Jing Fang in the Treatment of Emotional Disorders

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By Professor Huang Huang

The benefits of using classic formulas or Jing Fang to treat emotional disorders such as anxiety, depression, anorexia nervosa and insomnia are as follows:

  • Holistic treatment focuses on the root cause of disease
  • Treatment is in accordance with the patient’s overall constitution
  • The effects are gentle with minimal side-effects

Indications for Chinese medicine treatment:

  • Non response to conventional treatment or the unsuitability of Western medication due to undesirable side-effects
  • There are distinct physical symptoms and the patient suffers a significant level of pain

Chai Hu jia Long Gu Mu Li Tang
This is the ancient formula for the treatment of emotional and psychiatric disorders.

Formula: Chai Hu 4 liang; Huang Qinliang; Ren Shenliang, Gui Zhiliang; Fu Lingliang; Ban Xiage; Da Huang 2 liang; Long Guliang; Mu Liliang; Sheng Jiangliang; Da Zao 6 pieces, Qian Danliang.

Modern dosage: Chai Hu 6-12 g; Huang Qin 6-12g ; Dang Shen 6-12g; Gui zhi 6-12g; or Rou Gui 5-10g; Fu Ling 10-20g; Jiang Ban Xia 10-20g; Zhi Da Huang 5-10g; Long Gu 10-20g; Mu Li 10-20g; Gan Jiang 5-10g or Sheng Jiang 3-5 pieces; Da Zao 10-20g. Qian Dan is omitted due to toxicity of the herb.

Shang Han Lun [Clause 107]: Shang han for eight or nine days, with purgation, if the chest is full, there is vexation and fright, the urination is not free, there is delirious speech, the whole body feels heavy, so that the patient can not turn over, Chai Hu jia Long Gu Mu Li Tang governs.

Fullness of the chest does not refer to the outward appearance of the chest, but to the patient’s experience of an oppressed sensation in the chest, with difficulty breathing due to the perceived pressure, which is accompanied by emotional distress or a sense of oppression.

Vexation refers to difficulty sleeping due to emotional instability affecting the ability to work effectively. Fright refers to a sense of restlessness and anguish which can be accompanied by nightmares, a throbbing heart, palpitations, or a pulsating sensation in the umbilical region. Alternatively it may refer to mental impairment. Inhibited urination means difficulty in urination, including frequency or incontinence.

There may also be constipation and diarrhoea where tests show nothing abnormal. Delirious speech indicates mental dysfunction where there are barriers to proper thought processes as well as language. Heaviness of the body is a subjective feeling or may describe stiffness, sluggish movement, apathy and lack of motivation, apathy, or slow reflexes.

Clinical application

  1. Chai Hu Long Gu Mu Li Tang is indicated for depression, anxiety, phobia, hysteria, neurasthenia, epilepsy, mania, bipolar disorder, cerebrovascular sclerosis, and Parkinson’s disease or Parkinson’s syndrome.
  2. Physical pre-requisites: (Chai Hu Long Gu Mu Li physique): medium or thin build, normal nutritional status, sallow complexion, emotional depression with numerous subjective symptoms despite tests showing the absence of any abnormality. In general, the patient feels fatigued, and has difficulty sleeping, either difficulty in falling asleep or light sleep, or nightmares, a poor appetite, lack of motivation, aversion to cold, constipation or diarrhoea, generalised pain in the body and joints, and pain when pressure is applied in the lower ribs. It is more commonly seen in the middle-aged and elderly. The pulse is wiry.

Modifications

  • For mania with lower abdominal pain and constipation, add Tao Ren, Mang Xiao, Gan Cao
  • For insomnia, headache, emotional lability and a pale red tongue, add Chuan Xiong, Suan Zao Ren, Gan Cao, Zhi Mu
  • For haemorrhage where the tongue is tending to red, add Huang Lian.

Case Study
Tong xx, female 56 years old
First consultation: 12th April 2008

The patient was of medium build, her nutritional status was normal, and her complexion was dull. She had a history of chronic lymphatic thyroiditis and had had ablative surgery to remove the nodules. In addition she had a peptic ulcer, and blood analysis indicated an elevated lymphocyte count. She had also suffered from cardiac ischemia for two years and had been taking Dan Shen Ti Wan; when she reduced the dosage, she experienced an oppressed sensation in the chest. Her last menstruation was in October 2006.

At the time of the consultation, she was suffering from severe hayfever with a clear watery nasal discharge which worsened after meals and singing. She was allergic to certain medications, and also to seafood and duck. She was delusional after taking anti-histamines.

Recently she had felt fatigued and lacked strength, had occasional palpitations and her chest felt constricted, she had hot flushes, night sweats, a poor appetite abdominal pain and distension, occasional vexation and restlessness for no apparent reason and she was easily startled. Her sleep was poor, she felt anxious before falling asleep, with anxiety prior to sleep, woke easily and had nightmares. There was hypochondriac discomfort and she passed a stool 2-3 times a day. Her tongue was dull and swollen and her pulse was wiry, hard and slippery with pulse rate of 84bpm.

Formula: Chai Hu 12g; Zhi Ban Xia 12g; Huang Qin 6g; Fu Ling 20g; Dang Shen 12g; Rou Gui 6g; Gui Zhi 6g; Long Gu 10g; Mu Li 10g; Chuan Po 12g; Su Geng 12g; Gan Jiang 6g; Hong Zao 20g.

After taking this formula, she had mild diarrhoea for two days, with relief after the bowel movement. At the second consultation two weeks later, the patient reported passing a normal stool once or twice a day, her hayfever had cleared, her sense of fatigue was reduced, there was substantial improvement in her sleep, and she was not so easily startled or irritated.


About Professor Huang Huang

Professor Huang Huang, from the Nanjing University of Chinese Medicine, is one of China’s foremost experts in the use of formulas from Shang Han Lun and Jin Gui Yao Lue in the treatment of difficult-to-treat disease. In 1989 he was sent by the Chinese… Read more »


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