beginning it gives the vital force the force and the vital will
the will.5

As the will is dependent on the free flow of Qi, anger, which is able to impair
the free flow of Qi, is by this able to weaken the will. Reduced zhi may lead to
fear. And so it is natural that the kidney is also associated with anxiety kong.
Fear is the opposite of mental stability and of zhi. The kind of fear which is
associated with the kidney can be seen in the character for kong itself.
The radical below is xin (heart) . The phonetic part is composed of two single
parts: the right one reads fan , it is an abbreviation for hands holding an
instrument; the left one means work gong . This means that one has to
handle an instrument but one fears not to be able to fulfill his task. So kong
means fear not face to an immediate situation but a indefinite anxiety, a kind of
fearful expectation, fear of failure. Lingshu names ju as a synonym, which
means suspicion, cautiousness. Here the aspect of failing stability can be seen.
4
5

Lingshu (8); Lingshu yishi (1997): 76

L. Hammer (2002): 160

Fear which affects the kidney may also include anxiety attacks as a result of a
disruption of the lineage between heart and kidney. In this case symptoms like
panic, agitation, palpitation, transpiration, and shortness of breath may occur
because heart Qi rises up and loses contact to the weakened kidney.

2.1 Mental depression a psychic aspect of the kidney

A strong will is the manifestation of strong kidney Yang. This means that feeble
will, lack of self-confidence and anxiety may be first of all the result of weak
kidney Yang. Seen from the point of view of the five phases we can see that
even grief and sorrow which are associated with the lung may result in fear and
in the end in the exhaustion of the life spirit. Contemplation si which is
associated with the spleen may overcome fear. This is because the earth controls
water.
On the other hand the emotions anger and rage nu which are associated with
the liver - which is the kidneys son organ - may have a negative effect on the
kidney and impair the will the result being fear and anxiety.

Figure 2: The emotions and their impact on the kidney according to the Five Phases theory

At a long term these emotions like rage, anger and anxiety may result in
resignation and depression with symptoms like lack of self-confidence, avolition
and sadness. These symptoms are associated with lack of kidney Yang. So we

may indeed draw the conclusion that persons suffering of lack of kidney Yang
have tendency to mental depression.
At a long term fear and anxiety may under stress circumstances result in
palpitation, nervousness, restlessness, transpiration, and sleeplessness, that is in
symptoms which we may categorize as manifestations of lack of kidney Yin
So we see that the psychic symptoms associated with lack of kidney Yin and
lack of kidney Yang are directly correlated with each other.

3 The kidneys psychic aspects seen from the point of view of western
medicine

When we now have a look at these symptoms of depression from the point of
view of western medicine we have the same scenario: on the neuroendocrine
level they initiate the same mechanism:
Anxiety directly activates the amygdala, which Ruegg qualifies as the pivot of
anxiety-reaction6. The amygdala and the rest of the limbic system directly or
indirectly affect the hypothalamus and this small part of the interbrain causes
motoric reactions and the release of adrenaline and cortisol in the suprarenal
gland. There are two ways for the release of cortisol or adrenaline /noradrenalin:
1. The pivot of hypothalamus-pituitary gland-adrenal cortex
2. The activation of the sympathetic nervous system

Regg (2003): 76

Figure 3: Stress, the two pathways of stress reaction

A high level of cortisol in the blood is responsible for depressive disorders and it
makes a person inactive and lethargic, the activation of the sympathetic nervous
system makes symptoms like palpitation, nervousness, restlessness and so on.
On the one side we see the pathway of lack of kidney Yin (2) on the other side
we have the way of lack of kidney Yang (1) and these two pathways run parallel.

3.1 The triple burner, the kidney and the peripheral sympathetic nervous
system

As for the psychic aspects of Yin deficiency in general we have anxiety,

nervousness, tenseness, palpitation, agitation, shortness of breath, sweating and
sleeplessness. In sum these symptoms of Yin deficiency can be divided in lack
of Yin in the lung, heart, liver and kidney that is on different levels of the triple

burner. Lack of liver Yin may result in uprising liver Yang, lack of heart Yin
may lead to heat in the heart of heart fire and lack of lung Yin may lead to heat
in the lung.
But al lack of kidney Yin may also lead to lack of liver Yin and lack of heart
Yin or heat in the heart, finally lack of kidney Yin may also lead to heat in the
lung. So the Yin deficiency symptoms in the different levels of the triple burner
may have as a last consequence their base in the kidney.

Figure 4: Kidney Yin deficiency, the base of Yin deficiency

Seen from the point of view of western medicine these symptoms of Yin
deficiency or heat are nothing but sympathetic reactions on different levels.
We may find as a correlative for the triple burner the sympathetic cord running
parallel to the vertebral spine:

Figure 5: The triple burner and its relation to the peripheral nervous system

Now we know that the triple burner is governed by the kidney as the Lingshu (2)
states.7 And in the Ming Dynastys (1368 1644) discussion about the nature of
the mingmen Zhang Jiebin (1563 1640) states that this might be the fatty mass
nearby the kidney8. We see in this interesting statement that he identified the
suprarenal gland. When we bring these two ideas together and take into
consideration the fact that the triple burner and the mingmen have both a heating
function we may find as an anatomic correlative for both the adrenal medulla
and the peripheral sympathetic nervous system as a whole.

7
8

See Lingshu (2); Lingshu yishi (1997): 28

See Leijing (2000): 681

3.2 The thyroid gland and its relation to the kidney

We want to take into consideration another fact: depression is not only related to
the suprarenal gland or the sympathetic nervous system, but also to the function
of the thyroid gland. Some of the symptoms which we find in kidney Yang
deficiency or in kidney Yin deficiency may be associated with hyperthyroidism
or hypothyroidism respectively.
We have:
Hypothyroidism/kidney Yang deficiency: gain in weight, cold aversion, dry skin,
poor concentration, fatigue, lethargy, avolition
Hyperthyroidism/kidney Yin deficiency: loss of weight, nervousness, attack of
sweating, night sweats, palpitation, irritability, sleeplessness

We find these symptoms also during the climacteric period which in the sense of
Chinese medicine is associated with a decline of tiangui (water of heaven)
as a part of kidney Qi. We know that during this period also disturbances of the
thyroid functions may occur. A hint to this association between the kidney in the
sense of Chinese medicine and the thyroid gland is the fact that Lingshu (10) and
the Yuan dynasty physician Zhu Danxi (1280 - 1358) enumerate the symptoms
for kidney-deficiency and both mention throat swelling (yanzhong ), dry
and painful throat and swelling of the neck (jingzhong )9. We may speculate
here that these symptoms may refer to goiter caused by thyroid dysfunction.
We may also suggest that T3 has something to do with the kidney in the sense of
Chinese medicine and before all the Yang aspect of the kidney, because of the
activating and warming effect of this substance in the adult organism. And today
we know that depression can also have to do with lack of triiodothyronine. This
substance, that is, lack of this substance, may be responsible for depressive
conditions and some scientists assume that T3 is not only involved in the
metabolism of antidepressant substances in the brain but T3 itself has an
antidepressant effect in the adult brain.10 Moreover depressive patients show a
poor reaction on TSH (thyroid stimulating hormone) at midnight, the time when
9

See Lingshu (10); Lingshu yishi (1997): 107; Danxi xinfa (Introduction), Danxi yiji (2005): 142
See Morreale (2002): 278

10

kidney Yang begins to rise.11 Winter depression is a well-known phenomenon, it

is mostly associated with a relative deficiency of T3 and it occurs in November,
the month which from the Chinese point of view is already part of winter and
winter is associated with the kidney.

4 Conclusions

The kidney is represented by the trigram Kan. The trigram Kan shows one Yang
line between two Yin lines. The Yang line symbolizes the stability of a horses
spine and inner stability because of the Yang lines position imbedded in
between the Yin lines. This symbolism was the base for the idea that the kidney
stores the will which is the goal directedness of human consciousness.
The kidney is associated with the will zhi and anxiety kong. The will is a
function of the Yang aspect of the kidney. Full kidney Yang means strong will.
It is dependent on free flow of Qi and is stored in the essence. Impaired flow of
Qi and deficiency of essence may result in feeble will and anxiety. Anxiety,
which means the fear of failure and fearful expectation, may harm the kidney.
We saw that not only the will and anxiety are associated with the kidney but also
mental depression. Mental depression may be the result of long term anxiety,
that is, it may be the function of deficiencies in the kidney itself. On the other
hand mental depression may occur as the result of the influence of other
emotional disturbances like sorrow, which is associated with the lung, or anger,
which is associated with the liver. We may see this from the point of view of
psychology or from the point of view of the Five Phases` theory.
When we have a look at the symptoms of kidney Yang deficiency and kidney
Yin deficiency from the point of view of western medicine we find the
symptoms of hypercortisolism or sympathetic reactions respectively and
moreover those of hyperthyroidism or hypothyroidism.
These findings as well as further researches in this subject may provide evidence
that kidney in the sense of Chinese medicine may be associated with the thyroid
gland and endocrine pivots in general. Kidney Yang deficiency may be
compared to the hypofunction of an endocrine pivot, or lack of T3, whereas
11

See Morreale (2002): 290

kidney Yin deficiency may be associated with hyperfunction or disruption of an

endocrine pivot.
We may find the following correspondences of the kidney on the nervous and
endocrine level:

Organs/endocrine glands

Nervous system

Kidney

Hypothalamus

KIDNEY

Suprarenal gland

SHEN

Gonads

Autonomic nervous
system

Pituitary gland
Thyroid gland
Table 2: The kidney and its correspondences in the organism

The first conclusion we can draw is the fact that we may not interpret the
Chinese medicine as a stereotype and invariable system of correspondences but
as a dynamic system. Mental depression is not only a function of stagnating
liver-Qi but also a function of lack of kidney Yang or kidney Yin.
The second conclusion we can draw is, that in a good deal of cases we find
extraordinarily interesting correlations between the Chinese medicine which is
mere philosophy and the western medicine which is natural science. And a
comparison between the two systems may in several cases even be helpful for
better understanding of Chinese medical terms and theories.
A better understanding of Chinese medical terms and theories may have far
reaching effect on the combined therapy with western and Chinese medicine.
In our case of the relation between the kidney and the human psyche we saw
that for treatment as well as for prevention of psychic disorders we have to take
into consideration this organ as an important base for mental health.

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