Melancholia
Melancholia is a general term for disorders resulted from emotional
depression and stagnation of qi . The symptoms due to emotional frustration , and
depression of qi which lead to stagnation of blood , accumulation of phlegm ,
retention of food , collection of fire , and disharmony of the zang - fu organs fall
into this category . Zhu Danxi said , There is no disease when qi and blood
are in harmony . Once depression occurs , disease results .
Etiology and Pathogenesis :
Generally speaking , melancholia is caused by emotional injuries resulting
in disharmony of the activity of the zang organs . As said in Chapter 28 of
Miraculous Pivot : Grief , sorrow , worry and anxiety disturb the mind and
disturbance of the mind will affect all the five zang and six fu organs .
Depressed anger may give rise to many disorders of the liver with
impairment of the free flow of qi . Then the liver qi may go upward to attack
the mind , or conquer the spleen and stomach , or counteract the lung , or go
downward to the intestines , leading to various illnesses .
Too much worry may depress the liver and suppress the spleen , causing the
failure of the spleen in transportation and transformation , which brings about
accumulation of dampness and phlegm and retention of undigested food .
Agglomeration of the dampness , phlegm and undigested food in a long duration
is apt to produce fire . Overanxiety may also lead to dysfunction of the qi and
consumes yin ( nutrients and blood , ) generating many symptoms .
Differentiation
Depression of the qi in the liver :
Main manifestations : Mental depression , distress of the chest ,
hypochondriac pain , abdominal distension , belching , anorexia , or abdominal
pain , vomiting , abnormal bowel movement , thin , sticky tongue coating ,
string - taut pulse .
Analysis : In case of emotional injury , the liver fails to be harmonious
and flourishing , so mental depression appears . The Liver Meridian of Foot - Jueyin
runs up to the lower abdomen and curves around the stomach and then branches
out in the costal and hypochondriac regions . In case of stagnation of the qi
of the liver , there may appear distress in the chest , hypochondriac pain and
abdominal distension . If the stomach qi fails to descend , belching and
anorexia occur . When the liver qi encroaches the spleen , abdominal pain ,
vomiting and abnormal bowel movement result . Thin , sticky tongue coating and
string - taut pulse are the signs of disharmony between the liver and
stomach .
Transformation of depressed qi into fire :
Main manifestations : Headache , dryness and bitter taste in the mouth ,
irritability , distress of the chest , hypochondriac distension , acid
regurgitation , constipation , red eyes , tinnitus , red tongue with yellow
coating , string - taut , rapid pulse .
Analysis : When the depressed qi is transformed into fire , it flares up
along the Liver Meridian , resulting in headache , red eyes and tinnitus . When
the liver fire evaporates the fluid and heat accumulates in the stomach and
intestines , dryness and bitter taste in the mouth and constipation occur . If
the liver is hyperactive , it will encroach the stomach , leading to failure
of the stomach in descending function , then distress of the chest ,
hypochondriac distension , and acid regurgitation occur . Irritability , yellow
tongue coating , string - taut , rapid pulse are the signs of the fire in the
liver .
Stagnation of phlegm ( also known as globus hystericus ) :
Main manifestations : Feeling of a lump choking in the throat , hard to
spit it out or to swallow it , thin , sticky tongue coating , string - taut ,
rolling pulse .
Analysis : The depressed liver qi acts over the spleen and stomach ,
leading to disturbance of transportation and transformation . Dampness
derived from the water and food taken is gathered and turned into phlegm ,
which combined with qi , stays in the throat , giving rise to choking feeling .
Thin , sticky tongue coating and string - taut , rolling pulse are the signs of
the stagnation of phlegm with qi .
Insufficiency of blood ( also known as hysteria ) :
Main manifestations : Grief without reasons , capricious joy or anger ,
suspicions , liability to get frightened , palpitation , irritability ,
insomnia , or sudden distress of the chest , hiccup , sudden aphonia ,
convulsion , or loss of consciousness in severe cases , thin , white tongue
coating , string - taut , thready pulse .
Analysis : Because of over contemplation and emotional frustration , the qi
function is impaired and the blood is gradually consumed , leading to poor
nourishment of the mind , thus the above - mentioned symptoms occur . In case
the qi is blocked , there may be sudden distress of the chest , hiccup , sudden
aphonia and convulsion . Thin white tongue coating , and string - taut thready
pulse are the signs of a longstanding stagnation of qi that damages blood .
Treatment
Depression of qi in the liver :
Method : The Influential point of qi and the points of the Liver Meridian
are selected as the principal points . Even movement is applied to soothe the
liver , strengthen the spleen and harmonize the stomach .
Prescription : Ganshu ( B 18 ) , Tanzhong ( Ren 17 ) , Zhongwan ( Ren 12 ) ,
Zusanii ( S 36 ) , Gongsun' ( Sp 4 ) , Taichong ( Liv 3 ) .
Explanation : Tanzhong ( Ren 17 ) , the Influential point of qi , is able to
regulate the flow of qi . Ganshu ( B 18 ) and Taichong ( Liv 3 ) are the Back - ( Shu )
point and Yuan - ( Primary ) point of the liver respectively . When used in
combination , they may soothe the liver and remove depression . Zhongwan ( Ren
12 ) and Zusanii ( S 36 ) may harmonize the stomach and make the stomach qi
descend . Gongsun ( Sp 4 ) , the Luo - ( Connecting ) point of the Spleen Meridian ,
may strengthen the spleen and harmonize the stomach .
Transformation of depressed qi into fire :
Method : Points of the Liver , Gallbladder and Stomach Meridians are
selected as the principal points . Reducing method is used to dispel the fire
from the liver and strengthen the stomach function .
Prescription : Shangwan ( Ren 13 ) , Zhigou ( S J 6 ) , Yanglingquan ( G 34 ) ,
Xingjian ( Liv 2 ) , Xiaxi ( G 43 ) .
Explanation : Xingjian ( Liv 2 ) and Xiaxi ( G 43 ) , the Ying - ( Spring ) points
of the Liver and Gallbladder Meridians , may dispel fire from the liver and
gallbladder . Zhigou ( S J 6 ) in combination with Yanglingquan ( G 34 ) may
treat distress of the chest , hypochondriac distension , bitter taste in the
mouth and constipation . Shangwan ( Ren 13 ) may harmonize the stomach and
regulate the flow of qi to treat acid regurgitation .
Stagnation of phlegm :
Method : Points of the Liver Meridian and Ren Meridian are selected as the
principal points . Even movement is applied to soothe the liver , remove the
depression , regulate the flow of qi and resolve phlegm .
Prescription : Tiantu ( Ren 22 ) , Tanzhong ( Ren 17 ) , Neiguan ( P 6 ) , Fenglong
( S 40 ) , Taichong ( Liv 3 ) .
Explanation : Taichong ( Liv 3 ) is applied to soothe the liver and remove
the depression . Tiantu ( Ren 22 ) is needled to descend the qi and treat the
throat trouble . Neiguan ( P 6 ) is used to remove depression from the chest
and regulate the flow of qi . Tanzhong ( Ren 17 ) , the Influential point of qi ,
Fenglong ( S 40 ) , the Luo - ( Connecting ) point of the stomach , used together ,
may promote the circulation of qi and resolve phlegm .
Insufficiency of blood :
Method : Points of the Heart and Liver Meridians are selected as the
principal points . Even movement is applied to nourish blood , soothe the
liver and refresh and tranquilize the mind .
Prescription : Juque ( Ren 14 ) , Shenmen ( H 7 ) , Sanyinjiao ( Sp 6 ) , Taichong
( Liv 3 ) . Supplementary points : Distress of the chest : Neiguan ( P 6 ) ,
Tanzhong ( Ren 17 ) . Hiccup : Gongsun ( Sp 4 ) , Tiantu ( Ren 22 ) . Sudden aphonia :
Tongli ( H 5 ) , Lianquan ( Ren 23 ) .
Convulsion : Hegu ( Li 4 ) , Yanglingquan ( G 34 ) .
Loss of consciousness : Shuigou ( Du 26 ) , Yongquan ( K1 ) .
Explanation : Taichong ( Liv 3 ) is selected to soothe the liver and remove
depression . Juque ( Ren 14 ) , the Front - ( Mu ) point of the Heart Meridian ,
Shenmen ( H 7 ) , the Yuan - ( Primary ) point , combined with Sanyinjiao ( Sp 6 ) of
the Spleen Meridian , may nourish blood , refresh and tranquilize the mind .
Neiguan ( P 6 ) and Tanzhong ( Ren 17 ) may remove the depression of the chest .
Gongsun ( Sp 4 ) and Tiantu ( Ren 22 ) causes the qi to descend and checks
hiccup . Tongli ( H 5 ) and Lianquan ( Ren 23 ) are effective in the treatment of
aphonia . Hegu ( LI 4 ) is taken to regulate the flow of qi . Yanglingquan ( G
34 ) , the Influential point of the tendons , is used to check convulsion and
relieve pain . Shuigou ( Du 26 ) and Yongquan ( K 1 ) are used for resuscitation .
Remarks
This condition is seen in hysteria and neurosis in Western medicine .
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