Neurosis is caused by long-term mental stress which
results in imbalance of excito-inhibitory process of cerebral cortex. The patients
get excited or fatigue easily, and are frequently accompanied with various forms
of somatic discomfort. It is more common in middle-aged females. In TCM, this
disease is categorized as "bu mei" (sleeplessness), "xin ji"
(palpitation), "yu zheng" (melancholia), "yi jing" (emission),
"ang wei" (impotence), "zang zao" (hysteria), "xu xun"
(consumption), etc.
Main Points of Diagnosis
1. There is a history
of mental conflict, or a long period of mental stress.
2. Major clinical manifestations
(1) Insomnia and reduced cerebral functions: such as insomnia, dreaminess,
waking up easily, distractibility and bad memory.
(2) The emotion is easy
to be changed, accompanied with restlessness, hypersensitivity, poor tolerance
to the sound and light.
(3) Functional disorders of the viscera: The patients
frequently complain of palpitation, abdominal distension, belching, anorexia,
constipation, frequency of micturation, impotence, etc.
3. The organic diseases
should be excluded after examinations of nervous and visceral functions.
Differentiation
and Treatment of Common Syndromes
1. Stagnation of the Liver-Qi
Main Symptoms
and Signs: Emotional depression, doubting mania, anxiety, vertigo, blurred vision,
fullness in the abdomen, eructation, anorexia, feeling of oppression in the chest,
hypochondriac pain, irregular menstruation, reddish tongue with whitish fur, taut
and thready pulse.
Therapeutic Principle: Dispersing depressed liver-qi to
relieve emotional depression.
Recipe: Modified Bupleurum Powder for Relieving
Liver-Qi
bupleurum root
nutgrass flatsedge
curcuma root
fruit of
citron
white peony root
albizia flower
red sage root
All the above
herbs are to be decocted in water for oral administration.
In addition, the
recipe should include 10 grams of both medicated leaven and membrane of chicken's
gizzard if the case is with indigestion; 12 grams of pinellia tuber, 10 grams
of tangerine peel for the case with eructation and oppressed sensation in the
chest; 10 grams of moutan bark and 10 grams of capejasmine when a disorder is
ascribed to the fire-transmission due to stagnation of qi marked by bitter taste
in the mouth, restlessness, headache, conjunctival congestion, red tongue with
yellow fur, and taut rapid pulse; 10 grams of chrysanthemum and 15 grams of uncaria
stem with hooks to treat such symptoms as dizziness and feeling of fullness in
the head.
2. Hyperactivity of Fire due to Yin Deficiency
Main Symptoms
and Signs: Anxiety, insomnia, dizziness, tinnitus, feverish sensation in the palms
and soles, dry mouth with a few saliva, nocturnal emission, spermatorrhoea, premature
ejaculation, palpitation, amnesia, soreness of waist, red tongue with yellowish
fur, thready and rapid pulse.
Therapeutic Principle: Nourishing yin to clear
away pathogenic fire.
Recipe: Modified Prescriptions of Decoction of Coptis
and Donkey-Hide Gelatin and Heat-Tonifying Bolus.
dried rehmannia root
Chinese
angelica
white peony root
ophiopogon root
coptis root
spiny jujube
seed
fleece-flower stem
schisandra berry
poria with hostwood
red sage
root
prepared licorice root
donkey-hide gelatin
All the above herbs are
to be decocted in water for oral administration. In addition, donkey-hide gelatin
is melted with the decoction for oral use.
If the patient is extremely disturbed
by insomnia, 30 grams of raw fossil fragments and 30 grams of oyster shell ought
to be administered. If deficiency of the liver-yin and kidney-yin is remarkable
with symptoms of soreness and weakness of the loins and knees, 20 grams of prepared
rehmannia root and 12 grams of wolfberry fruit be included. When a disorder is
caused by insufficiency of the kidney-yang manifested as spermatorrhea, impotence,
premature ejaculation, aversion to cold, cold limbs, listlessness, pale tongue,
weak and deep pulse, the treatment should be aimed at tonifying the kidney-yang.
The preferred recipe is modified Kidney-yang-reinforcing Bolus. The compositions
are: prepared rehmannia root 20g, Chinese yam 12g, wolfberry fruit 12g, fruit
of medicinal cornel 12g, dodder seed 12g, morinda root 12g antler glue 10g boiling
water for oral administration with the decoction), red raspberry 10g, prepared
aconite root 6g, epimedium 10g, curculigo rhizome 10g. All the herbs are to be
decocted in water for oral administration.
3. Deficiency of the Heart and
Spleen
Main Symptoms and signs: Dreaminess and being easy to wake, palpitation,
amnesia, fatigue and weakness, anorexia, sallow complexion, pale tongue with thin
whitish fur, thready and weak pulse.
Therapeutic principle: Invigorating the
heart and spleen.
Recipe: Modified Decoction for Invigorating the Spleen and
Nourishing the Heart.
astragalus root
codonopsis root
big-headed atractylodes
rhizome
poria
Chinese angelica
spiny jujube seed
dried longan pulp
polygala
root
aucklandia root
prepared licorice root
All the above herbs are to
be decocted in water for oral administration.
If the patient ifs troubled
by frequent insomnia, the recipe should include schisandra berry 10g, fleece flower
stem 30g, or arborvitae seed 10g, raw fossil fragments 20g, oyster shell 20g,
and if the patient complains of anorexia, 10 grams of membrane of chicken's gizzard.
When a disorder is persistent depression resulting in impairment of the mind characterized
by trance, dysphoria, sadness and melancholy and tending to cry, pale tongue with
thin whitish fur, string-like and thready pulse, the treatment should be aimed
at nourishing the heart to tranquilize the mind. Decoction of Licorice, Wheat
and Chinese-Date with additional ingredients can be chosen for the case. It includes
the following herbs:
prepared licorice root
light wheat
Chinese date
spiny
jujube seed
arborvitae seed
albizia flower
dragon's teeth
curcuma
root
All the above herbs are to be decocted in water for oral administration.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua
city, Hunan province
China